Situation 1: It is Cancer Consciousness Week and you are participating in an Early Cancer Detection Drive of the Department of Health.

1. Based on the DOH and World Health Organization (WHO) guidelines, the mainstay for early detection method for breast cancer that is recommended for developing countries is: A. a monthly breast self examination (BSE) and an annual health worker breast examination (HWBE) B. an annual hormone receptor assay C. an annual mammogram D. a physician conduct a breast clinical examination every 2 years 2. The purpose of performing the breast self examination (BSE) regularly is to discover: A. fibrocystic masses C. areas of thickness or fullness B. cancerous lumps D. changes from previous BSE 3. If you are to instruct a postmenopausal woman about BSE, when would you tell her to do BSE: A. on the same day of each month C. on the first day of her menstruation B. right after the menstrual period D. on the last day of her menstruation 4. During breast self-examination, the purpose of standing in front of the mirror it to observe the breast for: A. thickening of the tissue C. lumps in the breast tissue B. axillary D. change in size and contour 5. When preparing to examine the left breast in a reclining position, the purpose of placing a small folded towel under the clients left shoulder is to: A. bring the breast closer to the examiners right hand B. tense the pectoral muscle C. balance the breast tissue more evenly on the chest wall D. facilitate lateral positioning of the breast

Situation 2: Ensuring safety is one of your most important responsibilities. You will need to provide instruction and information to your clients to prevent complications. 6. LM has chest tube attached to a pleural drainage system. When caring for LM you should: A. change the dressing daily using aseptic technique B. empty the drainage system at the end of the shift C. palpate the surrounding areas for crepitus D. clamp the chest tube when suctioning 7. After pelvic surgery, the sign that would be indicative of a developing thrombophlebitis would be: A. a tender, painful area on the leg C. a pitting edema of the ankle B. pruritus on the calf and ankle D. a reddened area of the ankle 8. To prevent recurrent attacks on FT who has glomerulonephritis, you should instruct her to: A. continue to take the same restrictions on fluid intake B. seek early treatment for respiratory infections C. avoid situations that involve physical activity D. take showers instead of tub bath

9. GT had a laryngectomy. He is now for discharge. He verbalized his concern regarding his laryngectomy tube being dislodged. What would you teach him FIRST? A. reinsert another tubing immediately C. recognize that prompt closure of the tracheal opening B. keep calm because there is no immediate D. notify the physician at once emergency 10. When caring for TU after an exploratory chest surgery and pneumonectomy, your PRIORITY would be to maintain: A. chest tube drainage C. ventilation exchange B. blood replacement D. supplementary oxygen Situation 3: Severe burn is one of the most devastating kinds of injury one can experience. It can affect any group. You have been ready to provide holistic care for patients with severe burns. 11. A burn that is white, painless, and leathery in texture describes a: A. second degree burn C. deep partial thickness burns B. third degree or full thickness burn D. first degree or superficial burns 12. Critically ill patients are at high risk for the following complication during the emergent phase: A. myocardial infarction C. burn shock B. neurogenic shock D. contractures 13. The MOST effective method of delivering pain medication during the emergent phase is: A. intramuscularly C. orally B. subcutaneously D. intravenously 14. Edema presents a significant problem in burn wounds because: A. loss of protein prevents tissue repair B. edema impedes tissue perfusion/oxygenation C. edema provides a milieu for bacterial proliferation D. edema can produce a tourniquet effect 15. Which of the following can be a fatal complication of upper airway burns? A. stress ulcers C. shock B. hemorrhage D. laryngeal spasms and swelling Situation 4: You are assigned to take care of four patients with different conditions. 16. KJ, who is to have a kidney transplant asks you how long will he take azathioprime (Imuran), cyclosporine and prednisone? You recognized that KJ understood the teaching when he states, I must take these medications: A. until the anastomosis heals C. until the supply is over B. during the preoperative period D. for the rest of my life 17. After the kidney transplant, you must observe KJ for signs of rejection which includes: A. fever and weight gain C. polyuria and jaundice B. hematuria and seizure D. moon face and muscle atrophy 18. FB, 28 years old with chronic renal disease plans to receive a kidney transplant. Recently, FB was told by his physician that he was a poor candidate for transplant because of his hypertension and diabetes

mellitus. Now, FB tells you I want to go off dialysis, Id rather not live than to be in this treatment the rest of my life. How would you respond to him? A. leave the room and allow him to collect his thoughts B. tell FB that We all have days when we dont feel like going on C. tell FB that Treatments are only three times a week, you can live with that D. take a sit next to him and sit quietly 19. DS signed a consent form for participation in a clinical trial for implantable cardioverter defibrillators. Which statement by DS indicates the need for further teaching before true informed consent can be obtained? A. a wire from the generator will be attached to my heart B. the physician will make a small incision in my chest wall and place the generator there C. I wonder if there is another way to protect these bad rhythms D. this implanted defibrillator will protect me from those bad rhythms my heart goes into 20. KP is participating in a cardiac study in which his physician is directly involved. Which statement by KP indicates a lack of understanding about his rights as a research study participant? A. My confidentiality will not be compromised in this study B. I understand the risk associated in this study C. I can withdraw from the study anytime D. Ill have to find a new physician if I dont complete this study

Situation 5. You are assigned in the neurology stroke unit. To prepare for this assignment, you should be able to answer the following questions. 21. Which of the following statements can BEST describe/define stroke or brain attack? A. it occurs when circulation to a part of the brain is disrupted B. it is usually caused by abuse of prescribed medications C. it is caused by a cerebral hemorrhage D. it may be the results of a transient ischemic attack (TIA) 22. Several diagnostic tests may be ordered for proper evaluation. The purpose of each of the following diagnostic examination is correct EXCEPT:
A. Cerebral Angiography is used to identify collateral blood circulation and may reveal site of rupture or occlusion B. ECG may reveal abnormal electrical activity, such as focal slowing and assess amount of brain wave activity. C. MRI may reveal the site of infarction, hematoma and shift of brain structures D. PET Scanning may reveal information on cerebral metabolism and blood flow characteristics.

23. Which of the following is the MOST common cause of stroke or brain attack? A. embolism C. cerebral arterial spasm B. hemorrhage D. thrombosis 24. To guide you in your assessment, it is also important for you to remember that the clinical features of stroke vary with the following factors EXCEPT: A. severity of damage C. artery affected B. gender D. the extent of collateral circulation 25. It is important for you to also teach clients and their families who are at risk to observed primary prevention which includes the following EXCEPT:

A. maintain serum cholesterol level between 220 and 180 mm/dL B. treat transient ischemic attacks (TIA) early C. teach preventive health behaviors (consequences of smoking, obesity, alcoholism, drug abuse) to children of patients with stroke D. screen for systolic hypertension Situation 6: Foot care among patients with peripheral vascular problems is very important. 26. When teaching a client with peripheral vascular disease about foot care, you should include which instructions: A. avoid wearing canvas shoes C. avoid use of cornstarch on the foot B. avoid using a nail clipper to cut toe nails D. avoid wearing cotton socks 27. FT, who has no known history of peripheral vascular disease, comes to the emergency room complaining of sudden onset of lower leg pain. Inspection and palpation reveal absent pulses, paresthesia and a mottled, cyanotic, cold, cadaverous left calf. While the physician determines the appropriate management, you should: A. shave the affected leg in anticipation of surgery C. keep the affected leg level or slightly dependent B. place a healing pad around the calf D. elevate the affected calf as high as possible 28. Peripheral neuropathies primarily affect: A. sensory functions B. vascular functions 29. Peripheral neuropathy can BEST be controlled by: A. good glucose control B. steroid therapy

C. optic functions D. motor functions

C. vitamin supplement D. nothing, there is no slowing the process

30. In addition to clients with diabetes mellitus you must be aware that acute hypoglycemia can also develop in a client with: A. hypertension C. liver disease B. hyperthyroidism D. diabetes insipidus Situation 7: You are assigned to take care of a group of elderly patients. Pain and urinary incontinence are their common concerns. You should be able to address their concerns in a holistic manner. 31. The WHO analgesic ladder provides the health professional with: A. specific pain management choices based on severity of pain B. general pain management choices based on level of pain C. pharmacologic and nonpharmacologic pain management choices D. nonpharmacologic interventions based on level of pain 32. As a nurse caring for patients in pain, you should evaluate for opioid side effects which include the following EXCEPT: A. pruritus C. constipation B. respiratory depression D. physical dependence 33. Which of the following statements about cancer pain is NOT true? A. opioids are drugs of choice for severe pain B. pain associated with cancer and the terminal phase of the disease occurs in majority of patients

C. under treatment of pain is often due to a clinicians failure or inability to evaluate or appreciate the severity of the clients problem D. adjuvant medications such as steroids, anti convulsants, nonsteroidal anti-inflammatory drugs enhance pain perception 34. TR has been on morphine on a regular basis for several weeks. He is now complaining that the usual dose he has been receiving is no longer relieving his pain as effectively. Assuming that nothing has changed in his condition, you would suspect that TR is: A. becoming psychologically dependent C. needing to have the morphine discontinued B. developing tolerance to the morphine D. exaggerating his level of pain 35. The guidelines for choosing appropriate nonpharmacologic intervention for pain include all of the following EXPECT: A. effectiveness for patient C. skill of the clinician health professional B. pain problem identification D. type of opioid being used Situation 8: To be able to provide care for patients in the critical areas, you should look into factors that will enhance your ability to provide quality nursing care. 36. Research study show that nurses who work with critically patients as opposed to nurses who work with less acute patient: A. are more satisfied with their role C. are most acceptable to burn out B. move a greater support system D. experience greater stress 37. Which of the components of HARDINESS has been linked to burnout? A. less commitment to work C. a sense of control over the patient B. perception of change D. sense of control to life 38. Nurses who work with critically ill patients should base their practice on all of the following EXCEPT: A. recognition and appreciation of a persons unique and social environmental relationships B. delegated responsibility C. thorough knowledge of the interrelatedness of body system D. appreciation of the collaborative role of all health team members 39. Common aspects of the critical care nursing role include: A. disaster management C. direct care provider B. staff liaison D. community referral 40. Which of the following interventions would support your patients circadian rhythm cycle? A. putting a wall clock up on your patients room B. decreasing environmental noise C. encouraging normal bowel movement D. dimming light during normal sleeping time Situation 9: To ensure continuity of care and for legal purposes, you have important responsibilities to accurately document all nursing activities. 41. For the past 24 hours, TD with dry skin and dry mucous membranes has had a urine output of 600 m and a fluid intake of 800 ml. TDs urine is dark amber. These assessments indicate which nursing diagnosis? A. Impaired urinary elimination C. Excessive fluid volume B. Deficient fluid volume D. Imbalanced nutrition: less than body requirement

42. Which document addresses the patients right to information, informed consent and treatment refusal? A. Code for Nurses C. Patients Bill of Rights B. Nursing Practice Act D. Standard of Nursing Practice 43. You are caring for GG with a history of falls. The FIRST PRIORITY when caring for GG who is at risk for falls is: A. instruct GG not to get out of bed unassisted B. keep the bedpan available so she does not have to get out of bed C. placing the call light for easy access D. keep the bed at the lowest position ever 44. Shortly after being admitted to the CCU for acute MI, JJ reports midsternal chest pain radiating down the left arm. You notice that JJ is restless, slightly diaphoretic, and has a temperature of 37.8 deg C, heart rate of 10 beats/min.; regular, slightly labored respirations at 26 breaths/min and a blood pressure of 150/90 mmHg. Which nursing diagnosis takes HIGHEST PRIORITY? A. decreased cardiac output C. acute pain B. anxiety D. risk for imbalanced body temperature 45. FF, has a nursing diagnosis of Risk for injury related to adverse effects of potassium-wasting diuretics. Whats the correct written client outcome for this diagnosis? A. FF states the importance of eating potassium rich foods daily B. Upon discharge, FF knows which food sources are rich in potassium C. Upon discharge, FF correctly identifies three potassium rich foods D. FF knows all the complications of the disease process Situation 10 : You are taking care of LC who develops acute respiratory distress. An endotracheal tube had to be inserted to correct the hypoxia. 46. The primary purpose of the endotracheal tube cuff is to: A. seal off the oropharynx from the nasopharynx C. seal off the oropharynx from the esophagus B. seal off the lower airway from the esophagus D. seal off the lower airway from the upper airway 47. Endotracheal tube size indicated on the tube reflects what measurements: A. the circumference size of the tube C. the internal diameter of the tube B. the length of the tube D. the length of the persons airway 48. In adults, an inflated E-T tube cuff is necessary for mechanical ventilation primarily because: A. it seals off the lower airway from the upper airway B. it prevents air from getting into the stomach C. it seals off the nasopharynx from the oropharynx D. it prevents stomach contents from getting into the lungs 49. Endotracheal tube size indicated on the tube reflects what measurements: A. the internal diameter of the tube C. the circumference size of the tube B. the length of the persons airway D. the length of the tube 50. Which of the following statements is TRUE about securing the artificial airway? A. artificial airways must be secured directly to the patient B. the airway is generally sutured in place

C. a nasotracheal tube does not require securing D. the inflated cuff provides sufficient securing Situation 11: Because of the serious effects of severe burns, management requires a multidisciplinary approach. You have important responsibilities as a nurse. 51. When caring for DS, who sustained 40% severe flame burn yesterday, which among these interventions should be your PRIORITY? A. provide a calm, efficient and safe environment B. keep the body parts in good alignment to prevent contractures C. assess for airway, breathing and circulation problems D. assess the injury for signs of sepsis

52. Your primary therapeutic goal for DS during the ACUTE PHASE is: a. wound healing c. emotional support b. reconstructive surgery d. fluid resuscitation 53. CV who sustained upper torso and neck burns. Which action is MOST likely to cause a functional contracture? a. hourly hyperextension neck exercises b. helping the patient to a position of comfort c. encouraging self-care d. discouraging pillows behind the head 54. AW, 3 year old boy just sustained full thickness burns of the face, chest and neck. What will be your PRIORITY nursing action? a. Risk for infection related to epidermal disruption b. Impaired urinary elimination related to fluid loss c. Ineffective airway clearance related to edema d. Impaired body image related to physical appearance 55. FG, with a full thickness burns involving entire circumference of an extremity will require frequent peripheral vascular checks to detect: a. hypothermia c. arteriosclerotic changes b. ischemia d. adequate wound healing

Situation 12: Infection can cause debilitating consequences when hosts resistance is compromised and environmental factors are favorable. As a nurse you have important roles and responsibilities in infection control. 56. EF was admitted to the hospital with a tentative diagnosis of acute pyelonephritis. To assess her risk factors, what question should you ask? a. Have you taken any analgesic recently? b. Do you have pain at your back? c. Do you hold your urine for a long time before voiding? d. Have you had any sore throat lately?

57. While caring for a patient with an infected surgical incision, you observe for signs of systemic response. These include all of the following EXCEPT: a. a febrile state due to release of pyrogens b. anorexia, malaise, and weakness c. loss of appetite and pain d. leukopenia due to increased WBC production 58. One of the MOST effective nursing procedures for reducing nosocomial infection is: a. proper handwashing technique b. aseptic wound care c. control of upper respiratory tract infection d. administration of prophylactic antibiotic 59. A wound that has hemorrhaged has increased risk for infection because: a. dead space and dead cells provide a culture medium b. retrograde bacterial contamination may occur c. the tissue becomes less resilient d. of reduced amounts of oxygen and nutrients are available 60. You are instructing EP regarding skin tests for hypersensitivity reactions. You should teach her to: a. stay out of the sun until the skin tests are read b. come back on the specified date to have the skin tests read c. wash skin test areas with soap and water daily d. keep skin test areas moist with mild lotion. Situation 13 : TR attends a Health Education Class on colostomy care. The following are taken up: types of ostomies, indications and care. 61. A colostomy can BEST be defined as: a. cutting the colon and bringing the proximal end through the abdominal wall b. creating a stomal orifice from the ileum c. excising a section of the colon and doing an end-to-end anastomosis d. removing the rectum and suturing the colon to the anus. 62. When an abdominoperineal resection is done, the patient should be informed he/she will have a; a. temporary colostomy c. transverse loop colostomy b. permanent colostomy d. double-barreled 63. A colostomy patient who wishes to avoid flatulence should not eat the following EXCEPT: a. corn and peanuts c. mangoes and pineapples b. cabbage and asparagus d. chewing gum and carbonated beverages 64. During the first post operative week, the nurse can BEST help the patient with a colostomy to accept the change in body image by: a. changing the dressing just prior to meals b. encouraging the patient to observe the stoma and its care c. deodorizing the room periodically with a spray can d. applying a large bulky dressing over the stoma to decrease odors

Situation 14: These are gastrointestinal disease that can compromise life and that would necessitate extensive surgical management. You are assigned to take care of a patient with such a condition. 66. BC diagnosed with cancer of the sigmoid colon is to have an abdominoperineal resection with a permanent colostomy. Before surgery, a low residue diet is ordered. You explain to BC that this is necessary to: a. prevent irritation of the intestinal mucosa b. reduce the amount of stool in the large bowel c. limit production of flatus in the intestines d. lower the bacterial count in the GI tract 67. Several days prior to bowel surgery, the patient may be given sulfasuxidine and neomycin, primarily to: a. soften the stool by retaining water in the colon b. reduce the bacterial content of the colon c. empty the bowel of solid waste d. promote rest of the bowel by minimizing peristalsis 68. To promote perineal wound healing after an abdominoperineal resection, you should encourage BC to assume: a. dorsal recumbent position b. left or right Sims position c. left or right side lying position d. knee-chest position 69. BC returns from surgery with a permanent colostomy. During the 24 hours, the colostomy does not drain. You, as the nurse should realize that this is a result of: a. the absence of intestinal motility b. a presurgical decrease in fluid intake c. proper functioning of the nasogastric tube d. intestinal edema following surgery 70. On the second day following abdominoperineal resection, you anticipate that the colostomy stoma will appear: a. moist, pink, with flushed skin and painful when touched b. moist, red and raised above the skin surface c. dry, pale pink and with flushed skin d. dry, purple and depressed below the skin surface Situation 15: Specific surgical interventions may be done when lung cancer is detected early. You have important peri-operative responsibilities in caring for patients with lung cancer. 71. GM is scheduled to have lobectomy. The purpose of closed chest drainage following a lobectomy is: a. expansion of the remaining lung b. facilitation of coughing c. prevention of mediastinal shift d. promotion of wound healing

72. Following thoracic surgery, you can BEST help GM to reduce pian during the deep breathing and coughing exercises by: a. splinting the patients chest with both hands during the exercises b. administering the prescribed analgesic immediately prior to exercises c. providing rest for 6 hours before exercises d. placing the patient on his/her operative side during exercises 73. During the immediate post operative period following a pneumonectomy, deep tracheal suction should be done with extreme caution because: a. the remaining normal lung needs minimal stimulation b. the patient will not be able to tolerate coughing c. the tracheobronchial tree are dry d. the bronchial suture line maybe traumatized 74. What should you do as a nurse when the chest tubing is accidentally disconnected? a. reconnect the tube c. notify the physician b. change the tubing d. clamp the tubing 75. Which of the following observations indicates that the closed chest drainage system is functioning properly? a. less than 25 ml drainage in the drainage bottle b. absence of bubbling in the suction-control bottle c. the fluctuating movement of fluid in the long tube of the water-seal bottle during inspiration d. intermittent bubbling through the long tube of the suction control bottle. Situation 16: Renal stones can cause one of the most excruciating pain experienced by a patient. As a nurse of BL which of the following nursing diagnosis will be your PRIORITY? 76. BL was brought to the Emergency Room for severe left flunk pain, nausea and vomiting. The physician gave a tentative diagnosis of right ureterolithiasis. As the nurse of BL which of the following nursing diagnosis will be your PRIORITY? a. imbalance nutrition: less than body requirements b. impaired urinary elimination c. acute pain d. risk for infection 77. Which of the following is the appropriate intervention for BL who has ureterolithiasis? a. inserting an indwelling urinary catheter b. administering opioid analgesics preferably intravenously c. administering intravenous solution at a keep vein open rate d. inserting a nasogastric tube (low suction) 78. You are caring for YA, 30 year old business woman, with renal stones. Her skin and mucous membranes are dry and her 24 hour intake and output record reveal an oral intake of 900 ml and a urinary output of 700 ml. Her urine is dark amber. Based on the above data, your nursing diagnosis is: a. imbalance nutrition, less than body requirements b. fluid volume deficit c. impaired urinary elimination

d. knowledge deficit regarding health 79. KJ has an indwelling urinary catheter and she is suspected of having urinary infection. How should you collect a urine specimen for culture and sensitivity? a. clump tubing for 60 minutes and insert a sterile needle into the tubing above the clamp to aspirate urine b. drain urine from the drainage bag into the sterile container c. disconnect the tubing from the urinary catheter and let urine flow into a sterile container d. wipe the self-sealing aspiration port with antiseptic solution and aspirate urine with a sterile needle 80. You are caring for WE, a 56 year old man who is dehydrated and with urinary incontinent. Upon physical examination, you noted perineal excoriation. What will be your PRIORITY intervention? a. orient him to time, person and place b. offer the bed pan every 4 hours c. encourage oral fluid intake d. keep the perineal area clean, and dry Situation 17: You are caring for several patients with various disease problems. 81. You are obtaining a history of MR. who is admitted with acute chest pain. Which question will be MOST HELPFUL for you to ask? a. Why do you think you had a heart attack? b. Do you need anything now? c. What seem you doing when the pain started? d. Has anyone in your family been sick lately? 82. BO who received general anesthesia returns from surgery. Post-operatively, which nursing diagnosis takes HIGHEST PRIORITY for BO? A. impaired physical mobility related to surgery B. decrease fluid volume related to blood and fluid loss from surgery C. risk for infection related to anesthesia D. acute pain related to surgery 83. WW is blind. She is admitted for treatment of gastroenteritis. Which nursing diagnosis takes HIGHEST PRIORITY for WW? A. anxiety C. activity intolerance B. risk for injury D. impaired physical mobility 84. You are documenting your care for CC who has iron deficiency anemia. Which nursing diagnosis is MOST appropriate? A. ineffective breathing pattern C. deficient fluid volume B. impaired gas exchange D. ineffective airway clearance 85. RR, age 89, has terminal cancer, he demonstrates signs of dementia. You should give HIGHEST PRIORITY to which nursing diagnosis: A. risk for injury C. ineffective cerebral tissue perfusion B. bathing or hygiene self care deficit D. dysfunctional grieving

Situation 18: The physician has ordered 3 units of whole blood to be transfused to WQ following a repair of a dissecting aneurysm of the aorta. 86. You are preparing the first unit of whole blood for transfusion. From the time you obtain it from the blood bank, how long should you infuse it? A. 6 hours C. 4 hours B. 1 hour D. 2 hours 87. What should you do FIRST before you administer blood transfusion? A. verify client identity and blood product, serial number, blood type, cross matching results, expiration date B. verify client identity and blood product serial number, blood type, cross matching results, expiration date with another nurse C. check IV site and use appropriate BT set and needle D. verify physicians order 88. As WQs nurse, what will you do AFTER the transfusion has started? A. add the total amount of blood to be transfused to the intake and output B. discontinue the primary IV of Dextrose 5% Water C. check the vital signs every 15 minutes D. stay with WQ for 15 minutes to note for any possible BT reactions 89. WQ is undergoing blood transfusions of the first unit. The EARLIEST signs of transfusion reactions are: A. oliguria and jaundice C. hypertension and flushing B. urticaria and wheezing D. headache, chills, fever 90. In case WQ will experience an acute hemolytic reaction, what will be your PRIORITY intervention? A. immediately stop the blood transfusion, infuse Dextrose 5% in Water and call the physician B. stop the blood transfusion and monitor the patient closely C. immediately stop the BT, infuse NSS, call the physician, notify the blood bank D. immediately stop the BT, notify the blood bank and administer antihistamines Situation 19. The kidneys have very important excretory, metabolic, erythropoietic functions. Any disruptions in the kidneys functions can cause disease. As a nurse it is important that you understand the rationale behind the treatment regimen used. 91. PL, who is in acute renal failure, is admitted to the Nephrology Unit. The period of oliguria usually lasts for about 10 days. Which assessment parameter for kidney function will you use during the oliguric phase? A. urine output directly related to the amount of IV fluid infused B. urine output is less than 400 ml/24 hours C. urine output of 30-60 ml/hour D. no urine output, kidneys in a state of suspension

92. During the shock phase, what is the effect of the rennin-aldosterone-angiotensin system on renal function? A. increased urine output, increased absorption of sodium and water B. decreased urine output, decreased absorption of sodium and water C. increased urine output, decreased absorption of sodium and water D. decreased urine output, increased absorption of sodium and water 93. As you are caring for PL who has acute renal failure, one of the collaborative interventions you are expected to do is to start hypertonic glucose with insulin infusion and sodium bicarbonate to treat: A. hyperkalemia C. hypokalemia B. hypercalcemia D. hypernatremia 94. BN, 40 year old with chronic renal failure. An arteriovenous fistula was created for hemodialysis in his left arm. What diet instructions will you need to reinforce prior to his discharge? A. drink plenty of water C. monitor your fruit intake and eat plenty of bananas B. restrict your salt intake D. be sure to eat meat every meal 95. BN, is also advised not to use salt substitute in the diet because: A. salt substitute contain potassium which must be limited to prevent arrhythmias B. limiting salt substitutes in the diet prevents a buildup of waste products in the blood C. fluid retention is enhanced when salt substitutes are included in the diet D. a substance in the salt substitute interferes with fluid transfer across the capillary membrane Situation 20. You are assigned to take care of a group of elderly patients. Pain and urinary incontinence are common concerns experienced by them. You should be able to address the concerns in a holistic manner. 96. Pain in the elder persons require careful assessment because they: A. experienced reduce sensory perception B. have increased sensory perception C. are expected to experience chronic pain D. have a decreased pain threshold 97. Administration of analgesics to the older persons requires careful patient assessment because older people: A. are more sensitive to drugs B. have increased hepatic, renal and gastrointestinal function C. have increased sensory perception D. mobilize drugs more rapidly 98. The elderly patient is at higher risk for urinary incontinence because of: A. increased glomerular filtration C. decreased bladder capacity B. diuretic use D. dilated urethra 99. Which of the following is the MOST COMMON sign of infection among the elderly?

A. decreased breath sounds with crackles B. fever

C. pain D. change in mental status

100. Priorities when caring for the elderly trauma patient: A. circulation, airway, breathing C. airway, breathing, disability (neurologic) B. disability (neurologic), airway, breathing D. airway, breathing, circulation

NURSING PRACTICE IV SET B NURSING PRACTICE IV Care of Clients with Physiologic and Psychosocial Alterations (Part B) MULTIPLE CHOICE

Situation 1 Because of the serious consequences of severe burns, management requires a multidisciplinary approach. You have important responsibilities as a nurse. 1. While Sergio was lighting a barbecue grill with a lighter fluid, his shirt burns into flames. The most effective way to extinguish the flames with as little further damage as possible is to: A. log roll on the grass/ground B. slap the flames with his hands C. remove the burning clothes D. pour cold liquid over the flames 2. Once the flames are extinguished, it is most important to: A. cover Sergio with a warm blanket B. give him sips of water C. calculate the extent of his burns D. assess the Sergios breathing 3. Sergio is brought to Emergency Room after the barbecue grill accident. Based on the assessment of the physician, Sergio sustained superficial partial thickness burns on his trunk, right upper extremities and right lower extremities. His wife asks what that means? Your most accurate response would be: A. Structures beneath the skin are damage B. Dermis is partially damaged C. Epidermis and dermis are both damaged D. Epidermis is damaged 4. During the first 24 hours after the thermal injury, you should asses Sergio for: A. hypokalemia and hypernatremia B. hypokalemia and hyponatremia C. hyperkalemia and hyponatremia D. hyperkalemia and hypernatremia 5. Teddy, who sustained deep partial thickness and full thickness burns of the face, whole anterior chest and both upper extremities two days ago begins to exhibit extreme restlessness. You recognize that this most likely indicates that Teddy is developing: A. Cerebral hypoxia B. Hypervolemia C. metabolic acidosis D. Renal failure Situation 2 You are now working as a staff nurse in a general hospital. You have to be prepared to handle situations with ethico-legal and moral implifications. 6. You are in night duty in surgical ward. One of your patients Martin is a prisoner who sustained an abdominal gunshot wound. He is being guarded by policeman from the local police unit. During your rounds you heard a commotion. You saw the policeman trying to hit Martin. You asked why he was trying to hit Martin. He denied the matter. Which among the following activities will you do first? A. Write an accident report B. Call security officer and report the incident C. Call your nurse supervisor and report the incident D. Call the physician on duty

7. You are on morning duty in the medical ward. You have 10 patients assigned to you. During your endorsement rounds, you found out that one of your patients was not in bed. The patient next to him informed you that he went home without notifying the nurses. Which among the following will you do first? A. Make an incident report B. Call security to report the incident C. Wait for 2 hours before reporting D. Report the incident to your supervisor 8. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. Which among the following will you do first? A. Write an incident report and refer the matter to the nursing director B. Keep your findings to yourself C. Report the matter to your supervisor D. Find out from the endorsement any patient who might have been given narcotics 9. You are on duty in the medical ward. The mother of your patient who is also a nurse, came running to the nurses station and informed you that Fiolo went into cardiopulmonary arrest. A. Start basic life support measures B. Call for the Code C. Bring the crush cart to the room D. Go to see Fiolo and assess for airway patency and breathing problems 10. You are admitting Jorge to the ward and you found out that he is positive for HIV. Which among the following will you do first? A. Take note of it and plan to endorse this to next shift B. Keep this matter to yourself C. Write an incident report D. Report the matter to your head nurse Situation 3 - Colorectal cancer can affect old and younger people. Surgical procedures and other modes of treatment are done to ensure quality of life. You are assigned in the cancer institute to care of patients with this type of cancer. 11. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the CI. After taking the history and vital signs the physician does which test as a screening test for colorectal cancer. A. Barium enema B. Carcinoembryonic antigen C. Annual digital rectal examination D. Proctosigmoidoscopy 12. To confirm his impression of colorectal cancer, Larry will require which diagnostic study? A. Carcinoembryonic antigen B. Proctosigmoidoscopy C. Stool hematologic test D. Abdominal computed tomography (CT) test 13. The following are risk factors for colorectal cancer, EXCEPT:

A. Inflammatory bowels B. High fat, high fiber diet C. Smoking D. Genetic factors-familial adenomatous polyposis 14. Symptoms associated with cancer of the colon include: A. constipation, ascites and mucus in the stool B. diarrhea, heart burn and eructation C. blood in the stools, anemia, and pencil shaped stools D. anorexia, hematemesis, and increased peristalasis 15. Several days prior to bowel surgery, Larry may be given sulfasuxidine and neomycin primarily to: A. promote rest of the bowel by minimizing peristalsis B. reduce the bacterial content of the colon C. empty the bowel of solid waste D. soften the stool by retaining water in the colon Situation 4 ENTEROSTOMAL THERAPY is now considered a specialty in nursing. You are participating in the OSTOMY CARE CLASS. 16. You plan to teach Fermin how to irrigate the colostomy when: A. The perineal wound heals And Fermin can sit comfortably on the commode B. Fermin can lie on the side comfortably, about the 3rd postoperative day C. The abdominal incision is closed and contamination is no longer a danger D. The stools starts to become formed, around the 7th postoperative day 17. When preparing to teach Fermin how to irrigate colostomy, you should plan to do the procedure: A. When Fermin would have normal bowel movement B. At least 2 hours before visiting hours C. Prior to breakfast and morning care D. After Fermin accepts alteration in body image 18. When observing a return demonstration of a colostomy irrigation, you know that more teaching is required if Fermin: A. Lubricates the tip of the catheter prior to inserting into the stoma B. Hangs the irrigating bag on the bathroom door cloth hook during fluid insertion C. Discontinues the insertion of fluid after only 500 ml of fluid has been instilled D. Clamps of the flow of fluid when felling uncomfortable 19. You are aware that teaching about colostomy care is understood when Fermin states, I will contact my physician and report: A. If I have any difficulty inserting the irrigating tub into the stoma. B. If I noticed a loss of sensation to touch in the stoma tissue. C. The expulsion of flatus while the irrigating fluid is running out. D. When mucus is passed from the stoma between the irrigations. 20. You would know after teaching Fermin that dietary instruction for him is effective when he states, It is important that I eat: A. Soft food that are easily digested and absorbed by my large intestines.

B. Bland food so that my intestines do not become irritated. C. Food low in fiber so that there is less stool. D. Everything that I ate before the operation, while avoiding foods that cause gas. Situation 5 Ensuring safety is one of your most important responsibilities. You will need to provide instructions and information to your clients to prevent complications. 21. Randy has chest tubes attached to a pleural drainage system. When caring for him you should: A. empty the drainage system at the end of the shift B. clamp the chest tube when suctioning C. palpate the surrounding areas for crepitus D. change the dressing daily using aseptic techniques 22. Fanny, came in from PACU after pelvic surgery. As Fannys nurse you know that the sign that would be indicative of a developing thrombophlebitis would be: A. a tender, painful area on the leg B. a pitting edema of the ankle C. a reddened area at the ankle D. pruritus on the calf and ankle 23. To prevent recurrent attacks on Terry who has acute glumerulonephritis, you should instruct her to: A. seek early treatment for respiratory infections B. take showers instead of tub bath C. continue to take the same restrictions on fluid intake D. avoid situations that involve physical activity 24. Herbert had a laryngectomy and he is now for discharge. He verbalized his concern regarding his laryngectomy tube being dislodged. What should you teach him first? A. Recognize that prompt closure of the tracheal opening may occur B. Keep calm because there is no immediate emergency C. Reinsert another tubing immediately D. Notify the physician at once 25. When caring for Larry after an exploratory chest surgery and pneumonectomy, yourpriority would be to maintain: A. supplementary oxygen B. ventilation exchange C. chest tube drainage D. blood replacement Situation 6 Infection can cause debilitating consequences when host resistance is compromised and virulence of microorganisms and environmental factors are favorable. Infection control is one important responsibility of the nurse to ensure quality of care. 26. Honrad, who has been complaining of anorexia and feeling tired, develops jaundice, after a workup he is diagnosed of having Hepatitis A. his wife asks you about gamma globulin for herself and her household help. Your most appropriate response would be: A. Dont worry your husbands type of hepatitis is no longer communicable B. Gamma globulin provides passive immunity for hepatitis B

C. You should contact your physician immediately about getting gammaglobulin. D. A vaccine has been developed for this type of hepatitis 27. Voltaire develops a nosocomial respiratory tract infection. He ask you what that means? Your best response would be: A. You acquired the infection after you have been admitted to the hospital. B. This is a highly contagious infection requiring complete isolation. C. The infection you had prior to hospitalization flared up. D. As a result of medical treatment, you have acquired a secondary infection. 28. As a nurse you know that one of the complications that you have to watch out for when caring for Omar who is receiving total parenteral nutrition is: A. stomatitis B. hepatitis C. dysrhythmia D. infection 29. A solution used to treat Pseudomonas wound infection is: A. Dakins solution B. Half-strength hydrogen peroxide C. Acetic acid D. Betadine 30. Which of the following is the most reliable in diagnosing a wound infection? A. Culture and sensitivity B. Purulent drainage from a wound C. WBC count of 20,000/L D. Gram stain testing Situation 7 As a nurse you need to anticipate the occurrence of complications of stroke so that life threatening situations can be prevented. 31. Wendy is admitted to the hospital with signs and symptoms of stroke. Her Glasgow Coma Scale is 6 on admission. A central venous catheter was inserted an I.V. infusion was started. As a nurse assigned to Wendy what will be your priority goal? A. Prevent skin breakdown B. Preserve muscle function C. Promote urinary elimination D. Maintain a patent airway 32. Knowing that for a comatose patient hearing is the last sense to be lost, as Judys nurse, what should you do? A. Tell her family that probably she cant hear them B. Talk loudly so that Wendy can hear you C. Tell her family who are in the room not to talk D. Speak softly then hold her hands gently 33. Which among the following interventions should you consider as the highest priority when caring for June who has hemiparesis secondary to stroke? A. Place June on an upright lateral position

B. Perform range of motion exercises C. Apply antiembolic stockings D. Use hand rolls or pillows for support 34. Ivy, age 40, was admitted to the hospital with a severe headache, stiff neck and photophobia. She was diagnosed with a subarachnoid hemorrhage secondary to ruptured aneurysm. While waiting for surgery, you can provide a therapeutic environment by doing which of the following? A. honoring her request for a television B. placing her bed near the window C. dimming the light in her room D. allowing the family unrestricted visiting privileges 35. When performing a neurologic assessment on Walter, you find that his pupils are fixed and dilated. This indicated that he: A. probably has meningitis B. is going to be blind because of trauma C. is permanently paralyzed D. has received a significant brain injury Situation 8 With the improvement in life expectancies and the emphasis in the quality of life it is important to provide quality care to our older patients. There are frequently encountered situations and issues relevant to the older patients. 36. Hypoxia may occur in the older patients because of which of the following physiologic changes associated with aging. A. Ineffective airway clearance B. Decreased alveolar surfaced area C. Decreased anterior-posterior chest diameter D. Hyperventilation 37. The older patient is at higher risk for incontinence because of: A. dilated urethra B. increased glomerular filtration rate C. diuretic use D. decreased bladder capacity 38. Merle, age 86, is complaining of dizziness when she stands up. This may indicate: A. dementia B. a visual problem C. functional decline D. drug toxicity 39. Cardiac ischemia in an older patient usually produces: A. ST-T wave changes B. Very high creatinine kinase level C. Chest pain radiating to the left arm D. Acute confusion 40. The most dependable sign of infection in the older patient is:

A. change in mental status B. fever C. pain D. decreased breath sounds with crackles Situation 9 A disaster is a large-scale emergencyeven a small emergency left unmanaged may turn into a disaster. Disaster preparedness is crucial and is everybodys business. There are agencies that are in charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated approach to the management of emergency programs and activities for all four emergency phases (mitigation, preparedness, response, and recovery), for all types of emergencies and disasters (natural, man-made, and attack) and for all levels of government and the private sector. 41. Which of the four phases of emergency management is defined as sustained action that reduces or eliminates long-term risk to people and property from natural hazards and their effects.? A. Recovery B. Mitigation C. Response D. Preparedness 42. You are a community health nurse collaborating with the Red Cross and working with disaster relief following a typhoon which flooded and devastated the whole province. Finding safe housing for survivors, organizing support for the family, organizing counseling debriefing sessions and securing physical care are the services you are involved with. To which type of prevention are these activities included: A. Tertiary prevention B. Primary prevention C. Aggregate care prevention D. Secondary prevention 43. During the disaster you see a victim with a green tag, you know that the person: A. has injuries that are significant and require medical care but can wait hours with threat to life or limb B. has injuries that are life threatening but survival is good with minimal intervention C. indicates injuries that are extensive and chances of survival are unlikely even with definitive care D. has injuries that are minor and treatment can be delayed from hours to days 44. The term given to a category of triage that refers to life threatening or potentially life threatening injury or illness requiring immediate treatment: A. Immediate B. Emergent C. Non-acute D. Urgent 45. Which of the following terms refer to a process by which the individual receives education about recognition of stress reaction and management strategies for handling stress which may be instituted after a disaster?

A. Clinical incident stress management B. Follow-up C. Debfriefing D. Defusion Situation 10 As a member of the health and nursing team you have a crucial role to play in ensuring that all the members participate actively is the various tasks agreed upon. 46. While eating his meal, Matthew accidentally dislodges his IV lines and bleeds. Blood oozes on the surface of the over-bed table. It is most appropriate that you instruct the housekeeper to clean the table with: A. Acetone B. Alcohol C. Ammonia D. Bleach 47. You are a member of the infection control team of the hospital. Based on a feedback during the meeting of the committee there is an increased incidence of pseudomonas infection in the Burn Unit (3 out of 10 patients had positive blood and wound culture). What is your priority activity? A. Establish policies for surveillance and monitoring B. Do data gathering about the possible sources of infection (observation, chart review, interview). C. Assign point persons who can implement policies. D. Meet with the nursing group working in the burn unit and discuss problem with them. 48. Part of your responsibility as a member of the diabetes core group is to get referrals from the various wards regarding diabetic patients needing diabetes education. Prior to discharge today, 4 patients are referred to you. How would you start prioritizing your activities? A. Bring your diabetes teaching kit and start your session taking into consideration their distance from your office. B. Contact the nurse in-charge and find out from her the reason for the referral C. Determine their learning needs then prioritize D. Involve the whole family in the teaching class 49. You have been designated as a member of the task force to plan activities for the Cancer Consciousness Week. Your committee has 4 months to plan and implement the plan. You are assigned to contact the various cancer support groups in your hospital. What will be your priority activity? A. Find out if there is a budget for this activity B. Clarify objectives of the activity with the task force before contacting the support groups C. Determine the VIPs and Celebrities who will be invited D. Find out how many support groups there are in the hospital and get the contact number of their president 50. You are invited to participate in the medical mission activity of your alumni association. In the planning stage everybody is expected to identify what they can do during the medical mission and what resources are needed. You thought it is also your chance to share what you can do for others. What will be your most important role where you can demonstrate the impact of nursing in health?

A. Conduct health education on healthy life style B. Be a triage nurse C. Take the initial history and document findings D. Act as a coordinator Situation 11 One of the realities that we are confronted with is our mortality. It is important for us nurses to be aware of how we view suffering, pain, illness, and even our death as well as its meaning. That way we can help our patients cope with death and dying. 51. Irma is terminally ill, she speaks to you in confidence. You now feel that Irmas family could be helpful if they knew what Irma has told to you. What should you do first? A. Tell the physician who in turn could tell the family B. Obtain Irmas permission to share the information in the family C. Tell Irma that she has to tell her family what she told you D. Make an appointment to discuss the situation with the family 52. Ruby who has been told she has terminal cancer, turns away and refuses to respond to you. You can best help her by: A. Coming back periodically and indicating your availability if she would like you to sit with her B. Insisting that Ruby should talk with you because it is not good to keep everything inside C. Leaving her alone because she is uncooperative and unpleasant to be with D. Encouraging her to be physically active as possible 53. Leo, who is terminally ill and recognizes that he is in the process of losing everything and everybody he loves, is depressed. Which of the following would best help him during his depression? A. Arrange for visitors who might cheer him B. Sit down and talk with him for a while C. Encourage him to look at the brighter side of things D. Sit silently with him 54. Which of the following statements would best indicate that Ruffy, who is dying, has accepted his impending death? A. Im ready to go. B. I have resigned myself to dying. C. Whats the use? D. Im giving up 55. Marla, 90 years old has planned ahead for her death-philosophically, socially, financially and emotionally. This is recognized as: A. Acceptance that death is inevitable B. Avoidance of the true situation C. Denial with planning for continued life D. Awareness that death will soon occur

Situation 12 Brain tumor, whether malignant or benign, has serious management implications. As a nurse, you should be able to understand the consequences of the disease and the treatment. 56. You are caring for Conrad who has a brained tumor and increased Intracranial Pressure (ICP). Which intervention should you include in your plan to reduce ICP? A. Administer bowel softener B. Position Conrad with his head turned toward the side of the tumor C. Provide sensory stimulation D. Encourage coughing and deep breathing 57. Keeping Conrads head and neck alignment results in: A. increased inthrathoracic pressure B. increased venous outflow C. decreased venous outflow D. increased intrabdominal pressure 58. Which of the following activities may increase intracranial pressure (ICP)? A. Raising the head of the bed B. Manual hyperventilation C. Use of osmotic diuretics D. Valsalvas maneuver 59. After you asses Conrad, you suspected increased ICP. Your most appropriate respiratory goal is to: A. maintain partial pressure of arterial O2 (PaO2) above 80 mmHg B. lower arterial pH C. prevent respiratory alkalosis D. promote CO2 elimination 60. Conrad underwent craniotomy. As his nurse, you know that drainage on a craniotomy dressing must be measured and marked. Which findings should you report immediately to the surgeon? A. Foul-smelling drainage B. Yellowish drainage C. Greenish drainage D. Bloody drainage Situation 13 As a Nurse, you have specific responsibilities as professional. You have to demonstrate specific competencies. 61. The essential components of professional nursing practice are all the following EXCEPT: A. Culture B. Care C. Cure D. Coordination

62. You are assigned to care for four (4) patients. Which of the following patients should you give first priority? A. Grace, who is terminally ill with breast cancer. B. Emy, who was previously lucid but is now unarousable. C. Aris, who is newly admitted and is scheduled for an executive check-up. D. Claire, who has cholelithiasis and is for operation on call. 63. Brenda, the Nursing Supervisor of the intensive care unit (ICU) is not on duty when a staff nurse committed a serious medication error. Which statement accurately reflects the accountability of the nursing supervisor? A. Brenda should be informed when she goes back on duty B. Although Brenda is not on duty, the nursing supervisor on duty decides to call her if time permits C. The nursing supervisor on duty will notify Brenda at home D. Brenda is not duty therefore it is not necessary to inform her. 64. Which barrier should you avoid, to manage time wisely? A. Practical planning B. Procrastination C. Setting limits D. Realistic personal expectation 65. You are caring for Vincent who has just been transferred to the private room. He is anxious because he fears he wont be monitored as closely as he was in the Coronary Care Unit. How can you allay his fear? A. Move his bed to a room far from nurses station to reduce B. Assign the same nurse to him when possible C. Allow Vincent uninterrupted period of time D. Limit Vincents visitors to coincide with CCU policies Situation 14 As a nurse in the Oncology Unit, you have to be prepared to provide safe, efficient and effective care to your patients. 66. Which one of the following nursing interventions would be most helpful in preparing the patient for radiation therapy? A. Offer tranquilizers and antiemetics B. Instruct the patient of the possibility of radiation burn C. Emphasis on the therapeutic value of the treatment D. Map out the precise course of treatment 67. What side effects are most apt to occur the patient during radiation therapy to the pelvis? A. Urinary retention B. Abnormal vaginal or perineal discharge C. Paresthesia of the lower extremities D. Nausea and vomiting and diarrhea

68. Which of the following can be used on the irradiated skin during a course of radiation therapy? A. Adhesive tape B. Mineral oil C. Talcum powder D. Zinc oxide ointment 69. Earliest sign of skin reaction to radiation therapy is: A. desquamation B. erythema C. atrophy D. pigmentation 70. What is the purpose of wearing a film badge while caring for the patient who is radioactive? A. Identify the nurse who is assigned to care for such a patient B. Prevent radiation-induced sterility C. Protect the nurse from radiation effects D. Measure the amount of exposure to radiation Situation 15 In a disaster there must be a chain of command in place that defined the roles of each member of the response team. Within the health care group there are preassigned roles based on education, experience and training on disaster. 71. As a nurse to which of the following groups are you best prepared to join? A. Treatment group B. Triage group C. Morgue management D. Transport group 72. There are important principles that should guide the triage team in disaster management that you have to know if you were to volunteer as part of the triage team. The following principles should be observed in disaster triage, EXCEPT: A. any disaster plan should have resources available to triage at each facility and at the disaster site if possible B. make the most efficient use of available resources C. training on the disaster is not important to the response in the event of a real disaster because each disaster is unique in itself D. do the greatest good for the greatest number of casualties 73. Which of the following categories of conditions should be considered first priority in a disaster? A. Intracranial pressure and mental status B. Lower gastrointestinal problems C. Respiratory infections D. Trauma

74. A guideline that is utilized in determining priorities is to asses the status of the following, EXCEPT: A. perfusion B. locomotion C. respiration D. mentation 75. The most important component of neurologic assessment is: A. pupil reactivity B. vital sign assessment C. cranial nerve assessment D. level of consciousness/responsiveness Situation 16 You are going to participate in a Cancer Consciousness Week. You are assigned to take charge of the women to make them aware of cervical cancer. You reviewed its manifestations and management, 76. The following are risk factors for cervical cancer EXCEPT: A. immunosuppressive therapy B. sex at an early age, multiple partners, exposure to socially transmitted disease, male partners sexual habits C. viral agents like the Human Papilloma Virus D. smoking 77. Late signs and symptoms of cervical cancer include the following EXCEPT: A. urinary/bowel changes B. pain in pelvis, leg or flank C. uterine bleeding D. lymph edema of lower extremities 78. When a panhysterectomy is performed due to cancer of the cervix, which of the following organs are removed? A. the uterus, cervix, and one ovary B. the uterus, cervix, and two-thirds of the vagina C. the uterus, cervix, tubes and ovaries D. the uterus and cervix 79. The primary modalities of treatment for Stage 1 and IIA cervical cancer include the following: A. surgery, radiation therapy and hormone therapy B. surgery C. radiation therapy D. surgery and radiation therapy 80. A common complication of hysterectomy is A. thrombophelbitis of the pelvic and thigh vessels B. diarrhea due to over stimulation

C. atelectasis D. wound dehiscence Situation 17 The body has regulatory mechanism to maintain the needed electrolytes. However there are conditions/surgical interventions that could compromise life. You have to understand how management of these conditions are done. 81. You are caring for Leda who is scheduled to undergo total thyroidectomy because of a diagnosis of thyroid cancer. Prior to total thyroidectomy, you should instruct Leda to: A. Perform range and motion exercise on the head and neck B. Apply gentle pressure against the incision when swallowing C. Cough and deep breath every 2 hours D. Support head with the hands when changing position 82. As Ledas nurse, you plan to set up an emergency equipment at her beside following thyroidectomy. You should include: A. An airway and rebreathing tube B. A tracheostomy set and oxygen C. A crush cart with bed board D. Two ampules of sodium bicarbonate 83. Which of the following nursing interventions is appropriate after a total thyroidectomy? A. Place pillows under your patients shoulders. B. Raise the knee-gatch to 30 degrees C. Keep you patient in a high-fowlers position. D. Support the patients head and neck with pillows and sandbags. 84. If there is an accidental injury to the parathyroid gland during a thyroidectomy which of the following might Leda develop postoperatively? A. Cardiac arrest C. Respiratory failure B. Dyspnea D. Tetany 85. After surgery Leda develops peripheral numbness, tingling and muscle twitching and spasm. What would you anticipate to administer? A. Magnesium sulfate B. Calcium gluconate C. Potassium iodide D. Potassium chloride Situation 18 NURSES are involved in maintaining a safe and healthy environment. This is part of quality care management. 86. The first step in decontamination is: A. to immediately apply a chemical decontamination foam to the area of contamination B. a through soap and water wash and rinse of the patient C. to immediately apply personal protective equipment D. removal of the patients clothing and jewelry and then rinsing the patient with water

87. For a patient experiencing pruritus, you recommend which type of bath. A. water B. colloidal (oatmeal C. saline D. sodium bicarbonate 88. Induction of vomiting is indicated for the accidental poisoning patient who has ingested. A. rust remover B. gasoline C. toilet bowl cleaner D. aspirin 89. Which of the following term most precisely refer to an infection acquired in the hospital that was not present or incubating at the same time of hospital admission? A. Secondary blood stream infections B. Nosocomial infection C. Emerging infectious disease D. Primary blood stream infection 90. Which of the following guidelines is not appropriate to helping family members cope with sudden death? A. Obtain orders for sedation of family members B. Provide details of the factors attendant to the sudden death C. Show acceptance of the body by touching it and giving the family permission to touch D. Inform the family that the patient has passed on Situation 19 As a nurse you are expected to participate in initiating or participating in the conduct of research studies to improve nursing practice. You have to be updated on the latest trends and issues affecting profession and the best practices arrived at by the profession. 91. You are interested to study the effects of meditation and relaxation on the pain experienced by cancer patients. What type of variable is pain? A. Dependent C. Independent B. Correlational D. Demographic 92. You would like to compare the support system of patients with chronic illness to those with acute illness. How will you best state your problem? A. A Descriptive Study To Compare The Support System Of Patients With Chronic Illness And Those With Acute Illness In Terms Of Demographic Data And Knowledge About Interventions. B. The Effect Of The Type Of Support System of Patients With Chronic Illness And Those With Acute Illness. C. A Comparative Analysis Of The Support System Of Patients With Chronic Illness And Those With Acute Illness. D. A Study To Compare The Support System Of Patients With Chronic Illness And Those With Acute Illness.

93. You would like to compare the support system of patients with chronic illness to those with acute illness. What type of research it this? A. Correlational B. Descriptive C. Experimental D. Quasi-experimental 94. You are shown a Likert Scale that will be used in evaluating your performance in the clinical area. Which of the following questions will you not use in critiquing the Likert Scale? A. Are the techniques to complete and score the scale provided? B. Are the reliability and validity information on the scale described? C. If the Likert scale is to be used for a study, was the development process described? D. Is the instrument clearly described? 95. In any research study where individual persons are involved, it is important that an informed consent for the study is obtained. The following are essential information about the consent that you should disclose to the prospective subjects EXCEPT: A. Consent to incomplete disclosure B. Descriptions of benefits, risks and discomforts C. Explanation of procedure D. Assurance of anonymity and confidentiality Situation 20 Because severe burn can affect the persons totality it is important that-you apply interventions focusing on the various dimensions of man. You also have to understand the rationale of the treatment. 96. What type of debridement involves proteolytic enzymes? A. Interventional B. Mechanical C. Surgical D. Chemical 97. Which topical antimicrobial is most frequently used in burn wound care? A. Neosporin B. Silver nitrate C. Silver sulfadiazine D. Sulfamylon 98. Hypertrophic burn scars are caused by: A. exaggerated contraction B. random layering of collagen C. wound ischemia D. delayed epithelialization 99. The major disadvantage of whirlpool cleansing of burn wound is:

A. patient hypothermia B. cross contamination of wound C. patient discomfort D. excessive manpower requirement 100. Oral analgesics are most frequently used to control burn injury pain: A. upon patient request B. during the emergent phase C. after hospital discharge D. during the acute phase