PRE-BOARD EXAM IV (NURSING PRACTICE IV) 1 PRE-BOARD EXAMINATION IV NURSING PRACTICE IV Care of Clients (Part B)

GENERAL INSTRUCTIONS: 1. This test booklet contains 100 test questions. 2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheet. 3. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer. 4. AVOID ERASURES. INSTRUCTIONS: 1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. 2. Write the subject title Nursing Practice IV on the box provided. 3. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B.

SITUATION 1: Man develops within the culture of his society, which strongly influences his health beliefs, values and behaviors patterns. 1) Which factor most affect the course of ones illness: a) Competence of care given b) Attitudes and feelings c) Educational level d) Previous hospital experience 2) A persons responses to health and illness are culture specific based on: a) Support of Family and significant others b) Ones experience and perception of health c) Availability and accessibility of health services d) Influence of social norms 3) Health promotion behaviors are those that enhance. a) Optimum functioning b) Quality of life c) Healthy functioning d) Social and productive life 4) The following statements on a personal persons response to crisis is true: a) One does not generally face a crisis alone b) Success in coping with crisis can be learned c) A situation maybe a crisis for one but not for another d) All of these

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 2 5) In recent years the government have more emphasis which of the following a) Rehabilitation b) Treatment of disease c) Preventing of illness d) Treatment and rehabilitation SITUATION 2: Mrs. Violy 38 years old complaints of chest pain and she was admitted in the Medical Emergency Hospital. 6) How will you assess angina pectoris? a) Subinternal chest pain b) Stabbing c) Crushing chest pain d) Vertigo on standing 7) In stages of hypertension stage 3 is described as> a) Systolic 140 159; diastolic 90 99 b) Systolic 180 209; diastolic 110 119 c) Systolic 160 179; diastolic 100 109 d) Systolic equal to or greater than 210; diastolic equal to or greater than 120 8) Drugs for M.I. a) Nitro glycerine b) Demerol

c) Ponstan d) Morphine

9) Levines sign is define as: a) Pain radiating to the left shoulder and arm, jaw, epigastric area. b) Clients clenches first over a few minutes of rest c) Generally subsides after a few minutes of rest d) Crushing or pressure pain 10) a) b) c) d) The least complication will occur in coronary occlusion is: Congestive heart failure Hypertensive Ventricular fibrillation Cardiac arrest

SITUATION 3: The Public health Nurse conducts heath education classes to the group of high school students in Barangay Babak. 11) A period at which menses begin is called: a) Menstruation b) Sexual development c) Menarche d) Sex maturation 12) a) b) c) d) 13) a) b) The normal sperm characteristics. Big head, long tail, pearly white Big head, short tail, yellowish Small heads, long tails, white Small heads, long tail, pearly white The average P.H. of a sperm is: 7.2 c) 6.0 7.5 d) 6.8

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 3 14) The average amount of semen released during ejaculation is. a) 2 to 3 ml c) 5 to 6 ml. b) 3 to 5 ml d) 60 to 10 ml. 15) Variations in the length of the menstrual cycle are due to the variations in the numbers of days in the: a) Follicular phase c) Ischemic phase b) Luteal phase d) Secretory phase SITUATION 4: Irene 39 years old was admitted because of a mass the size of a 5centavo on the lower quadrant of her left nipple. 16) You advice her to breast self-examination. The optimal time to encourage regularly and routine BSE on Irene is: a) 8th day of the menstrual cycle b) 5th day of the menstrual cycle c) 8th day of every month d) 1st day of every month 17) a) b) c) d) On palpation you observe that the mass is movable this is indicative of: Benign tumor Malignant tumor Spread of cancer cells Invasion of cancer cells

18) Diagnostic examination for breast cancer before its clinically palpable is: a) Frozen section c) X-ray of the breast b) Galactography d) Mammography 19) Most common sites of metastasis is/are; EXCEPT: a) Bone marrow c) Lungs b) Brain d) Heart 20) a) b) c) d) Radical mastectomy is the removal of: Breast, pectoral muscles pectoral fascia and nodes Breast, pectoral fascia and nodes Breast and nodes only Lump and surrounding breast tissue

SITUATION 5: Anacleto 18 years old has just graduated from high school and he got a scholarship in the College entrance test after the routine medical examination he was diagnosed to have Hepatitis-B. 21) How could you explain to him about his situation? a) Anacleto you have Hepatitis-B b) Inform his parents c) You are out of your scholarship d) Refer him to the Doctor 22) The incubation period of Hepatitis B is: a) 15 to 50 days c) 10 to 15 days b) 50 to 90days d) 3 to 5 days

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 4 23) a) b) c) d) 24) a) b) c) d) Hepatitis-B virus is transmitted through. Contaminated syringe and needles Eating raw fruits and vegetables Contaminated food and water Droplets from throat and carrier Hepatitis-B vaccination is given as follows: 2 doses at 3 weeks interval 2 doses at 4 weeks interval 3 doses at 4 weeks interval 3 doses at 3 weeks interval

25) Hepatitis-B vaccinations have been incorporated with the plans of the EPI. The main target for this vaccination are the: a) New born and infants b) Carriers c) School children d) Pre-schoolers SITUATION 6: Mr. Duhaylungsod was brought to the ER complaining of pain located in the upper abdomen. Diagnosis is peptic ulcer. 26) A frequent discomfort experience by the client due to his peptic ulcer is: a) Nausea c) Vomiting b) Diarrhea d) Eructation 27) a) b) c) d) The purpose of dietary treatment of the client is to: Neutralize the free HCL in the stomach Delay gastric emptying Prevent constipation Delay surgery

28) Diet is an important factor in the treatment of the peptic ulcer which is: a) Sippy c) Bland b) Liquids d) Frequent meals 29) a) b) c) d) 30) a) b) c) d) Which of this diagnostic measure is NOT indicated for the client: Gastric analysis Gastrointestinal Patients history X-ray of the abdomen Antacids are administered to the client to: Tranquilize the intestine Lower the acidity of gastric secretions Aid in digestion Decrease gastric motility

SITUATION 7: Mrs. Martha Trazo, sought consultation due to indigestion following ingestion of fatty, fluid and gas-forming foods causing an upper abdominal pain. The admitting diagnosis is cholecstitis with cholelithiasis. 31) Ingestion of fatty foods may precipitate upper abdominal pain, this is cause by: a) Fats in the duodenum which increases gastric secretions

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 5 b) Fats in the duodenum content initiates the reactions which causes gallbladder contraction c) Fatty foods are difficult to digest which causes gallbladder contraction d) Fatty foods initiates gastric secretions 32) Mrs. Martha Trazo is experiencing pruritus in the lower extremities, what is the most helpful in relieving the discomfort. a) Massaging with isopropyl alcohol b) Rubbing with face towel c) Applying weak sodium bicarbonate d) Using liberal babys oil and talcum powder 33) a) b) c) d) The reason for the clay colored stool for a client with cholelithiasis is: Decrease of bacterial flora of the bowel Obstruction of the bile flow to the gallbladder Interference in the absorption of proper nutrients Obstruction in the bile flow to the bowel

34) Mrs. Trazo underwent cholecytectomy and choledochotomy and a T-tube in place. To evaluate the effectiveness of the T-tube, the nurse should understand that the primary reason for using it with this client is to: a) Promote wound drainage b) Provide a way to irrigate the biliary act c) Minimize the passage of bile into the duodenum d) Prevent bile from entering the peritoneal cavity 35) How much bile would the nurse expect the T-tube to drain the first 24 hours after surgery? a) 50-100 ml c) 300-500 ml b) 150-250 ml d) 550-700 ml SITUATION 8: Leonardo, a 3 week-old infant is brought to the by his parents. His mother state he has been crying almost constantly since birth and frequently draws his knees up to his abdomen. Colic is suspected. 36) Which of the following assessment findings would be consistent with a diagnostic of colic? a) Frequent vomiting b) Soft abdomen c) Expulsion of flatus d) Failure to gain weight 37) a) b) c) d) Which of the following is a preventive measure for colic attacks? Give oral antispasmodic Insert rectal tube gently Let him lie on his abdomen after feeding Burped frequently during and after feeding

38) The nurse asks the parents to describe the infants bowel movements. Which of the following descriptions would the nurse expect if the infant does indeed have colic. a) Mucus-like stools b) Ribbon-like stools c) Frequent watery stools d) Soft, yellow stools

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 6 39) a) b) c) d) 40) a) b) c) d) Which of the following would not provide pertinent diagnostic data about colic? The position of the infant during burping The use of an infant high chair The infants crying pattern The amount of formula given the infant The nurse performs the following to determine the familys nursing problems. Goal setting Family health care plan formulation Assessment Evaluation

SITUATION 9: Mr. Camilo, 55 years old, is complaining of pain in his left leg. A diagnosis of intermittent claudication is made. 41) The following Diagnostic exam is considered. a) Arteriogram c) Phlebography b) Encephalography d) Doppler flow rate 42) Heparin IV is ordered to Mr. Camilo at the rate of 1,000 U per hour. The concentration of heparin solution is 12,500 U of heparin in 250 ml. Of 0.9 % Nacl. The nurse set to deliver the amount per hour. a) 12 ml c) 25 ml b) 20 ml d) 50 ml 43) All of the following are drugs of choice for leg cramps, EXCEPT: a) Calci-aid c) Calpol b) Cal-pcede d) Calcebone 44) During Heparin therapy monitors the following: a) APTT c) BT b) PT d) CT 45) a) b) c) d) Nursing intervention for the diagnosed with peripheral vascular disease include: Providing and teaching about [roper foot care Warning against alcohol ingestion Promoting a low residue diet Encouraging the use of heavy support stocking

SITUATION 10: Estong, age 52, is referred for treatment of severe obsessivecompulsive disorder. 46) Mario has a compulsive ritual of washing his hand 25 times before he eat his meals. Which of the following nursing interventions is most helpful? a) Suggest that he begins his ritual earlier b) Prohibit Estong from carrying out meal ritual c) Discuss his ritualistic behavior with him 47) a) b) c) d) 48) Estong will not be able to stop handwashing ritual until he: Acquires more super ego strength Can manage his feeling of anxiety Recognize that behavior is unrealistic Regains contact with reality A relevant nursing diagnosis is:

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 7 a) b) c) d) Ineffective individual coping Self esteem disturbance Social isolation Altered throughout process

49) In formulating a plan of care focused on decreasing Estongs anxiety, the nurse should: a) Work with him to develop limits on the behavior b) Discourage him from performing the rituals c) Ignore the ritualistic activities d) Help him regain self control 50) The ego defense mechanism, which are commonly utilized in obsessive compulsive disorder are. a) Displacement and undoing b) Suppression and projection c) Sublimation and introjections d) Rationalization and repressions SITUATION 11: Mrs. Maacap a newly-married couple, plan to start a family only after at least a year of adjustment. They want to practice family planning. 51) Mrs. Maacap is interested is IUD. You tell her that its insertion is usually done at this period of the menstrual cycle. a) 1st to 4th days b) 7th to 10th days c) 12th to 16th days d) 18th to 20th days 52) You introduce to the couple to the cervical mucus method. That intercourse is discourage when cervical secretion is: a) Whitish and thin b) Cloudy and viscous c) Yellowish and thick d) Clear and stretchable 53) You also explain to them the basal body temperature method, in which the fertility period surrounding ovulation usually extends from. a) 5 hours before to 10 hours after ovulation b) 10 hours before to 96 hours after ovulation c) 24-48 hours before to 48 hours after ovulation d) 72 hours before and 72 hours after ovulation 54) Another commonly used birth control method if the Pills. The oral contraceptive prevent pregnancy by: a) Rendering the spermatozoa inactive b) Preventing ovulation c) Prevent implantation d) Prevent fertilization

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 8 55) This is used to prevent transmission of STDs. a) Condom c) Rhythm method b) IUD d) Billings Method SITUATION 12: Katherine, 14 years old Junior high school student sexually assaulted by five men. 56) The common initial reaction to sexual assault is: a) Increased anxiety b) Difficulty in concentrating c) Difficulty indecision making d) Shock, numbness and disbelief 57) Katherine, verbalizes to her mother and the Nurse, I feel so dirty. I feel so ashamed. The most appropriate response to the nurse is: a) You should have fought back b) There is nothing to be ashamed of, people would not know c) You have a terrible experience, Do you like to talk about it d) Why do you feel so dirty? 58) When Katherine expressed feelings of ashamed or self blame, the appropriate nursing intervention is: a) Remain neutral, non-judgmental and assure her of confidentiality b) Bring with her a private place night away c) Stay with her during the physical examination d) Tell her that those are common reactions experienced by victims of sexual assault 59) Katherine cries helplessly while being comforted by her mother. As a nurse, you would say to her. a) Be calm, it will help you see through your problem b) It must really be disturbing to be in your situation c) Ill go see a doctor so he can prescribed a drug to calm you d) Ill leave you to your mother and come back when you are comfortable already 60) During the initial phase of crisis, an appropriate of crisis, an appropriate nursing intervention to help Katherine is: a) Providing an environment to meet her current psychological needs b) Focusing on rape crisis situation rather than previous problems c) Attending to her physical needs d) Helping her take shock of her life prior the crisis SITUATION 13: Mr. Harimon, 42 years old, a police officer has been diagnosed as not slept for 2 months. 61) Which of the following would be the most appropriate initial intervention by the nurse, when she saw my. Harimon, restless and walking around the room who seems to be anxious. a) Lets sit down and watch T.V b) Would you like to tell me about what makes you so anxious c) You look very anxious, what are you experiencing right now d) I will walk with you might probably want to tell something 62) In assessing Mr. Harimon coping style. The nurse asks the following question. a) What would you like to discuss

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 9 b) c) d) 63) a) b) What are you thinking about Does it seems life is meaningless to you What do you think, you could do help in your situation He is prescribes with lithium carbonate adequate fluid intake is: 1,000 ml/day c) 2,000 ml/day 1,500 ml/day d) 3,000 ml/day

64) The therapeutic serum lithium level in adult is: a) 1.0 to 2.0 Meg/L c) 1.0 to 2.5 Meg/L b) 0.5 to 1.5 Meg/L d) 0.8 to 1.8 Meg/L 65) Which of the following characteristics of hyperactive client can be used by nurse to direct his activities? a) Flight of ideas b) Emotional liability c) Distractibility d) Delusions of grandiosity SITUATION 14: Mr. Simon, 28 years old was rushed to the hospital due to burns sustained from a movie house. 66) The initial nursing management upon admission in the ER is: a) Assess airway, breathing and circulation b) Vita signs c) Administer oxygen therapy d) Apply antimicrobial cream over burned are. 67) The nurse inserts an indwelling urinary catheter. The rationale for this action is to help. a) Decrease the workload of the kidneys b) Ensure adequate urine output measurement c) Obtained regular urine specimens d) Prevent urine retention 68) A priority nursing diagnosis category for Mr. Simon during the emergent period would be. a) Fluid volume excess b) Altered nutrition; less the body requirements c) High risk for urine falls d) High risk for infection 69) While caring for MR. Simon with a burn injury, the nurse should observe for signs and symptoms of which complication believed to be due primarily to stress. a) Injection b) Gastric dilatation c) Nitrogen imbalance d) Hourly urine specific gravity 70) During the first 48 72 hours following a major burn injury. IV infusion rate will be adjusted by evaluating Mr. Simons. a) Daily body weight c. b) Hourly body temperature c) Hourly urine output d) Hourly urine specific gravity

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 10 SITUATION 15: Mrs. Lloren, 60 years of age, fell and fractured her right femur. 71) In the hospital she was placed on Bucks extension in order to: a) Reduce swelling b) Strengthen involved muscles c) Reduced the fracture d) Shorten the time required for healing 72) Following interval fixation. The clients legs should be positioned: a) Inflexion c) Abduction b) In adduction d) Inflexion at the hip 73) a) b) c) d) 74) a) b) c) d) The following statements are true about Russell traction: It permits bending at the knees It can apply only unilaterally It may contribute to severe pain No freedom of motion Nursing measures to prevent pneumonia post-operatively: Turn her to sides every shift Turn her to sides every 6 hours Turn her contribute to severe pain Turn her to sides every 2 hours

75) The doctor ordered 1-liter ofdD50Rs to be given in 6 hours. How many drops should the nurse regulate the flow of IV fluids per minutes a) 55 gtts/min c) 33 gtts/min b) 42 gtts/min d) 22 gtts/min SITUATION 16: Samuel, 40 years old was brought to the mental health Rehab.Center after a history of physically abusing his wife every time he is intoxicated. 76) Initial assessment upon admission would help the nurse identify one of the following as the clients problem a) In effective individual coping b) Disturbance in self-esteem c) Impaired social interaction d) Altered health maintenance 77) During a nurse-client interaction, Samuel says, Alcohol made it. This is an example of what defense mechanism. a) Rationalization b) Sublimation c) Displacement d) Altered health maintenance 78) The psychotherapy most appropriate to Mr. Samuel, sine the family members is affected. a) Milieu therapy c) Family therapy b) Group therapy d) Behavior therapy 79) Drug of choice for Alcoholics is / are: a) Disulfiram c) Valium b) Lithium carbonate d) Thorazine

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 11 80) Nursing interventions which can help Samuel rebuild trust in his relationship with his wife. a) Allow his wife to visit regularly b) Refers him to a marriage counselor c) Encourage them to attend a marriage encounter seminar d) Encourage him to verbalize his concerns to his wife

SITUATION 17: These questions pertain to child growth and development. 81) At what age proper tooth brushing should be imposed: a) Weaning b) Post 2 years old c) Star of school age d) Before 4 months to 2 years old 82) At what age do concepts of reversibility and cause and effect develop? a) 5 to 7 years c) 6 to 12 years b) 3 to 5 years d) 1 to 3 years 83) To properly visualize the auditory canal a 4 year old during an otoscopic examination. The nurse should pull the pinna of the ear. a) Up and back c) Down and back b) Up and forward d) Down and forward 84) a) b) c) d) 85) a) b) c) d) The most appropriate toy is s for 6 month old infant would be: Push-pull toys Wooden blocks Soft stuffed animals Shape matching toys A developmental assessment of a 9 month old would be expected to reveal. A two-to three word vocabulary An ability to feed self with a spoon The ability to sit steadily without support Closure of both anterior and posterior fontanels

SITUATION 18: Nichole Victoria, Mutya ng Davao is admitted to the Community mental Hospital and she diagnosed as having anorexia nervosa. 86) Anorexia Nervosa is usually precipitated by: a) The acting out of aggressive impulses, which results in feelings of hopelessness b) An unconscious wish to punish a parent who tries to dominate the adolescent life c) The inability to deal with being the center of attention in the family and a desire for independence d) An inaccurate perception of hunger stimuli and a struggle between dependence and independence 87) a) b) c) d) To obtain information for the nursing history Nicholes history is likely to reveal. Strong \desire to improve her self-image A close, supportive mother-daughter relationship Low achievements in school., with little concern for grades Satisfaction with and a desire to maintain her present weight

88) a) b) c) d) 89) a) b) c) d) 90) a) b) c) d)

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 12 The nursing intervention that should receive the highest priority is: Provide adequate rest and nutrition Monitoring the clients fluid and electrolyte balance Completing an assessment of the clients mental status Obtaining more data about the clients diet and exercise program When interacting with Nichole, the Nurse should. Show empathy Maintain control Set and maintain limits Focus on dietary nutrition One day, Nichole starts to discuss food and eating, the nurse should plan to: Tell her gently but firmly to direct all discussion of food to the dietician Use her current interest in food to encourage her to increase her intake Listen closely to determine her favorite foods and secure these foods for her Let her talk about foods as long as she wants, but limit discussion about her eating

SITUATION 19: For professional development, it is a policy of nursing service to encourage nurses to participate on the improvement of nursing practice. 91) When you participate in nursing research you main activity is to: a) Solve a nursing problem b) Develop problem-solving skills c) Explain a nursing phenomenon d) Understand man as human being 92) a) b) c) d) Which of the following would you do first? Ask an attendant to help you Attend first to pts. With watchers Attend first to pts. With watchers Organize activities by priority

93) After one year, Mrs. Monreal was rotated to the OR. As OR nurse, she was ordered by the obstrician to give spinal anesthesia because the anesthesiologist was rate. The nurse should. a) Give the anesthesia, if the Doctor writes the order b) Give the anesthesia, if the supervising nurses allows it c) Give the anesthesia, if the Obstetrician supervises her d) Never given the anesthesia 94) When a physician gives a telephone order, the only way for the order to be legal is. a) The physician must give his name over the phone b) The nurse record the order in the Treatment Sheet c) The physician must sign the order within the prescribed time d) The supervisor must accept the phone order 95) a) b) c) d) This is the best course of action when faced with ethical difficulties: Discuss with a lawyer Assess the ethical problem in question Reflect on your conscience Refer to spiritual group

PRE-BOARD EXAM IV (NURSING PRACTICE IV) 13

SITUATION 20: Mr. Santiago is admitted for cardiac catherization: 96) In taking care of clients for cardiac catherization, the nurse noted that the client manifested fear to the procedure and its outcome. This statement is an example of: a) Nursing diagnosis b) Implementation c) Assessment d) Evaluation 97) When caring for Mr. Santiago after cardiac catherization. It is most important that the nurse: a) Provide for rest b) Administer oxygen c) Check the ECG every 30 minutes d) Check pulse distal to the insertion site 98) Mr. Santiago is receiving anticoagulants; the nurse care should include observations for. a) Nausea c) Headache b) Epitaxis d) Chest pain 99) a) b) c) d) 100) a) b) c) d) The nurse is aware that the Bradycardia means. A grossly irregular heartbeat A heart of over 90 / min. A heart rate of under 60 / min A heart beat that has regular skipped beats Youre monitoring the CVP line every 2 hours. You are aware that: A normal reading is 60 to 120 mm of water A high reading maybe indicative e of hydration The zero point of the manometer is level with mid axilla The client must be kept flat in bed while the catheter is in place

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