Republic of the Philippines

PROFESSIONAL REGULATION COMMISSION

Manila
BOARD OF NURSING
Nurse Licensure Examination
NURSING PRACTICE III – CARE OF CLIENTS WITH PHYSIOLOGIC AND
PSYCHOSOCIAL ALTERATIONS (PART A)
INSTRUCTION: Select the correct answer for each of the following
questions. Mark only one answer for each item by shading the box
corresponding to the letter of your choice on the answer sheet
provided.
STRICTLY NO ERASURES ALLOWED.

Situation. Jungkook rushed to the ER due to severe abdominal pain

radiating to the scapular region. Health history revealed that
his meals were mostly from KFC. Patient appeared jaundiced with
facial grimaces. The physician on duty (POD) examined him and an
impression of Cholelithiasis was given by the POD. Patient was
ordered to be admitted for further work-up and possible surgery.
1. Which of the following questions should be asked by the nurse
to accurately describe biliary colic?
A. Nararamdaman niyo po ba ang sakit bagomatulog?
B. Nararamdaman niyo po bang sakit sa kaliwang parte ng inyong
tiyan?
C. Panandalian lamang po ba ang sakit?
D. Nararamdaman niyo po ba ang sakit matapos kumain?

2. In a patient with obstructive jaundice, which of the following

assessment findings would you expect?
A. Itchiness of the abdomen
B. Clay-colored stool
C. Reddish-colored urine and stool
D. Presence of urobilinogen in the urine
3. Mr. Jungkook had bile duct exploration with open
cholecystectomy. A t-tube was connected to drain after surgery.
After 12 hours, there was a marked decrease in output from 260 ml
to 90 ml. What is the nurse's priority action?
A. Call the physician stat
B. Assess the tube for any obstruction
C. Irrigate the tube with normal saline
D. Change the position.

4. One of the most common complications post-operatively is:

A. Pleurisy
B. Bronchopneumonia
C. Pneumonia
D. COPD

5. Which dietary restriction should be recommended by the nurse

to help prevent recrrence of stone formation?
A. Orange juice,pan de sal
B. Whole milk, dairy crème, fried chicken breast
C. Steamed lapu-lapu, nilagang okra, salabat
D. Nilagangsaba, vegetable salad

Situation. Mr. Olaf, a 62 year-old male, complains of shortness

of breath, dyspnea on exertion, palpitation, and expectorating
frothy, blood-tinged sputum. He was brought to the emergency room
of Hospital C. During the interview, he also complained of easy
fatigability and weakness.
6. Given the following assessment cues, Nurse Olaf makes a
nursing care plan with the priority nursing diagnosis of:
A. Anxiety related to actual threat to biological integrity
secondary to heart failure
B. Ineffective breathing patterns related to decreased
respiratory depth secondary to pulmonary edema
C. Activity intolerance related to compromised oxygen transport
system secondary to heart failure
D. Activity intolerance related to compromised oxygen transport
system secondary to heart muscle dysfunction

7. Mr. Snowman has been diagnosed with heart failure. Nurse Olaf
expects this patient to not exhibit the following signs and
symptoms EXCEPT:
A. Pulse rate of 48 bpm
B. Murmurs
C. Respiratory rate of 18 cpm
D. Strong, bounding pulse

8.The doctor ordered oxygen administration for the patient. The

nurse knows that the rationale behind this intervention is that:
B. Oxygen is contraindicated in heart failure so the order is
questionable
C. Oxygen is given to reduce anxiety
D. Oxygen is administered through mechanical ventilation only

9. Nurse Olaf prepares to perform the following interventions for

the immediate management of Mr. Snowman excluding:
A. Establish an IV line and administer PNSS immediately
B. Monitor heart rate and dysrhythmia by using a cardiac monitor
C. Continuously assess level of consciousness
D. Provide reassurance and support to the patient
10. The nurse knows that the management of a patient with heart
failure requires interprofessional collaboration. Mr. Snowman
asks Nurse Olaf from whom can he ask for assistance and counsel
regarding home care services. Nurse Olaf responds that the
professional who can help him with his concern and who assists
the continuing care nurse with planning the patient's discharge
is the:
A. Physical therapist
B. Social worker
C. Psychologist
D. Head nurse

Situation. Nurse Dengdeng handles various patients with

elimination problems. She always performs her best nursing care
to these patients.
11. Nurse Dengdeng teaches an incontinent patient bowel training.
Which among the following would Nheng not include in her health
teaching?
A. Opioids are avoided to prevent decrease in bowel peristalsis.
B. Regular exercise is encouraged.
C. Leaning backward at the hips while sitting on the toilet will
help stimulate colon emptying.
D. A hot tea or fruit juice may be taken before the patient
defecates.

12. An enema to provide relief from gaseous distention is

prescribed to a patent. Dengdeng knows that this is a/an:
A. Oil retention enema
B. Carminativeenema
C. Soapsuds enema
D. Fleet enema
13. After inserting a nasogastric tube, Dengdeng checks its
placement by measuring the pH of the aspirate. Dengdeng knows
that proper placement has likely been made if the aspirate has a
pH of:
A. pH 3.0
B. pH 7.0
C. pH 9.0
D. pH 7.4

14. Nurse Dengdeng knows that the approximate length of a normal

female urethra is:
A.1.5-2.5cm
B.4-6.5cm
C.20-25cm
D.10-12cm

15. To prevent urinary tract infection in a female patient with

an indwelling catheter, Dengdeng instructs her to decrease intake
of which of the following fruit juices?
A. Pineapple Juice
B. Prune Juice
C. Apple Juice
D. Cranberry Juice

Situation. Anna, while going on a date with Kristoff, suddenly

complains "I can't breathe". Kristoff rushed her immediately in
the ER. She was given Theophylline and Cromolyn sodium for the
attack.
16. The following are expected assessment findings for Anna
except:
A. Decreased tactile fremitus
B. Resonant to tympanitic
C. Wheezing sounds
D. Crackles

17. Upon administration of theophylline, you are monitoring Anna

for which drug induced adverse effect?
A. Bradycardia
B. Diarrhea
C. Constipation
D. Restlessness

18. Upon administration of Theophylline, the therapeutic effect

that you would expect is:
A. Decrease in breath sounds
B. Increase in body temperature
C. Decrease in wheezing
D. Pruritus

19. Kristoff asks the nurse why Anna needs Theophylline. The best
response of the nurse is:
A. "Pinaluluwag nito ang daluyan ng hangin."
B. "Iniiwasan nito na magkaroon pa ng allergic attack si Athena."
C. “Iniiwasan nito na atakihin ng epilepsy si Athena"
D. "Binabawasan nito ang pamamaga ng baga"

20. Kristoff brought food in Anna's room. Which of the following

food should be restricted for Anna in consideration to her
therapeutic regimen?
A. White Chocolate Mocha drink
B. Mango juice
C. One piece chicken with rice
D. One peach mango pie
Situation. Nurse Rosé has newly admitted patients in the Medicine
Ward who are for workup.
21.A patient with suspected pneumonia is ordered to have sputum
culture and sensitivity. Nurse Rosé orders the patient to cough
up how much sputum into the container?
A.15-30mL
B.1-5mL
C.4-10mL
D.250ml

22. Jisoo is a 25-year-old patient suspected to have chronic

myelogenous leukemia. She is advised to undergo bone marrow
biopsy. The following bones may be used for the procedure,
except:
A. Posterior superior iliac crest
B. Anterior superior iliac spine
C. Sternum
D. Triquetrum

23. Patient Jennie likes to eat melons and strawberries. On the

day of her specimen collection for fecal occult blood, she
claimed that she has been bingeing on these fruits since 5 days
ago. What will be its implication on the test/results?
A. Results can become falsely positive for occult blood.
B. Results can become falsely negative for occult blood.
C. Increased intake of fruits will confirm presence of occult
blood in stool.
D. Stool specimen will become clay-colored.

24. Nurse Rosé knows that 24-hour urine collection is needed in

determining the following, except:
A. Vanillylmandelic acid (VMA) in pheochromocytoma
B. Uric acid in gouty arthritis
C. Culture and sensitivity of causative agent in urinary tract
infections
D. Creatinine clearance in acute kidney injury (AKI)

25. Immediately after obtaining blood for an arterial blood gas

examination, Nurse Rosé instructs the patient to do which of the
following?
A. Perform ROM exercise on the proximal joint.
B. Apply pressure for 5-10 minutes
C. Elevate extremity above heart level.
D. Increase oral fluid intake.

Situation. Nurse Lisa is a staff nurse in the medical ward. Most

of her patients are afflicted with intestinal and rectal
disorders.
26. Upon assessment, which of the following differentiates
Crohn's disease from ulcerative colitis?
A. Presence of bleeding: severe in Crohn's disease while in
Ulcerative Colitis bleeding is mild.
B. Presence of diarrhea: severe in Crohn's disease in ulcerative
colitis it is mild
C. Affected area: Crohn's disease is the descending while
Ulcerative colitis is the ascending colon.

27. In terms of therapeutics, which of the following medications

can be used for inflammatory bowel diseases?
A. Corticosteroids
B. Atropine sulfate
C. Dulcolax-loxorlive
D. Maalox
28. Which systemic complication can be expected from a patient
with Crohn's Disease?
A. Perforation
B. Small bowel obstruction
C. Hemorrhage
D. Megacolon

29. In order to accurately diagnose ulcerative colitis, which of

the following laboratory studies is needed?
A. Proctosigmoidoscopy
B. Albumin study
C. Colonoscopy
D. Ultrasound

30. Which of the following is the MOST appropriate nursing

diagnoses for a patient in acute exacerbation of ulcerative
colitis?
i. Imbalanced nutrition less than body requirements R/T impaired
absorption
ii. Risk of deficient fluid volume R/T abnormal fluid loss
iii. Risk of ineffective tissue perfusion R/T low hemoglobin
iv. Acute Diarrhea R/T inflammation of the bowel
A. ii & iii
B. i, ii, & iii
C. i, ii, iii, & iv
D. i & ii
Situation. In her 15 years of being a ward nurse, Vebs has
witnessed and taken cared of several terminally-ill patients and
their families.
31.Which among the following is not considered palliative care?
A. Administering anti-emetics to a cancer patient who underwent
chemotherapy
B. Frequently turning the position of a comatose patient post-CVA
C. Removing the tumor in a Stage I breast cancer
D. Providing pain relief to a cancer patient

32. What is the immediate focus of nurses in caring for a

grieving family who just lost their father from cancer?
A. Post-mortem care
B. Return patient's belongings (watch, clothes, etc) to the
family
C. Obtaining consent for autopsy
D. Provide and facilitate time for mourning

33. Which among the following is not true regarding grief in the
older population?
A. Many older adults exhibit resilience in facing losses.
B. They are not at risk for complicated grieving.
C. Their increased age increases their likelihood of having faced
multiple losses.
D. Positive reappraisal helps older adults adapt to significant
losses.

34. Which among the following statements from Nurse Vebs assesses
the social support systems of a person experiencing grief from
the death of his sister?
A. “What does this loss mean to you?”
B. "Tell me how you are feeling."
C. "Which friends or family members do you wish were here with
you?"
D. "Tell me about your relationship with your sister."

35.Which nursing action of Nurse Vebs will promote a dying,

elderly patient's dignity and self-esteem?
A. Providing him regular baths and good hygiene
B. Instructing the patient's family members to decide for his
food choices
C. Calling the elderly patient by his first name only
D. Encouraging his siblings to join during your private
conversations with the patient

Situation. The nursing director assigned Rendon, RN in the

orthopedic ward to care for patients with mobility problems.
36. Rendon is caring for a patient with an arm cast. He knows
that the functional position of the wrist and fingers is which
among the following:
A. Wrist in extension, fingers and thumb in flexion
B. Wrist in flexion, fingers in flexion, thumb in extension
C. Wrist in flexion, fingers and thumb in flexion
D. Wrist in extension, fingers in flexion, thumb in extension

37. Rendon is teaching a patient with crutches how to go up the

stairs. Which among the following should he instruct the patient
with?
A. When moving the affected leg up, the body weight should be on
the crutches.
B. The unaffected leg goes up the step after the affected leg.
C. Patient should keep his feet together at the bottom of the
stairs.
D. The crutches and the affected leg go up the step together.
38. Rendon is assisted by another staff nurse in lifting a
patient. Which among the following actions will prevent injury to
A. Keeping the feet wide apart and knees extended
B. Positioning himself close to the patient
C. Using the muscles of the back in lifting
D. Rotating at the waist in lifting

39. Nurse Rendon asks two more nurses to help him logroll a
patient. Where should Xydo place the patient's arms prior to
logrolling?
A. Along the sides
B. Crossed on the chest
C. Overhead, extended
D. Behind the hips

40. In applying restraints, Rendon should employ which type of

tie?
A. Half-bow
B. Surgical tie
C. Double knot
D. Two-throw knot

Situation. Because it is already her board exams in a few days,

Rihanna practices computing medications dosages with the
following scenarios.
41. Nurse Rihanna administered 2 tablets of Losartan to Patient
Grande within the past 24 hours. According to the doctor's
orders, Patient Grande is to receive 100mg of valsartan a day.
With this information, Taylor Swift knows that the stock dose
Nurse Ariana has on hand is:
A. Losartan 1 mg/tablet
B. Losartan 25 mg/tablet
C. Losartan 20mg/tablet
D. Losartan 50 mg/tablet

42. Phenytoin(Dilantin) 200mg PO BID was prescribed to a patient.

The medication label reads 0.1 g/capsule. For each dose, the
nurse prepares how many capsules to give to the patient?
A. 500
B. 2
C. 3
D. 4

43. Mannitol 0.25g/kg/day was prescribed to a 7-year-old patient

with meningitis. The patient weighs 28.6 lbs. How much mannitol
should the nurse give?
A. 32.5g
B. 3.25mg
C. 3.25g
D. 0.325g

44. Nurse Rihanna received an order of enalapril 10 mg OD for a

hypertensive patient. How many tablets will she give to the
patient if they have a stock dose of 20mg/tablet?
A. 1/2 tablet
B. 1 tablet
C. 1 1/2 tablets
D. 2 tablets

45.Amoxicillin 250 mg oral suspension is prescribed to a patient

q8h. Nurse Joan checked the stock dose and saw that the bottle
reads Erythromycin Oral Suspension 125mg/5mL. How much will Nurse
Ariana administer to the patient in a day?
A. 6mL
B. 12mL
C. 10mL
D. 30mL

Situation. Nurse Neytiri is reviewing concepts and practicing

skills on intravenous transfusions.
46. Nurse Neytiri is selecting a vein for an intravenous
transfusion in a 62-year-old patient. He wants to dilate and
distend the veins for easier insertion. He does the following
methods, except:
A. Tapping the selected vein multiple times
B. Placing extremity in a dependent position if there are no
contraindications
C. Applying warm washcloth on to the extremity for several
minutes
D. Stroking the extremity from distal to proximal below his
desired site

47.Which among the following catheters is used for less than 24

hours?
A. Butterfly needle
B. Midline catheter
C. Plastic indwelling cannula
D. Angiocath

48. How often should Nurse Neytiri observe a patient with

intravenous infusions?
A. Every 2 hours
B. Every 6 hours
C. Every 8 hours
D. Every 12 hours
49.Six hours after initiating an IV line in a patient, Nurse
Neytiri noticed that the IV site was red and warm. The patient
complained that it was painful. Nurse Ravi would suspect which of
the following? keyword
A. Phlebitis
B. Extravasation
C. Infiltration
D. Clot formation

50. What should be the size/gauge of the needle Nurse Neytiri

would use in administering IV infusions for trauma
patients?
A. 18
B. 22
C. 20
D. 24

Situation. There are extensive legal aspects that guide the

Filipino nurses in terms of regulation in practice of her
profession.
51. The Professional Regulation Commission, Board of Nursing
(PRC- BoN) as a regulatory board has the legal functions and
responsibilities EXCEPT in ONE of the following.
A. Ensure the quality nursing education by jointly monitoring
with the Commission on Higher Education (CHED) adherence to its
guidelines, policies and standard
B. Monitor and enforce quality standards and nursing practice in
the Philippines to ensure efficient, ethical, moral, technical
professional standards
C. Issue, suspend or revoke certificates of registration for the
practice of nursing
D. Recognize specialty organizations in coordination with the
accredited professional organization and collect fees to upgrade
the conditions of Nurses
52. You are a nurse in Batangas Medical Hospital and have just
completed a 2 year experience in the surgical unit. One day, your
supervisor ordered you to go on a float to the Intensive Care
Unit (ICU) as two of the nurses called "on sick" in the said
unit. What is the MOST important action you should do in this
situation?
A. Explain to your supervisor that you might not be able to
perform safely your duty as a nurse in the unit
B. File a leave instead and call your husband to fetch you in the
hospital
C. Refuse the order and tell your supervisor you don't want to
put your license in jeopardy
D. Report to the surgical ward of your assignment and request one
of your nurses to replace you instead as floater in the ICU.

53. Janina, a 35-year old, married to an insurance agent, was

diagnosed with colon cancer only a month ago. The couple have
very limited information about this condition. One day, you saw
the husband in the room reading the chart which was inadvertently
left by a medical intern. What PRIORITY Nursing actions should
you do in this situation?
A. Get the chart from the husband so he will not be able to read
the diagnosis of his wife
B. Explain to the husband as per policy, relatives are not
allowed to read the chart
C. Report immediately to the supervisor on duty and submit an
incident report
D. Ask the husband what information he would like to ask from the
health care professional regarding medical plan and diagnosis

54. Nurse Celin, is assisting Mr. Robert who just came from the
Recovery unit for a thoracic surgery. She noted that the
dressings are saturated with blood, but the Surgeon just
reassured the Nurse to reinforce the dressings and monitor him
closely. After an hour, Mr. Robert went into shock and died. The
family filed charges against the Doctor and the Nurse. What is
the lawsuit involved in this case?
A. Murder
B. Battery
C. Assault
D. Malpractice

55. What is the MOST important Nursing measure that Nurse Celin
should have done to avoid this situation?
1. Monitor and record closely the vital signs until stable
2. Report to the surgeon the vital signs and degree of bleeding
from operative site
3. Call the supervisor on duty to assist you in referring the
patient to the surgeon
4. Ask the family members to call the surgeon to see the patient
A. 2 & 3
B. 1 & 2
C. 1, 2, & 3
D. 1 & 3

Situation. Chatty, 40 years old, came to the hospital for a

diagnostic work-up for a cholelithiasis prior to surgery.
56. Which of the following clinical manifestations would you MOST
likely to observe when a patient is suffering from
Cholelithiasis?
A. Indigestion, pain on the right upper quadrant radiating pain
to the shoulder
B. Vague left upper quadrant pain radiating to the scapula
C. Feeling of abdominal tenderness after waking-up in the morning
D. Feeling of abdominal fullness after taking meals
57. Which ONE of the following vitamins is interfered when there
is obstruction of the bile flow in cholecystitis?
A. Vitamin C
B. Vitamin B
C. Vitamin B12
D. Vitamin K

58. The patient was ordered Endoscopic Retrograde

Cholangiopancreatography (ERCP). She was put on a mild sedation.
As a Nurse, what should you check as a PRIORITY action when he
returns to the ward?
A. Irritation of orropharynx
B. Nausea and vomiting
C. Cough and gag reflex
D. Signs of bleeding

59. Which of the following conditions is NOT a side effect of

anticholinergic drugs?
A. Constipation
B. Blurred Vision
C. Dryness of the mouth
D. Increased blood pressure

60. When a client has a nasogastric tube (NGT) due to abdominal

distention post-surgery. Which of the following nursing
responsibilities should you do?
1) Measure gastric secretion every shift
2) Observe and record color, viscosity of secretions
3) Ensure that the gastric tube is patent
4) Assist patient to assume a comfortable position
A. 1, 2, 3, &
4
B. 1, 2, & 3
C. 1 & 2
D. 2, 3, & 4
Situation. Nurse Charm admitted Blanch, 38 years old, who was
diagnosed by her physician with Type I Diabetes Mellitus. She
complains of easy fatigability and increased tiredness. Nurse
Charm, during the assessment, noted the presence of a foot ulcer
which Blanch was trying to hide.
61. Nurse Charm holds the hands of Blanch while doing her
assessment. Her hands were cold and clammy, she suspected that
the patient was having hypoglycemia. To relieve her condition, an
immediate action is to offer her
A. Candy
B. Sandwich
C. Full meal
D. Fruits

62. Nurse Charm watches Ms. Blanch while sleeping. An EXCELLENT

guideline to differentiate if a patient is just sleeping or
experiencing hypoglycemic reaction is when one is observed to be
_____.
A. With dyspnea
B. With diaphoresis
C. Snoring
D. Grunting his teeth

63. Nurse Charm practiced surgical asepsis during foot care.

Which of the following techniques has to be observed?
A. Opening container of sterile water after putting gloves on.
B. Changing the sterile field after sterile water spilled on it
C. Placing sterile dressing 2 cm from the edge of the sterile
field.
D. Cleaning the wound in circular motion from outer towards the
ulcer site

64. Nurse Charm after foot care encourages Patient Blanch to do

which of the following APPROPRIATE measures?
A. Apply lanolin generously between the toes
B. Cut toenails rounded at the edges and close to the skin
C. Apply alcohol after cleansing feet to improve infection
D. Wear a shoe-type slipper at home

65. Ms. Blanch was administered NPH insulin at 8 am. At what time
would Nurse Charm expect the patient to be at risk for
hypoglycemic reaction.
A. 11am
B. 6pm
C. Noon
D. 4pm

Situation. Nurse Jess admits Mr. Ramos, 45 year-old, who was

brought to the Emergency room by his co-worker because of severe
abdominal pain. He was observed to be very anxious; holding his
abdomen with his right hand while bending towards his right side.
The Emergency Room doctor made his initial assessment and
referred the patient to the Surgical doctor on duty for further
assessment.
66. To describe a sensation of severe pain felt for ruptured
appendicitis, Nurse Jess applies deep pressure of her finger into
the abdomen at a point away from the pain and then releases. This
maneuver is termed as
A. Perforation
B. Rovsing's sign
C. McBurney's point
D. Rebound tenderness
67. Mr. Ramos was diagnosed with ruptured appendicitis. When the
appendix is suspected ruptured, a generalized abdominal pain is
felt and becomes
A. Merely a discomfort and steady rather that intermittent
B. Intense and the patient guards the area by living room
C. Rigid, stiff and board like feeling
D. Tender and focused on the umbilical cord region

68. Immediate surgery was done on Mr. Ramos. Which of the

following measures for pain control is NOT advisable to be done
by Nurse Jess while patient Ramos is having post-op pain?
A. Coughing exercises
B. High-fowler's position
C. Deep breathing
D. Semi-fowler's position

69. After operation, a nasogastric tube (NGT) was inserted to

Patient Ramos. The rationale for this surgical measure is to
A. Prevent use of antibiotics
B. Decrease hospitalization to two days
C. Decrease pain after the operation
D. Avoid the use of analgesics

70. Nurse Jess assesses the pain intensity of Mr. Ramos. The pain
assessment tool APPROPRIATE to be used for Mr. Ramos is
A. Face Pain Rating Scale
B. World Rating Scale
C. Visual Rating Scale
D. Numeric Rating Scale
Situation. Lu, a retired Barangay Health Worker, came to the OPD
for her check-up for her diabetes mellitus. She had been diabetic
since she was 37 years old. She has been taking her maintenance
medications which she sometimes does not comply with.
71.There are metabolic abnormalities in the development of type 2
Diabetes. Which of the following is NOT included in these
abnormalities?
A. Inappropriate production of the liver
B. Increased ability of the pancreas to produce insulin
C. Insulin resistance
D. Altered production of hormones by adipose tissues

72. Ms. Lu was admitted to the hospital for further check-up.

Which of the following diagnostic tests do you expect to be
ordered by the diabetologist as an indicator that the patient is
compliant to her prescribed diet?
A. Oral glucose tolerance test
B. Glycosylated hemoglobin level (hgb, Alc)
C. Finger glucose findings for one day
D. Fasting blood glucose level

73. While Nurse Dianne was completing her assessment, she

discovered the following findings. Which of the following should
she refer immediately to the physician?
A. Tingling sensation of the hands and feet neuropathy
B. Changes in the peripheral vision retinopathy
C. Beginning ulceration of the left big toe
D. Fruity odor breath
74. Nurse Dianne, the nurse in charge of patient Lu, informed her
physician that her serum glucose level is 38mmol/L and quite
unresponsive to verbal questioning. The nurse suspects that she
is starting to develop Diabetes Ketoacidosis (DKA). Which of the
following manifestations is UNIQUE to this condition?
rapid
A. Shallow slow respirations
B. Increased serum potassium
C. Rapid deep respirations
D. Decreased serum albumin

75. Nurse Dianne's counseling role includes lifestyle changes as

well as pharmacologic regimen. Lu's family were interested to
know information regarding insulin. She differentiated an
intermediate acting insulin from that of short-acting which is

A. Regular onset is 2 hrs. Peak is 3 1/2 hr., duration -7 hrs.,

administered 20-30 min. before meal
B. Regular onset is 2-4 hr., peak is 4-12 hr., duration is 8 hr.,
administered 20-30 min. after meal
C. Regular, onset is 1 1/2 hr, peak is 3-4 hrs, duration is 6
hrs. administered 20-30 min after meal
D. Regular onset is 1 1/2 - 1hr, peak is 2-3 hr., 4-6hr duration
administered 20-30 min. before

Situation. Lia, 23-year-old, a dental student has been having

frequent bouts of tonsillitis in the past. One day, she developed
low grade fever, dyspnea, dizziness, syncope, and fainting spells
while preparing for her final examination. She was rushed to the
hospital by her parents and was seen in the Emergency room by the
physician on duty (POD), Ms. Hanna was the nurse-on-duty. The POD
ordered a 12 lead Electro-cardiogram (EKG) and other laboratory
tests.
76.What specific information is essential for the Health
professionals to know when this EKG is ordered for patient Lia?
A. Rate, rhythm and pressure within the blood vessels
B. Rate, rhythm, axis and circulation
C. Rate, rhythm, axis, hypertrophy, and infarction
D. Rate, hypertrophy and blockage to the chambers of the heart

77. Aside from the EKG and laboratory studies, the POD ordered
patient Lia to undergo cardiac catheterization to establish
further the medical diagnosis of Valvular heart disease. Which of
the following is NOT true as part of Nurse Hanna instructions to
the patient regarding this procedure?
A. Signing of consent is optional
B. Normal procedure is less than 2 hours
C. Fasting should be 8 to 12 hours
D. Presence of pounding sensation in the chest during the
procedure

78. Nurse Hanna must be alert that certain complications may

arise after the procedure. What PRIORITY nursing assessment
should she observe?
A. Tingling sensation
B. Signs of bleeding at the puncture site
C. Blurring vision
D. Disorientation

79.When teaching patient Lia about self-management following

cardiac catheterization, Nurse Hanna should emphasize to AVOID
which ONE of the following?
A. Diet high in Protein and Carbohydrates to low cholesterol and
fats
B. Lifting objects heavier than five (5)lbs
C. Taking shower with the site covered after 24 hours
D. Light exercise program within 48 hours when tolerated
80. The POD established Lia's diagnosis that she is suffering
from acquired valvular heart disease. This condition is brought
about by.
A. Rheumatic fever
B. Alcohol consumption
C. Drug abuse
D. Heredity

Situation. You are the nurse on night duty in the medical ward.
You were assigned by Ms. Heart, the Charge Nurse of the
unit to monitor the status of a 8 year old boy with bronchial
asthma.
81. Which of the following manifestations of the child would
cause you to be alarmed?
A. Excessive sweating
B. Choking sensation
C. Cough with phlegm
D. Generalized chest tightness

82. You would like the child to be comfortable in bed. Which

position should you put the child to ease his discomfort?
A. Lying on his side
B. High-fowler's position
C. Prone position
D. Supine position

83. The Pediatrician ordered theophylline by IV route. The

effect(s) of this drug is
A. Decrease gastric acid secretion
B. Causes coronary vasoconstriction
C. Relaxes the smooth muscle of the bronchial tree
D. Stimulation of the peripheral nervous system

84. What APPROPRIATE activity should you advise the child while
in the hospital?
A. Talk on the phone with his classmates adolescent
B. Finish his assignments in school promote rest
C. Watch cartoon movies on TV
D. Play with his teddy bear promote rest, reserve energy

85. The patient is ready to go home. What health teachings can

you give to him and to his mother?
1.Prevent the child from exposure to dust and pollutants
2. Avoid exposure to extreme hot or cold weather
3.Increase fluid intake
4.Avoid hyper-allergenic food
A. 1 & 2
B. 1, 2, 3, & 4
C. 2, 3, 4
D. 1 only

Situation. Rhods, 65-year-old cook, restless and obese was

brought to the Emergency Room due to right abdominal pain, nausea
and vomiting for a week. She frequently changes her position to a
more comfortable one due to intense pain. You are the nurse in
charge who admitted the patient after the attending doctor
diagnosed her with Acute Cholelithiasis.
86. Patient Rhods's vomiting can be treated with a nasogastric
tube insertion with a suction attachment. This measure will
remove the gastric juice stimulating painful contractions of the
gallbladder which is
A. Cholecystokinin
B. Lithotripsy
C. Ecchymosis
D. Acalculus

87. Patient Rhods, was ordered by the physician to undergo

several diagnostic tests. You expect that patient will have an
elevation of
A. Bromsulphalein excretion
B. Lactate dehydrogenase
C. Serum gamma glutamyltranspeptidase
D. Alkaline phosphatase

88. Nurse Carl provides important instructions to Ms. Rhods on

the prevention of Cholelithiasis. Select all that apply.
1.Maintain ideal weight
2.Adapt low fat diet
3.Regular exercise
4.Prevent pregnancy
A. 2, 3, 4
B. 1, 2, 3
C. 1, 3, 4
D. 1, 2, 4

89. Ms. Rhods is prepared for surgery. Nurse Carl provides

comfort measures to relieve pain with the following nursing
intervention, EXCEPT
A. Quiet environment
B. Administering analgesic
C. Positioning
D. Back rub
90. Immediate postoperative care of Nurse Carl includes providing
careful instructions to Ms. Rhods. Which of the following
interventions should be delegated to the caregiver?
A. Administration of intravenous therapy
B. Reinforce information on exercise
C. T-tube care and changing
D. Instructions for the reduction of pain

Situation. A 6-year-old boy is suffering from pain on his right

inguinal region. His mother brought him to the hospital and was
diagnosed to have incarcerated hernia. He had a scheduled
herniotomy.
91. What will be your FIRST pre-operative nursing measure?
A. Get informed consent from the mother.
B. Change the boy's street clothes to surgical gown
C. Shave the operative site
D. Call the OR nurse for scheduling

92. The boy is transferred to the operating room. What is the

BEST mode to be used in transferring the patient?
A. Nurse's carry
B. Mother's carry
C. Stretcher
D. Wheelchair

93. The nurse must prepare the OR environment to be safe and

comfortable for the child by reducing the air conditioning
temperature so as to prevent
A. Hypoventilation
B. Hypothermia
C. Hyperventilation
D. Hyperthermia

94.The scrub nurse has to prepare for a pediatric herniotomy.

Which of the following should be ready?
A. Subcuticular 3/0 round, absorbable
B. Subcuticular 3/0 cutting, absorbable
C. Monofilament 3/0 cutting, absorbable
D. Monofilament 3/0 round, absorbable

95. The mother was afraid to submit the child for surgery. What
is the BEST response to the Nurse in this situation?
A. "It is alright to feel that way but you cannot do anything
now."
B. “It is the doctor's order; you'll have to accept the
situation."
C. “Your child's condition is an emergency case. If he is not
operated on, he will die."
D. "I understand your feelings, but your child needs to be
operated on."

Situation. The hospital director of a tertiary hospital is

alarmed with the recent report of the head Human Resource
Department Office (HRDO) that there is so much conflict going on
among the health care professionals which is affecting quality
patient care.
96. Which of the following is a form of dispute resolution and
considered a legal technique which is outside the court?
A. Suppresion
B. Bribe
C. Arbitration
D. Negotiation
97. Change is defined “as making something different from what it
was". If you become a unit manager in the future, which of the
following is your FIRST step as an agent in promoting successful
change in your health care setting?
A. Revisit Institutional Vision-Mission and adhere to its
commitment
B. Obtain majority agreements when issues are presented
C. Include obsessed people as part of your Task force for change
D. Ignore organizational conflict as possible

98. Decision-making in an organizational structure comes at many

levels. The level which is considered empowering to staff-member
is when the unit manager does which one of the following?
A. Makes a decision when she reads the reported concerns
B. Ask direct report from personnel to decide on a solution
C. Makes a decision after convening a core group to analyze the
concerned issues
D. Makes a decision by herself and assumes responsibility for her
action

99. The nurse manager is receiving some feedback that one of her
staff-nurses has been observed to be always irritated, "bossy",
and indifferent to her patients and some co-workers. Which of the
following PRIORITY nursing actions should the manager implement?
A. Conduct a joint meeting of both parties involved
B. Request the concerned patients and co-workers to submit an
Incident report
C. Call the nurse concerned and talk to her privately about the
observations
D. Give a memo to the nurse involved
100. A team building session was conducted by the HRDO task force
to come up with strategies for conflict resolution. Which of the
following is a WIN-WIN approach in conflict management?
A. Each party involved agree to respond to majority vote
B. Each participants agree to resolve conflicts by adhering to
the Institutional Vision and Mission
C. Each participants will give way to 60-40% of their agreements
D. Disagreements are settled with respective compromises on
issues presented
 KEY TO CORRECTION
1. D 21. C 41. D 61. A 81. D
2. B 22. D 42. B 62. B 82. B
3. B 23. A 43. C 63. B 83. C
4. C 24. C 44. A 64. D 84. C
5. B 25. B 45. D 65. C 85. B
6. B 26. D 46. A 66. B 86. A
7. B 27. A 47. A 67. C 87. D
8. A 28. B 48. A 68. A 88. B
9. A 29. A 49. A 69. C 89. D
10. B 30. A 50. A 70. A 90. C
11. C 31. C 51. D 71. B 91. A
12. B 32. D 52. A 72. B 92. C
13. A 33. B 53. D 73. D 93. B
14. B 34. C 54. D 74. C 94. D
15. A 35. A 55. B 75. D 95. D
16. B 36. A 56. A 76. C 96. C
17. D 37. D 57. D 77. A 97. A
18. C 38. B 58. C 78. B 98. C
19. A 39. B 59. B 79. C 99. C
20. A 40. A 60. A 80. A 100. B