Merge Online Review

Diagnostic Examination – Part 2

NLE May 2021

Situation – The roles of the Disaster Management Services (DMS) are to provide
relief in times of disasters and to carry on measures to minimize the suffering
caused by them. Disaster preparedness is also a major component of its program
that aims to prepare especially the vulnerable communities in the event of
calamities.

Climate change is increasing the risk of extreme weather events, including droughts,
flooding, heat waves, and natural disasters, according to a new report. One reason
for this is GREEN HOUSE EFFECT.
1. Which of the following describes Green House effect?
A. It is a sudden event, such as an accident or a natural catastrophe,
that causes great damage or loss of life. DISASTER
B. It is a disastrous event caused directly and principally by one or
more identifiable deliberate or negligent human actions. Also called
human-made disaster MAN MADE DISASTER
C. It is the observed century-scale rise in the average temperature of
the Earth's climate system and its related effects, as part of climate
change. GLOBAL WARMING
D. This is the effect of Carbon dioxide (CO2) and
other greenhouse gases act like a blanket, absorbing IR radiation
and preventing it from escaping into outer space
2. A greenhouse gas is a gas that absorbs and emits radiant energy within the thermal
infrared range. Increasing greenhouse gas emissions cause the greenhouse effect.
The primary greenhouse gases in Earth's atmosphere are, select all that apply:
1. water vapor
2. carbon dioxide
3. methane
4. nitrous oxide
5. ozone.
A. 1
B. 12
C. 123
D. 1234
E. 12345

3. Health Effects of CLIMATE CHANGE, storms, severe heat and drought may
increase cases of diseases like cholera, diarrhea, malaria, dengue, leptospirosis
and allergy. Who discovered the bacteria of the genus Leptospira?
A. Benjamin Rush ----- DENGUE
B. Charles Louis Alphonse Laveran MALARIA
C. Landouzy and Adolf Weil 1883-1886
D Robert Koch ----TUBERCULOSIS/CHOLERA
E. Girolamo Fracastoro and Louis Pasteur in 1885 RABIES

4. A gas explosion occurred in Paranaque. Which of the following is a PRIORITY in

the care of neck burns in the first 24 hours of exposure?
A. Refer the patient to the therapist
B. Prepare TPN for client’s diet
C. Fluid resuscitation EMERGENT
D Administer antiulcer drug

5. Nurse Anaski attended patients in the Emergency department with different

injuries and signs from vehicular accident. Her priority nursing action would be to
assess the extent of injuries incurred by the victims of the accident. Which of the
following patient is her LAST PRIORITY in the Primary Survey Method?

A. Samuel with ALS complaining of dyspnea and severe fatigue

B. Elmer who contracted head injury after doing a “selfie” in the

stairways
C. A client in the ER with a BLACK tag, GCS 3

D. A client with gunshot in the chest caused by “riding in tandem” suspects

Situation - Survey and Statistics are important part of research that is necessary to
explain the characteristics of the population.

6. Which of the following is a measure of Central Tendency?

A. Mode C. Standard Deviation

 B. Variance D. Range

7. In the value : 80, 80, 80, 82, 82, 90, 90, 100; What is the mode?
MODE- most frequent value observed

A. 80 B. 82 C. 90 D. 85.5

8. In the value : 87, 85, 88, 92, 90; What is the mean?
MEAN-average

A. 88.2 B. 88.4 C. 87 D. 90

9. In the value: 80,80,10,10,25,65,100,200; What is the median?

Median- Corresponds to the Value in the middle in grouped and ungrouped data

1st step>>>>>> arrange from lowest to highest

10 10 25 65 80 80 100 200

2nd step Formula>>>>> Median=

A. 71.25 B. 22.5 C. 10 and 25 D. 72.5

10. How is qualitative research different from quantitative research? Qualitative

research:

A. Is more valid when large numbers of participants are studied

B. Reports data in the form of words
C. Is less useful than quantitative research
D. Requires careful attention to methods and techniques
 Situation – Manny, 60 years old painter sought admission to the hospital because of
laryngeal tumor. Patient is scheduled for total laryngectomy.

11. Risk factors for laryngeal cancer are the following, EXCEPT

A. Smokeless and tobacco smoking

B. Familial predisposition, more prevalent among White Americans AFRICAN
AMERICANS
C. Secondhand smoke, paint fumes and cement dust
D. Nutritional deficiencies and weakened immune system
E. Mustard gas, leather and metals

12. Before the nurse can develop a relevant care plan, the nurse understands that in
post total laryngectomy, the trachea and esophagus are permanently separated.
Therefore, which of the following will the nurse expect?

A. No risk of aspiration during swallowing and breathing

B. Unable to communicate with difficulty swallowing and breathing
C. Normal speaking, breathing and swallowing are restored
D. Permanent tracheostomy created; normal speech is lost

13. Preoperatively, the assigned nurse identified the nursing diagnosis, DEFICIENT
KNOWLEDGE about the surgical procedures and postoperative course. Which of
the following is INAPPROPRIATE nursing intervention?

A. Clarifying any misconceptions by identifying the location of the larynx, its

function, the nature of the planned surgical procedure, and its effect on
speech
B. Giving informational materials about the surgery to the patient and family
for review and reinforcement.
C. Reviewing equipment and treatments for postoperative care with patient and
family, teaching important coughing and deep breathing exercises, and
helping the patient perform return demonstrations
D. Promoting a patent airway by positioning the patient in the semi-fowler’s or
fowler’s position after recovery from anesthesia

14. After recovery from anesthesia, the nurse assesses labored breathing, restlessness,
apprehension, increase pulse rate and abnormal breath sounds by listening over the
trachea with a stethoscope. The nurse should immediately-POST OP
A. Report to the surgeon
B. Report to the anesthesiologist
C. Perform immediate intubation
D. Do CPR

15. The nurse is preparing Manny for discharge. The following are instructions
regarding stoma and post laryngectomy care EXCEPT:

A. avoid exposure to persons with upper respiratory disease

B. instruct client to assume supine position as necessary
C. avoid swimming and use care when using the shower
D. prevent foreign body from entering the stoma

Situation - While being prepared for a biopsy, the patient asks the nurse what the
difference is between a benign tumor and a malignant breast tumor.

16. The nurse explains that a benign tumor differs from a malignant tumor in that
benign tumors

BENIGN TUMORS- grow gradually and never metastasize, but still need to be removed
in some cases because they can compress adjacent or proximal tissues and organs
causing damage.
a. do not cause damage to adjacent tissue.
b. do not spread to other tissues and organs. 
c. are simply an overgrowth of normal cells.
d. frequently recur in the same site."

17. A gastrectomy is performed on a client with gastric cancer. In the immediate

postoperative period, the nurse notes bloody drainage from the nasogastric tube.
Which of the following is the appropriate nursing intervention?" 
a. notify the physician
b. measure abdominal girth
c. irrigate the nasogastric tube
d. continue to monitor the drainage

18. Which one of the following expected outcomes about nutrition would be
appropriate for a client who has had a total gastrectomy for gastric cancer? The
client will:

a. Regain any weight lost within 4 weeks of the surgical procedure.

b. Eat three full meals a day without experiencing gastric
complications.
c. Learn to self-administer enteral feedings every 4 hours.
d. Maintain adequate nutrition through oral or parenteral feedings.
19. All of this factors affect the sterility of the OR equipment, these are the following
except:

A. The material used for packaging

B. The handling of the materials as well as its transport
C. Storage
D. The chemical or process used in sterilizing the material

ALL approved methods of sterilization are capable of achieving the same level of
sterility. The difference is the time it takes to achieve sterility and not its quality

AUTOCLAVE(steam under pressure)---sterility is achieved in 5 to 15 minutes

**** NOT ideal for heat-sensitive equipment like blades or rubber/plastic material

Chemical

A. Liquid(2%glutaraldehyde or Cidex)
immersion for 10 minutes-DISINFECTION
immersion for 10 HOURS- STERILIZATION
B. Gas( Ethylene Oxide)
Usually the instruments are placed in a chamber and exposed to the gas for up to
18 Hours

20. In using liquid sterilizer versus autoclave machine, which of the following is true?

A. Autoclave is better in sterilizing OR supplies versus liquid sterilizer

B. They are both capable of sterilizing the equipment, however, it is
necessary to soak supplies in the liquid sterilizer for a
longer period of time
C. Sharps are sterilized using autoclave and not cidex
D. If liquid sterilizer is used, rinsing it before using is not necessary

Situation – The Sustainable Development Agenda was adopted by the United

Nations in September 2015 to end poverty, protect the planet and ensure prosperity
to all.

21. As the member of the UN, the Philippine Government and other member-states are
committed to achieve these goals by the year:
A. 2030
B. 2050
C. 2025
 D. 2040

22. In the 17 Sustainable Development Goals (SDG’s) health has a central place in,
A. SDG 10
B. SDG 3---- “ Good Health and Well-being”
C. SDG 1
D. SDG 6

23. Ban Ki-moon, the United Nations Secretary-General from 2007 to 2016, has stated
that: "We don’t have plan B because there is no planet B. In the Goal 13: Climate
Action, the focus is to "Take urgent action to combat climate change and its
impacts by

A. “Regulating emissions and promoting developments in renewable energy.

B. "End poverty in all its forms everywhere." SDG1
C. "End hunger, achieve food security and improved nutrition, and promote
sustainable agriculture". SDG2
D. "Ensure healthy lives and promote well-being for all at all ages."SDG 3

24. Though most disasters are a natural in nature, they are sometimes intensified due
to undesirable human activities. Which of the following is considered a natural
and man-made disaster?--- Look for both natural/man-made disaster
A. Explosion
B. Plane crash
C. Flood
D. Yangtze River Dolphin Extinction
E. Minneapolis Bridge Collapse

25. The NDRRMP has four distinct yet mutually reinforcing thematic areas. The goal
of this thematic area is to restore and improve facilities, livelihood and living
condition and organizational capacities of affected communities, and reduce
disaster risk in accordance with the “build back better” principles, is:
A. Disaster prevention and mitigation
B. Disaster preparedness
C. Disaster response
D. Disaster rehabilitation and recovery
Situation - He is known to discover the cause of tuberculosis and development
methods and technical procedure still used by epidemiologist.

26. This German Scientist is:

A. Louis Pasteur
B. Robert Koch
C. Edward Jenner
D. Edwin Chadwick

27. A hospitalized patient who may have tuberculosis (TB) has an order for a sputum
specimen. When will be the best time for the nurse to collect the specimen?

A. After the patient rinses the mouth with mouthwash

B. As soon as the order is received from the health care provider
C. Right after the patient gets up in the morning
D. After the skin test is administered

28. The reason for the number 27 question is:

A. Mucus is likely to accumulate during the night

B. Not too many people around
C. Most of the patients are not yet awake
D. Energy is high in the morning

29. A patient who has active TB has just been started on drug therapy for TB. The
nurse informs the patient that the disease can be transmitted to others until

A. the chest x-ray shows resolution of the tuberculosis.

B. three sputum smears for acid-fast bacilli are negative.
C. TB medications have been taken for 6 months. 14 days(continuous)
D. sputum substances are not present anymore

30. A patient is receiving isoniazid (INH) after having a positive test to TB.
Which information will the nurse include in the patient teaching plan?
A. "Take vitamin B6 daily to prevent peripheral nerve damage."
B. "Read a newspaper daily to check for changes in vision." Ethambutol
C. "Schedule an audiometric examination to monitor for hearing loss."
 Streptomycin
D. "Avoid wearing soft contact lenses to avoid orange staining."Rifampicin

Isoniazid

Side effects(Normal/temporary)

Increases the failure rate of oral contraceptives

Intended mild neurotoxicity(peripheral neuritis)

ACTIONS:
1. Avoid using oral contraception
2. Increase intake of Pyridoxine(Vitamin B6)

ADVERSE EFFECT(ABNORMAL)
Discontinue the drug immediately if client experiences

Intracerebral damage(severe neurotoxicity)- SEIZURES

Situation - The nurse is caring for a patient with colon cancer who is scheduled for
external radiation therapy to the abdomen.

External radiation therapy also known as EBRT( External Beam Radiation

Therapy) or TELETHERAPY

*** Client is IMMEDIATELY free from radiation once the current session ends.

NOTES:

A void Direct Sunlight especially 9am to 3pm

void swimming- aggravates irritation
B ody-moisturize with lotion(use hydrophilic or water-soluble
lotions)
C leaning- client can take a bath with warm water and MILD
soap
Do not erase the markings on the skin
Teletherapy Side Effects:
1. Desquamation/Skin Peeling
2. Erythema/Redness
3. Redness and Swelling

31. Which information obtained by the nurse would indicate a need for patient
teaching?- look for the NEGATIVE/WRONG ANSWER

A. The patient swims a mile 3 days a week.

B. The patient snacks frequently during the day.
C. The patient showers every day with a mild soap.
D. The patient has a history of dental caries with amalgam fillings.

32. Interleukin-2 (IL-2) is used as adjuvant therapy for a patient

with metastatic renal cell carcinoma. Which information should the nurse include
when explaining the purpose of this therapy to the patient?

A. IL-2 enhances the immunologic response to tumor cells.

B. IL-2 stimulates malignant cells in the resting phase to enter mitosis.
C. IL-2 prevents the bone marrow depression caused by chemotherapy.
D. IL-2 protects normal cells from the harmful effects of chemotherapy.
33. The nurse assesses a patient who is receiving interleukin-2. Which finding should
the nurse report immediately to the health care provider?

A. Generalized muscle aches

B. Complaints of nausea and anorexia
C. Oral temperature of 100.6° F (38.1° C)
D. Crackles heard at the lower scapular border

34. A patient with breast cancer has a nursing diagnosis of imbalanced nutrition: less
than body requirements related to altered taste sensation—called Hypogeusia.
Which nursing action is most appropriate?
A. Add strained baby meats to foods such as casseroles.
B. Teach the patient about foods that are high in nutrition.
C. Avoid giving the patient foods that are strongly disliked.
D. Add a spicy substance to enhance the flavor of foods that are served.

35. A patient with leukemia is considering whether to have hematopoietic stem cell
transplantation (HSCT). The nurse will include which information in the
patient's teaching plan?

BONE MARROW TRANSPLANT

Donor Bone Marrow is transfused to the Recipient similar to a Blood Transfusion but
usually given via a Central Line

This Procedure can be performed in the client’s room if the client is stable

Once the procedure is done, the client should be under observation for 28 to 35 days for
any untoward reactions.

A. Transplant of the donated cells is painful because of the nerves in the

tissue lining the bone.
B. Donor bone marrow cells are transplanted through an incision into
the sternum or hip bone.
C. The transplant procedure takes place in a sterile operating
room to minimize the risk for infection.
D. Hospitalization will be required for several weeks after the stem
cell transplant procedure is performed.

Situation - The nurse notes that the site of a client's peripheral intravenous (IV)
catheter is reddened, warm, painful, and slightly edematous proximal to the
insertion point of the IV catheter.
36. After taking appropriate steps to care for the client, the nurse should document
in the medical record that the client experienced which condition?

A. Phlebitis of the vein – inflammation of vein due to irritation

B. Infiltration of the IV line – cool, swollen, pale, due to dislodged needle
C. Hypersensitivity to the IV solution
D. Allergic reaction to the IV catheter material
C and D, usually marked by manifestations similar to ANAPHYLAXIS like breathing
problems
37. A client has a prescription to receive a unit of packed red blood cells. The nurse
should obtain which intravenous (IV) solution from the IV storage area to
hand with the blood product at the client's bedside?
A. Lactated RInger's
B. 0.9% sodium chloride
C. 5% dextrose in 0.9% sodium chloride
D. 5% dextrose in 0.45% sodium chloride

38. A client requiring surgery is anxious about the possible need for a blood
transfusion during or after the procedure. The nurse suggests to the client to
take which action(s) to reduce the risk of possible transfusion complications?
Select all that apply.

1. Ask a family member to donate blood ahead of

time
2. Give an autologous blood donation before the
surgery
3. Take iron supplements before surgery to boost
hemoglobin levels
4. Request that any donated blood be screened twice
by the blood bank
5. Take adequate amounts of vitamin C several days
prior to the surgery date.

1. Correct, increases the likelihood of compatibility

2. Correct--Autologous(donor:self)- Blood is extracted from the client weeks before

surgery and can be stored and given in case of severe bleeding during surgery

3. INCORRECT: Iron will not prevent transfusion reactions

4 INCORRECT: resource intensive
5. INCORRECT: Vitamin C will not prevent transfusion reactions

A. 1 only
B. 1 and 2
C. 123
 D. 1234

39. The nurse has obtained a unit of blood from the blood bank and has checked the
blood bag properly with another nurse. Just before beginning the transfusion, the
nurse assesses which priority item?

a. Vital signs
b. Skin color
c. Urine output
D. Latest hematocrit level

40. Which of the following would be the most appropriate outcome for a patient who
has a nursing diagnosis of spiritual distress related to loneliness?

A. Encourage the patient to meditate 2 to 3 times a week.

B. The patient will set up a time to speak to a close friend
in 1 week.
C. Encourage the patient to phone his brother and set up a time to go
out for dinner.
D. The patient will experience greater connections with
family members in 2 months.

Situation - A child is admitted to the pediatric unit with a diagnosis of suspected

meningococcal meningitis.

41. Which of the following nursing measures should the nurse do FIRST?

A. Institute seizure precautions

B. Assess neurologic status
C. Place in respiratory isolation/droplet precaution
D. Assess vital signs

42. Which of the following is the priority in preventing infections when

providing care for a client with COVID-19?

A. Handwashing and proper PPE

B. Wearing gloves
C. Using a barrier between client's furniture and nurse's bag
D. Wearing gowns and goggles
43. Which statement made to the nurse by a health care worker assigned to care
for the client with AIDS/HIV indicates a breach of confidentiality and requires
further education by the nurse?

A. ''I told the family members they needed to wash their hands when
they enter and leave the room.''
B. ''The other health care worker and I were out in the hallway discussing
how we were concerned about getting HIV from our client, so no one could
hear us in the client's room.''
C. ''Yes, I understand the reasons why I have to wear gloves when I bathe my
client.''
D. ''The client's spouse told me she got HIV from a blood transfusion.
Then I replied, she told you that she got it from the blood that she
received?”

44. The nurse in charge is evaluating the infection control procedures on the unit.
Which finding indicates a break in technique and the need for education of staff?

A. The nurse aide is not wearing gloves when feeding an

elderly client.
B. A client with active tuberculosis is asked to wear a mask when
he leaves his room to go to another department for testing.
C. A nurse with open, weeping lesions of the hands puts on gloves
before giving direct client care.
D. The nurse puts on a mask, a gown, and gloves before
entering the room of a client on strict isolation.

45. The community health nurse is visiting a client at home and is assessing
him for risk of a fall. The most important factor to consider in this
assessment is:

A. Correct illumination of the environment.

B. amount of regular exercise.
C. the resting pulse rate.
D. status of salt intake.

Situation - Grieving is a very emotional process that greatly affects both clients and
health care providers. A nurse must be able to handle situations appropriately.

46. When a terminally-ill client assumes artificial tearfulness and refuses to

believe that loss is happening, what stage of grieving is he in?
 A. Bargaining
B. Acceptance
C. Denial
D. Depression

47.It is the stiffening of the body that occurs 2-4 hours after death:
A. Livor mortis
B. Rigor mortis
C. Algor mortis
D. Forensic entomology

48.The following are appropriate interventions for the body after death:

A. Make the body appear natural and comfortable

B. Place the body in supine position
C. Close the eyelids, insert the dentures and close the mouth
D. All of the above

49. Which of the following is appropriate nursing intervention for a client who is
grieving over the death of her husband?

A. Advise her not to cry because it would do no good for her

B. Encourage her to accept new love object to replace loss person

C. Provide opportunity to the person to “tell their story”

D. Discourage expression of difficult feelings such as anger and
sadness

50.What is the last sense to disappear in a dying client?

A. Hearing
B. Taste
C. Smell
D. Sight
Situation – Informed consent.
51. When informed consent is obtained from the pregnant client, the explanation of the
surgical procedure, possible risks, complications and alternatives is the
responsibility of the

A. registered nurse
B. surgeon
C. admission clerk
D. anesthesiologist

52. The grandmother has brought an infant to the clinic for a checkup and has signed
the consent for immunization administration. Which of the following would the
nurse do first?

A. Ask who is the infants legal guardian

B. Notify the physician immediately
C. Administer the immunization as ordered
D. Call the infant’s mother for verbal consent

53. Prior to assisting with invasive therapy, the nurse notices the signature of the
patient’s significant other on the consent form. Which of the following actions
should the nurse take first?

A. Check to verify the legal guardianship for this patient

B. ask the patient to explain why the form doesn’t have the patient’s
own signature
C. proceed with the treatment
D. call a third party to witness the signature

54. A patient who is to undergo surgery will be signing an informed consent. The
nurse’s main responsibility when informed consent is obtained is to
Nurse’s Responsibility- to ensure that the patient understood the nature and the
procedure and no coercion was involved
And to ensure that the patient understood what the doctor/surgeon stated, the nurse
verifies that the patient is lucid and capable of mentally-sound decisions.
A. Assure that the patient has not received any sedation
B. Discuss the complications of the procedure
C. complete all blank spaces in front of the patient before witnessing and
completing an incident report
D. Divulge the informed consent to other nurses working in other
hospital
 55. The charge nurse on a unit should be aware that which of the following patients
may not legally sign an informed consent?

A. A 55-year-old patient who is crying about the surgery she will be

scheduled. CAN SIGN
B. A 16-year-old married patient Emancipated Minor, can sign the consent
C. A 45-year-old patient who has been sedated
D. An 80-year-old patient CAN SIGN, never assume that older clients have
dementia or any alteration in mental capacity unless stated

Situation – Gebhil, 9 years old, was playing in the garden when all of a sudden he
stopped playing and started scratching his legs. Gebhil’s mother washed his legs
but Gebhil complained of difficulty of breathing, was nauseated and had cold moist
skin. In the Emergency department, anaphylaxis was suspected. Insect bites were
noted on Gebhil’s legs.

56. The health team suspects that Gebhil experienced a sting at some previous
time. Which of the following could be the rationale for the itchy
skin?

A. Accumulation of histamine at the insect bite site

B. Sensory nerve endings irritated by histamines
C. Infiltration of inflammatory cells into the epidermis
D. Irritation caused by digestive substance released by the insect

57. Which of the following drugs will the nurse expect the physician to
prescribe INITIALLY?

A. Antihistamine – mild allergic reactions

B. Aminophylline bronchodilator, can only treat the symptom but not the root cause
C. Corticosteroids anti-inflammatory that reduces swelling but does not address the root
cause
D. Epinephrine EMERGENCY drug for Anaphylaxis that acts as a bronchodilator and
addresses severe allergic reactions
 58. The mother asked the nurse what could have caused her son to experience
difficulty of breathing. Which of the following is the MOST appropriate
response of the nurse?

A. “It was due to a threatening throat swelling.”

B. “Histamine released due to the allergic reaction caused
narrowing of the airway.”
C. “Chemical mediators due to hypersensitivity reactions caused
edema in the bronchioles.”
D. “It was an early sympathetic response to insect bite.”

NEVER USE MEDICAL JARGONS IN COMMUNICATING WITH THE CLIENT

59. The mother claimed this is the first time it happened. Which of the following
should be given PRIORITY by the nurse?
A. Identification of environment hazards
B. Identification of allergens
C. Recommend desensitization
D. Instruct mother on emergency measures in case of recurrence
----- instruct the client and family on how to use an auto-injection of Epinephrine
for emergency situations or recurrence.

60. Since Gebhil is allergic to insect venom, which of the following is MOST
appropriate to ensure that Gebhil gets immediate treatment during a
recurrence?
A. Teach Gebhil to get help when symptoms develop
B. Use of medical information such as bracelet or necklace
C. Have Gebhil carry an emergency kit all the time
D. Teach Gebhil to perform CPR

Situation – The following questions pertain to OB question.

61. Which is considered a normal physiologic change during pregnancy?
A. ECG T-wave changes
b. Increased cardiac output
c. Increased bleeding time
d. Decreased renal perfusion
62. A woman provides the nurse with the following 
obstetrical history:
BONUS: NO QUESTION

Gravida- refers to number of pregnancies (G)

Term- refers to number of pregnancies that reached at least 37 weeks of gestation (T)
Pre-Term- refers to the number of pregnancies that are between 20 weeks to 36 weeks of
gestational(P)
Abortion- refers to the number of pregnancies that were terminated before reaching 20
weeks of gestation (A)
Living- refers to the number of living offspring (L)
Multiple- refers to multiple gestations (M)

Which of the following correctly portrays her GTPAL?

Question options:
a)  G4P2121
b)  G4P1212
c)  G5P1122
d)  G5P2211

63. The cardinal signs of PIH:

A. Bleeding, proteinuria, hypertension

B. Proteinuria, smoky urine, hematuria
C. Ketonuria, acetone breathe
D. HPN, proteinuria, edema---- usually on the hands and face because edema
on the legs/feet are considered normal
64. Which of the following shows Magnesium toxicity?

A.
Absence of patellar DTR, Urine output less than
30ml/hr, respiratory rate less than 12/min—ANTIDOTE: CALCIUM
GLUCONATE
B. (+) DTR, oliguria, Kussmaul’s
C. HPN, edema, albuminemia
D. Spasm, coma and jaundice

65. The CHN is preparing a community education program on Family

Planning. A woman asks the nurse, "How do oral contraceptives
prevent pregnancy?" The nurse explains that the combination of
estrogen and progesterone in oral contraceptives:

a. makes cervical mucus hostile to sperm. ---- spermicide

b. prevents ovulation. - pills work by increasing progesterone, fooling the
body that it is pregnant, thus inhibiting ovulation
c. prohibits implantation of the egg. ----- IUD
d. acts as a barrier by destroying sperm.---- cervical diaphragm and spermicide

Situation - The CHN is attending a mother in the Barrio.

66. The pregnant client is experiencing threatened abortion. Which of the

following are the signs?

A. Vaginal bleeding without cervical dilation occurring

before 20 weeks gestation, indicating that
spontaneous abortion may occur.
 B. (+) Cullen’s sign- hematoma around umbilical area( peritonitis and
pancreatitis

C. (+) Turner’s sign-hematoma at the Flank(peritonitis and pancreatitis)

D. Couvade syndrome- also known as sympathetic pregnancy, wherein the

partner is the one experiencing the signs and symptoms associated with pregnancy

67. The CHN knows that diagnosis will be done using an ultrasound and
quantitative HCG. Which of the following is the treatment?

A. Decrease activity for 24-48 hours

B. avoid stress
C. no sexual intercourse for 2 weeks after bleeding stops.
D. Monitor amount and character of bleeding; report clots, tissue, foul odor
E. All of these

68. Another family with a 6-month-old baby is visited by the CHN. The mother
asked, “Nurse, when an object is placed in my infant's hand and strokes their palm,
the fingers will close. What is that?” The nurse will respond, that’s the

A. Moro
B. Fencing
C. Stepping
D. Palmar grasp reflex

69. Children in remote communities are risks to the development of communicable

diseases. WHO management utilizes IMCI. What is the definition of IMCI?
 Integrated Management of Childhood Illness

A. A collective, participatory, transformative, liberative, sustained and

systematic process of building people’s organizations by mobilizing and
enhancing the capabilities and resources of the people for the resolution of
their issues and concerns towards effecting change in their existing
oppressive and exploitative conditions COPAR Community Organizing
Participatory Action Research
B. It is an integrated approach to child health that focuses on the well-being of
the whole child. IMCI aims to reduce death, illness and disability and to
promote improved growth and development among children under five years
of age.
C. A person’s condition with regard to their psychological and emotional well-
being. MENTAL HEALTH
D. IMCI is the treatment used in Tertiary hospitals that provide pedialyte,
ricelyte and glucose solution during diarrhea
IMCI is used in Primary Health Care Facilities like Health Centers and RHU or at
home

70. The public health nurse provides education to people about breast cancer
prevention. Which one is considered invasive?
A. BSE
B. Mammogram
C. CBE
D. Prophylactic Mastectomy

Situation – The importance of research is to advance your knowledge base and stay
current on new nursing practices.

71. Which of the following will be done first in the steps of research process?
A. Data analysis 
B. Sample 
C. Define research problem
D. Study design

72. Which of the following describes convenience sampling?

A form of non-random or non-probability sampling which is also called

an “ambush interview”. Where the subjects for the study are chosen based on
who is available at a given time or place.

A. Its a non-probability sampling technique where

 subjects are selected because of their convenient accessibility
and proximity to the researcher.
B. "Subjects are selected by random.”
C. "Subjects are selected through referral." 
D. "Subjects are selected where in the researcher divides the
population into separate groups, called strata. Then, a
probability sample is drawn from each group. "

73. Which of the following is an example of probability sampling?

A. Random Sampling
B. Stratified Sampling.
C. Cluster Sampling.
D. SLOVIN METHOD

74. For which of the following research questions would qualitative method be most
appropriate?

TYPES OF RESEARCH DESIGNS

QUANTITATIVE QUALITATIVE
Numerical Data non-
numerical

A. Which pain medications decrease the need for sleep

medication in elderly patients? 
B. What is the meaning of health for migrant farm-
worker women? 
C. Under what conditions does a decubitus ulcer heal most
quickly? 
D. How does frequency of medication administration impact
the degree of pain experienced following knee
replacement surgery?
75. Which type of research allows researchers to be 
neutral observers?
A. Qualitative research
B. Ethnographic research
C. Quantitative research
D. Case studies

Situation - Pre-operative nursing is the time when the client decides to undergo the
surgery and ends when the client is on the operating table.

76. A client is diagnosed with Acoustic Neuroma. Which of the following surgery is
appropriate?- benign tumor of the 8th cranial nerve(Acoustic Nerve)

A. Glossectomy C.Enucleation
B. Vulvectomy D. Translabyrinthine surgery

77. The nurse receives the preoperative blood work report for a client who is scheduled
to undergo surgery. Which of the following laboratory is related to Lung cancer?

A. Red blood cells, 4.5 million/mm₃.

B. Elevated Creatinine, 1.6 mg/dl.
C. Elevated CA 19-9 (Cancer Antigen)- tumor marker for pancreatic cancer or
colorectal cancer
 D. Elevated Carcinoembryonic antigen

78. The nurse is preparing to administer a premedication to client with GRAVE’S.

Which of the following action should the nurse take first?

A. Have the family present.

B. Ensure that the anaesthesiologist is present in the OR.
C. Have the client empty his bladder.
D. Make sure the client is capable of paying bills

Atropine Sulfate( premedication)

a preop med given prior to introduction of sedatives
Main Function: Decreases Salivation during surgery to decrease the risk
of aspiration.
Anticholinergic effects(side effect)
1. can’t shit- constipation r/t decreased peristalsis
2. can’t spit- dry mouth
3. can’t pee- bladder distention r/t urinary retention

79. Generally, Atropine sulfate (Atropine) is given to?

A. Prevent aspiration during surgery

B. Prevent infection
C. Prevent bradycardia
D. Dilates the pupil

80. In the Intraoperative, the following are the responsibilities of the Scrub Nurse
EXCEPT:

A. Passes instruments to the surgeon.

B. Monitors the client’s heart rate and rhythm Anesthesiologist
C. Counts all instruments, sponges and other tools and informs the surgeon of
the count
D. Ensure sterility of supplies.
 E. Helps apply dressing to the surgical site and transports the patient to the
recovery area

Situation - Nurse QL is reviewing the health records of assigned clients.

81. The nurse plans care knowing that which client is at risk for fluid volume deficit?

A. The client with cirrhosis

B. The client with a colostomy
C. The client with decreased kidney function
D. The client with CHF

A. IMPAIRED LIVER FUNCTION>>>> Albumin accumulation>>> attracts water>>>>

edema and ascites FLUID VOLUME EXCESS
B. CONTINUOUS PASSAGE OF STOOL + IRRIGATION during cleaning== leads to
water loss FLUID VOLUME DEFICIT
C. DECREASED GLOMERULAR FILTRATION RATE>>> urinary retention> FLUID
VOLUME EXCESS
D. POOR CARDIAC OUTPUT>> decreased blood flow>>>> congestion>>>>FLUID
VOLUME EXCESS

82. A client with abdominal pain is being examined by the nurse.

Which of the following order is correct in techniques of physical exam?

Usually, in physical exam of the abdomen, the order is IPePaA or

IPPA

but in the presence of abdominal pain, touching the abdomen

before auscultation may cause spasms which lead to the
inability to detect sounds during auscultation
ORDER in the presence of Abdominal Pain-- I Am Peter Pan or
IAPePa
Inspection Auscultation Percussion Palpation

A. Observe, auscultate, percuss, palpate

B. Palpate, percuss, auscultate, observe
C. Auscultate, observe, percuss, palpate
E. Percuss, palpate, auscultate, observe
83. Nurse QL is assessing a client with dehydration. Which one is an objective sign of
fluid volume deficit?

A. The skin is pink, hypertension and rapid bounding pulse

B. The client is pale, has a dry skin and hypokalemia
C. The skin has blemishes in the face and decrease specific gravity
D. The client has cough, occasional vomiting, irritability, dyspnea

84. Which of the following substances is most likely to cause gastritis?

A. Milk
B. Bicarbonate of soda, or baking soda
C. Enteric coated aspirin
D. Nonsteriodal anti-inflammatory drugs

NSAIDS control pain by inhibiting the effect of PROSTAGLANDIN, a chemical

mediator that causes spasms and painful muscular contractions

However, PROSTAGLANDIN is also an important component of the gastric barrier in

the stomach.

85. A nurse caring for a patient with a diagnosis of chronic gastritis. The
nurse anticipates that this patient is at risk for which vitamin deficiency?

A. vitamin B12
B. vitamin B6
C. vitamin B1
D. vitamin B9

STOMACH>>>>> parietal Cells>>> these process a substance called “intrinsic

factor”>>>>>> promotes absorption of B12 in the Ileum(last part of the small
intestine)
86. Signs and symptoms of Pernicious anemia:

A. Fatigue
B. Beefy red tongue
C. Paresthesia
D. Paleness
E. All of these

87. The nurse and UAP are caring for clients on a medical unit. Which task should the
nurse delegate to the UAP? Unlicensed Assistive Personnel(Aide)- can only take
on routine procedures on stable clients.

A. Check on the bowel movements of a client dx with melena

B. Routine VS
C. Evaluate the dietary intake of a client who has been noncompliant
with eating 
D. Shave the client diagnosed with severe hemolytic anemia

88. When assessing the client with the diagnosis of peptic ulcer disease, which
physical examination should the nurse implement first? 

A. Auscultate the client's bowel sounds in all four quadrants. 

B. Palpate the abdominal area for tenderness. 
C. Percuss the abdominal borders to identify organs. 
D. Palpate the tender area progressing to nontender

89. Which of the following is a sign of duodenal ulcer?

a. Weight gain and RUQ pain

b. Bloating and nausea
c. Pain is relieved immediately after he has eaten.
d. Coffee-ground emesis

90. When obtaining a nursing history on a client with a suspected gastric ulcer, which
signs and symptoms should the nurse expect to assess?

A. Epigastric pain at night.

 B. Relief of epigastric pain after eating.
C. Vomiting
D. Weight gain

Situation - A client is admitted to the hospital after vomiting bright red blood
and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden,
sharp pain in the midepigastric region along with a rigid, boardlike abdomen.
---sign of Peritonitis

91. These clinical manifestations most likely indicate which of the following? 

A. An intestinal obstruction has developed. 

B. Additional ulcers have developed. 
C. The esophagus has become inflamed. 
D. The ulcer has perforated

92. What is the nursing priority in the management of a patient with an active upper
G.I. bleed?

A. Obtain vital signs. --- to determine if the client is in

shock( hypotension/tachycardia/tachypnia)
B. Apply gauze
C. Type and crossmatch the patient for blood products.
D. Notify the physician.

93. Which diagnostic results support the diagnosis of peptic ulcer disease (PUD)?

A Low hemoglobin (Hgb)

B Low hematocrit (Hct)
C. Positive for H. pylori bacteria
D. All of these
94. When will be the best time to administer PPI?
PPI- proton pump inhibitor( omeprazole) regulates the secretion of gastric acid

********* Should never be combined with other ANTACIDS

********* NEVER TAKEN IMMEDIATELY BEFORE MEALS- causes indigestion
FOR MAXIMUM EFFECT-- which leads to proper regulation and control of gastric acid
secretion throughout the day, this type of drug should be given 1 Hour before
breakfast(Morning)

A. 1H before breakfast
B. 1H after breakfast
C. IH before bedtime-- this is for H2 Receptor Antagonists like Ranitidine or
Zantac
D. IH after bedtime

95. Antibiotics must not be given at the same time with antacids because antacids
A. cause bleeding in the GIT
B. may increase the dose of ABT
C. can reverse the action of ABT
D. delay absorption of ABT

Situation - The nurse is caring for a group of patients on the medical-surgical unit.

96. Which patient is most likely to experience the most difficulty in adapting to
a change in body image? The patient

A. Who suffered a traumatic amputation of the left leg in an industrial

accident

B. With hypothyroidism who has coarse, dry, thinning hair and weight gain

C. Who is obese and who underwent gastric bypass surgery

D. With peripheral vascular disease who required a wound graft

97. The nurse is updating a care plan for a patient who has a nursing diagnosis of
Anxiety. Which patient behavior might suggest that the problem is resolving?
A. Pacing in the hallway at intervals
B. Using relaxation techniques
C. Speaking rapidly when spoken to
D. Avoiding eye contact

98. Which statement by the nurse is best when communicating with a patient with
clinical depression?

A "It's a beautiful day today; you'll feel better if you look out the
window." Giving advice
B "You're having a bad day; I'm sure you'll feel better soon." FALSE
REASSURANCE
C "Life seems overwhelming at times; would you like to discuss how
you're feeling?" --encourage verbalization of feelings
D "You are very lucky to have such a supportive family."

99. A patient comes to the emergency department complaining of headache,

palpitations, nausea, and dizziness. After determining that the patient is anxious,
the nurse notes tachycardia and trembling. Which level of anxiety is this patient
exhibiting?

A. Mild anxiety
B. Moderate anxiety
C. Severe anxiety
D. Panic anxiety

100. A patient with a history of refractory depression but no history of cardiovascular

disease is admitted to the emergency department with circulatory collapse. For
which medication should the nurse search the patient's medical record as a
contributing factor in the patient's condition?
 A. Tranylcypromine (Parnate)
B. Chlordiazepoxide (Librium) Anxiolytic
C. Chlorpromazine (Thorazine) Antipsychotic(Schizophrenia)
D. Lithium carbonate (Lithobid) FOR MANIA

Tranylcypromine (Parnate)

An antidepressant categorized under Monoamine Oxidase Inhibitors or

MAOi

TOXICITY>>>>>>>> HYPOTENSION, CIRCULATORY COLLAPSE

similar to shock

If MAOi is combined with Tyramine, this induces a HYPERTENSIVE

CRISIS which could cause a hemorrhagic stroke or rupture of
Aneurysms if there are any.
when taking MAOi, avoid tyramine rich foods such as:

1. Fruits that are prone to over-riping

2. Fermented Foods and Beverages
3. Canned meat/ preserved food items