TITO A.

, RN

PHILIPPINE NURSING LICENSURE

EXAMINATION (PNLE)

REVIEWER

COMPILATION OF BOARD EXAM

JULY 3 & 4, 2021

SUBJECTS COVERED

NURSING PRACTICE I: Community Health Nursing

NURSING PRACTICE II: Care of Healthy/At Risk Mother and Child

NURSING PRACTICE III: Care of Clients with Physiologic and Psychosocial Alterations, Part A

NURSING PRACTICE IV: Care of Clients with Physiologic and Psychosocial Alterations, Part B

NURSING PRACTICE V: Care of Clients with Physiologic and Psychosocial Alterations, Part C

COMPILED BY: TITO A., RN

TITO A., RN

NURSING PRACTICE I: Community Health Nursing

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

1. In assessing the health condition of the pregnant patient, Nurse Vera should focus on
the _____.

A. Last menstrual period

B. Number of days of menstruation
C. Age of patient during menarche
D. Amount of menstrual flow

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

A. 2nd trimester
B. Before delivery
C. 3rd trimester
D. First trimester

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

A. Give pamphlets and books to read

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

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

A. 9th month
B. 5th month
C. 3rd month
D. 1st month

5. Nurse Vera informs the patient she should be screened for preeclampsia during this term
of patient

A. First
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B. Second
C. Third
D. Before delivery

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

6. The nurse in the practice of her profession is guided by ___.

A. Code of ethics
B. Standards of care
C. Local Government code
D. Nursing Process

7. In the ethical principles of beneficence, which is the BASIS of every nursing action in
all work setting?

A. Treating all patients selectively

B. Informing the patient of the hospital bill
C. Respecting refusal of treatment
D. Doing good at all times

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

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

9. Nurse Mary randomly selected individuals in the community who will be part of a
project. Which of the following ethical principles is observed by the nurse?

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

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

A. Faithfully promotes health and prevents disease

B. Frequently assists in providing health service
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C. Fairly evaluated health progress and initiatives

D. Collaborates and works with the barangay officials

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

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

a. The educational qualification

b. Family support
c. Activities of daily living
d. Residence of the elderly

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

a. Sufficient
b. Disoriented
c. Dependent to others financially
d. Save pension

13. In planning their care Nurse Gina should consider

a. Socialization is more important

b. Holistic care
c. Physically dependent
d. Spiritual healing

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

a. They must live on their own

b. The environment should be safe for them
c. They are free what to do
d. They have rights

15. The elderly should be afforded health protection by

a. Avoid end hazards

b. Pollution and environment
c. Placing them in the home for the aged
d. Regular health check ups
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Situation – Nurse Jenny is in charge of record keeping in the health center

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

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

17. In the community setting which is the essential record about the patient?

A. Treatment record
B. Tally sheet
C. Chart
D. Kardex

18. Which of the following is the purpose of record keeping?

A. Quantify medication usage

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

19. Records are IMPORTANT in health care for

A. Counting hospital bills

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

20. What is the ultimate purpose of record keeping?

A. Safeguard information
B. Archive
C. History
D. Store information

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

21. Which infection control measure should Nurse Emma observe during her visit to the
family?
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A. Wear mask
B. Use gloves
C. Use face shield
D. Wear gown

22. During the history taking, which of the following is the most common symptom of
scabies that the family would report to Nurse E?

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

23. In providing health teaching to the family, Nurse Emma would include in her teachings
the etiology of scabies which is

A. Virus
B. Fungi
C. Bacteria
D. Parasite

24. The mother of the family asked Nurse Emma how to apply the anti-scabies lotion. The
nurse should teach the family how to apply the anti-scabies lotion to

A. All skin areas

B. Affected skin
C. Open lesions
D. Reddened areas

25. In order to prevent the spread of scabies infestation to other residents in the
community, Nurse Emma should teach the family which of the following?

A. Boil the utensils used by the patients

B. Avoid sharing items used by the infected person
C. Take a bath 3 or more times a day
D. Wear a mask and shield at all times even at home

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

26. Which type of plan should the nurse employ to assess the strength and weaknesses of
the organization?
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A. Nursing care
B. Operational
C. Strategic
D. Program

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

A. Get and develop people to do the work

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

28. To assist then enhance their performance at work, the nurse manager should review
regularly pertaining to the staff’s

A. Number of submitted incident report

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

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

A. Planning
B. Controlling
C. Organizing
D. Staffing
30. Which is the most important criterion in budgeting

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

Situation – Nurse Mely considers teamwork and collaboration as important components of

community HEALTH NURSING.

31. Which of the following is the primary goal of collaboration?

a. Less number of people is needed

b. Camaraderie
c. Accomplish goals - NOVEMBER 2021 EXAM NP1#32
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d. Work is faster

32. Which are key element of collaboration?

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

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

33. Which of the following is the most important purpose of teamwork?

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

a. 1, 2
b. 1,2,3,4
c. 3, 4
d. 1, 2, 3

34. Which of the following best describe a strong team?

A. Cohesive
B. Shared goal - NOVEMBER 2021 EXAM NP1#35
C. Driven
D. Sense of mission

35. Collaboration and teamwork are essential in Public health to improve

A. Staff performance
B. Proper use of resources
C. Equity in service
D. Quality health care

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

36. In order to determine the patient’s ability to concentrate and focus, which would be
the priority Nursing action?

a. Ask for academic performance

b. Conduct paper and pencil test
c. Assess the mental status of the patient
d. Refer the patient to the psychiatrist

37. While the nurse was taking her blood pressure, the patient suddenly stated, “They are
talking about me!” She was referring to other pts who were waiting fo nor their
consultation. Which of the ff. should be the appropriate nursing action.

a. Present the reality situation

b. Distract the pts attention
c. Disagree with the patient
d. Validate the statement

38. In taking the patients history from the mother, the nurse should ask the mother
information related to the daughter’s

a. Schooling
b. Menarche
c. Pregnancy
d. Immunization

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

a. Refer all co tertiary hospitals

b. Request for psychiatric drugs
c. Set up debriefing center
d. Set up mental health program

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

a. Give the patient more time for self

b. Impose strict discipline
c. Do traditional parenting style
d. Need for emotional support
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Situation – When prioritizing problems in the community, the problems are categorized as
health status, health resources or health related.- NOVEMBER 2021 EXAM NP1#51-55

41. Nurse Maris is correct in identifying which of the following is a health resource
problem?

a. Increase in number of deaths from Pneumonia

b. Feud between the midwife and head of the sanitation committee
c. Absence of midwife in the community to render health services
d. High maternal mortality rate

42. There are 5 criteria’s in prioritizing community health problems. If Nurse Maris is
estimating the proportion of the population affected by the problem, she is using what
criterion in prioritization?

a. Social concern
b. Nature of the problem
c. Magnitude of the problem
d. Modifiability of the problem

43. Nurse Maris oftentimes encounter barriers select a barrier to goal setting between the
nurse and the family?

a. Educational attainment
b. Nature of employment
c. Failure of family to perceive existence of problem
d. Socio economic status

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

a. Allow family to decide to use health resources

b. Help the family recognize the problem
c. Leave the family what action take on their problem
d. Refer family to barangay officials for guidance

45. Choose the step of Ng process that identifies the family health seeking behavior

a. Assessment
b. Implementation
c. Planning
d. Evaluation
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Situation - Nurse Jane is the team leader of group nurses who plans to utilize COPAR

46. Which of the following best describes the primary goal of CO-PAR

a. Enhances the skills of the nurses in research

b. Makes the community empowered and self-reliant
c. Increases funding of the community programs
d. Helps clean up and beautify the community

47. At the pre-entry phase, which of the following is the first step in the COPAR process?

a. Survey the community

b. Train technical working group
c. Hold a community assembly
d. Create a core group

48. In PAR, which step will empower the community?

a. The nurse performs most of the task

b. Health team directs all the activities of the place
c. Participation and engagement of the community
d. Barangay head appoints people in charge

49. The nurse, as the community organizer, immerse self by joining local folks in their
usual everyday activities in order to

a. Gain trust and rapport of people

b. Make self popular among people
c. Identify and spot leaders
d. Become familiar with the place

50. In COPAR, which is the most important role of the public health nurse?

a. Caregiver
b. Expert
c. Financer
d. Adviser

Situation – Nurse Vince is assigned as the team leader of newly hired nurse community
health nurses of the component city in the province. He oriented them about primary health
care.
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51. Which of the following are some elements of primary health care except?

a. Use of appropriate technology

b. Safe water supply
c. Free medicines
d. Maternal and child care

52. Nurse V is going to refer patient to secondary health facility. Which of the ff. is an
example of secondary health facility?

a. District hospital
b. Puericulture center
c. Rural health unit
d. Barangay health station

53. Which of the following herbal medicines is recommended for cough?

A. Sambong
B. Guava
C. Bawang
D. Lagundi

54. Guava leaves are recommended by the DOH to?

a. Dissolve kidney stones

b. Lower blood pressure
c. Remedy for cough
d. Wash wound

55. This global program aims to end poverty and protect the planet?

a. Center for disease control

b. Sustainable development goals
c. Millennium development goals
d. World health organization

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

56. Which initiative should nurse N introduce in order to decrease incidence of risk
factors especially obesity.
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a. Wellness and fitness program

b. Obesity in natural body response
c. Tell them to go to the gym
d. They have to undergo strict dietary regimen

57. Which should be emphasized by the nurse in her health teaching

a. Jogging a mile a day

b. No need to diet
c. Vigorous exercise
d. Weight reduction

58. Nurse Noli should advice the patients the following except

a. Cut down on salt intake

b. More fruits and vegetables
c. Eat regular meals
d. Eat more saturated fats

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

a. Cholesterol
b. Nitrogen
c. Type
d. Oxygenation

60. Nurse N should include in his health teaching the ff. except

a. Less saturated fat

b. Weight within normal limits
c. Exercise regularly
d. More fats in the diet

Situation – Nurse Mae is a new supervisor of the health center. Her program thrusts
include excellent and quality provision of services and performance of the staff.

61. To ensure that the staff adheres to their job responsibilities which should be the
appropriate tool should Nurse Mae utilize in evaluation staff performance?

a. Memorandum
b. Performance evaluation
c. Incident report
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d. Anecdotal report

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

a. Become a role model

b. Reprimand every now and then
c. Frequent meetings
d. Allow them to read books

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

A. Encourage to use social media

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

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

a. What protects the nurse

b. How the nurse will behave
c. How much work is done
d. What to do

65. Which is the BEST strategy that Nurse should employ to give feedback on patient’s
evaluation of health services?

a. Put the evaluation at supervisor’s office

b. Send letter to all
c. Conduct staff meeting
d. Through bulletin board

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

66. Identify the causative agent of dengue fever

a. Fomite
b. Vector
c. Bacteria
d. Virus
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67. Which of the following strategies would prove effective in preventing more incidence
of dengue infection?

a. Healthy nutritious food

b. Burning of leaves and garbage
c. Destruction of breeding place of vectors - NOVEMBER 2021 EXAM NP1#23
d. Adequate rest and sleep

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

A. 4th to 7 days
B. At the onset of symptoms
C. 2nd to 3rd day
D. 1st day

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

a. It is always life threatening.

b. It could be deadly but preventable.
c. It responds well to antibiotics.
d. The incubation period is variable.

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

a. Rumpell – Leede
b. Mantoux
c. Elisa
d. Widal

Situation – Nurse Rica finds effective communication as the key to successful

community–health nursing.

71. When writing a memorandum, which of the following is the MOST important guideline

a. Purpose is included
b. Content Clear
c. Friendly tone
d. One topic at one time

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

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a. Receiver
b. Feedback
c. Sender
d. Non verbal communication

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

a. Clarifying
b. Restating
c. Challenging
d. Broad opening

74. The patient told her something about her treatment to make sure she understood the
patient, which communication technique should be used by the nurse?

a. Clarifying
b. Focusing
c. Validating
d. Restating

75. Nonverbal communication is as strong in conveying information because the nurse can
______.

a. Observe gestures
b. Body language could be observed
c. Sender less effort
d. Action speaks louder than words

Situation – Nurse Lyn plans to enhance her personal and professional development

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

a. Utilizes communication and social media responsibly

b. Attends conferences
c. Enrolls in school
d. Joins civic organization

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

a. Maternal Child Nursing

b. Philippine Nurses Association, Inc.
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c. National League of Government Nurses of the Philippines

d. Association Nursing Service Administrators of the Philippines

78. A profession is characterized by the following except:

a. Body of knowledge
b. Code of ethics
c. Member of professional organization
d. Engages in research

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

a. Research at work
b. Attends webinars
c. Attendance to graduate school
d. Resource person

80. Aside from attending seminars which of the following informal continuing education
programs should the nurse engages herself EXCEPT:

a. Attending professional conventions

b. Webinars
c. Symposium
d. Doing research as academic requirement

Situation – Nurse Betty is assigned as team leader of the group of Community Health
Nurses who are tasked to conduct a Community Diagnosis in one of the far – flung
barangays of the municipality.

81. While preparing to depart to their assigned barangay, Nurse Betty informs her group
that the PRIMARY purpose of conduction community diagnosis is to

a. Do assessment of the community profile

b. Count the number of morbidity in the place
c. Assess the number of indigenous people
d. Form a core group of selected residents

82. Nurse Betty and her group followed the steps of community diagnosis. Which comes after
the formulation of objectives?

a. Determine data to be collected

b. Define the study population
c. Analyze the collected data
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d. Collect the needed data

83. Is the step of community diagnosis where data are collected, which of the following
tools is utilized less?

a. Interview guide
b. Observation checklist
c. Survey questionnaire
d. Case study

84. To prepare the collected data about the health status of the community for analysis,
which is the APPROPRIATE step that the group of Nurse Betty should do?

a. Analyze data
b. Interpret data
c. Present data
d. Make conclusion

85. Ones the group of Nurse Betty is able to identify community health problems, which
would be APPROPRIATE for them to do in order to be able to plan for necessary
intervention?

a. Present the data

b. Formulate objectives
c. Evaluate the data
d. Set priorities

Situation – At present the public knows their rights in health care. The community health
Nurse should be confident and safe in the practice of her profession

86. Nurse has a complaint from a parent for administering wrong dose of vaccine to the
child. This act in a form of _________.

a. Battery
b. Assault
c. Negligence
d. Malpractice

87. When Nurse Ace submitted a report to the physician that she committed an error in
medication. This is an example of _____.

a. Responsibility
b. Accountability
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c. Commitment
d. Delegation

88. Who among the following is the BEST to sign an informed consent during a surgical
procedure of a child at the health center?

a. A 26 year old brother who is a drug addict.

b. A father who is 40 years old and illiterate.
c. A sister, 21 years old but undergoing dialysis.
d. A mother, 35 years old with on and off seizure.

89. A nurse administer an extra dose of vaccine to a child and the patient developed
adverse reaction and died. She can be sued for ____.

a. Negligence
b. Malpractice
c. Tort
d. Battery

90. A patient was for transfer to a tertiary hospital because of severe asthma but the
nurse did not prepare the patient right away and the patient dies. Which of the following
the nurse is liable?

a. Malpractice
b. Assault
c. Murder
d. Battery

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

91. Which of the following is TRUE about health education in public health?

a. Its only done by professionals like nurses.

b. It is every health worker responsibility.
c. It remains constant.
d. It is seldom use is public health setting

92. The BEST result of health education process is

a. It influences and changes behavior

b. It provides new inputs
c. Update others
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d. Information transfer

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

1. It could employ a variety of strategies

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

a. 1, 2, 3
b. 1, 2
c. 3, 4
d. 1, 2, 3, 4

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

a. To study their life history

b. To identify their weaknesses
c. To totally change their lifestyle
d. To motivate them to develop skills and literacy in health.

95. As a whole health education in public health aims to ________.

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

Situation – Nurse Mary is assigned to manage the Non Communicable Disease Prevention and
Control. She is alarm by the increase number of residents who are having Hypertension.

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

A. Family members with high blood pressure

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

97. Identify the MOST appropriate diagnostic examination that confirms the incidence of
hypertension among residents.

A. Chest X-ray
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B. Electrocardiogram
C. Ultrasound
D. BP monitoring

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

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

99. Nurse Mary had observed that most patients with hypertension stop taking their
medication and heard them saying “I feel good already”. Which is the
APPROPRIATE nursing diagnosis?

A. Impaired gas exchange

B. Anxiety
C. Knowledge deficit
D. Ineffective coping

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

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

A. 2, 3, 4, 5
B. 1, 2, 3, 4
C. 1, 2, 4, 5
D. 1, 3, 4, 5
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NURSING PRACTICE II: Care of Healthy/At Risk Mother and Child

Situation – Nurse Trining has been assigned to the Pediatric ward for 2 years. She wants
to join the team of nurses who will be conducting a study on sleep. The team leader wants
to be assured that Nurse T is equipped with the basic knowledge of nursing research.

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

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

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

2. As to observance of respecting privacy, Nurse Trining explained about___

A. Breach of contract
B. Anonymity
C. Ethical dilemma
D. Confidentiality

3. In nursing, Nurse Trining explained that the MAIN goal of conducting a research is to

A. Justify is the role of nurses as health care provider

B. Establish a credible body of evidence to support and improve the delivery of care
C. Identify research priorities that will justify the oversupply of nurses
D. Develop a body of knowledge to address non-nursing problem
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4. In conducting a study on sleep, Nursing Trining was asked which of the types of
research will be used should it involve collecting numerical data which is most often
under considerable control. Her answer should be:

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

5. Should a 24 hour period clinical observations and activities be considered in

conducting the research on sleep, the type of study that trining will be conducting is?

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

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

6. Patient Presley asks the nurse why such a diagnostic procedure is required. What is the
most appropriate answer the nurse can give?

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

7. Betamethasone is prescribed to be administered and the patient asks nurse H about the
purpose of this medication?

A. Promote fetal lung maturity

B. Prevent the premature closure of the ductus arteriosus
C. Delay delivery for at least 48 hours
D. Stop the premature uterine contraction

8. Patient Presley who is ordered for the diagnosis pelvic ultrasound asks what
preparation she’ll take. Appropriate preparations for this procedure include

A. Explanation of the procedure

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B. NPO 6 hours before

C. Informed consent
D. Voiding

9. Pelvic ultrasound can detect which of the following?

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

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

10. The labor progressed and the physician performed an amniotomy. Nurse H should FIRST
assess for

A. Bladder distention
B. Maternal BP
C. Cervical dilatation
D. Fetal heart rate pattern

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

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

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

12. Patient Sienna who seems to be irritated with the nurse said “I don’t want to talk
with you because you’re only a nurse. I will wait for my doctor.” Which of the following
should the nurse say in response to the patient?

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

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

13. Nurse Mauve is now on an ethical dilemma. This occurs when ____.
TITO A., RN

A. A decision had to be made quickly under stressful situation

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

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

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

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

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

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

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

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

A. History of present illness

B. Religious Affiliation
C. Social and Family History
D. Past medical history

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

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

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

18. Past medical history section of Krini contains the following, but NOT___.

A. Prenatal history
B. Childhood illness
C. Current history
D. Birth history

19. Which of the following statements is TRUE?

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

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

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

A. Inspection of the throat with a throat stick.

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

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

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

A. Give the drug as prescribed.

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

22. The patient refuses to take the medication because it causes diarrhea. Nurse Parker
explain the action of the drug but the patient vehemently refuses the medication. What
should the INITIAL action of the nurse?
TITO A., RN

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

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

A. Dependently
B. Collegially
C. interdependently
D. independently

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

A. It will cause discrimination from friends and relatives

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

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

A. Explain the purpose of the medication

B. Encourage the patient to take the medication
C. Check the original medication prescription
D. Ask what the other pill looked like

Situation – A newly hired nurse is assigned in the OB ward. She was supervised by a
senior nurse.

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

A. Right occipitoposterior with no flexion

B. Right occipitoposterior with full flexion
C. Left transverse anterior in moderate flexion
D. Left sacroanterior with full flexion
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27. The physician ordered sonography. The nurse informs the ultrasound unit in charge in
prepares the patient for the procedure. The patient asks the importance of the procedure,
the nurse’s CORRECT response is?

A. To determine diameters of the fetal skull

B. Increase sensitivity for common bile duct of the fetus
C. Useful to a visualized cystic duct of the fetus
D. To assess fetal well-being

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

A. “I understand how you feel. Tell me more.”

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

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

A. Promote vasoconstriction of uterine muscles

B. Hasten uterine contractility and control bleeding
C. Facilitate the return of prepregnancy vital signs
D. Promote vasodilation of uterine muscle

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

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

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

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

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

A. Enlarged glands in the axilla

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

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

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

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

33. Lillian complains of unbearable pain. Which of the following characteristics are
EMPHASIZED in a culturally sensitive nursing care? (Select all that apply)

I. The expression of pain is affected by learned behavior

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

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

34. Nurse Addison provides instructions about measures to prevent postpartum mastitis who
is breastfeeding her newborn. Which of the following would indicate that the mother needs
further instruction? “I should ____”.

A. Wash my hands well before breastfeeding

B. Breastfeed every 2-3hours
C. Change the breast pads frequently
D. Wash my nipples with soap and water prior to feeding

35. Considering her level of knowledge and the anxiety of her condition, patient Lillian
raised questions on possible ways of relieving her breast discomfort. Which of the
statements NEED further instructions?
TITO A., RN

A. ‘’I have to stop breastfeeding until this condition resolves’’

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

Situation - Nurse Lyca is assigned to the nursery. She is performing newborn assessment on
Baby Boy Pratts born at 40 weeks gestation.

36. Using APGAR score, nurse Lyca should bear in mind that this method of evaluating a
newborn’s condition is used at how many minutes after birth?

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

37. Nurse Lyca is aware that testing of vision in infants and children has been treated
separately from the testing of adults. Which of the statements is NOT TRUE?

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

38. The false statement about physiologic jaundice in the statements below is:

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

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

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

1. Face
2. Forehead
3. Trunk
4. Extremities
TITO A., RN

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

40. When caring for patients with hyperbilirubinemia, the nursing care plan should focus
on the following, EXCEPT:

A. Informing appropriately the significant others

B. Preventing injury
C. Maintaining physiological homeostasis with bilirubin levels increasing
D. Preventing complications

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

41. When the patient was informed about induction, she asks Nurse Aurora what it is all
about. Which of the following statements by the nurse is correct? Induction is a ____.

A. Local anesthesia used for blocking pain during episiotomy

B. Deliberate initiation of uterine contractions that stimulates labor
C. Medication injected into the subarachnoid space and has a rapid onset of action
D. Procedure performed by artificial rupture of the membranes.

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

A. Preinducing cervical ripening

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

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

I. Fatigue and drowsiness

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

A.III and IV
TITO A., RN

B.II and III

C. I and III
D. I and II

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

A. 5% Dextrose in water
B. Normal saline 0.99%
C. Normal saline 0.45%
D. Lactated Ranger’s

45. Take home medication given to Patient Lily includes digitalis therapy which was given
to patient since she was pregnant, which of the following would the nurse anticipate with
patient’s drug therapy?

A. Switching to a more potent drug

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

Situation – The indication of tracheostomy has changes substantially in the last two
decades, Nurse Robert is taking care of Patient Irma, an eight year old female child, who
was admitted to the Pediatric ward due to Pneumonia, The child is hooked to Tracheostomy
tube. Nurse Robert is quite anxious in taking care of the patient being her first day of
duty in the Pediatric Ward.

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

A. Perform hand hygiene

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

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

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

A. 1, 2 & 3
TITO A., RN

B. 2 only
C. 1 & 2
D. 1 only

48. Usually the common indication (s) for the tracheostomy in Patient Irma’s condition is
which of the following? (Select all that apply)

1. Prolonged Intubation
2. Sepsis
3. Hypoventilation associated with neurologic disorder
4. Severe sleep Obstructive Apnea Syndrome (SOAS)

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

49. The Priority nursing objective when caring a patient with tracheostomy is __________

A. To increase tissue oxygenation

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

50. The TOP nursing expected outcome when performing suctioning is

A. Lessened amount of secretion leading to decrease frequency of suctioning

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

Situation – Sony, 11 years old is admitted due to bronchitis, upon admission, he

manifested the following signs and symptoms: Cough, Production of mucus (Sputum),
Yellowish in color, fatigue, shortness of breath, slight fever and chills and chest
discomfort. The physician orders 4L/min oxygenation.- NOVEMBER 2021 EXAM NP2 #91-95

51. The first standard step in oxygen therapy that the nurse should do is _________

A. Assess the client's condition.

B. Gather all the equipment and supplies
C. Prepare the client for the oxygen treatment
D. Check the chart for ordered flow rate and oxygen delivery method
TITO A., RN

52. In planning for sonny’s oxygen therapy, the nurse should consider which of the
following, EXCEPT_________

A. Need for a humidifier

B. Length of tubing
C. Determine the age of excel
D. Manner of administering oxygen, continuous or intermittent.

53. Which of the following is the PRIORITY action of the nurse for Sonny who is on oxygen
therapy?

A. Check the flow

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

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

A. Humidifier’s water should be checked regularly

B. No Smoking sign
C. Turn on the oxygen
D. Attach the humidifier and connecting tubing to the oxygen delivery device.

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

A. Reassess the patient.

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

Situation – The senior nurse Reese, is planning to revisit and implement a change in the
management system for the Obstetric Unit. This problems have occurred one of which is the
present documentation system, and the charge nurse determines that the change is required.

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

A. Set goals and priorities regarding the change process

B. Plan strategies to implement the change.
C. Identify potential solutions and strategies for the change
D. Identify the inefficiency that needs improvement or correction
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57. Nurse Reese is preparing the patient assignment for the day and needs to assign
patients to a midwife and nursing assistant. Which patient should assign to the midwife
because of patient needs that cannot be met by the nursing assistant? A patient requiring?

A. Dressing change of post cesarean delivery

B. Collecting urine specimens for urinalysis testing.
C. Performing range of motion exercise twice a day.
D. Taking of Vital signs measurement every 4 hours.

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

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

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

A. Primary
B. Team
C. Total Care
D. Functional

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

A. Refreezing
B. Unfreezing
C. Movement
D. In activism

Situation - Olivia a 15 years old, high school student visited the health center for her
prenatal check-up. Per nurse’s initial assessment, the patient drinks alcohol and smokes
cigarettes about 5 sticks a day for 2 years now, her last menstrual period (LMP) was
October 10, 2020.
TITO A., RN

61. Based on the nurse’s computation utilizing Nagele’s rule, the patient’s expected
date of birth (EDB) will be on.

A. September 17, 2021

B. June 17, 2021
C. July 17, 2021
D. August 17, 2021

62. Which of the following is the MOST common emotional response among women during the
first trimester of pregnancy?

A. Ambivalence
B. Depression
C. Acceptance
D. Jealousy

63. Olivia mentioned that she can experience uterine squeezing. Which of the following
signs of normal pregnancy should the nurse consider?

A. Braxton-hicks Contractions
B. Hegar’s sign
C. Ballottement
D. Goodell’s sign

64. Nurse Emma advised the patient to quit smoking because nicotine will contribute to
__.

A. Low birth weight infant

B. Ectopic tubal pregnancy
C. Congenital anomalies
D. Large for gestational age infants.

65. Emotional lability is common to pregnant women. Identify which of the following
reactions is accepted as part of a normal pregnancy

A. Feelings are easily hurt by remarks

B. Mood swings
C. Amusing or even charming situations
D. Narcissism

Situation - Nurse Lingling is in the process of evaluating the effectiveness of her

teaching which is the critical part of the process.
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66. Which of the following would BEST help Nurse Lingling in conducting her evaluation?

A. Written examination
B. Change in behavior
C. Return Demonstration
D. Obtain feedback from the client

67. Which of the following aspects should nurses continually teach patients to do? (select
all that applies)

1. Disease or disorder
2. Diet medication
3. Treatments
4. Self care

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

68. The first step in teaching is assessing which of the following? (select all that
apply)

1. Learning needs
2. Knowledge deficit
3. Education background
4. Social status

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

69. Which of the following environmental factors affect learning? (select all that
apply)

1. Client comfort
2. Lighting
3. Noise level
4. Room temperature

A. 2 & 4
B. 3 &4
TITO A., RN

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

70. Which of the following are good sources for teaching? (select all that apply)

1. Nursing Specialists
2. Videotapes
3. Demonstration equipment
4. Books

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

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

71. In what way will the nurse handle the situation?

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

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

72. This appropriate nursing diagnosis to protect the patient from further injury is,
which of the following?

A. Altered mucous membrane related to chemotherapy.

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

73. Mouth sores have developed in the child’s mouth. The father ask the nurse the reason
for this. The MOST APPROPRIATE response of the nurse is?

A. The child’s oral hygiene needs to be improved

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

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

A. Talk about the reality of death

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

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

A. Assist the mother to pay the hospital bill

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

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

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

1. Needs assessment
2. Needs analysis
3. Per recommendation by the chief
4. Incidents Report

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

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

A. Ensure safe practice in the hospital

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

78. One of the lecturers discuss the complication that the patients may have while on IV
therapy. Which of the following is the most common complication that IV patients may
contract while on IV therapy?
TITO A., RN

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

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

A. Professional Regulatory Board of Nursing

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

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

A. Professional seminar and conferences

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

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

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

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

A. Make sexual educations program voluntary

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

82. Maternal and Child Nursing is the concept under the National Goals. Which objective
should Nurse Railey emphasize to support the program?

A. Avoid having misdirected children and become street children

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

83. Which of the following topics should the patient feel MORE comfortable when
reproductive anatomy and physiology is discussed with the nurse?

A. Sexual health education

B. Gender reassignment
C. Varied sexual positions
D. Gender identity

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

A. All diagnostic laboratory tests performed had been completed

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

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

A. Anxiety-related inability to conceive after six months

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

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

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

A. Maintain strict asepsis

B. Maintains adequate hydration
C. Monitors the temperature
D. Reassures the patient

87. Nurse Sophie hooks a 1000 ml intravenous IV solution of D5Water as ordered by the
physician at 9am to infuse 80ml/hr. via macro drop infusion set (20gtts = 1ml). On the
assessment of the infusion at what would be the level of the remaining amount in the IV
bag at 2pm?==

A. 500
B. 200
C. 400
D. 300
TITO A., RN

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

A. Recheck the unit of blood for compatibility

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

89. Nurse Sophie checks the gauge of the patient’s intravenous catheter. Which is the
smallest gauge catheter that the nurse can use to administer blood?

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

90. The nurse reviews the patient’s plan of care. Which of the following nursing
diagnosis will be the PRIORITY?

A. Fluid volume, deficit

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

Situation – Nurse Nilda is beginning nurse assigned in the Pediatrics Unit in a

government hospital. The Unit has pediatric patients of different ages. Since she will be
dealing with patients of varied ages, she thought it best to review her notes on human
growth and development, specifically Erikson’s psychosocial theory.=

91. The BEST reason why nurse Nilda opted to review Erikson’s psychosocial theory is,
which of the following statements?

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

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

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

A. To attend to her patients who cannot communicate verbally

TITO A., RN

B. To check if the child is hungry or wet

C. To lessen the noise overload in the Unit
D. A powerful influence over that individual’s interactions with others for the remainder
of his/her life

93. Nurse Nilda is attending to a two year old Neneng who was admitted due to chronic
bronchitis. Neneng sports a long hair that extends up to her shoulder. As part of the
morning care, Nurse Nilda decided to style Neneng’s hair into a pony tail. However,
Neneng vehemently resisted her hair being tied by a rubber band. The BEST thing that Nurse
Nilda should do, is which of the following?

A. Assert her authority

B. Deny Neneng’s preference
C. Explain that a pony tail would make Neneng’s more beautiful
D. Allow Neneng’s preference

94. Joji, 17 years old, is admitted in a private room due to influenza. In one of Nurse
Nilda’s conversations with Joji, the patient expressed is unhappiness with the program he
is taking up in college. This is not his choice but rather the choice of his parents. In
which of Erikson’s stage of development does this case fall?

A. Autonomy versus shame/doubt

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

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

1. Struggling to acquire a sense of autonomy

2. Discovering they have a will of their own
3. Awareness that they cannot control others
4. Learning which behavior gains approval

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

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

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

A. Secondary source
B. Primary source
C. Objective data
D. Subjective data

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

A. Administering skin testing

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

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

A. Patient fell from the bed

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

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

A. Giving the patient the wrong medication

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

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

A. Changing wound dressings

B. Administering analgesic drug
C. Performing a physical assessment
D. Taking vital signs
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NURSING PRACTICE III: Care of Clients with Physiologic and Psychosocial Alterations, Part A

Situation - Ethical and moral issues are becoming a common scenario in practice setting so
health care providers have to be equipped with this competency.

1. In the clinical setting, when nurses are confronted with ethical dilemmas the BEST
practical guide she can use is?

A. PRC oath for professionals

B. Code of ethics
C. Theological Doctrine
D. Florence Nightingale Oath

2. Mr. RAD was admitted to the hospital complaining of chest pain due to clogging in his
coronary arteries. He is diabetic hypertensive and considered by the physician to be a
high risk for cardiovascular surgery. What PRIORITY action should the members of the
health team do in this situation?

A. Consult the family members and let them give their decision.
B. Proceed with the planned surgery, as this will save the patient.
C. Consult the ethics committee on what to do with the patient.
D. Discuss with Mr. RAF his health status and let him decide.

3. Mrs. Agnes, 77 y/o is suffering from dementia and demonstrates unruly behavior. When
Nurse Gigi describes the patient in her shift report, as “That awful, dirty old woman in
Bed 14.” is an example of what ethical behavior being employed by the nurse?

A. Stigma
B. Ageism
C. Gender Bias
D. Depersonalization

4. Mr. Rey, who is on an end-stage of life, has an order of “Do Not Resuscitate” and
passes away in your shift. He was declared dead by his physician at 8:30 AM. What should
be your PRIORITY nursing action in this situation?
TITO A., RN

A. Prepare the death certificate for the physician to sign.

B. Allow the family to have private moments with the deceased.
C. Request your nurse attendant to call the funeral parlor at once.
D. Clean the body and remove all the IV lines, tubes and other appliances

5. When a nurse is in full support of a patient's care, safety and personal rights
throughout her hospital stay, she is implementing what ethical principle?

A. Responsibility
B. Empathy
C. Advocacy
D. Accountability

Situation - A manager of an accounting firm is admitted to the hospital due to an acute

abdominal pain and passing out of bloody stools. After several diagnostic and laboratory
examinations the physician ordered him for exploratory laparotomy. You are the nurse on
duty that day.

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

A. Portion of duodenum and jejunum, left kidney, appendix and ovary

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

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

A. Do you experience your wounds healing quickly?

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

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

A. Spinal
B. Caudal
C. Local
D. General
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9. There are preoperative medications given to the patient. Which of the following drugs
are given in order to decrease intraoperative anesthetic requirements and pain?

A. Celebrex
B. Ibuprofen
C. Acetaminophen
D. Demerol

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

I. Patient’s Identity
II. Surgical Procedure
III. Surgical Site
IV. Surgical equipment

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

Situation - Crisostomo a 40 y/o employee has been complaining of difficult painful

urination for almost a week now. He said he saw some fresh blood in his urine but was
afraid to see a physician, instead, he went to his neighbor who is a herbalist. After a
week his condition worsened and his wife brought him to a community clinic.

11. A community clinic does primary care for patients. Most often the one who manages this
is which of the following?

A. Physician
B. Barangay Health Worker
C. Nurse
D. Midwife

12. Upon assessment, the patient was referred immediately to a 25 bed capacity hospital,
which does not have any capacity to do intensive diagnostic examinations. You are a nurse
in this hospital, which you know is a LEVEL __?

A. 3
B. 1
C. 4
D. 2
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13. In the tertiary hospital where the patient was again referred, he was considered an
emergency case. The nurse immediately called for a specialist who is ___.

A. Neurologist
B. Urologist
C. Phlebotomist
D. Nephrologist

14. After thorough assessment by the physician-specialist, an order for an immediate

stonogram was made. The nurses was instructed to call which of the following section of
the hospital?

A. Operation room
B. Laboratory
C. Intervention
D. CT Scan

15. After the procedure, the patient was ordered for Lithotripsy, under spinal anesthesia.
The nurse has to call the department of.

A. Internal medicine
B. Anesthesia
C. Surgery
D. Imagery

Situation - An alert 67 year-old woman with diabetes mellitus is discharged from the
hospital. A referral is made to a community nursing agency. You are asked to reinforce the
teaching program started in the hospital. The patient is using sulfonylurea compound
tolbutamide (Orinase).

16. When the patient turned 69 years old Orinase was discontinued and NPH insulin is
prescribed for her. After several months, she is determined to be suffering from the
Somogyi effect. Which of the following conditions will most likely result when the patient
is receiving too much insulin?

A. Developing an elevation of the blood glucose level

B. Producing even more insulin
C. Becoming resistant to insulin
D. Conserving excessive amount of fluid

17. A few days later, the patient comes into the emergency department via ambulance
stretcher and reveals a work-up of a blood sugar level at 800mg/l, ketones are absent in
TITO A., RN

the urine, she is dehydrated, and has an altered mental status. Based on the data, the
patient is most likely suffering from what specific medical condition?

A. Hyperosmolar nonketotic coma (HNKC)

B. Diabetic retinopathy
C. Acute renal failure
D. Diabetic ketoacidosis (DKA)

18. Upon interview, the patient reported that she often felt nauseated, restless,
perspired a lot, felt fatigued, and was often hungry when she was younger. What do these
signs indicate?

A. Diabetic nephropathy
B. Hyperglycemia
C. Hypoglycemia
D. Diabetic retinopathy

19. Upon further assessment, you noticed that she had many scratches on her right ankle, a
resulting infection, and cellulitis. When you ask her about the scratches, the patient
states, “Oh, my cat must have been using my leg as a scratching post again and I did not
even feel it.” which diabetic complications suspect the patient to have?

A. Neuropathy
B. Macroangiopathy
C. Retinopathy
D. Ephropathy

20. You should check the patient for suspect disturbed thought processes related to
depressed metabolism and altered cardiovascular and time, place, date, and events?

A. Shows improved cognitive functioning

B. Provides reality orientation to patient
C. Permits evaluation of the effectiveness of treatment
D. Let’s the patient identify the time, place, date, and events correctly

Situation - Nurse Pat is a newly hired Registered Nurse together with 5 licensed graduate
nurses coming from different regions. It is their first day of orientation in a big health
facility. The continuing nurse educator started the session by projecting the
organizational structure of the the medical center.

21. Which of the following is the MAJOR PURPOSE of an organizational structure? It is a?

A. Blueprint representing committees for delegation of roles and functions

TITO A., RN

B. Flow chart that shows interaction among members of major and minor groups
C. Framework of relationship of units, departments and channels of communication
D. Design that identifies roles, collaboration, interdependence between functions of
people.

22. Line and staff functions are identified in the presented organizational chart. What
does line authority mean?

A. Staff relationship in the organization is advisory in nature

B. Staff mix of personnel reporting to the “Boss”
C. Decisions are made from bottom to top in an organization
D. Direct responsibility over a subordinate within an organization.

23. Which of the following statements is CORRECT of nursing service system in health
care?

A. Informed leaders are more effective than formal leaders in an organization

B. A shared governance tends to be controlling and with less autonomy
C. Institutional policies are more powerful tool in nursing practice than laws and
regulations.
D. A situational leadership style provides effective means in achieving patient
outcomes.

24. The mode of nursing service delivery system is being revisited in respond to
patient’s outcome. Which of the following is NOT TRUE of the manager’s role in the
health care delivery system?

A. Provides direct nursing care when needed

B. Manages resource utilization
C. Act as a liaison in litigation cases in court
D. Collaborates with members of the health

25. Budgeting is an important aspect of financial management. When a unit manager

allocates expenses for unit supplies, stocks and medical-surgical supplies. This is
considered?

A. Cash budget
B. Operational budget
C. Capital budget
D. Flexible budget

Situation - Mely, 68 year old, was admitted to the hospital because of decreased appetite,
easy fatigability, dehydration and weight loss of about 15 lbs. for the past weeks. She
TITO A., RN

was examined by the physician and advised to be admitted. You are the nurse assigned to
take care of her.

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

A. Determine if the family can afford the whole treatment

B. Evaluate the tolerance of the patient to glucose
C. Identify allergies of patient to the supplemental nutrition.
D. Assess the basic understanding of the patient regarding TPN

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

I. Promote weight gain

II. Improve nutritional status
III. Maintain muscle mass
IV. Establish nitrogen balance
V. Enhance healing process

A. I, II, & III

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

28. When a patient is undergoing TPN, you have to monitor closely for the?

A. Serum creatinine level

B. Potassium level
C. Serum glucose level
D. Sodium level

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

A. Sepsis due to IV line

B. Air embolism
C. Hyperglycemia
D. Allergic reaction to TPN

30. What priority nursing action should you do with the presenting clinical manifestations
of the patient?
TITO A., RN

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

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

Situation – Ms. Monina is a retired Community Health Nurse in barangay San Pablo. Due to
her commitment to the nursing profession, she has classes. One Saturday morning, several
patients who are hypertensive and with pulmonary health problems attended her session.

31. Mang Luis, is a newly diagnosed patient with Chronic Obstructive Lung Disease (COPD).
Which of the following PRIORITY teaching instructions should he be given in relation to
his condition?

A. He should assume supine position when resting

B. Know early signs of respiratory infection
C. He has to be taught how to do Bronchial clapping
D. Family should be advised that patient should sleep in a warm room

32. Which of the following health interventions should be included in your teaching plan
for Mang Luis?

A. Be on prolonged corticosteroid therapy

B. Lung exercises must be done with longer inhalation than exhalation
C. Reduce risk for infection
D. Have a high flow of oxygen administration

33. Pulmonary rehabilitation for COPD has a duration of at least 4 to 12 weeks. Which of
the following should be avoided while the patient is having this program?

A. Pursed lip breathing

B. Smoking cessation
C. Aerobic, upper and lower body conditioning
D. Peripheral muscle wasting

34. Weight loss and Malnutrition are commonly observed among patients with COPD. They
should be taught to avoid?

A. Have full stomach even when in dyspneic condition

B. Keeping body mass between 21 – 25 kg
C. A high caloric and high protein diet
D. Exercises one hour before and after eating
TITO A., RN

35. Which of the following energy conserving strategies should NOT be done by COPD
patients?

A. Exhale when pushing or exerting effort when doing daily activities

B. Assume tripod position with elbows supported on the table when shaving or combing
C. Inhale when resting, sitting and lying down
D. Stand in front of the mirror while shaving or combing hair

Situation – A housewife, appearing jaundice, complaining of abdominal pain, nausea and

bloated sensation was rushed to the hospital. The patient was examined by the physician
and ordered for admission due to a suspected stone in the gall bladder. You are the nurse
on duty that day.

36. When performing an interview, which is the BEST initial question should you ask when a
patient is on pain?

A. How often do you feel the pain?

B. How would you describe your pain?
C. Did you take any drug to relieve the pain?
D. When did you first feel the abdominal pain?

37 Which of the following imaging test that uses transducer will be likely be ordered by
the physician to detect gallstone?

A. Computed tomography
B. Abdominal x – ray
C. Abdominal ultrasound
D. Doppler sonography

38. The test revealed presence of gallstones and inflamed gall bladder. The patient was
advised to undergo open cholecystectomy. This operation compared to laparoscopic
cholecystectomy are?

I. Invasive
II. Less pain
III. Longer recovery
IV. Shorter hospital stay

A. I, II & IV
B. I & II
C. I, II & III
D. I & III
TITO A., RN

39. After 2 hours post – operative, the nurse observed reddish drainage from the
operative area of the patient. Which of the following nursing actions should you performed
FIRST?

A. Check if stitches from the operation have come apart

B. Check where is the source of possible bleeding
C. Cover the operative area with sterile gauze bandage
D. Put hand as a pressure on the operative area

40. After several days in the hospital, the physician ordered for the patient to be
discharged. Which of the following is the PRIORITY restriction that you should emphasize
when he goes home?

A. Stool softener to induce bowel elimination

B. Driving if not using narcotic drug
C. Take shower even if still with surgical drain
D. Lifting of objects not more than 10lbs

Situation - Sarah, 18 year old, a teller from a bank is admitted to a tertiary hospital
due to hypertension and frequent hematoma of the lower extremities every time she bumps
herself in the workplace. The physician who examined her gave impression of Cushing
disease.

41. Which of the following characteristics of Cushing disease is TRUE?

I. The disease occurs in woman between 20 to 40 years of age

II. The use of Corticosteroids for multiple immune condition is a cause of the disease
process
III. Condition is aggravated by excessive production of ACTH
IV. The surgical treatment of choice is Transsphenoidal hypophysectomy

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

42. When one has a Cushing disease the focal structured affected is the?

A. Hypothalamus
B. Pituitary gland
C. Adrenal gland
TITO A., RN

D. Para thyroid gland

43. Which of the following clinical manifestation will NOT be a complaint from Sarah’s
condition?

A. Edema of the extremities

B. Poor wound healing
C. Decrease libido
D. Absence of growth in the pubic area

44. The attending physician ordered a Magnetic Resonance Imaging (MRI) to patient Sarah in
order to validate the medical impression. This imaging technique is done to detect?

A. Hemorrhagic injury in the brain

B. Electrical impulse in the brain
C. Level of oxygen in the brain
D. Non-hemorrhagic injury in the brain

45. While patient Sarah is confined in the hospital, the safety measure to be observed by
the nurses is prevention from fall. This is brought about by the patient being prone to
fracture as a result of?

A. Aging process
B. Change in vision
C. Osteoporosis
D. Hematologic condition

Situation – Mr. Aida, 50 year old company driver is admitted in the Emergency room (ER)
because of pain of the left chest and difficulty of breathing. History revealed that the
patient smokes one half to one pack of cigarettes per day especially when he goes on
overtime. Vital signs: BP is 150/90, PR 110/min. RR 30/beats. Has clammy perspiration and
quite restless. The physician ordered chest X-ray and revealed patient has Pneumothorax.
You are the nurse In-charge of the patient.

46. As a nurse you are guided that pain is usually described BEST? As a phenomenon which
is a?

A. Neurologic activation of nociceptor

B. Subjective unpleasant experience
C. Adaptive mechanism to a stimulus.
D. Creation of one’s imagination.
TITO A., RN

47. When a patient has a Pneumothorax, the nurse’s assessment findings will likely
reveal?

I. Absent breath sound on the affected side

II. Decreased chest expansion unilaterally
III. Sharp chest pain
IV. Burning chest pain

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

48. Which of the following statements is NOT true of Pneumothorax?

A. Atmospheric air within the pleural spaces can result to a rise in intra thoracic
pressure and reduced vital capacity in the lungs.
B. The loss of positive intrapleural pressure can produce pneumothorax
C. The loss of negative intrapleural pressure can result to collapse of the lungs
D. A spontaneous pneumothorax can occur with the rupture of pulmonary bleb

49. The physician inserted a chest tube drainage to Mr. Aida in order to help re-expand
the lungs, Which of the following should you prepare FIRST as a nurse in case of emergency
when the tube is accidentally disconnected

A. Sterile clamps
B. Another chest tube
C. Sterile dressing
D. A bottle of sterile water

50. In order to relieve Mr. Aida of pain, the physician prescribe morphine So4 2mg/IV PRN
for intolerable pain. The overall goal of the Health Care professional is to provide
adequate control so the patient can breath easily. Which of the following would indicate
successful attainment of this goal?

A. Anxiety level of patient will be reduced

B. Respiratory rate will be decreased to 20 breath/ min
C. Oxygen saturation is at 76 level
D. Pain scale will show 1 to 2. In rating scale of 10 (highest 0 lowest)

Situation - Nurse Rachel is assigned in the medical unit of tertiary hospital where most
of the patients admitted are suffering from Endocrine disorders, She is currently assigned
to Patients: Claire, 54 years old, Married with hyperthyroidism, Aster 66 years old has an
TITO A., RN

impression of Cushing syndrome, while Sonia, 48 years old is suffering from

hyperthyroidism.

51. While you are doing your physical assessment to patient Aster, she has exhibiting a
UNIQUE clinical manifestation different from patients Claire and Sonia which is
characterized by

A. Cyanosis, increasing growth of hands and feet

B. Anemia, weight loss and presence of acne
C. Moon facies, purple striae on trunk and buffalo hump
D. Moon facies, easy fatigability and peripheral edema

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

A. 24 hour urine cortisol level

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

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

A. Cold extremities
B. Increased weight
C. Decreased bowel movement
D. Fine motor tremor

54. Patient Sonia, who has hypothyroidism is given which ONE of the following drug
therapy?

A. Propranolol
B. Iodine
C. Iron pills
D. Levothyroxine

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

A. Use of warm blankets

B. Light activities done at home
C. Taking foods low in fiber
D. Exposure to cold temperature
TITO A., RN

Situation - Nurse Eileen has just passed the Board Examination for Nurses and set her
goals for her Nursing Career for the next 5 years. She is aspiring to become a Diabetes
Nurse Educator after completing her 2 years as a bedside nurse.

56. Which of the following can Nurse Eileen adopt to visualize her future?

A. Flow chart
B. Decision tree
C. Gantt chart
D. Decision grid

57. She started to create her personal and professional portfolio as a preparation for her
application to a university medical center in Metro Manila. Which of the following is NOT
a major purpose of keeping a portfolio?

A. Keep on ongoing records of skills development

B. Create a system for documenting accomplishments
C. Set career and educational goals
D. Set system for a possible shift to another job

58. One area of the professional portfolio is to indicate one’s philosophy of life. Which
of the following workplace values should Nurse Eileen consider as NOT favorable to be
written in her portfolio?

A. Customer service based on acceptance, empathy and selfless duty.

B. Time and compensation limiting her pursuit of excellence in her job
C. Commitment to continual life long and self-directed learning.
D. Challenges which can lead to growth, responsibility and accountability

59. In order for Nurse Eileen to be active as a bedside nurse, she has to comply with the
renewal of PRC ID by undertaking continuing professional development (CPD) as mandated by
the CPD law. The purposes of which are _______.

I Promote and upgrade the practice of the profession.

II Improve the competence of the professional
III International alignment of competence.
IV Develop quality assurance for accreditation

A. I & III
B. I, II & III
C. I, II, III. IV
D. I & II
TITO A., RN

60. Nurse Eileen is aware that her personal and professional portfolio has to include and
keep up to date the following EXCEPT?

A. Certificate of CPD attended

B. Letter of reference
C. Photographs
D. Confidential information from past employers

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

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

A. Age of patients
B. Absence of complications
C. Length of stay 4-5 days
D. Date of admission January-March

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

A. Salary of nurses
B. Caring attitude of nurses
C. Responsiveness of staff
D. Competence of nurses

63. He plans to used likert scale to determines

A. Compliance to expected standards

B. Degree of agreement and disagreement
C. Level of satisfaction
D. Degree of acceptance

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

A. Reliability
B. Sensitivity
C. Objectivity
D. Validity
TITO A., RN

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

A. Delphi technique
B. Meta-analysis
C. Triangulation
D. Experiment

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

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

A. Staff-Nurses
B. Caring behavior
C. Women with ostomy
D. Satisfaction

67. What is the dependent variable in the study?

A. Staff-Nurses
B. Ostomy
C. Degree of satisfaction
D. Caring behavior

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

I Caring behavior
III Ostomy pathogenesis
III Contentment and satisfaction
IV Concept of body image

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

69. If Nurse Tarly and her core group decide to formulate a directional hypothesis it will
be?
TITO A., RN

A. There is an increase relationship between the caring staff nurses and degree of
satisfaction of ostomized patients
B. The caring behaviors of the staff nurses is related to increased satisfaction of
ostomized patients
C. The staff nurses behaviors has an effect on the patients satisfaction with ostomized
patients
D. A significant relationship exist between the caring behaviors of the staff – nurses
and degree of satisfaction of ostomized patients.

70. Based on the research problem, what is the Reseach design of the study?

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

Situation – Nurse Virgo admits Benito, 67 year – old, due to severe abdominal and back
pain and vomiting after attending a party. He had positive alcohol breath and was
tentatively diagnosed with pancreatitis. He was scheduled for diagnostic laparotomy to
further confirm the diagnosis.

71. Nurse Virgo gathers more appropriate data from Patient Benito. Which of the following
APPROPRIATE questions should Nurse Virgo asks?

I. Can you describe your pain?

II. Is your urine yellow?
III. Is your stool clay colored?
IV. Do you drink alcohol often?

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

72. Patient Benito asks Nurse Virgo, “Why can’t the surgeon just take out my pancreas?”
The BEST response of Nurse Virgo is?

A. Your body needs to function well with your pancreas

B. Your attack will soon be overcome when you are at rest
C. If your pancreas is removed, you can never eat fat and fried foods again
D. Antibiotic will relieve signs of infection
TITO A., RN

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

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

74. Nurse Virgo asks Patient Benito how can he help reduce pain while waiting for his
operation. Which is the MOST appropriate question of Nurse Virgo?

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

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

A. Increase my intake of high protein products

B. Try to stop drinking alcohol
C. Follow a high fat diet faithfully
D. Be careful of exposing myself to infection

Situation – The Department of Health (DOH) is an agency that set standards for safe and
quality health care together with Phil health Insurance which takes care for accreditation
and reimbursement of cost of health care services.

76. The professional conduct of doctors, nurses and other health care providers in the
health facilities belong to which of the following quality standards?

A. Improving performance
B. Organizational ethics
C. Patient care standards
D. Leadership and management

77. The positive practice environment (PPE) is part of the quality standards of every
health facilities in the country today. Which of the following is NOT a component of PPE
in the work setting?

A. Waste management
B. Peer review
TITO A., RN

C. Electrical wires
D. Infection control

78. When a health facility formulates its Vison-Mission to guide the Management and health
personnel in the work place is what part of quality standards?

A. Human resource management

B. Patient care standards
C. Leadership and management
D. Organizational ethics

79. When Nurse Sarah distributed a Patient satisfaction survey form to be filled by the
consumer to be discharge in a hospital setting is in compliance to what quality standards?

A. Organizational structure and professional ethics

B. Identification of Patient rights and welfare
C. Improving performance of health care personnel
D. Human resource management and staffing pattern

80. When an accurate documentation whether done manually or by electronic by the

healthcare professionals in their work setting is a component of what quality standards in
a health care delivery system?

A. Patient care standards

B. Information management
C. Leadership and management
D. Human resource management

Situation – Mr. Lar, a 44 year-old, male obese, married was rushed to the Emergency room
because of feeling nauseated with shortness of breath and severe chest pain radiating to
the back.

81. As a nurse, what is your PRIORITY step to be done in this situation?

A. Palpate of the point of maximal impulse

B. Inspect the nail bed if cyanotic
C. Take the vital signs and report to the physician
D. Auscultate the chest for murmurs

82. A 12 lead EKG was ordered by the physician. Which finding in the EKG is suggestive
evidence that the patient has Myocardial Infarction (MI)?

A. Prominent segment elevation

TITO A., RN

B. ST segment elevation
C. Peaked P wave
D. Minimal QRS wave

83. The physician confirmed that the patient is suffering from MI. She was advised to be
hospitalized and was given streptokinase. Which of the following is the DESIRED effect of
the drug?

A. Dissolve clot formation

B. Reduce tissue damage of the heart
C. Prevent dysrhythmia
D. Reduced edema formation

84. As a nurse you are aware that the heart muscles damage after an attack without
treatment becomes permanent within___ hours?

A. 7-9
B. 10-12
C. 4-6
D. 1-3

85. In designing a care plan, which modifiable risk factors have to be emphasized to the
patient to prevent for another heart attack to happen?

1. Smoking
2. High blood pressure
3. High cholesterol
4. Overweight

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

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

86. The licensure examination which is administered by the Professional Regulation

Commission, Board of Nursing is given to____.

A. Apply the theory learned from class room to practice settings

B. Protect the public from incompetent practitioners
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C. Apply the scope of nursing practice

D. Demonstrate expected competency standards

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

A. Enforce and monitor quality standards of nursing practice in the country

B. Issue, suspend, revoke or reissue certification of registered nurses
C. Ensure proper conduct of nurse licensure in the country
D. Issue permit for the opening of nursing programs in the country

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

A. Oath of professional for new nurses

B. Nursing practice act 7164
C. Code of ethics for nurses
D. Core competency standards

89. Nurse Rey with the members of the team from a tertiary hospital is going for their
annual outreach program “Operation TULI”. There were 300 patients who came in the
morning with only 4 doctors, 3 nurses, and 1 pharmacist. Due to the volume of patients,
Nurse Rey, was asked to participate in performing circumcision with the rest of the
doctors. Nurse Rey can be liable of committing?

A. Assault
B. Invasion of privacy
C. Tort
D. Malpractice

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

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

Situation – Documentation is a basic competency expected of a graduate nurse when

performing her role in the clinical setting.
TITO A., RN

91. Mr. Rey had his insulin therapy on the day of his admission. On the second day he
developed allergic reactions after 2 hours of the insulin administration. What clinical
manifestations do you expect the nurse to write in her documentation as a reaction to this
drug?

1. Redness
2. Swelling
3. Tenderness
4. Induration

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

92. Mr. Rey has been anxious regarding his diagnosis as well as the recent reaction to the
insulin therapy. As a nurse, the PRIORITY nursing action to overcome this anxiety behavior
is to?

A. Conduct a family conference for the concern of the patient

B. Refer to the physician for an order of tranquilizer
C. Express your empathy and respect for his feelings
D. Take time to explain his disease process and effects of insulin

93. When a patient is suffering from Ketoacidosis, you expect that the entry of Nurse
assessment findings in the chart will include the following clinical manifestation EXCEPT?

A. Kussmaul respiration
B. Cheyne stokes breathing
C. Lethargy
D. Acetone breath odor

94. Nurse Gladys who is on morning shift was making her rounds when she observed Mr. Joe
who is suffering from Congestive heart failure is an edema of his lower extremities. If
the edema is 3+, what do you expect the nurse to write in her assessment findings?

A. Deeper pit, rebounds in 30 seconds

B. Barely the pit is not perceptible
C. Deeper pit, rebounds is only few seconds
D. Deep pit, rebounds in 10-20 seconds
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95. When auscultating the breadth sounds of patients with respiratory disorder they are
instructed to breadth thru their mouth. A possible complaint the nurse has to watch and be
written in her documentation when performing this procedure is which of the following?

A. Palpitation
B. Dizziness
C. Tachycardia
D. Bradycardia

Situation – Mary, a hairstylist, is experiencing peri-umbilical pain, feeling feverish

and nauseated while at work. She was rushed to the hospital as the pain is becoming
intense at the right lower quadrant of the abdomen. She was advised by the ER physician to
be admitted for further wok-up.

96. Nurse Ella admitted the patient and started to do her assessment. What sign is
elicited by the nurse when a deep palpitation of the left iliac fossa is done and causes
pain on the right iliac fossa of the patient?

A. Obturator sign
B. Blumberg sign
C. Psoas sign
D. Rovsing sign

97. After a thorough physical examination, laboratory and diagnostic tests, the physician
ordered an emergency open appendectomy due to a suspected MAJOR complication?

A. Thrombosis
C. Perforation
B. Sepsis
D. Bleeding

98. The nurse prepares the patient for surgery. The overall goals by the surgical team for
the patient going for operation include which of the following?

I. Relief of pain
II. Preventing fluid volume deficit
III. Reducing anxiety reaction
IV. Eliminating infection

A. I, II, III & IV

B. I, II & III
C. III & IV
TITO A., RN

D. I & II

99. As a safety alert, which of the following nursing measure should be AVOIDED by the
nurse prior to appendectomy?

A. Observe nothing by mouth

B. Administration of enema
C. Removal of nail polish
D. Instruct to urinate

100. In wound care management, the nurse is aware NOT to perform which of the following
intervention?

A. Allow the wound to drain freely

B. Maintenance of an acidic or neutral PH
C. Application of cold pack solutions
D. Maintenance for a moist wound environment
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NURSING PRACTICE IV: Care of Clients with Physiologic and Psychosocial Alterations, Part B

Situation - The Hospital Research Coordination is discussing the basics of research with
the members of the Research facility as part of continuing Education. Questions and answer
are also part of the program.

1. During the open forums, the Hospital Research Coordination raised the question as to,
who among the following, provides information in the questionnaire.

A. Participants
B. Key informants
C. Respondents
D. Subjects

2. One of the members of the Research Committee wishes to conduct a study involving an
interdisciplinary colleague. This study is termed as _________.

A. Clinical
B. Exploratory
C. Collaborative
D. Applied

3. In conducting qualitative research, a nurse should follow logical reasoning process

termed as, which of the following?

A. deductive
B. Intuition
C. Causal
D. Inductive

4. The lecturer reminded the committee members that bias in an influence that distorts the
study results. In qualitative research, which will eliminate bias?

A. trustworthiness
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B. Credibility
C. Randomness
D. Triangulation

5. One of the committee members raised the question on how to make an abstract. The
question was followed by how many words are required in an abstract should (APA) style be
followed? What is the correct answer?

A. 450-550
B. 250-350
C. 150-250
D. 350-450

Situation - The clinical instructor is conducting a ward class on how to perform breast
self-examination.

6. The CI is expected to set the atmosphere by welcoming everyone and by ______.

A. Showing everyone the picture of the breast.

B. Discussing the objective of the ward class.
C. Giving an anecdote about an old man.
D. Going ahead with the first part of the lecture.

7. For the students’ better understanding about the anatomy of the breast, the CI
shares_____.

A. Various pictures of the breast, external and internal views.

B. Pictures of different types of mastectomies.
C. The experiences of breastfeeding mothers.
D. Artistic drawing of breast.

8. The clinical instructor proceeded with the lecture to the students using the _____.

A. Question and answer method

B. Entertainment style of presentation
C. student as the resource persons
D. outline of the lecture she just presented

9. When the lecture presentation was finished, the CI proceeded with the ______.

A. Evaluation of the activity

B. Q and A on anything that the students are interested to tackle
C. Open forum to solicit questions related to the topic under discussion
TITO A., RN

D. cracking humorous anecdote to keep the class alive

10. The last necessary part of the activity is ______.

A. Informing the students their next day’s assignment

B. The joke portion for good vibes
C. evaluation so that future but similar activities can be improved
D. after care venue, an earlier reminder of the head nurse

Situation - Hypovolemic shock. The adult patient on his way to the office met a vehicular
accident and was continuously bleeding from the head. He was brought to the nearest
hospital by the bystander.

11. What does the Emergency Nurse do FIRST?

A. Start an intravenous line at once

B. Position with head lower than the extremities
C. Request for laboratory examination
D. Stop bleeding immediately

12. Due to continuous bleeding the patient goes into the 2nd stage of shock with BP 80/60.
What are the possible effect on the heart in this stage?

I. Increased heart rate

II. Chest pain
III. Increased cardiac troponin
IV. Myocardial infarction

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

13. The BEST position for patient to assume in cases of shock is ______.

A. Modified trendelenburg
B. High fowler’s
C. recumbent
D. Low fowler’s

14. What isotonic electrolyte solution are COMMONLY used as fluid replacement in
hypovolemic shock?
TITO A., RN

I. D5Water
II. 0.9% Sodium Chloride
III. Lactated Ringer’s Solution
IV. D10Water

A. II, III, & IV

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

15. In case a patient would go into cardiovascular overload as a result of intravascular

fluid therapy, the PRIORITY nursing action should focus on ______.

A. Respiratory distress
B. Increase in total urine output
C. Increase in body temperature
D. Edema in the lower extremities

Situation - Patient Lola, a 53 y/o mother of 5, has been having involuntary urine leaks
aggravated whenever she sneezes or cough. She is diagnosed with urinary incontinence. The
next 5 questions refer to this case.

16. The type of incontinence patient Lola manifest, where there is involuntary loss of
urine as a result of sneezing, coughing or even change in position is called ______.

A. overflow
B. reflex
C. Stress
D. functional

17. The nurse is aware that urinary incontinence brings about psychosocial cost, including
the following except _______.

A. increase expenses
B. social isolation
C. embarrassment
D. loss of self-esteem

18. The nurse instructs the patients that the BEST time for an incontinent patient to take
his diuretics is _______.

A. Any time of the day

B. After 4pm
TITO A., RN

C. In the morning
D. At bedtime

19. When providing health teaching to the patient with urinary incontinence, the nurse
must STRESS that it is _______.

A. Only surgery can alleviate the condition

B. Often reversible and treatable
C. treatable with drugs all the time
D. controlled with the aid of alcohol

20. The aim of pelvic muscle exercise for patient with urinary incontinence is to
strengthen the muscle that control the _________.

A. vagina and rectum

B. perineal area
C. bowel and bladder
D. vagina and urethra

Situation - Nurses should not only abide by the law, but be guided by the Code of Ethics
for Nurses as well.

21. The Code of Ethics for Nurses have articles relating to the relationship of nurses on
______. (SATA)

I. People
II. Practice and the Profession
III. Co-worker
IV. Society and Environment

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

22. The Code of Ethics adopted all the principle under the ______.

A. Code of Good governance

B. Patient’s Bill of Right
C. ICN Code of Ethics
D. American Nurses Association (ANA) Code of ethics
TITO A., RN

23. According to the code of ethics, WHO determines the coverage and scope of the
examination for the practice of Nursing in the Philippines?

A. Professional Regulation Commission

B. Association of Deans of the Philippines in the College of Nursing
C. Professional Regulatory Board of Nursing
D. Professional Association of Philippines Regulatory Board

24. What are the three important legal principles in nursing professional ethics?

I. Autonomy
II. Informed Consent
III. Confidentiality
IV. Truth-telling

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

25. The “end- justifies- the- means” ethics is described as ______.

A. Having no correct or wrong conclusion

B. Basically, without any ethical issue.
C. Conclusively unethical
D. Unavoidable during these modern times

Situation - Ma. Lanni, aged 40, has varying degrees of weakness in the lower extremities,
inability to perform voluntary movements and paresthesias. Her physician gives a tentative
diagnosis of Guillain-Barre Syndrome. (GBS)

26. Which is a common verbalization of the patient with GBS regarding the EARLIEST onset
of symptoms?

A. Acute Hemiplegia
B. Ascending motor weakness
C. Weakness of the four lower extremities
D. Acute hemiparesis

27. The nurse is aware that which occurrence in the patient’s health history suggest the
diagnosis of GBS?

A. Viral Illness few weeks before

TITO A., RN

B. Encephalitis
C. Severe Bacterial Infection
D. Meningitis

28. A PRIORITY nursing diagnosis of GBS is ____.

A. Ineffective breathing pattern

B. Impaired verbal communication
C. Imbalance nutrition
D. Impaired physical mobility

29. If the patient is unable to talk, how should the nurse BEST communicate to the
patient?

A. Enunciating the word slowly and well

B. By using picture cards
C. Just stop as he could no longer understand.
D. Talking loudly face-to-face with the patient

30. The nurse informs the patient and family that rehabilitation prior to discharge is
BEST describe as_______.

A. A period of up and down, physically and emotionally

B. Long and one requiring involvement of significant others
C. Easy and smooth from discharge onward
D. A rapid process toward recovery

Situation - Elmo, 69 y/o, is diagnosed with Benign Prostatic Hyperplasia (BPH)

31. The Nurse anticipates that the sign and symptoms of BPH do NOT include_______.

A. Frequency in Urination
B. Pain on urination
C. Dribbling urine
D. Hesitancy in starting urination

32. Elmo ask the nurse to explain his condition (BPH). Which statement are correct
explanation of the nurse?

I. It blocks the urethra

II. It obstructs the bladder
III. It spreads to other parts of the body
IV. It leads to urinary retention
TITO A., RN

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

33. What “IMMIDIATE” danger should the nurse anticipate post Transurethral Resection of
the Prostate?

A. Infection
B. Bleeding
C. Thrombosis
D. Shock

34. The Nurse knows that the normal colour of the bladder irrigation right after TURP is
_______.

A. Reddish pink
B. Bright red
C. Light pink
D. Yellowish

35. Sexual dysfunction like impotence, erectile dysfunction, and lack of libido are likely
possibilities of what prostatic surgery?

A. Suprapubic prostatectomy
B. Transurethral Resection of the Prostate
C. Laparoscopic prostatectomy
D. Perineal prostatectomy

Situation - General concepts of immunology must be learned by the Nurse to appreciate the
management of her patient.

36. Immunity that the baby gets from the immune mother through breastfeeding is:

A. Passive Natural
B. Active Artificial
C. Passive Artificial
D. Active Natural

37. Cell-mediated immunity is NOT usually associated with what condition:

A. Rejection of tissue graft

TITO A., RN

B. Production of Antibodies
C. Skin Hypersensitivity reaction
D. Surveying for malignant cell

38. When a person vaccinated with a Covid 19 vaccine produces antibodies to the disease,
this immunity is termed:

A. Active artificial
B. Passive Natural
C. Active Natural
D. Passive Artificial

39. The blood protein involve in the immune system is:

A. Thrombin
B. Globulin
C. Albumin
D. Hemoglobin

40. The immunity conferred by tetanus toxoid is best described as:

A. Lifelong Passive
B. Long lasting active
C. Temporary passive
D. Lifelong active

Situation - Even if still a staff nurse, Minda, can well contribute with the management of
the resources and environment of her unit.

41. The electric fan in the unit sparks occasionally but continues to function relatively
well. Nurse Minda knows though that she _____.

A. Has to ask one of the staff to preliminary check it

B. Will just wait until the fan stops to function
C. Should alert the unit staff to closely observe the fan
D. Must have it checked by maintenance department immediately

42. The electric fan stop now stops to work every now and then and continues to spark at
interval. The BEST thing to DO NEXT is to _______.

A. Turn off the fan immediately

B. Call the maintenance immediately
C. Let it continue to function
TITO A., RN

D. Request for another fan as soon as possible

43. The last fire in the hospital was due to a malfunction equipment. The fire
extinguisher was no where to be found. What should have been practiced?

A. A dedicated fire extinguisher must be in every strategic place.

B. Place one extinguisher between two units
C. A fire extinguisher can be replaced with fire sensors
D. Borrowing fire extinguisher may be tolerated if on the same floor

44. The staff assigned to check the fire extinguisher failed to monitor the
“whereabouts” of assigned equipment. The following statements are true except:

A. All employees are lazy

B. Monitoring staff is important
C. Not all staff are diligent in their task
D. Two errors added together can be potentially devastating

45. Because of the failure to replace the defective electric fan immediately, a fire broke
out and it became big enough to burn a major portion of the unit because a fire
extinguisher was missing. What lesson can be gained from this?

A. Punishment must be imposed on erring employees.

B. Reorientation of the new staff
C. Refer the erring employee to HR
D. Every protocol must be followed

Situation - In order for the medical team to work best, there must be smooth collaboration
and teamwork among its members.

46. John, the patient with urinary tract infection (UTI) is on hid 3rd day of antibiotic
but is still having high fever. There is a need for the nurse to refer her observation to
which of the following?

A. Intern
B. Resident-on-duty
C. Attending physician
D. Head Nurse

47. Urine C/S was ordered and the nurse was told by the secretary from the laboratory that
the result will be due in 5-7 days. The nurse knows from her reading that the bacterial
C/S may be reported in 3 days’ time. Thus, she plans to follow up the result from which
of the health allied professionals?
TITO A., RN

A. Head Nurse
B. Intern
C. Medical technologist
D. Physician

48. The patient developed worsening cough and was given an anti-cough elixir. After 30
mins he developed itchiness with hives. The nurse is hesitant to call anyone since it is
already midnight, and there was no one else since it is holiday. Who will she refer the
patient to?

A. Head Nurse
B. Nurse Supervisor
C. Consultant-in-charge
D. Head intern

49. The patient suddenly developed chest pain. The result of the stat Troph I revealed
high results. What steps are CORRECT according to protocol in this situation?

I. The medical technologist immediately calls up the physician to update him of the
result.
II. The nurse waits for the doctor to call to confirm the results
III. The nurse calls up the physician to inform him of just-in lab result
IV. The Doctor waits for the update of the result from the hospital

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

50. The patient was prescribed a number of stat Medication to prevent any untoward
complication. The nurse closely coordinates with which professionals to facilitate the
immediate release of the necessary medicine and supplies?

A. Attending Physician
B. Nurse Supervisor
C. Pharmacist
D. Head Nurse

Situation - Romy, 58 years old, has been a cigarette smoker since age 15. He has nagging
cough and hoarseness of voice and dyspnea. Based on the physical and laboratory findings,
the physician suspected him of having lung cancer.
TITO A., RN

51. Which of the following is NOT a known predisposing factor to lung cancer?

A. House is near a banana plantation.

B. Works as a sprayer of vegetables and fruit trees.
C. Lives in a suburban area.
D. Living with mother who is a tobacco smoker.

52. Upon history-taking, the nurse notes that the cough of a patient with lung cancer
usually STARTS off to be ________.

A. blood-tinged
B. productive
C. dark yellow sputum
D. dry and persistent

53. Which diagnostic procedure is commonly used to establish the diagnosis of lung cancer
which provides a detailed description of the tracheobronchial tree and allows for biopsies
of suspicious areas?

A. Computerized Tomography (CT) scan

B. Bronchoscopy
C. Sputum cytology
D. Positron Emission Tomography (PET)

54. To help the patient with his breathing difficulty, the nurse places him in which
position?

A. Prone
B. Fowler’s
C. Sim’s lateral
D. Supine

55. Romy is diagnosed with small cell lung cancer (SCLC), a rapidly growing type of
cancer. He and his family were shocked when told by the doctor that the patient will just
undergo palliative treatment. Which nursing action is MOST APPROPRIATE?

A. Providing relief from symptoms

B. Reducing fatigue
C. Providing psychological support
D. Advising treatment options

Situation - Proper recording is a vital task that the nurse is trained to do properly in
nursing school and expected to practice as a professional.
TITO A., RN

56. Nurses are taught as students that the ideal and PROPER time for recording vital signs
and notes on the patient is ________.

A. To wait for lunch break to do the recording

B. After all the tasks are done, in order to conserve time
C. As soon as they obtain the signs or observations on the patient
D. To wait for lunch break to do the recording

57. Right after endorsement and during the rounds, the incoming nurse observes that the IV
fluid is at 800 cc level and not 400 cc, as endorsed. What is the CORRECT information that
she will chart?

A. Anything goes, nobody reads the charting anyway.

B. Record the 400 cc
C. Chart that she received 800
D. Refer to the Head Nurse on what to do.

58. Which is the APPROPRIATE way to correct an error in the Nurses Notes?

A. Take the whole page out and replace with a fresh one
B. Draw a single line across the error and initial it
C. Use the sticky side of the plastic tape to erase the error
D. Use a rubber eraser to erase an error.

59. If a medicine is unavailable and therefore not given to the patient, how is it
charted?

A. Leave it blank.
B. Sign and make an explanation in the Nurses Notes.
C. With an asterisk or mark, as per hospital protocol.
D. Write the letter.

60. If the patient is referred to another consultant and the latter has made an order
already, what can the nurse CORRECTLY chart?

A. The attending physician has not yet ready read the order.
B. Only one order has been left to be carried out.
C. She has carried out the orders of the consultant
D. That the consultant has seen the patient with new orders.

Situation - Dog Bites are relatively common in the Philippines. The presence of a number
of stray dogs predisposes to the occurrence of rabies.
TITO A., RN

61. Upon entry of the patient to ER, the nurse must FIRST perform which nursing
intervention?

A. Inject with rabies immune globulin.

B. Cleanse the bite with soap and running water.
C. Inject the rabies vaccine immediately.
D. Administer the pain reliever, as ordered.

62. The nurse knows that a dog bite has a shorter incubation for rabies if located in the
______.

A. Leg
B. Hand
C. Abdomen
D. Face

63. The nurse anticipates that which one is prescribed to prevent a common bacterial
complication from the dog bite?

A. Ibuprofen (Motrin)
B. Ciprofloxacin (Cipro)
C. Tetanus toxoid (Tetavax)
D. Meperidine (Demerol)

64. In administering the rabies immune globulin (Rig), the nurse infiltrates the
calculated dose around the wound edges and the rest of the dose injected_______.

A. Intradermally
B. Intramuscularly
C. Subcutaneously
D. Intravenously

65. According to RA 9482 or the anti – Rabies Act of 2007, which of the following
statements regarding rabies post exposure prophylaxis is APPLICABLE?

A. Have the dogs be regularly vaccinated against rabies

B. Do not allow the dog to roam the street
C. Put the dog in a leash when in a public place
D. The owner will assist the bite victim with the medical expenses
TITO A., RN

Situation - The 3-year-old child has just finished ingesting the kerosene stored in a
lem-o-lime bottle. When the mother saw the child, she immediately brought him to the
nearest hospital.

66. The assessment of the patient with ingested poison must include _________.

I. Determining the poison ingested and the amount

II. The time from ingestion and the signs and symptoms
III. Weight of the patient
IV. Patient’s immunization history

A. I, II, III and IV

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

67. In case of poisoning, the nurse is aware that the main goals in poisoning are
to__________.

I. Inactivate the poison

II. Administer the specific antidote
III. Induce the patient to vomit
IV. Support vital organ functions

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

68. To remove the ingested poisonous substance, the physician ordered a gastric lavage.
What is the role of the nurse immediately prior to the procedure?

A. Get the right size of the nasogastric tube

B. Remind parents to be careful next time
C. Obtain and informed consent immediately
D. Tell the parent that they are negligent

69. The nurse is aware that the proper management of poisoning includes the following
EXCEPT to ________.

A. Perform hemoperfusion
B. Remove the toxin through dialysis
C. Dilute the ingested substance
TITO A., RN

D. Induce vomiting after ingestion of the caustic substance or petroleum distillate

70. Discharge instruction made by the nurse to the parents should include________.

A. Close monitoring of the toddler

B. Disciplining the child every time
C. Poison-proofing the home
D. Lecturing the child on safety

Situation - Nurse Emma is working in the ER when a strong earthquake shook the city.
Fifteen minutes later, a number of patients have been starting to arrive in the ER.

71. As the triage Nurse, which of the following will be Emma’s priority?

A. A non-responsive patient with sunken skull

B. The patient with facial wounds and fracture
C. Patient with sucking chest wound
D. A man with over 50 percent second and third-degree burns

72. Patients brought in who are unresponsive with penetrating head wounds are tagged by
the triage nurse in which colour?

A. Green
B. Red
C. Black
D. Yellow

73. Those who suffered stable abdominal wounds without significant bleeding will be
tagged_________.

A. Green
B. Red
C. Black
D. Yellow

74. It is very important that nurses must plan for mass casualties, which
include__________.

I. Warfarin
II. Terrorism
III. Natural disasters
IV. Infectious disease outbreaks
TITO A., RN

A. I, II, and III

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

75. Nurse Emma must work with the Disaster Committee for an appropriate disaster response
strategy, in order to succeed, must have physical assets which includes which of the
following?

I. Increased security
II. Stockpiles of equipment
III. Numerous medications
IV. Trained staff

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

Situation - The nurse when practicing the profession must adhere to ethical principles.

76. When the nurse treats the patients in the air-conditioned rooms favorably compared to
those in the charity wing, she violates which of the following ethical principles?

A. Veracity
B. Justice
C. Respect
D. Autonomy

77. The nurse has an obligation to tell the truth. When she admits mistakes promptly, she
manifests________.

A. Fidelity
B. Veracity
C. Respect
D. Autonomy

78. The cancer patient has been frequently complaining of pain and demands that the pain
reliever be administered even before the due time. The nurse prepares to inject NSS as a
placebo. Which principle will she transgress?

A. Respect
B. Veracity
TITO A., RN

C. Justice
D. Fidelity

79. The nurse knows that ethical dilemmas may be referred to the regulated ethics
committee that the PRIMARY role to _______.

A. Prevent the physicians from making the wrong decision

B. Decide what must be done under the circumstances
C. Prevent ethical dilemmas from occurring
D. Provide guidance for healthcare terms and family of patient

80. Nurses were overheard talking about the patient and his prognosis. What ethical
principle is violated?

A. Autonomy
B. confidentiality
C. non-maleficence
D. Beneficence

Situation - Nurses must continually grow as a person and as a professional. - NOVEMBER

2021 EXAM NP4#76-80

81. As a newly licenced nurse employed in a tertiary hospital, you are required to attend
Continuing Professional Development (CPD) program. When the training program is for the
enrichment of nurses in the hospital, it is called______.

A. Informal training program

B. Formal education program
C. Self-directed
D. In-service training

82. The professional development of a nurse can be achieved through various ways, such as
_______.

A. Participating in political rallies

B. Attending in socio-civic activities
C. Attending demonstration of baking
D. Engaging in CPD program

83. When Nurses are projected in a television advertisement as sex symbols, what
APPROPRIATE action is expected from a concerned nurse?

A. Keep your silence, it is the television’s prerogative

TITO A., RN

B. Go to the street to manifest displeasure of the nurse’s portrayal

C. Make a petition paper to denounce the advertisement
D. Condemn the issue in the radio program

84. To grow as a person, the student nurses can attend lecture-demonstration on which of
the following procedure?

A. Bathing the newborn

B. Proper bandaging
C. Doing first aid
D. Doing make up

85. Nurse Merry’s application to Canada has finally been approved and she was advised to
depart in three months, but she is also enrolled in the graduate school and ambivalent to
go because of this engagement plus the fact that her mother has just been discharge from
the hospital. Which of the following action is BEST?

A. Tell the family that the money spent in the graduate school can be easily earned in
Canada.
B. Inform the agency that she could go anytime as they wish
C. Tell the recruiter to give her more time to settle her personal affairs
D. Share to her friends this is her escape from her sad life with her family

Situation – Marlene, a kasambahay, is admitted for Luekemia in exacerbation. She appears

shy and seldom talks to hospital staff, except with the watcher who is her sister.

86. Nurse Myra wants to draw the patient out of her shell so she would be better able to
elicit the patient’s cooperation. Which of the following action is MOST helpful?

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

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

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

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

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

A. Whatever it is, you lift up to God

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

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

A. You can go to the cashier for to find out what she can advise you.
B. The government has agencies for those who need financial assistance. I will give you
the list.
C. You can always pay in staggered amounts to be given every 15 days.
D. Ask help from generous relatives so you can have additional down payment.

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

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

Situation – You are the Quality Improvement officer of the Hospital X. To achieve safe
and quality outcomes, necessary protocols must be in place and every error or adverse
event investigated to find the root cause and thereafter apply the necessary improvement.

91. A sentinel event is an unexpected occurrence involving death or serious physical or

psychological injury to a patient. As the QI Officer, what is your INITIAL STEP following
a sentinel event?

A. Reporting to the Department of Health

B. Immediate investigation
C. Corrective action on the personnel
D. Reporting to the Chief Executive Officer

92. In one of the Board meetings, the QI Officer will report the results of Quality
Improvement efforts in the hospital. The report will be presented much BETTER by using
which of the following? (Select all that apply)
TITO A., RN

I. diagrams
II. charts
III. graphs
IV. flow charts

A. I, II, III and IV

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

93. The WHO Surgical Safety Checklist aims to increase the safety of patients undergoing
surgery. This is being adopted by the Hospital’s Quality Department. Based on the
Checklist; you are aware that the surgeon, nurse and anesthetist should be present during
the recapitulation and reassurance of correct patient identity, correct site and correct
procedure, which occur right before skin incision. In what phase should the above take
place?

A. Debriefing
B. Sign out
C. Sign in
D. Time out

94. As the QI Officer, you have strongly recommended to the Surgery Department the
adoption of the WHO Surgical Safety Checklist to prevent a “wrong site” surgery?

A. Debriefing
B. Briefing
C. Time out
D. surgical site marking

95. The QI Officer conducts her random visit to the Operating Room. She asks one of the OR
nurses in what phase in the WHO Surgical Safety Checklist will the nurse account for the
sponges and needles used in the surgery?

A. Sign out
B. Time out
C. Sign in
D. Debriefing

Situation – Tommy, a 50-year-old chain smoker, is suspected to have lung cancer after he
was seen and examined by his physician. He and his wife got very worried about his
diagnosis.
TITO A., RN

96. Which procedure has to be done to the patient to establish a definitive diagnosis of
lung cancer.

A. Chest x-ray followed by a CT scan

B. Cytological study of the sputum
C. Bronchoscopy
D. Magnetic resonance imaging

97. The MOST significant contributory factor to the development of lung cancer is
__________.

A. being a cigarette smoker

B. belonging to the male sex
C. Being extremely obese.
D. Age over 40 years

98. The patient while in the hospital is complaining of chest pain. When the nurse is
assessing the degree of pain of the patient, the MOST APPROPRIATE basis is_________.

A. watcher’s description of patient’s pain

B. patient’s own rating of his pain
C. Non-verbal cues observed in the patient
D. nurses’s own rating of the patient’s pain

99. Health teaching on chemotherapy includes informing Tommy on the adverse effect of
bleeding related to bone marrow depression. Which verbalization of the patient indicates
further teaching?

A. I should watch out for discolorations in my skin

B. I am going to take two tablets of Aspirin for my headache
C. I may need platelet transfusion in the future
D. I should not blow my nose

100. The patient underwent a left pneumonectomy due to lung cancer. During surgery the
phrenic nerve is accidentally cut. This incident will result to ___________.

A. Allow greater expansion of the lungs

B. Make the diaphragm descend with ease
C. produce a partially functioning diaphragm
D. make diaphragm go up with ease
TITO A., RN

NURSING PRACTICE V: Care of Clients with Physiologic and Psychosocial Alterations, Part C

Situation - Sandro 8 years old, 1st grader child has always been the subject of her
mother’s prompting and care. He always test his mom’s rule in preparing for school.
Although this has been for five months now, Sandro still has to be reminded in getting
dress completely, and dilly dally eating his breakfast. He still plays with his toys
and interferes with her sister in playing blocks. The mother is so anxious in reminding
Sandro that his school bus will be arriving in 10 minutes every day.

1. Attention deficit hyperactivity disorder (ADHD) is characterized by NOT one of the

following?

A. Mental retardation
B. Overactivity
C. Inattentiveness
D. Impulsiveness

2. Which of the following would the nurse expect to see as symptoms in a child with
ADHD, except:

A. Moody, sullen and pouting behaviour

B. Interrupts others and can’t take turns
C. Excessive running, climbing and fidgeting
D. Easily distracted, and forgetful

3. Sandro is taking pemoline (Cylert) for ADHD. The nurse must be aware of which of the
following side effects?

A. Decreased thyroid stimulating hormones

B. Decreased red blood cell count
C. Elevated white blood cell count
TITO A., RN

D. Elevated liver function test results

4. An effective nursing intervention for the impulsive and aggressive behaviours that
accompany conduct disorder is________.

A. Open expression of feelings

B. Assertiveness training
C. Negotiation of rules
D. Consistent limit setting

5. Nursing diagnosis commonly used when working with Sandro is ________.

A. Ineffective role performance

B. Impaired social interaction
C. Compromised family coping
D. Risk for injury

Situation - The nurse is teaching a client taking an MAOI about foods with tyramine
that he or she should avoid.

6. Which of the following statements indicates that the client needs further teaching?

A. “I will have to avoid drinking non-alcoholic beer.”

B. “I will be able to eat cottage cheese without worrying.”
C. “I can eat green beans of this diet.”
D. “I’m so glad I can have a pizza as long as I don’t order pepperoni.”

7. Patient’s health teaching for Lamotrigine (Lamictal) should include which of the
following?

A. Take each dose with food to avoid nausea

B. Eat a balanced diet to avoid weight ga in.
C. Report any rashes to your doctor immediately .
D. This drug ma y cause psychological dependence.

8. Which of the following health teaching concern for the nurse as discharged plan for
suicidal patient who had been taking tricyclic antidepressant drugs for 2 weeks and now
ready to go home?
TITO A., RN

A. The nurse will need to include teaching regarding signs of neuroleptic malignant
syndrome.
B. The patient will need regular laboratory work to monitor therapeutic drug levels.
C. The nurse will evaluate the risk for suicide by overdose of tricyclic
antidepressant.
D. The patient may need a prescription for Benadryl to use for side effects.

9. A patient is to take regularly Lithium after discharged. The MOST important

information to impart to the patient and his family is that the patient
should__________.

A. Not eat foods which has high tyramine content like cheese, wine, liver
B. Limit his fluid intake
C. Have a limited intake of sodium
D. Have an adequate intake of sodium

10. The patient with diagnosis of schizophrenia who has been taking Clozapine will
inform the patient’s family that the positive effect of this drug is__________.

A. Monthly liver function studies change moderately

B. Psychotic symptoms, such as hearing loss are reduced
C. Patient develops leukopenia
D. Patient’s energy level and involvement in activities goes up.

Situation – Patrick, Charge nurse, is aware that the uses of resources are essential
for patient care.

11. A safe patient environment includes following factors EXCEPT ________.

A. Socio-economic needs
B. Basic needs are met
C. Sanitation is maintained
D. Physical hazards are reduced

12. As an individual, which of the following is an INTERNAL variable affecting health

status, belief, or practices?
TITO A., RN

A. Genetics
B. Socioeconomic status
C. Family structure
D. Living situation

13. Falls are one of the leading environmental hazards reported in health facilities.
One of the MOST common occurrences that precipitate a patient fall is _________.

A. Experiencing stress, anxiety, and fatigue

B. Leaving the side rails down
C. Reaching item at the bedside
D. Performing activities of daily living

14. In case a patient falls, the nurse’s FIRST responsibility is to _________.

A. Assess the patient’s injury

B. Write an incident report
C. Report the incident to the head nurse
D. Notify the physician at once

15. In healthcare facility, a planned program of loss prevention and liability control
refers to __________.

A. Quality assurance
B. Critical pathways
C. Risk management
D. Peer review

Situation - Mark, a 25 years old student suddenly had convulsive movements with loss of
consciousness during their lecture. After the episode he was rushed to the nearest
hospital.

16. A nurse is conducting physical assessment, which of the following is INAPPROPRIATE

action in this stage?

A. Insert intravenous cannula

B. Assess patient’s lifestyle
C. Assess patient source of stress and coping habits
TITO A., RN

D. Identify the patient’s daily activity

17. Mark is scheduled for an EEG after having a seizure for the first time. What is
the BEST patient preparation instruction before the procedure?

A. “Avoid thinking and personal matters for 12 hours before the test.”
B. “Do not shampoo your hair for 24 hours before the test.”
C. “Do not eat anything for 12 hours before the test.”
D. “Avoid stimulants and alcohol for 24 to 48 hours before the test.”

18. Which of the following manifestation should the nurse APPROPRIATELY observe during
generalized seizures?

A. Loss of consciousness, dilated pupils, and muscular stiffening

B. Jerking movements of all extremities
C. Facial grimace with patting and smacking.
D. Vacant stare with a brief loss of consciousness

19. What is the FIRST priority which the nurse must observe in caring for patient with
seizure?

A. Safety
B. Airway
C. Nutrition
D. Mobility

20. Phenytoin (Dilantin) has been prescribed for a patient. Based on an understanding
of the medicine, what is the APPROPRIATE nursing instruction of the nurse?

A. Give Dilantin intramuscularly

B. Administer good oral hygiene
C. Dilute IV Dilantin with 5% dextrose
D. Maintain a Dilantin level of 30-50 ug/ml

Situation – Gloria is a nurse researcher in the Department of Health. She is assigned

to conduct research on patient’s safety practices of nurses in the psychiatric unit.
She is given 6 months to conduct the study.
TITO A., RN

21. After formulating and delimiting the research problem, which of the following will
be a PRIORITY action of Gloria?

A. Develop the theoretical framework of the study

B. Formulate the hypothesis
C. Plan the research design of the study
D. Conduct a literature search on the topic

22. Gloria decides to include only nurses who have a minimum three years - experience
as psychiatric nurse. Which of the following terms refer to this?

A. Concept
B. Assumption
C. Hypothesis
D. Delimination

23. The statement “The length of service is not associated with the degree of patient
safety practices of staff nurses” is an example of a/an ________.

A. Phenomenological study
B. Experimental
C. Exploratory
D. Correlational

24. Which of the following research designs is MOST APPROPRIATE for this study if the
aim is to find a relationship between two variables in the study?

A. Phenomenological study
B. Experimental
C. Exploratory
D. Correlational

25. She plans to interview the Psyche Nurse Manager about the patient practices of the
nurses. What type of sampling includes “those who happens to be in the conference from
where the activity is scheduled?

A. Random
B. Purposive
TITO A., RN

C. Convenience
D. Quota

Situation – Belle is a 30-year-old single mother who is dependent on her family for
support. Her diagnosis is mild mental retardation with post-traumatic disorder with
depressive episodes related to her irritability, difficulty tolerating frustration,
difficulty falling asleep, increased appetite and weight gain, hypervigilance, and
worry that something terrible will happen to her child.

26. A cognitive assessment of Belle indicated that according to Piaget’s theory she
was functioning at the concrete operational stage. Which of these behaviours would the
nurse observe in Belle?

A. Thinks logically and sees possibilities

B. Understands only her own viewpoint
C. Feels her own reasoning should agree with the reasoning of others.
D. Makes and tests hypothesis

27. Belle has difficulty tolerating frustration. The GOAL of the nurse is to assist
Belle to ________.

A. Increase her self-esteem

B. Cope with anxiety
C. Recognize her needs
D. Mobilize her resources

28. Which of the following historical data MOST probably led to a post-traumatic stress
disorder?

A. Unstable relationship with ex-fiance

B. Suicide of her mother
C. No gang-relationship with peers
D. Dropping out of school

29. Given her problems of hyper vigilance and worry that something terrible will happen
to her child, nursing intervention should be aimed at addressing her needs
for____________.
TITO A., RN

A. Love and belongingness

B. Biological integrity
C. Psychological security
D. Self-esteem

30. In terms of social support therapy, which of those is the MOST APPROPRIATE and
therapeutic?

A. With appropriate support, lives in the community, either independently or in

supervised setting
B. Individualized relationship with a caregiver
C. High structured environment with constant aid and supervision
D. Vocational training with moderate supervision but not beyond second grade
academic challenges.

Situation – The following scenarios are potential routines that could check work
ethics of a professional nurse.

31. A patient asks to be discharged from the health care facility against medical
advice (AMA). What should the nurse do?

A. Notify the physician

B. Prevent the patient from leaving
C. Have the patient sign an AMA form
D. Call a security guard to help detain the patient

32. A nursing assistant is assigned to provide morning care to a patient. How should
the nurse document care given by the nursing attendant?

A. “Morning care rendered”.

B. “Morning care rendered by Grace Go, NA”.
C. “Morning care provided by G.G., nursing assistant”.
D. “Morning care refused to be given by nursing assistant”.

33. A nurse administers the wrong intravenous fluid to a patient. She should accomplish
which of the following documents to be submitted to her immediate supervisor?

A. Patient Kardex
TITO A., RN

B. Incident report
C. Progress report
D. Endorsement record

34. When developing a care plan for a patient with a do-not-resuscitate order, the
nurse should NOT include which intervention on the care plan?

A. Allow access to individuals who can provide spiritual care.

B. Administer pain medications as ordered by physician.
C. Provide usual routine and nursing care as ordered by physician.
D. Administer lethal doses of medication as patient request.

35. A patient is to undergo a laminectomy in the morning. The physician asks the nurse
to witness the patient’s signing of the consent form. What is the BEST action the
nurse?

A. Provide emotional support for the patient while the patient signs the consent.
B. Make sure the physician explains the risks of undergoing the procedure.
C. Make sure the physician thoroughly describes the procedure
D. Make sure the patient is competent, awake and alert before he/she signs the
consent form.

Situation – Charge Nurse Tessie works at the surgical ward. She ensures good record
management is implemented in her unit at all times.

36. A patient is having elective surgery under general anesthesia. Who is responsible
for obtaining the informed consent?

A. Surgeon - NOVEMBER 2021 EXAM NP5#19

B. Nurse
C. Nurse anesthetist
D. Anesthesiologist

37. Which statement by the patient indicates that he understands the explanation of the
surgeon?

A. “I refuse to sign the consent form; another family member can sign for me.”
B. “Now I know what the alternative treatments and procedures are.”
C. “If I refuse to sign the consent form, other treatment will be withdrawn.”
TITO A., RN

D. “I can’t refuse the procedure after the consent is signed.”

38. The unit secretary who transcribes the physicians order asks the nurse to interpret
an order because she cannot read the writing. The nurse’s BEST action is to
___________.

A. Clarify the order with the pharmacies

B. Clarify the order by calling the physician
C. Interpret the order according to the patient’s previous medication record
D. Clarify the order with junior staff

39. The physician orders to transfuses 500ml packed RBC blood postoperatively. The
nurse must check the name on the label of the blood with the name on the
patient’s___________.

A. Medication administration record

B. Wristband in the presence of another nurse
C. Medical chart
D. Wristband

40. The patient’s wife is so anxious about the condition for her husband. The MOST
appropriate INITIAL intervention for the nurse to make is to__________.

A. Describe her husband’s medical treatment since admission

B. Reassure her that the important fact is her presence
C. Explain the nature of the injury and reassure her that husband’s condition is
stable
D. Allow her to verbalize her feelings and concerns

Situation – Quality and safety are rooted in the daily work of a healthcare
professional. Nurses in the Orthopedic unit attends monthly quality assurance meeting.
The following questions were discussed.

41. Who should be involved in quality improvement measure?

A. Everyone
B. Management staff
C. Professional staff
TITO A., RN

D. Consumers

42. To start a nursing improvement project. What is the FIRST step that a nurse must
keep in mind?

A. Implement plan to correct the problem

B. Determine the nursing standards
C. Determine findings if warrant correction
D. Collect data, determine if standards are met

43. To achieve organized work flow in the unit, the staff must be aware of the head
nurse’s role. What is the PRIMARY purpose of supervision and delegation?

A. Enhances the delivery of quality nursing care

B. Influences organization’s approach in personnel evaluation
C. Improves staff attendance in seminars
D. Assigns any staff to do the tasks or project

44. To ensure quality nursing care to a patient in skin traction. What is the PRIORITY
intervention that a nurse has to assess frequently?

A. Signs of infection around the pin site.

B. Signs of skin breakdown
C. Urinary incontinence
D. Presence of bowel sounds

45. The nursing team plans to do chart audit project on post-op patients who had
developed pressure sores at the orthopedic unit over the past year to present. What
type of audit is?

A. Retrospective
B. Process
C. Concurrent
D. Outcome

Situation – Incidence of drug abuse greatly increased overtime. Korino has been using
drugs for the past three years
TITO A., RN

46. You are a Drug Abuse Treatment and Rehabilitation Center Nurse. During the
assessment of a newly admitted Person who uses drugs (PWUDs) named Korino, which of the
following is the MOST APPROPRIATE question to ask?

A. Ask Korino how long he thought that he could take drugs without someone finding
it
B. Ask Korino why he started taking illegal drugs.
C. Not ask any questions for fear Korino will deny and may become assaultive
D. Ask Korino about the amount of drug used and its affect and how long he had been
using.

47. Upon data collection he had been failing three times in his math class and Korino
was known for substance dependent for three years. What is the MOST APPROPRIATE nursing
diagnosis for him?

A. Alteration in perception
B. Alteration in social interaction
C. Ineffective individual coping
D. Impaired judgement

48. Korino has been using meperidine and codeine for personal consumption. Which of the
following does the nurse understand as the physiologic effect of these drugs?

A. Increase sexual stimulation

B. Relieves pain by increasing pain threshold
C. Decrease craving for alcoholic intake
D. Heightens concentration and alertness

49. Which assessment by the nurse would case a concern for Meperidine overdose?

A. Respiration rate of 12 bpm.

B. Hypercapnia
C. Dryness of the skin
D. Pinpoint pupils

50. What drug should the nurse prepare for administration to reverse all signs of
toxicity?

A. Digibind (Digoxin)
B. Naloxone (Narcan)
TITO A., RN

C. Atropine sulfate
D. Diazepam (Valium)

Situation – Effective communication is a core skill for nurses that a professional

nurse must apply in their daily routine for patient care, colleagues and family.

51. The nurse asks the patient “What do you fear MOST about your surgery tomorrow?
This is an example of which communication technique?

A. Providing general leads

B. Summarizing
C. Seeking clarification
D. Presenting reality

52. The patient made the following statement to the nurse, “My doctor told me that he
cannot save my leg and that I need to have an above-the-knee-amputation. Which response
by the nurse is MOST APPROPRIATE?

A. “Tell me more”
B. “Dr. Benito is an excellent surgeon”
C. “If I were you, I will get a second opinion”
D. “Are you in pain”

53. A nurse is communicating with attending physician about medical intervention

prescribed for a patient post spine surgery. Which statement is INDICATIVE of a
collaborative relationship?

A. Can we talk about Mrs. Santos?

B. I am worried about Mrs. Santos blood pressure. It is not decreasing even with the
new antihypertensive medication
C. That new medication you prescribed for Mrs. Santos is ineffective
D. We do not need to talk about Mrs. Santos blood pressure

54. An 80-year-old male, admitted for emergency suturing of the forehead sustained from
accident fall while gardening under local sedation. He was just received in the ward.
Which nursing intervention is APPROPRIATE to facilitate effective communication with
this patient?
TITO A., RN

A. Talk to patient when fully awake and inform him and family events which may occur
post-surgery
B. Provide the patient with instructional materials about discharge
C. Tell the patient, “You are fine nothing to worry”
D. Ask the patient, “Do you know where you are”

55. The nurse who uses appropriate therapeutic listening skills will display which BEST
behaviour?

A. Presume an understanding of the patient needs

B. React quickly to the message
C. Reassure the patient that everything will be fine
D. Absorb the content and the feeling which patient is conveying

Situation - Effective teamwork and collaboration in nursing is achieved when

individuals work together in harmony, processes and goals are aligned towards achieving
safe quality patient care.

56. Which of the following actions is INAPPROPRIATE for a nurse leader to apply in a
work setting?

A. Ask staff members of their opinion on the matter

B. Modifies his own behaviour favoring the needs of individual staff
C. Gives equal consideration to each staff members
D. Plans and organizes group activities of staff members

57. In problem solving, the head nurse must know what is the MAJOR characteristics of
negotiations?

A. Be positive in your approach since optimism gives further favorable results

B. Harmony is possible even when strategies are not well planned
C. It is not important to get anything in writing since the truth will prevail
D. Resources tend to involve too many individuals in decision-making process

58. Applying multidisciplinary approach of the patient care, which among the members of
the multidisciplinary team that the nurse would MOST likely collaborate with when the
patient is at risk of fall due to an impaired gait?

A. Podiatrist
B. Physical therapist
TITO A., RN

C. Speech therapist
D. Nutritionist

59. The nurse manager has implemented a change in the method of the nursing delivery
system from functional to team nursing. A nurse is resistant to change and is not
taking an active part in facilitating the process of change. Which is the BEST approach
in dealing with the nurse?

A. Exert coercion on the nurse

B. Provide a positive reward system for the nurse
C. Talk and encourage verbalizing feelings of the change
D. Ignore the resistance of the nurse

60. Which among the members of the multidisciplinary team that the nurse would be BEST
to collaborate with when the patient can benefit the use of leg prosthesis?

A. Occupational therapist
B. Physical therapist
C. Podiatrist
D. Pharmacist

Situation – Karen is seventeen years old, grade twelve, active in gymnastics. She is
five feet and seven inches tall, weighs eighty five pounds. Her family doctor diagnosed
her with anorexia nervosa.

61. Which of the following statements should Nurse Cora consider as TRUE with anorexia
nervosa?

A. Thinness is equated with vanity among peers.

B. Eating disorders are not major health problems
C. Cultures linking beauty to thinness increase risk of the illness
D. Anorexia nervosa is not considered as a mental disorder

62. Karen is being assessed for eating disorder. Which option is suggestive of anorexia
nervosa?

A. Lack of knowledge about food and nutrition

B. Guilt and shame about eating patterns
C. Refusal to talk about food-related topics
TITO A., RN

D. Unrealistic perception of body size

63. Nurse Cora is working with Karen. Even though Karen has been eating all her meals
and snacks, her weight has remained unchanged for a week. Which nursing intervention is
APPROPRIATED for Karen?

A. Supervise Karen closely for 2 hours after meals and snacks

B. Supervise Karen closely 2 hours before and after meals
C. Increase the daily caloric intake from 1500 to 2000 calories.
D. Increase the daily caloric intake from 1800 to 3000 calories

64. One morning, as Nurse Cora entered Karen’s room, she noticed that the patient was
engaging in a rigorous push ups. Which nursing action is MOST APPROPRIATE?

A. Allow her to complete her exercise program

B. Tell her that she is not allowed to exercise rigorously
C. Interrupt her and offer to take her for a walk
D. Interrupt her and explain that exercise is not needed

65. Which of the following is the INITIAL goal for treating severely malnourished
patient with anorexia nervosa?

A. Nutritional rehabilitation
B. Correction of body image disturbance
C. Weight restoration
D. Correction of electrolyte imbalances

Situation - Annie is a 38-year-old-woman with three children. She has a history of

otosclerosis. She is admitted for ear surgery.

66. While taking nursing history on Annie, what will be the response of the patient
that indicate her present condition?

A. She frequently experience vertigo, nausea and nystagmus when sitting.

B. She has ear pain and discharge from the left ear when travelling
C. She has had impaired hearing since birth
D. Her hearing loss has become worse with each succeeding pregnancy
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67. Annie states, I’m afraid to let my children out of my sight now that I can’t hear
them. What is the nurse’s BEST response?

A. “Tell me about your fears of losing contact with your children now that you
can’t hear them.”
B. “Children need some freedom and the mother has to learn to trust them.”
C. “Do the children usually misbehave when they cannot be seen or heard by you”
D. “What can the children do to make you feel more comfortable?”

68. What should be APPROPRIATE in the nursing care plan for Annie having otosclerosis?

A. Substitute meaningful sensory input by the use of other senses

B. Orient Annie to the staff, the unit, and all treatments
C. Give nursing care that will meet her psychological needs
D. Make frequent calls to prevent isolation and loneliness

69. The day after surgery, Annie expresses concern that hearing is not as good as it
was before admission. What is the BEST nurse action?

A. Encourage Annie to divert her attention by reading

B. Encourage Annie to blow more her nose to clear the eustachian tubes
C. Reassure Annie that it is temporary loss due to post-op edema and ear packing
D. Check the external ear for blood clots and remove them.

70. What post-operative teaching will the patient STRICTLY follow?

A. Reinforce the fact that airplane travel is no longer permitted.

B. Show patient how to gently irrigate the external auditory canal.
C. Inform physician any dizziness that develops after she is discharged.
D. Stress that hair washing should be avoided immediately after surgery.

Situation – Sandy, a 58-year-old teacher had a left total hip replacement due to
osteoarthritis.

71. Sandy should be placed in which of these positions for meals?

A. Supine
B. Trendelenburg’s
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C. Semi-fowlers
D. Sim’s lateral

72. The nurse did preoperative teaching to Sandy who’s admitted for hip replacement
surgery. Which statement of Sandy indicates the need for further preoperative teaching

A. “I’ll rest in bed for 2 to 3 hours after surgery.”

B. “I’ll begin gait training within 18 hours
C. “I should do muscle strengthening exercises in both legs.”
D. “I need to turn, cough, and breathe deeply every 2 hours.”

73. The physical therapist orders exercises of Sandy’s left hip, knee and foot to
gradually increase range of motion to the left hip. The nurses can BEST assist Sandy
by______.

A. Observing Sandy’s ability to perform the exercises

B. Performing the exercises for Sandy
C. Administering an analgesic before the exercises
D. Stopping the exercises if Sandy experiences pain

74. Sandy should be instructed to avoid _________.

A. Assuming prone position abducting her left leg

B. Abducting her left leg
C. Putting any weight on her left leg
D. Adducting her left leg

75. Sandy asks the nurse if her new joint will function normally. The nurse can BEST
answer this by saying that the________.

A. Doctor will be able to assess your limitations in 6 weeks and then explain them
to you
B. New joint will function almost as well as a normal joint, if you perform your
exercises faithfully
C. New joint will be stronger that the old one if you exercise well
D. New joint won’t function as well as the new joint, but will be better that the
arthritic joint
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Situation – When nurses are considering issues on control, shame and stigma,
surrounding the subject of mental illness, one of the primary considerations should be
nurse’s own sensitivity in recognizing signs of mental health problem. Ethics pervades
good practice. The following situation apply.

76. A patient is brought to the hospital by his officemates because he kept on blaming
his immediate superior of getting him fired from his job. Ethical problems may arise
when diagnosing psychiatric patients because of __________.

A. Inadequate staffing
B. Lack of exercise
C. Subjectivity
D. Inappropriate diagnostic procedures

77. The nurse is administering psychotropic medication to the patient. The patient
refused to take the medication. Which of the following situations would guide the nurse
where a patient refuses medication?

A. Cannot refuse his medication regardless of his medical diagnosis

B. Need a court order to allow the patient to refuse his medication
C. Can refuse this medication if he has not been deemed incompetent by formal legal
procedures
D. May refuse the medications only if his attending physician agrees

78. Which of the following is a basic safeguard to ethical reaction by the nurse in
providing care to patients with borderline personality disorders who are extremely
provocative and manipulative?

A. Observing human to human relationship

B. Seeking clinical expert opinion
C. Practicing self-awareness constantly
D. Applying person centered approach

79. The patient verbalizes to the nurse about thought of threatening to kill his wife.
The nurse is in dilemma whether to tell the wife about this conversation. Given this
situation which of the following is the appropriate action of the nurse?

A. Alert immediately the proper authorities regarding the threat to safeguard the
safety of the wife
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B. Tell the wife to be very extra careful as her life is in danger

C. Weigh carefully the situation by viewing it as dilemma between disclosing
confidential information on warning appropriate authorities
D. Keep the information to herself and be vigilant on the action of the patient to
protect the wife

80. The psychiatric diagnosing of patients is a morally charged issue and the assigning
of diagnosis maybe an ethical issue. The role of the nurse is diagnosing psychiatric
patient is important because nurses are

A. Collaborators in the diagnostic process

B. Planners or psychiatric nursing care
C. Knowledgeable in the field of psychiatry due to extensive clinical experience
D. Competent by virtue of their educational preparation

Situation – Mrs. Juan, a young female patient, believes that doorknobs are
contaminated with Covid 19 and refuses to touch them except with the aid of tissue
paper.

81. Her diagnosis of obsessive compulsive disorder constantly does repetitive cleaning.
The nurse knows that this behaviour is probably MOST basically an attempt to _________.

A. Decrease the anxiety to a tolerable level

B. Focus attention on non-threatening tasks
C. Control others
D. Decrease time available for interaction with people

82. What response should the nurse use in dealing with this behaviour?

A. Encourage her to scrub the doorknobs with a strong antiseptics so she does not
need to use tissue papers.
B. Supply her with paper tissue to help her function until her anxiety is reduced.
C. Force her to touch doorknobs by removing all available paper tissue until she
learns to deal with the situation
D. Explain to her that ideas about doorknobs with covid 19 is part of her illness
and is not necessary.

83. Signs such as using tissues to doorknobs develop because the patient is:
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A. Unconsciously controlling unacceptable impulses or feelings

B. Listening to voices that tell her doorknobs are unclean
C. Consciously using this method of punishing herself
D. Fulfilling a need to punish others by carrying out annoying procedure

84. Therapeutic treatment for Mrs. Juan should be directed towards helping her to:

A. Learn that her behaviour is not serving a realistic purpose

B. Forget her fears by administering antianxiety medications
C. Redirect her energy into activities to help others
D. Understand her behaviour is caused by unconscious impulses that she fears.

85. The nurse plans to educate the entire family about obsessive compulsive disorder.
Which of the following plans would be MOST effective?

A. The nurse direct Mrs. Juan and her family to the other resources to help them learn
about the illness and medication to treat it
B. The nurse teaches the family about Mrs. Juan’s illness and medication and suggest
that they educate Mrs. Juan about her disease and the medication to treat it
C. The nurse educate the entire family at the same time about the disease and
medications to treat it
D. The nurse teaches Mrs Juan about her illness and her medications and suggest that
she teaches her family what she has learned

Situation – Latest death toll in the Philippines due to Corona virus after Easter 2021
was 13,425. It was so scary that within a year this COVID 19 virus takes its toll. The
nurse must understand the importance of self-awareness and competencies in helping
patients and families during bereavement.

86. When human needs are taken away or not met for some reason, a person experiences
loss. Using Maslow’s hierarchy of human needs, which one of the following will the
nurse consider a loss in case of death?

A. Loss of security and a sense of belonging

B. Loss related to self-actualization
C. Physiologic and safety loss
D. Loss of self esteem
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87. Vangie, 73 years old, comorbid with hypertension and asthma died of COVID. Ariel
grieved and mourned to the loss of his mother’s untimely death. He is now aware that
his mother is one of those 13,425 deaths. The nurse will consider at what stage of
grieving process is Ariel experiencing?

A. Depression
B. Bargaining
C. Denial and Anger
D. Acceptance

88. Which of the following gives cues to the nurse that the patient may be grieving for
a loss?

A. Thoughts, feelings, behaviour, and physiologic complaints

B. Hallucination, panic level of anxiety, sense of impending doom
C. Sad affect, anger, anxiety, and sudden change of mood
D. Complaints of abdominal pain, diarrhea, loss of appetite

89. Which of the following situations will the nurse consider as risks factors for
complicated grief?

A. Childbirth, marriage and divorce

B. Death of a spouse, child, death by suicide
C. Inadequate perception of the grieving process
D. Inadequate support and old age

90. As a nurse, which of the following are the critical factors for successful
integration of loss during the grieving process?

A. The patient’s predictable and steady movement from one stage of the process of the
next
B. Accurate assessment and intervention by the nurse or helping person
C. The nurse trustworthiness and healthy attitude about grief
D. The patient’s adequate perception, adequate support, and adequate coping

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

91. Ms. Diaz learns that some leaders are transactional leaders. Which of the
following does NOT characterize a transactional leader?
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A. Focuses on management tasks

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

92. Ms. Diaz finds out that some managers have benevolent-authoritative style of
management. Which of the following behaviors will she exhibit MOST likely?

A. Have condescending trust and confidence in their subordinates

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

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

A. Demands of the labor sector to increase wages

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

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

A. Majority rule
B. Dominance
C. Collaboration
D. Compromise

95. The nurse ask the aide to weight a patient. Later the nurse discovered that a
patient has been weighed who is supposed to be in rest. This situation violates which
of the following rights of delegation?

A. Right person
B. Right direction and communication
C. Right supervision and evaluation
D. Right task
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Situation - Peter, a 19-year-old college student, has been in excellent health until
developing a flu-like illness couple of weeks. He is admitted with diagnosis of
Guillain Barre Syndrome ago.

96. Which of the following clinical manifestations would the nurse expect to find
when performing admission assessment?

A. Rapid progressive muscular atrophy

B. Ascending paralysis with ataxia
C. Hyperactive deep tendon reflexes
D. Paresthesia and muscle weakness of upper body

97. What is the MOST APPROPRIATE nursing diagnosis for this patient?

A. Self-care deficit related to neuromuscular impairement

B. Alteration in nutritional status related to possible choking
C. Alteration in nutritional status related to anorexia
D. Alteration in urinary elimination related to sensory motor impairment

98. What is the PRIORITY of care for patient diagnosed with Guillian-Barr syndrome?

A. Maintenance of respiratory function

B. Control of urinary tract infection
C. Prevention of decubitus
D. Replacement of fluid and electrolytes

99. In planning the nursing care for this patient, what is the MOST important nursing
intervention a nurse must do?

A. Encourage patient to release anxiety by crying

B. Reassure family that complete recovery is probable
C. Assess patient for respiratory distress
D. Have patient assist with care

100. What symptom is an INDICATOR of cranial nerve involvement?

A. Difficulty of speaking and chewing

B. Spastic paralysis of the extremities
C. Loss of pain sensation
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D. Forgetfulness and syncope