CLOSED DOOR COACHING PART 2 eventually she will stop throwing toys.

"
D. "At this age, she should stay in time-out for nine
Nursing Practice 3
minutes."

Situation: Growth and development refer to the Situation: Nursing ethical and moral issues
physical, cognitive, emotional, and social changes that encompass dilemmas that arise in patient care,
occur throughout an individual's lifespan. It involving conflicts between professional duties, patient
encompasses various aspects of human development, rights, and moral principles.
from infancy to adulthood.
1. Which of the following infant reflex groups is 9. What is the best practical guide for nurses to use
present at birth and remains throughout adulthood? when they encounter ethical dilemmas in a clinical
A. Rooting, blink, cough, gag setting?
B. Blink, sneeze, cough, gag A. PRC Oath for Professionals
C. Blink, cough, sneeze, stepping B. Code of Ethics
D. Rooting, sneeze, cough, swallowing C. Theological Doctrine
D. Florence Nightingale Oath
2. Which statement is true about the principles of
growth and development? 10. What should the healthcare team prioritize in the
A. Gross motor skills are developed first before case of Mr. Carpenter, 63 years old, who has been
fine motor skills. admitted with chest pain from atherosclerotic plaque
B. Different children pass through the predictable and is classified as high-risk for cardiovascular surgery
stages at the same rates. due to his diabetes and hypertension?
C. All body systems develop at the same rate. A. Consult the family members and let them give
D. Development proceeds from distal to proximal their decision.
body parts. B. Proceed with the planned surgery, as this will
save the patient.
3. According to Erikson, what should the nurse C. Consult the Ethics Committee on what to do
anticipate when assessing a toddler? with the patient.
A. Participating in school activities D. Discuss with Mr. Carpenter his health status
B. Questioning sexual identity & let him decide.
C. Engaging in fantasy activities
D. Taking pride in pulling off the lollipop wrapper 11. What type of ethical behavior is demonstrated
when Nurse Gigi refers to Mrs. Pattie, a 77-year-old
4. The mother of an 8-month-old told the nurse that her with dementia exhibiting unruly behavior, as "That
child continually cries whenever she goes to work. This awful, dirty old woman in Bed 14" in her shift report?
attitude displayed by the infant is in what stage of A. Stigma
Piaget's Theory? B. Ageism
A. Preoperational thought C. Gender bias
B. Concrete operational thought D. Depersonalization
C. Sensorimotor stage
D. Formal operational thought 12. Mr. TJ, who is at the end stage of life and has a
"Do Not Resuscitate" order, passed away during your
5. In what stage of Kohlberg's theory of moral shift. He was declared dead by the physician at 8:30
development is a person linked with obeying a law AM. What should be your primary nursing action in this
even if it is discriminatory towards a racial group? situation?
A. Society-maintaining orientation A. Prepare the death certificate for the
physician's signature.
B. Social contract orientation
C. Universal ethical principle orientation B. Allow the family to have private time with the
D. Instrumental relativist orientation deceased.
C. Ask your nurse attendant to immediately
6. Railey, 4 years old believes that there is more contact the funeral home.
chocolate milk in her sister's tall thin glass than her D. Clean the body and remove all the IV lines,
short, wide glass. She has not yet achieved with of the tubes and other medical equipment.
following principles of Piaget?
A. Conservation 13. When a nurse fully supports a patient's safety and
B. Object permanence personal rights during their hospital stay, which ethical
C. Assimilation principle is she upholding?
D. Accommodation A. Responsibility
B. Empathy
7. Which of the following best describes the cognitive C. Advocacy
development of an 18-month-old child? D. Accountability
A. The child understands the concept of "forever"
B. The child can name six body parts Situation: A manager from an accounting firm is
C. The child can follow one-part directions hospitalized due to severe abdominal pain and the
D. The child has an attention span of approximately presence of bloody stools. Following various
diagnostic tests and lab evaluations, the physician has
5 minutes

8. A nurse is assisting a client and her nine-month-old

daughter. The mother says, "Sometimes, she is so
naughty! I had to put her in time-out yesterday for
throwing toys!" What is the nurse's most suitable
response?
A. "Where do you place her when she goes to
time-out?"
B. "Remind her not to throw toys but don't
discipline her for this behavior."
C. "Keep doing that to teach her the right way;
recommended an exploratory laparotomy. You are the B. 1
nurse assigned to care for him that day. C. 4
14. During your assessment, you need to identify D. 2
which organs are located in the epigastric region?
A. A portion of duodenum & jejunum, left 21. At the tertiary hospital to which the patient was
kidney, appendix & ovary referred, he was classified as an emergency case. The
B. Duodenum, pancreas, portion of the liver nurse promptly contacted a specialist who is
and pyloric end of the stomach.
----·
C. Stomach, spleen, tail of pancreas and
A. Neurologist
adrenal gland.
D. Gallbladder, duodenum, gallbladder and B. Urologist
portion of the right kidney. C. Phlebotomist
D. Nephrologist
15. What is the appropriate question to ask during a
pre-operative nursing history regarding the patient's 22. Following a comprehensive evaluation by the
health perception and health management? physician-specialist, an order for an immediate
A. Do you feel that your wounds heal quickly? stonogram was issued. The nurse was directed to
B. Do you experience shortness of breath contact which section of the hospital?
during physical activity? A. Operation Room
C. Are you familiar with the risk factors B. Laboratory
associated with your condition? C. Rehab
D. Have you noticed any changes in your D. CT scan
weight recently?
23. After the procedure the patient was ordered for
16. The patient was seen by the anesthesiologist, who Lithotripsy, under spinal anesthesia. The nurse has to
explained the anesthesia options for his upper call the department of .
abdominal surgery. What type of anesthesia would you A. Internal medicine
anticipate being ordered? B. Anesthesia
A. Spinal C. Surgery
B. Caudal D. Imagery
C. Local
D. General Situation: A 67-year-old woman with diabetes mellitus,
who is alert, is being discharged from the hospital. She
17. What pre-operative medications are administered has been referred to a community nursing agency, and
to the patient to reduce intra-operative anesthetic you are tasked with reinforcing the teaching program
requirements and manage pain? that began during her hospital stay. The patient is
A. Celebrex (Celecoxib) taking the sulfonylurea medication tolbutamide
B. Ibuprofen (Motrin) (Orinase).
C. Acetaminophen (Tylenol)
D. Demerol (Meperidine HCl) 24. When the patient reached 69 years old, Orinase
was stopped, and NPH insulin was prescribed. After
18. Ensuring patient safety in the operating room is several months, she was found to be experiencing the
essential for all members of the surgical team. Which of Somogyi effect. What condition is most likely to occur
the following Universal Safety Protocols are when the patient receives excessive insulin?
implemented and confirmed before surgery? A. Developing an elevation of the blood
I. Patient's identity glucose level
II. Surgical procedure B. Producing even more insulin
III. Surgical site C. Becoming resistant to insulin
IV. Surgical equipment D. Conserving excessive amount of fluid
A. II & III
B. I & II 25. A few days later, the patient arrives at the
emergency department on an ambulance stretcher and
C. I, II & IV has a blood sugar level of 800 mg/dL. There are no
ketones in her urine, she is dehydrated, and her
D. I, II & Ill
mental status is altered. Given this information, what
specific medical condition is she most likely
Situation: Crisostomo, a 40-year-old employee, has experiencing?
been experiencing painful and difficult urination for A. Hyperosmolar nonketotic coma (HNKC)
nearly a week. He noticed some fresh blood in his urine B. Diabetic retinopathy
but was hesitant to consult a physician. Instead, he C. Acute renal failure
sought help from a neighbor who is a herbalist. After a D. Diabetic ketoacidosis (DKA)
week of worsening symptoms, his wife took him to a
community clinic. 26. During the interview, the patient mentioned that
she frequently felt nauseous, restless, excessively
19. A community clinic provides primary care for sweaty, fatigued, and often hungry in her younger
patients. Who typically manages this type of facility? years. What do these symptoms indicate?
A. Physician A. Diabetic nephropathy
B. Barangay health workers B. Hyperglycemia
C. Nurse C. Hypoglycemia
D. Midwife

20. During the assessment, the patient was promptly

referred to a hospital with a 25-bed capacity that
lacks the ability to perform intensive diagnostic tests.
As a nurse in this facility, you recognize that it is a
LEVEL .
A. 3
 D. Diabetic retinopathy D. Collaborates with members of the
healthcare.
27. During the assessment, you observed several
scratches on her right ankle, which had led to an 33. Budgeting is a crucial component of financial
infection and cellulitis. When you inquired about the management. When a unit manager assigns funds for
scratches, the patient replied, "Oh, my cat must have supplies, inventory, and medical-surgical materials,
been using my leg as a scratching post again, and I this is referred to as .
didn't even notice." What diabetic complications might A. Cash budget
this suggest the patient is experiencing? B. Operational budget
A. Neuropathy C. Capital budget
B. Macroangiopathy D. Flexible budget.
C. Retinopathy
D. Ephropathy Situation: Saturn, a 68-year-old patient, was admitted
to the hospital due to a reduced appetite, fatigue,
28. You should assess the patient for potential dehydration, and a weight loss of approximately 15
disturbed thought processes due to decreased pounds over the past few weeks. After a physician's
metabolism and changes in cardiovascular and examination, she was recommended for admission.
respiratory status. What is the reasoning behind You are the nurse responsible for her care.
orienting the patient to the time, place, date, and
events? 34. The physician has ordered Total Parenteral
A. Shows improved cognitive functioning Nutrition (TPN) for Ms. Saturn. What is your INITIAL
step to take BEFORE this intervention?
B. Provides reality orientation to patient A. Determine if the family can afford the whole
C. Permits evaluation of the effectiveness of treatment.
treatment B. Evaluate the tolerance of the patient
D. Lets the patient identify the time, place, date to glucose.
and events correctly C. Identify allergies of patient to the
supplemental nutrition.
Situation: Nurse Pepper, along with five licensed D. Assess the basic understanding of the
graduate nurses from various regions, is starting her patient regarding TPN
first day of orientation at a large healthcare facility. The
nurse educator began the session by presenting the 35. Choose from the following the primary goals of
organizational structure of the medical center. TPN?
I. Promote weight gain
29. What is the PRIMARY PURPOSE of an II. Improve nutritional status
organizational structure? It is a . III. Maintain muscle mass
A. blueprint illustrating committees for delegating IV. Establish nitrogen balance
roles and functions V. Enhance healing process
B. flow chart depicting interactions among major A. I, II, & III
and minor groups B. I, II, III, &IV
C. framework outlining the relationships among C. I & II
units, departments, and communication D. I, II, III, IV & V
channels
D. design that clarifies roles, collaboration, and 36. When a patient is receiving TPN, it's essential to
interdependence among functions of keep a close watch for the .
personnel A. Serum creatinine
B. Potassium level
30. Line and staff functions are highlighted in the C. Serum glucose level
organizational chart. What does line authority refer to? D. Sodium level
A. Staff relationships within the organization
are primarily advisory. 37. While Mrs. Saturn is receiving TPN, she suddenly
B. The staff consists of personnel who report to reports mild chest pain, shortness of breath, and
the "Boss." shows signs of cyanosis. What potential IMMEDIATE
C. Decisions are made in a bottom-up manner complication do you suspect she is experiencing?
within the organization. A. Sepsis due to IV line
D. There is direct responsibility for a B. Air embolism
C. Hyperglycemia
subordinate within the organization.
D. Allergic reaction to TPN
31. Which of the following statements correctly
38. What should be the PRIORITY nursing action in
characterizes the nursing service system 1n
response to the patient's current clinical symptoms?
healthcare?
A. Report to the physician status of the patient
A. Informed leaders are more effective than
at once.
formal leaders within an organization.
B. Shared governance often tends to be
controlling and offers less autonomy.
C. Institutional policies serve as a more powerful
tool in nursing practice compared to laws and
regulations.
D. A situational leadership style is an effective
approach for achieving patient outcomes.
32. The approach to nursing service delivery is being
reassessed in light of patient outcomes. Which of the
following statements about the manager's role in the
healthcare delivery system is NOT TRUE?
A. Provides direct nursing care when needed.
B. Manages resource utilization.
C. Act as a liaison in litigation cases in court.
 B. Take blood pressure and respiratory rate. A. Computed Tomography
C. Temporarily stop TPN B. Abdominal X-ray
D. Administer 02 inhalation. C. Abdominal Ultrasound
D. Doppler sonography
Situation: Ms. Alice is a retired Community Health
Nurse in Bamban, Tarlac. Due to her commitment to 46. The test indicated the presence of gallstones and
the nursing profession, she has volunteered in their an inflamed gallbladder. The patient was
community to conduct health education classes. One recommended to have an open cholecystectomy. This
Saturday morning, several patients who are procedure, in comparison to laparoscopic
hypertensive and with pulmonary health problems cholecystectomy, is .
attended her session. I. Invasive

39. Mang Dong has recently been diagnosed with II. Less pain
Chronic Obstructive Pulmonary Disease (COPD). What III. Longer recovery
are the key teaching instructions that should be IV. Shorter hospital stay
prioritized for him regarding his condition? A. I, II, & IV
A. He should assume supine position when B. I & II
resting. C. I, II & III
B. Know early signs of respiratory D. I & III
infection. 47. Two hours after the operation, the nurse noted
C. He has to be taught how to do bronchial reddish drainage from the patient's surgical site. What
clapping. is the FIRST nursing action you should take?
D. Family should be advised that patient should A. Check if stitches from the operation have
sleep in a warmroom. come apart.
B. Check where is the source of possible
40. Which of the following health interventions should
be included in your teaching plan for Mang Dong? bleeding.
A. Be on prolonged corticosteroid therapy. C. Cover the operative area with sterile gauze
B. Lung exercises must be done with longer bandage.
inhalation than exhalation. D. Put hand as a pressure on the operative
C. Reduce risk for infection. area.
D. Have a high flow of oxygen administration.
48. After several days in the hospital, the physician
41. Pulmonary rehabilitation for COPD lasts a has ordered the patient to be discharged. What is the
minimum of four to twelve weeks. What should be PRIORITY restriction you should emphasize for the
avoided during this program? patient when they go home?
A. Pursed lip breathing A. Stool softener to induce bowel elimination.
B. Driving while using narcotic drug.
B. Smoking cessation C. Take shower even if still with surgical drain.
C. Aerobic, upper and lower body conditioning. D. Lifting of objects not more than 10 lbs.
D. Peripheral muscle wasting
Situation: Sarah, an 18-year-old bank teller, was
42. Weight loss and malnutrition are commonly admitted to a tertiary hospital due to hypertension and
observed among patients with COPD. They should be frequent bruising on her lower extremities whenever
taught to avoid . she bumps herself at work. After examining her, the
A. Have a full stomach even when in physician suspected she has Cushing's disease.
dyspneic condition
B. Keeping body mass between 21-25 kg 49. Which of the following characteristics of Cushing
C. A high caloric and high protein diet disease is correct?
D. Exercise one hour before and after eating I. The condition typically affects women aged 20 to
40.
43. Which of the following energy-conserving
II. The use of corticosteroids for various immune
strategies should be avoided by patients with COPD?
A. Exhale when pushing or exerting effort when disorders contributes to the disease.
doing daily activities III. The condition is worsened by the overproduction
B. Assume tripod position with elbows supported of ACTH.
on the table when shaving or combing IV. The preferred surgical treatment 1s
C. Inhale when resting, sitting and lying down. transsphenoidal hypophysectomy.
D. Stand in front of the mirror while shaving or A. II & III
combing hair B. I, II, & III
C. I, II, III, & IV
Situation: A housewife presenting with jaundice,
abdominal pain, nausea, and a bloated feeling was D. I & II
taken to the hospital. The physician examined her and
recommended admission due to a suspected 50. When someone has Cushing's disease, the
gallbladder stone. You are the nurse on duty that day. specific structure affected is the .

44. What is the BEST initial question to ask a patient

who is experiencing pain during an interview?
A. How frequently do you experience the pain?
B. How would you characterize your pain?
C. Have you taken any medication to alleviate
the pain?
D. When did you first notice the abdominal
pain?

45. Which of the following imaging tests that utilizes a

transducer is most likely to be ordered by the
physician to identify gallstones?
 A. Hypothalamus A. sterile clamps.
B. Pituitary gland B. Another chest tube.
C. Adrenal gland C. Sterile dressing.
D. Parathyroid gland D. A bottle of sterile water.

51. Which of the following clinical manifestations is 58. To relieve Mr. Aida's pain, the physician
NOT likely to be a complaint from Sarah's condition? prescribed morphine sulfate 2 mg IV as needed for
A. Edema of the extremities intolerable pain. The primary goal of the healthcare
B. Poor wound healing professional is to ensure effective pain control so the
C. Decrease libido patient can breathe comfortably. Which of the following
D. Absence of growth in the pubic area would indicate that this goal has been successfully
achieved?
52. The attending physician ordered a Magnetic A. Anxiety level of patient will be reduced.
Resonance Imaging (MRI) for patient Sarah to confirm B. Respiratory rate will be decreased to
the medical impression. This imaging technique is used 20 breadths /min.
to identify . C. Oxygen saturation is at 76% level.
A. hemorrhagic injury in the brain
B. electrical impulse in the brain D. Pain scale will show 1 to 2, in a rating scale
C. level of oxygen in the brain of 10 (highest, 0-lowest)
D. non-hemorrhagic injury in the brain
Situation: Nurse Rachel works in the medical unit of a
53. While patient Sarah is hospitalized, one of the tertiary hospital, where the majority of patients are
safety measures that nurses should implement is fall diagnosed with endocrine disorders. She is currently
prevention. This is necessary because the patient is at caring for the following patients: Claire, a 54-year-old
increased risk of fractures due to . married woman with hyperthyroidism; Aster, a 66-
A. Aging process year-old with a suspected case of Cushing's syndrome;
B. Change in vision and Sonia, a 48-year-old woman suffering from
hypothyroidism.
C. Osteoporosis
D. Hematologic condition 59. During your physical assessment of patient Aster,
she displays a UNIQUE clinical manifestation that
Situation: Mr. Alda, a SO-year-old company driver, has differs from those of patients Claire and Sonia,
been admitted to the Emergency Room (ER) due to left characterized by .
chest pain and difficulty breathing. His history indicates A. cyanosis, increasing growth of hands and feet
that he smokes half to one pack of cigarettes daily, B. anemia, weight loss and presence of acne
particularly when he works overtime. His vital signs C. moon face purple striae on trunk and buffalo
show a blood pressure of 150/90, a pulse rate of 110 hump
beats per minute, and a respiratory rate of 38 breaths D. moon face easy fatigability and peripheral
per minute. He is also experiencing clammy sweating
edema.
and restlessness. The physician ordered a chest X-ray,
which revealed that the patient has a pneumothorax.
60. Which of the following diagnostic tests do you
You are the nurse responsible for his care.
expect Dr. Lim NOT to order for patient Aster, who is
suspected of having Cushing's syndrome?
54. As a nurse, you understand that pain is typically
A. 24 hour urine cortisol lever
described BEST as a phenomenon that is a .
A. Neurologic activation of norciceptors B. C reactive Protein level
B. Subjective unpleasant experience C. ACTH serum concentration
C. Adaptive mechanism to a stimulus D. Computerized tomography of the brain,
D. Creation of one's imagination chest and abdomen

55. When a patient has a pneumothorax, the nurse's 61. Which clinical manifestation should Nurse Rachel
assessment findings will likely indicate . watch for patient Claire if she is suffering from
I. absent breath sounds on the affected side hyperthyroidism?
II. decreased chest expansion unilaterally A. Cold extremities
III. sharp chest pain B. Increased weight
IV. burning chest pain C. Decreased bowel movement
D. Fine motor tremor
A. I, 11,111
B. III &IV 62. Patient Sonia, who has hypothyroidism,
C. I, II, IV 1s prescribed which of the following
D. I & II medications?
A. Propranolol
56. Which of the following statements about B. Iodine
pneumothorax is NOT true? C. Iron pills
A. The presence of atmospheric air in the pleural D. Levothyroxine
space can lead to an increase in intrathoracic
pressure and decrease the lungs' vital
capacity.
B. The absence of positive intrapleural
pressure can lead to pneumothorax.
C. The loss of negative intrapleural pressure can
cause the lungs to collapse.
D. A spontaneous pneumothorax can happen
when a pulmonary bleb ruptures.

57. The physician placed a chest tube for Mr. Alda to

aid in re-expanding the lungs. What should you
prepare FIRST as a nurse in case of an emergency if
the tube is accidentally disconnected?
63. Which of the following should temperature.. A. Flow chart
patient AVOID while undergoing Sonia B. Decision tree
treatment hypothyroidism? for C. Gantt chart
A. Use of warm blankets 71. Which of the following strategies D. Decision grid
B. Light activities done at home can Nurse Eileen use to envision her
C. Taking foods low in fiber future? 72. She began developing her
D. Exposure to cold personaland
Situation: Nurse Sammy is a Pediatric ICU nurse. professional portfolio in preparation for her application
The following questions apply. to a university medical center in Metro Manila. Which
64. After giving 2 minutes of CPR and 1st shock, the of the following is NOT a primary purpose of
ECG reading is rate: rapid, uncoordinated, and maintaining a portfolio?
ineffective and QRS complex: no formed QRS A. Keep on ongoing records of
complexes, rapid irregular undulation without any skills development.
specific pattern. Nurse Sammy's next action will be: B. Create a system for documenting
A. Document the care accomplishments.
B. Do not defibrillate the i:,atient C. Set career and educational goals.
C. Deliver the second shock of 41/Kg
D. Set system for a possible shift to
D. Continue CPR another job.
65. The recommended dose of amiodarone for
arresting pediatric patient with ECG reading of 73 One aspect of the professional portfolio is to reflect
Ventricular fibrillation is: one's philosophy of life. Which of the following
A. 5mg/kg total of 2 doses workplace values should Nurse Eileen consider as
B. lOmg/kg total of 2 doses NOT suitable to include in her portfolio?
C. lOmg/kg total of 3 doses A. Customer service grounded in acceptance,
D. Smg/kg total of 3 doses empathy, and selfless duty
66. Nurse Sammy seen her pediatric patient with heart B. Limitations on time and compensation that
rate of 60 bpm. Upon assessment, the patient has level hinder her pursuit of excellence in her job
of consciousness. BP: 100/60 mmHg. The team has C. A commitment to lifelong, self-directed
initiated positive pressure ventilation. What should learning
Nurse gabby do? D. Challenges that can foster growth,
A. Give Atropine as ordered.
responsibility, and accountability.
B. Document the finding
'------
c. Initiate CPR
D. Give Epinephrine 1mg IV push 74. For Nurse Eileen to remain active as a bedside
nurse, she must renew her PRC ID by participating in
67 Recommended dose of Atropine if a pediatric
continuing professional development (CPD) as
patient is consistent bradycardia is:
required by the CPD law. The purposes of this are
A. O.lmg/kg
---·
B. 0.5mg[kg'---------
Ip.romote and upgrade the practice of the profession
C. 0.02mg/kg
II. improve the competence of the professional
D. lmg/kg III. international alignment of competence
68. Maximum dose of Epinephrine for pediatric

----------- ----
patient is
-:
IV. develop quality assurance for
accreditation
- 1mg working as a bedside nurse.
B. 0.1mg A. II & III
B. I, II, & III
C. 2mg
D. 5mg C. I, II, III, &IV
69. Epinephrine can be given via, except: D. I& II
A. Via Intravenous route
B. Via ET route
75. Nurse Eileen understands that her personal and
C. Via intraosseous route
D. None of the above professional portfolio must include and be kept up to
date with the following EXCEPT .
70. According to American Heart Association, the
A. certificate of CPD attended
following should be done to give quality of
B. letters of reference
cardiopulmonary resuscitation to pediatric patients,
C. photographs
except:
D. confidential information from past
A. Push hard (> 1/3 of anteroposterior
employers
diameter of chest) and fast (
100-120/min) Situation: Mr. Reynaldo has been assigned to carry
B. If with advanced airway, provide out a study aimed at assessing patient satisfaction
continuous compression and given regarding the care they received at the hospital. To
breath every 2-3 seconds achieve this, he intends to include: all adult patients
C. Minimize interruptions of compressions admitted between May and October, those
D. If no advanced airway, 30: 2 experiencing their first admission, with an average
compression-ventilation ratio hospital stay of 4 to 5 days, and without any
complications.
Situation: Nurse Eileen has recently passed the Board
Examination for Nurses and has outlined her career 76. Which of the following 1s an
goals for the next five years. She aims to become a EXTRANEOUS variable in the study?
Diabetes Nurse Educator after spending two years A. Age of patients.
B. Absence of complications
C. Length of stay 4-5 days.
 D. Date of admission January-March. D. Anya refuses to sleep in her bed due
to its different location in her room.
77. Which of the following variables is he likely to 83. Nurse Chie should expect the following laboratory
EXCLUDE from his study? values in relation to the cardiovascular system in
A. Salary of nurses newborns:
B. Caring attitude of nurses A. Hemglobin levels average at
C. Responsiveness of staff around 17-18 g / lg ml
D. Competence of nurses
B. The hematocrit level is between 50%
78. He intends to utilize a Likert scale to assess: to 60%
A. compliance to expected standards C. Indirect bilirubin is 0.5 to 1.5
B. degree of agreement and disagreement mg/lOOmL
C. level of satisfaction D. Normal blood volume is 50-90ml per
D. degree of acceptance kilogram of body weight only
79. Which criterion pertains to the instrument's ability 84. Newborns are born with a lower than normal level
to identify subtle differences among the subjects being of Vitamin K in the body resulting in them having a
studied? prolonged coagulation or prothrombin time. Which
A. Reliability clotting factors are involved in the synthesis of Vitamin
B. Sensitivity Kin order to form:
C. Objectivity A. Clotting factors I, II, Illa, IVa
D. Validity B. Clotting factors II, IX, X
C. Clotting factors II, VII, IX, X
80. This technique involves using multiple references
to arrive at conclusions about what defines the truth. D. Clotting factors I and II only
A. Delphi technique 85. A newborn's first breath is a major undertaking
because it requires a tremendous amount of pressure.
B. Meta-analysis
It is initiated by a combination of factors. How much
C. Triangulation
pressure is needed for the newborn to inflate their
D. Experiment
alveoli for the first time?
A. 30-40 cm H20
Situation: Nurse Chie reviews the normal pediatric
processes. The following questions apply. B. 70-100 cm H20
C. 110-150cm H20
81. Nurse Chie knows that an important assessment of D. 40-70 cm H20
observation is behavior. This helps shape the infants'
environment, and their ability to react to various stimuli Situation: Nurse Tarly, the research coordinator at a
and how others relate to them. A method of tertiary hospital, noticed an increasing number of
systematically assessing their behavior is through the complaints from patients and their families about
Brazelton Neonatal Behavioral Assessment (BNBAS) nurses being "rude and cranky." In response, she
Scale. Which among these statements is true regarding formed a core group to carry out a study on the
the said scale? "Caring Behavior of Staff Nurses and Satisfaction of
A. Autonomic stability is measured through Women with Ostomy".
the ability to respond to and then inhibit
response to discrete stimulus while 86. Based on the research statement, what is the
asleep. independent variable in thestudy?
B. Orientation is the quality of alert A. Staff nurses
and the ability to attend to visual and B. Caring behavior
auditory stimuli. C. Women with ostomy
C. Their regulation of state is a
D. satisfaction
measurement of general arousal level or
the arousability of the infant.
87. What is the dependent variable in the study?
D. Habituation is assessed through their A. staff-nurse
reaction to several neonatal reflexes.
B. ostomy
82. Nurse Chie is aware that toddlers who are
C. degree of satisfaction
approximately 2 years of age enters the preconceptual
D. caring behavior
phase of cognitive development which lasts until about
4 years. Along with it are the development of different
88. What relevant literature can Nurse Tarly and her
characteristics of preoperational thought. Which of the
group members use for this study?
following is a good example of global organization?
I. Caring behaviour.
A. Riri refuses to eat the food given by her
mother because her previous experience II. ostomy pathogenesis.
with the same food did not taste good. III. contentment and satisfaction.
B. Meri refuses to eat the cupcake IV. Concept of body image.
because she wanted it to be blue despite A. III and IV
the food being acceptable in taste and B. I, II and III
smell. C. I and II
C. Garry thinks the taller glass has more D. I, II, Ill and IV
water than the shorter glass even though
they contain the same volume. 89. 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 indicate to Nurse Virgo that he understood the
related to increased satisfaction of instructions for preventing pancreatitis? I will
ostomized patients. ----·
C. The staff nurses behaviors has an effect on A. "increase my intake of high protein products"
the patients' satisfaction with ostomized
B. "try to stop drinking alcohol"
patients.
C. "follow a high fat diet faithfully
D. A significant relationship exists between the
D. "be careful of exposing myself to infection"
caringbehaviors of the staff-nurses and
degree of satisfactionof ostomized patients. Situation: The Department of Health (DOH) is an
agency that establishes standards for safe and quality
90. Based on the research problem, what is the healthcare, in collaboration with Philippine Health
research design of the study? Insurance, which manages accreditation and
A. Quasi-experimental reimbursement for healthcare service costs.
B. Descriptive
C. Expost-facto 96. The professional behavior of doctors, nurses, and
D. Experimental other healthcare providers in health facilities falls
under which of the following quality standards?
Situation: Nurse Virgo admits Benito, a 67-year-old, A. Improving performance
who is experiencing severe abdominal and back pain, B. Organizational ethics
along with vomiting after attending a party. He exhibited C. Patient care standards.
signs of alcohol consumption and was tentatively D. Leadership and management
diagnosed with pancreatitis. A diagnostic laparotomy
has been scheduled to confirm the diagnosis. 97. The positive practice environment (PPE) is
95. Which statement from Patient Benito would included in the quality standards for healthcare
91. Nurse Virgo collects B. 1 and 4 C. electrical wires
additional information from C. 1, 2 and 4 D. infection control
Patient Benito. Which following D. 1, 2 and 3
questions should Nurse Virgo ask? relevant of the 98. When a healthcare facility
l."Can you describe your pain?" facilities across the country. Which of establishes its Vision and Mission to
2. "Is your urine yellow?" the following is NOT a component of direct management and healthcare
3. "Is your stool clay colored?" the PPE in the workplace? personnel in the workplace, it pertains
4."Do you drink alcohol often?" A. waste management to which aspect of quality standards?
A. 2 and 4 B. peer review A. Human resource
management
92. Patient Benito asks Nurse Virgo, "Why can't the B. Identification of Patient rights and welfare.
surgeon just remove my pancreas?" The best reply C. Improving performance of health care
from Nurse Virgo is . personnel.
A. "your body needs to function well with your D. Human resource management and staffing
pancreas" pattern.
B. "your attack will soon be overcome when you
are at rest" 100. When healthcare professionals provide accurate
C. "if your pancreas is removed, you can never documentation, whether done manually or
eat fat andfried foods again" electronically, in their work environment, it reflects a
D. "antibiotic will relieve signs of infection" component of which quality standards in a healthcare
delivery system?
93. Before the surgery, Patient Benito is on nothing by A. Patient care standards
mouth (NPO) status. He informs Nurse Virgo that he B. Information management
feels thirsty and hungry. What is the most appropriate
response from Nurse Virgo? C. Leadership and management
A. "You can sip only this amount of water to D. Human resource management
moisten your mouth"
B. "An NGT will be insertedto remove gastric Situation: Mr. Lan, a 44-year-old married man with
secretions alleviate your thirst" obesity, was brought to the emergency room due to
C. "I will give you ice chips to relive your thirst" nausea, shortness of breath, and intense chest pain
that radiated to his back.
D. "Oral and fluid intake stimulates
pancreatic enzymes andpain"
101. As a nurse, what is your PRIORITY step to be
done in this situation?
94. Nurse Virgo asks Patient Benito how she can
A. Palpate the point of maximal impulse.
assist him in managing his pain while he waits for his
B. Inspect the nail bed it cyanotic
operation. What is the most appropriate question for
Nurse Virgo to ask?
A. "Are you ready for the operation? The pain
will soon beaver."
B. "After operation, everything will be alright."
C. "Is your present position reducing pain?"
D. "Does exercise reduce your pain?"
B. Patient care standards
C. Leadership and management
D. Organizational ethics

99. When Nurse Sarah handed out a patient

satisfaction survey for consumers to complete upon
discharge from the hospital, which quality standard
does this comply with?
A. Organizational structure and professional
ethics.
 C. Take the vital signs and report to the the country
physician. D. issue permit for the opening of nursing
D. Assess quality of pain programs in the country

102. A 12 lead EKG was ordered by the physician. 108. Ms. Bogum is a new nursing graduate and in dire
Which finding in the EKG issuggestive evidence that need of the hospitalization of her ailing mother. She is
the patient has myocardial infarction (MI)? being offered to endorse a detergent product on TV
A. Prominent segment elevation Commercial wearing a mini skirt and plunging neckline
B. ST segment elevation shirt. In doing this performance Ms. Sanchez is
C. Peaked P wave violating the neckline shirt. In doing this performance
D. Minimal QRS wave Ms. Sanchez is violating the .
A. Oath of professional for new nurses
103. The physician confirmed that the patient is B. Nursing practice act 7164
experiencing a myocardial infarction (MI). She was C. Code of ethics for nurses
advised to be hospitalized and received streptokinase. D. Core competency standards
What is the DESIRED effect of this medication?
A. Dissolve clot formation 109. At the tertiary level hospital where Nurse Rory
works, the healthcare team participates in an annual
B. Reduce tissue damage of the heart.
outreach program "Operation Tuli". During the first day,
C. Prevent dysrhythmia
there were already 200 patients who came but there
D. Reduce edema formation.
were only 4 doctors, 3 nurses, and 1 pharmacist. Due
to the volume of patients, Nurse Rory was asked to
Situation: Mr. Ian, a 46-year-old, male obese, married
participate in performing circumcision with the rest of
was rushed to Emergency Room because of feeling
the doctors. Nurse Rory can be liable for committing .
nauseated, with shortness of breath and severe chest
A. Assault
pain radiating to the back.
B. Invasion of privacy
C. Tort
104. As a nurse you are aware that after an attack and
D. Malpractice
without treatment, the damage to the heart muscles
and tissues becomes permanent within
110. Which of the following actions when done is
-- hours? likely to be considered as GROSS NEGLIGENCE?
A. 7-9 A. Complied with the request of a bedridden
B. 10-12 patient not to be turned because of pain.
C. 4-6 B. Nasogastric feeding was not given on time
D. 1-3 because the patient is feeling nauseated.
C. A patient suffering from bleeding due to
105. In creating a nursing care plan for the patient, post-operative wound and the nurse failed
what are the modifiable risk factors that can be to report to the attending physician.
included to prevent another heart attack in the future? D. Urine output that has not been measured
1. Smoking because of an emergency admission.
2. High blood pressure.
Situation: A 10-year-old girl, named Tyla with a
3. High cholesterol
history of poorly controlled asthma presents to the
4. Overweight
emergency department with severe shortness of
breath and audible inspiratory and expiratory
A. 1,2, & 3
wheezing. She is pale, refuses to lie down, and
appears extremely frightened. Her pulse is 120 bpm
B. 3&4
and respirations 32/min. Her mother states that Tyla
has just recovered from a mild case of flu and had
C. 1&2
seemed comfortable until this afternoon.
D. 1,2,3, 4
111. Asthma is identified as the disease with a triad of
physiologic processes, except:
Situation: Ms. Bogum is newly graduate BS degree A. Airway inflammation
holder of Nursing. She is now reviewing for the B. Edema
upcoming National Licensure Examination (NLE) and is
determined to pass the boards. C. Airway tightness
D. Airway Hyperactivity
106. The licensure examination, which is administered 112. While receiving an adrenergic beta 2agonist drug
by the Professional Regulation Commission, Board of for asthma, Tara complains of palpitations, chest pain,
Nursing is given to . and a throbbing headache. What is the most
A. apply the theory learned from classroom to appropriate nursing action?
practice settings A. Tell the client not to worry; these are
B. protect the public from incompetent expected side effects from the medicine.
practitioners B. Withhold the drug until additional
C. apply the scope of nursing practice
orders are obtained.
D. demonstrate expected competency
standards

107. 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 inthe country
B. issue, suspend, revoke or
reissue certification of registered nurses
C. ensure proper conduct of nurse's licensure in
 C. Ask the client to relax; then give of the following clinical manifestations do you expect
instructions to breathe slowly and deeply the nurse to document as a reaction to the drug?
for several minutes. 1. Redness
D. Explain that the effects are temporary 2. Swelling
and will subside as the body becomes 3. Tenderness
accustomed to the drug. 4. Induration
113. The wall of the larynx is composed of nine
pieces of cartilage. Three occur in singly and three
A. 1, 2, & 3
occur in pairs. Of the paired cartilages, the _
B. 2&4
cartilage are the most important because it influence
changes in position and tension of the vocal folds. It C. 1, 2, 3, & 4
also known to be in triangular pieces of mostly
hyaline cartilage located at the D. 1 &2
posterior, superior border of the cricoid cartilage.
A. Cricoid 119. Jebb verbalized being anxious about his
B. Corniculate diagnosis and his reaction to insulin therapy. As his
C. Arytenoid nurse, which of the following is the PRIORITY nursing
D. Epiglottis action to overcome the patient's anxious behavior?
E. Cuneiform A. Conduct a family conference for the concern
114. After a while, Tyla developed difficulty of of the patient
breathing accompanied by hypotensive episodes. Dr. B. Refer to the physician for an order of
Guerero decided for that Tyla is for intubation. Nurse tranquilizer
Yana is aware that Rapid sequence intubation is a C. Express your empathy and respect for his
seven step process that is often used to intubate the feelings
critically ill patient. It is considered safer for the patient D. Take time to explain his disease
as it decreases the risk for aspiration. The second step process and effects of insulin
for rapid sequence intubation is:
A. Preparation 120. When a patient was suffering from ketoacidosis,
B. Pretreatment you expect to find the following nurse assessment
C. Paralysis with induction findings in the chart EXCEPT?
D. Preoxygenation A. Kussmaul respiration
115. Which of the following interventions would be
most likely to Tyla in developing respiratory distress B. Cheyne-stokes breathing
C. lethargy
syndrome (ARDS)?
A. Replacing fluids adequately during D. acetone breath odor
hypovolemic states
121. Mr. Park, a patient who is diagnosed with
B. Teaching cigarette smoking cessation
congestive heart failure, is under the care of Nurse
C. Maintaining adequate serum potassium Sam. Mr. Park is complaining of heaviness in his legs
levels during the morning shift when the nurse was making
D. Monitoring clients for signs of her rounds. She observed that there is (+) edema on
hypercapnia his lower extremities. If the nurse recorded it as 4+
116. Tyla later on developed Acute Respiratory edema, which is the corresponding characteristic of
Distress Syndrome. Tyla's peak inspiratory pressures this documentation?
and spontaneous respiratory rate are increasing and a. Deeper pit, rebounds in 30 seconds.
the P02 is not improving. Using the SBAR technique for b. Barely the pit is not perceptible.
communication, the nurse calls the physician with c. Deeper pit, rebounds in only few seconds.
recommendation for: d. Deep pit, rebounds in 10-20 seconds.
A. Starting a high protein and low
carbohydrate diet 122. During the assessment of a patient with
B. Initiating IV Sedation respiratory disorder, you instruct the patient to breathe
C. Providing pain medication through their mouth as you auscultate for breath
D. Increasing the ventilatory rate sounds. A possible complaint that the nurse must
117. A number of methods can be used to wean Tyla watch out for and be written in her documentation
from the ventilator. There are three main methods for when performing this procedure is which of the
weaning which are T-tube Trials, Synchronized following?
intermittent mandatory ventilation and Pressure support
ventilation. The mechanism for T-tube trials 123. When auscultating the breadth sounds of
IS: patients with respiratory disorder they are instructed to
A. It is a gradual transition from ventilatory breathe through their mouth. A possible complaint the
support to spontaneous breathing which nurse must watch and be written in her documentation
is placing into SIMV modes and slowly when performing this procedure is which of the
decreasing the rate. following?
B. The level of pressure is gradually A. Palpitation
decreasing in increments of 3-6 cm H20 B. Dizziness
while the tidal volume is maintained at C. Tachycardia
10-15 ml/kg. D. Bradycardia
C. It is initiated by removing the
patient from the ventilator and having the
patient breath spontaneously.
D. It is placing patient on constant positive
airway pressure.
Situation: Documentation is a basic competency
expected of a graduate nurse when performing her
role in the clinical setting.

118. On the day of admission, Jebb is admitted for his

insulin therapy. The next day, he developed allergic
reactions after two hours of the administration. Which
Situation: Camie, an employed junior hair stylist, is IV. Eliminating infection
experiencing periumbilical pain, feels feverish, and
nauseated at work. She was rushed to the emergency A. I, II, III, &IV
room as the pain was becoming intense at RLQ of the B. I, II, & III
abdomen. She was advised to be admitted for further C. II & IV
work-up. D. I &II
What is the normal ratio of bicarbonate to carbonic
124. Camie was admitted, and Nurse Elle started her acid?
assessment. What sign would be elicited by the nurse A. 1:10
when a deep palpation of the left iliac fossa is done B. 10:1
and causes pain on the right iliac fossa? C. 20:1
A. Obturator sign D. 1:20
B. Blumberg sign 131. Macy, a 7-year-old child, was diagnosed with
C. Psoas sign acute gastroenteritis. According to her mother, Macy
D. Rovsing sign started to have symptoms after eating at a fast-food
chain. You are asked to assess and monitor Macy's
125. Within the day, after a thorough physical condition. What manifestations belong to the acid-
assessment and diagnostic tests, the physician base imbalance associated with her diagnosis? Select
ordered an emergency appendectomy due to all that apply.
suspected ruptured appendicitis. What MAJOR i. Dizziness
complication does the physician aim to prevent? ii. Weakness
A. Thrombosis iii.Tingling of fingers and toes
B. Sepsis iv. Depressed respirations
C. Perforation v. Constipation
D. Bleeding
A. i and ii only
126. When preparing the patient for surgery, the goals
set by the surgical team for the patient going for B. all of the above
operation are which of the following? C
I, II, V
I. Relief of pain . .. . .
D
II. Preventing fluid volume deficit I. II, IV, V
III. Reducing anxiety reaction .
127. Which of the following nursing measures should
be CONTRAINDICATED for patients prior to
appendectomy?
A. Observe nothing by mouth
B. Administration of enema.
C. Removal of nail polish
D. Instruct to urinate.

128. For wound care management, the nurse knows

NOT to perform which of the following interventions?
A. Allow the wound to drain freely.
B. Maintenance of an acidic or neutral PH
C. Application of cold pack solutions.
D. Maintenance for a moist wound
environment.

Situation: Acid-base disturbances are commonly

encountered in clinical practice, especially in critical
care units. Identification of the specific acid-base
imbalance is important in determining the underlying
cause of the disorder and its appropriate
management.
129. Diagnostic test has been ordered to differentiate
between normal anion gap acidosis and high anion gap
acidosis in an acutely ill patient. What health problem
typically precedes normal anion gap acidosis?
A. Excessive administration of
chloride
B. Metastases
C. Excessive potassium intake
D. Water intoxication
130. In an acid-base disorder, the pulmonary or renal
system compensates to return the pH to normal.