RECALLS 2 - NP3

Situation 1
Mr. GI Joe is 55 year old, married, a car dealer has consulted the ER because of on and fever,
indigestion, weight loss, right abdominal pain, body malaise, and itchiness of the skin. Based on the
health history the patient has been a chain smoker and drinks alcoholic beverages almost every
day especially when he has clients to entertain. His physical examination showed he has suspected
liver cirrhosis. He was advised for admission for further work-up and treatment.

1. You are the nurse on duty when Mr. GI Joe was admitted in the pay floor. In your
observational data what additional EARLY SIGN of liver cirrhosis do you expect patient to
manifest?
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A. Gonadal atrophy
B. Hypotension
C. Splenomegaly
D. Ankle edema

Correct answer
A. Gonadal atrophy

2. Which of the following statements is TRUE of liver cirrhosis?

1. Nutritional deficiency with decreased protein intake attributes to liver damage.

2. Cirrhosis can happen to people with alcohol intake

3. Women are at greater risk for the development of alcohol-induced liver disease

4. Most patients affected by liver cirrhosis are between 40 to 60 years of age.

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

D. 2 & 3

Correct answer
A. 1, 2, 3, and 4

3. During Mr. GI Joe’s confinement he developed further itchiness of the skin and jaundice.
Which of the following nursing actions is NOT recommended as this will induce skin
breakdown?
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A. Add baking soda when bathing the patient.
B. Massage the skin with emollients every 2 hours.
C. Use of commercial soaps and alcohol-based lotions.
D. Rub the itchy skin with knuckles instead of using the nails.

Correct answer
C. Use of commercial soaps and alcohol-based lotions.

4. At early stage of Mr. GI Joe’s disease process, the physician ordered this SPECIFIC diet
for Mr. GI Joe, You emphasized to the dietitian that he should be served foods that is
_________.
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A. High carbohydrate and low sodium

B. High calorie and high carbohydrate

C. Low protein and high fat
D. High protein and high fat

5. Mr. GI Joe started to develop ascites and complained of heaviness of the lower
extremities to the physician. An order of Spironolactone (Aldactone) 25 mg. /day. What
adverse effect of the drug should you monitor?
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A. Hyperkalemia

B. Palpitation
C. Irregular pulse rate
D. Hypokalemia
Situation 2
Juliet, a Pediatric Cardiovascular Nurse is assigned to take care of 3 children in her unit. She just
admitted a 12- year- old female patient suffering from Rheumatic Fever (RF)

6. When doing an assessment, which ONE of the following conditions is NOT present based
on the Jones Criteria?
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A. Erythema Marginatum
B. Subcutaneous nodules
C. Chorea
D. Bronchopneumonia

7. In Rheumatic fever, the factor contributory to the development of this disease process is
brought about by __________.
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A. Auto-immune reaction to streptococcal infection

B. Auto-immune reaction to collagen disease

C.Parents had rheumatic heart disease
D.Exposure to colds and droplet infection

8. Marimar, 6 years old, is receiving digitals for having Patent Ductus Arteriosus with heart
failure with heart failure. Prior to the administration of the medicines, which of the
following nursing actions should be done by nurse Rica?
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A. Take the carotid pulse rate for one full minute.

B. Take the heart rate for one full minute

C. Take the respiratory rate
D. Take the blood pressure

Correct answer
B. Take the heart rate for one full minute

9. While Nurse Juliet was doing her regular rounds, one of the mothers approached her
saying that her child who has a Tetralogy of Fallot preferred to squat on bed rather than
assuming a supine position. The BEST action of the Nurse is ___________.
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A. Let the mother continue the position of her child if she feels comfortable with it.

B. Divert the child’s attention by letting her join the nurses’ rounds
C. Put her on bed and start to administer oxygen inhalation
D. Discourage the child and let her lie on bed with 2 pillows instead.

10. Another patient in the Unit is Nikki, 8 years old, waiting to be scheduled for surgery
because of a Coarctation of the Aorta. With this disorder, Nikki will manifest which one of
the following symptoms?
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A. Murmur and bruit of the lungs
B. Central and peripheral edema
C. Hypertension and diminished pulses in the extremities.
D. Hepatomegaly and shortness of breath

Correct answer
C. Hypertension and diminished pulses in the extremities.
Situation 3
Mr. Gaudencio Suarez is a surgical nurse in a medical center and he had been practicing for almost
five years in this unit. The staffs go on shift rotation. For that shift, he had two patients for
operation. One is for Lobectomy and another is for Nephrectomy

11. When is the BEST time for the operative consent is be signed by his patients?
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A. As soon as the surgical procedure is explained to the patient
B. On admission when the relatives are around
C. A day before the surgery

D. Before any pre-op medications are administered

Correct answer
A. As soon as the surgical procedure is explained to the patient

12. Which of the following nursing goals are achieved when early ambulation is done by
post-surgery patients?

1. Improved circulation

2. Improved respiratory functions

3. Prevent venous stasis

4. Prevent emboli formation

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A. 3 and 4
B. 1, 2, 3,4

C. 1, 3, 4
D. 1 and 2

13. Which of the following patients is MOST at risk during the induction of anesthesia?
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A. 6-year-old with history of allergy

B. 65 year old diabetic woman

C. 35 year old TB case
D. 25 year old Polio Case

Correct answer
B. 65 year old diabetic woman

14. As a circulating nurse, which of the following is your PRIORITY nursing action to
promote safety of your patient?
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A. Prevent peri-operative position injury
B. Provide adequate lighting during the procedure
C. Optimize surgeon’s access to surgical site
D. Maintain surgical aseptic technique during the procedure

15. Being the nurse in the Post-Anesthesia Care Unit, which of the following is your
PRIORITY concern after surgery?
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A. Monitor vital signs

B. Observe surgical site for bleeding

C. Validate doctor’s orders
D. Check level of consciousness

16. There are several factors contributory to the development of these conditions. Which
of the following are the PRIORITY causative factors that should be emphasized by Nurse
Lydia in her health teaching?
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A. Cigarette smoking

B. Aging process and alcohol intake

C. Stress and overacidity
D. Sedentary life and obesity

Correct answer
D. Sedentary life and obesity
17. Mr. Jesse is admitted due to congestive heart failure. Nurse Brilliantina would expect
that if the failure is on the right side of the heart, the patient will manifest which of the
following.
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A. Juguar vein distention
B. Crackles on auscultation

C. Dry productive cough

D. Improved bowel elimination

Correct answer
A. Juguar vein distention

18. The patient has been receiving, Digoxin 0.25 mg per day to regulate his heart rate.
Which of the following outcomes would indicate that his medication is achieving its desired
effects?
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A. Improved appetite
B. Increased pedal edema

C. Increased urine elimination

D. Improved bowel elimination

Correct answer
C. Increased urine elimination

19. The other patient of Nurse Brilliantina is suffering from Buerger’s disease. He has been
complaining of intermittent claudication of the lower extremities which has been giving
him so much discomfort. What is the Best nursing action she should perform to address the
patient’s complaint?
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A. Allow the patient to lie flat on bed
B. Teach him foot care and leg exercises.

C. Place affected extremities in a dependent position

D. Apply hot water bag to the affected extremities

20. Which of the following information is NOT True of Buerger’s disease?

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A. Small and medium arteries and veins are mostly affected.
B. Smoking is a major cause of Buerger’s disease.
C. Incidence of Buerger’s disease is high in men than women.
D. A strong relationship exists between diabetes and Buerger’s disease.

Situation 5
Gloria, 58 years old, beautician has undergone bowel obstruction surgery. During his first day post-
op. she vomited clear liquids about three times during your shift. Her vital signs include: temp-37.9
degree C. 138/84 PR-78/min and RR- 26/min. her surgical incision is intact, slight bleeding, swilling
and tenderness with slight pain.

21. Which of the following manifestations would indicate the development of wound
infection?
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A. Presence of elevated red blood cells count.

B. Profuse and increasing perspiration.

C. Increased blood pressure, respiratory rate and pulse rate.
D. Increasing pain on the surgical incision.

Correct answer
D. Increasing pain on the surgical incision.

22. If the wound draining is serosanguineous, it means that the secretion is colored ______.
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A. Yellow-tinged
B. Pinkish-red

C. Green-tinged
D. Bright-red

23. Later during the day, Gloria became confused, started to pull out her IV fluids as well
as her wound dressings. Complained of severe pain over the wound area. The PRIORITY
action of the NURSE is to ________.
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A. Apply sterile dressings over the surgical wound

B. Call the surgeon at once for the health status of the patient
C. Administer the pain medication at once
D. Restrain the hands of the patient

Correct answer
C. Administer the pain medication at once
24. The drug of choice of pain relief to patient Gloria considering score of 8 which was
assessed by the nurse based on the rating scale of 0-10 (0-lowest, 10 is the highest) is
________.
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A. Morphines S04
B. Ibuprofen

C. Demerol
D. Paracetamol

Correct answer
A. Morphines S04

25. When patient is receiving opioid medication, the nurse should observe complications
from the side effects by ______.
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A. Checking for the presence of loose bowel movement
B. Observing signs and symptoms of addiction
C. Assessing changes of circulatory status

D. Assessing wakefulness of the patient at least every 2 hours

Correct answer
D. Assessing wakefulness of the patient at least every 2 hours

26. When the physician clarifies the process of Drug Administration, this Quality
Improvement Process is known as
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A. System analysis
B. Root cause Analysis

C. Problem identification
D. Pareto Chart

27. Which of the following is the primary reason why the physician wanted to clarify the
process?
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A. Measures the turnaround time of medication
B. Better communication with patient and result
C. Identify gap in the medication administration
D. Improve care management in drug administration

Correct answer
C. Identify gap in the medication administration

28. While the medical director is conducting his rounds he observed the presence of
scattered supplies and equipment along the corridor as well as 02 tank not properly
secured. The Quality Circle (QC) team was informed about this observation. Which of the
following is the BEST strategies to be adopted by the team with this concern?
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A. Adopt the 5 S audit.

B. Identify and prioritize the problem

C. Select Alternative Solution.
D. Enhance Continuous quality improvement.

29. The approach adopted by quality circle team was presented to top management.
Which of the following tools is APPROPRIATE to be utilized as a guide for their time
management?
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A. Pre chart
B. Radar chart
C. Process of flow chart
D. Gantt chart

30. In order to determine if the implementation of the activity is successful, the First step
to be done by the team is ______________.
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A. Prioritize the problem
B. Coordinate with the different units
C. Have a random report to the supervisor
D. Develop a monitoring plan

31. Mr. Anthony, 38 years old, is scheduled for Laparoscopic Cholecystectomy in the
morning the next day. He verbalizes to you and says, “Dr. Unido will open me up to remove
my gallstones?” which of the following is your BEST response?
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A. “Let us discuss with the surgeon your operation before you go to the OR.”

B. “I know the surgeon will remove your stones with a new technique.”
C. “Let me call the OR supervisor to discuss the procedure with you.”
D. “I will call the anaesthesiologist to explain more the procedure.”

32. A critical component before Mr. Anthony goes for surgery is the nurse’ preoperative
teaching. Which of the following is NOT advisable prior to surgery?
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A. Teach him deep breathing exercises
B. Fast at midnight, but can drink water if he becomes thirsty.
C. Instruct him to void before going to the operating room.
D. Teach him leg and coughing exercises

Correct answer
B. Fast at midnight, but can drink water if he becomes thirsty.

33. While giving health instructions to Anthony. He looks very anxious and said to you, “I
might not be able to wake from anesthesia after my operation.” Your BEST response is
_________.
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A. “Do not worry, everything will be alright.”
B. “Let me tell to your family your fear.”
C. “I will not let you go to the OR until I have talked to your surgeon.”
D. “Don’t Say that, I will discuss your concerns with your anaesthesiologist.”

34. Mr. Anthony returned back to the ward, after recovering from anaesthesia. He complain
of pain over the scapular region. Which of the following nursing actions should you do?
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A. Apply heating pad over the painful area.
B.Turn client from side to side.
C. Give demerol as ordered.
D. Apply cold pack over the affected area.

Correct answer
A. Apply heating pad over the painful area.
35. After 5 days, Mr. Anthony is ready to go home. His discharge instructions include
observations of the following complications, EXCEPT:
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A. Palpitation
B. Loss of appetite

C. Increased body temperature

D. Bleeding

36. How will your distribute the patients to the 3 Registered Nurses and 2 Nursing
Assistants?
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A. 2 Registered Nurse for Total Care patients, 1 Registered Nurse and 1 Nursing Assistant for
Primary Care Patients, 1 Nursing Assistant for Total Care.
B. 1 Registered Nurse and 1 Nursing Assistant for Total Care Patients, 1 Registered Nurse and 1
Nursing Assistant for Primary Care Patient, 1 Registered Nurse for Ambulatory Care patients.

C. 2 Registered Nurse for Total Care patients, 2 Nursing Assistant for Primary Care Patients, 1
Registered Nurse for Ambulatory Care Patients.
D. 1 Registered Nurse for Total Care patients, Registered Nurse and 1 Nursing Assistant for Primary
Care patients, 1 Registered Nurse and 1 Nursing Assistant for Ambulatory Care patients

37. In as much as this is a cardio-ward what basic equipment/materials should be available

at all times?

1. o2 2. Ambu Bag

3. Suction Apparatus 4. Endotracheal

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A. 1, 2, 4

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

Correct answer
B. 1, 2, 3, 4

38. Which of the following emergency medicines should be available at the emergency cart
at the Cardio Ward?

1. Epinephrine 3. Valium
2. Demerol 4. Coumadin
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A. 1, 3
B. 1, 2

C. 2, 4
D. 3, 4

Correct answer
A. 1, 3

39. When stocking fluids in the emergency cart. What should Nurse Meg instruct the
nurses?

1. Put the recently- delivered at the back of the old stock

2. Put the old stock in front of the newly-delivered ones

3. Check the fluids for sediments and discoloration

4. Keep the fluids inside the cooler

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

D. 2, 3

Correct answer
D. 2, 3

40. How will Nurse Meg arrange the patients in the ward? Put the ______________.
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A. Primary Care in between the Ambulatory Care patients.
B. Primary Care and Ambulatory Care patients together and Total Care at the corner of the room.

C. Total Care patients near the nurses and the Ambulatory farthest
D. Ambulatory Care patients near the Total Care ones.

Correct answer
C. Total Care patients near the nurses and the Ambulatory farthest
Situation 9
Mr. Nelson, 62 year old, an Executive of a shoe company was brought to the hospital after having
vomited bright red blood immediately after supper. He claimed he had drinking session with his
former classmates in college. He was already advised by their family physician not to drink alcohol
due to a suspected fatty liver. You are the nurse-on-duty when he was admitted.

41. Based on your assessment and history taking for Mr. Nelson which PRIORITY FINDINGS
should you document and report to the physician?
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A. Use of anti-inflammatory drugs.
B. Vital signs BP- 140/90, PR- 88/min.PR24/min.
C. abdominal pain (3 in a scale of 10)
D. Tense, rigid abdomen

Correct answer
A. Use of anti-inflammatory drugs.

42. You have formulated your Nursing Diagnosis for the patient and wrote in the nursing
care plan. Which ONE of the following?
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A. Deficient Fluid Volume R/T vomiting of blood and gastric secretion.
B. Non-compliance R/T alcohol and medication intake.
C. Fear of death R/T unknown cause of bleeding.
D. Risk for Aspiration R/T active bleeding.

Correct answer
A. Deficient Fluid Volume R/T vomiting of blood and gastric secretion.

43. The physician orders insertion of nasogastric tube with lavage to Mr. Nelson. What kind
of solution will you expect to be written in the doctor’s order when a patient will undergo a
lavage?
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A. Normal Saline Solution
B. Distilled Water
C. Tap warm water

D. Dextrose 5% in water

Correct answer
A. Normal Saline Solution
44. When a patient has a gastro-intestinal bleeding and there is a presence of
hematemesis, how should you describe this in your documentation?
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A. Bloody vomitus appearing as fresh, bright red or “Coffee-ground” in appearance.

B. Brownish vomitus appearing as “Chocolate” in appearance from a previous Food Intake.

C. Black, tarry stools in appearance often foul smelling, from a previous food intake.
D. Small amounts of fresh blood observed either through gastric secretions or stools.

45. The following are the practice guidelines in documentation. Which ONE of these is NOT
recommended to be written in your charting?
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A. Had urine output of 600 cc during the whole shift.
B. “Appears to be comfortable with good night rest and sleep”
C. Refused to eat her dinner as she feels nauseated at meal time

D. Slept from 11 PM to 6 AM after Valium 5mg. was given.

Correct answer
B. “Appears to be comfortable with good night rest and sleep”
Situation 10
The following situations are related to ethical practices in the workplace.

46. Jillian a registered nurse has signed a contract for two years in a medical center. A
recruitment agency has offered her a “fat” salary for foreign employment. If you are in the
position of Jillian, what should you do?
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A. Discuss your plans with your parents
B. Accept the recruitment offer and go Absence without official leave.
C. Write a letter of resignation to your employer 30 days before leaving.

D. Accept recruiter’s offer and give an excuse to employer on behalf her “sick” mother.

47. Karylle is a BSN graduate but did not take the National Licensure exams. She is in dire
need of money so she applied and was accepted in a health facility. As a nurse she
submitted a fake PRC license in order to be given a job. Riza is liable to be charged of
___________.
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A. False statement
B. Misrepresentation
C. fraud and deceit
D. malpractice

Correct answer
C. fraud and deceit

48. Ms. Kendall an R.N was invited as a resource person in a nursing conference. The
curriculum vitae she submitted to the PRC Continuing Professional Development Council
reflects the word Masters of Arts in Nursing (MAN) after her name. She only completed
academic requirements but not her thesis writing. Which of the following did Ms. Paras
violate?
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A. RA 9173 of Nursing Law
B. Code of Professional Ethics for Teachers

C. Magna Carta for Health Workers

D. Code of Ethics for Registered Nurse

Correct answer
A. RA 9173 of Nursing Law

49. It is a hospital policy for nurses in a health facility that reporting time is 15 minutes
before the official designated time. Nurse Khloe reported 30 minutes late and requested
her co-staff to sign in for her. This is an example of __________.
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A. Dishonesty
B. Falsification of document
C. Unprofessional conduct
D. All of the options

50. What ethical justification is observed when administering Opioids despite the possibility
of hastening death.
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A. Rule of double effect

B. Rule of single effect

C. Maleficence
D. Justice
51. Which component of chest physiotherapy involves rhythmic clapping with cupped
hands on the chest wall over the area being drained?
A. Postural drainage
B. Percussion
C. Nebulization
D. Vibration

52. Which among these would indicate that coughing was ineffective?
A. Decreased normal breath sounds
B. Clearing of adventitious breath sounds
C. Sputum expectoration
D. Patient’s report of swallowed sputum

53. Postural drainage improves clearance and drainage of secretions by which principle?
A. Entropy
B. Enthalpy
C. Gravity
D. Motion

54. A goal for a post-operative patient using an incentive spirometry is:

A. Decrease pulmonary ventilation
B. Expand collapsed alveoli
C. Potentiate effects of general anesthesia
D. Thicken respiratory secretions

55. As safety precautions for clients receiving oxygen, which among these should Nurse Tin
not do?
A. Place a “No Smoking” sign on the client’s door and at the foot or head of the bead.
B. Replace woolen blankets with cotton blankets.
C. Place and arrange substances like acetone, alcohol, and oils at the bedside.
D. Ensure that all electric devices are in good working order.
Situation 12
Mr. Berroya, who has just finished his one (1) year period as a registered nurse in a medical center,
is assigned in the medical unit on 3-11 shift. He is having a difficulty interacting with the patient’s
family so he consulted his senior Nurse regarding this matter.

56. The BEST approach to be employed by Mr. Berroya upon the advise of his senior nurse
is __________.
A. send the family members home
B. confront with the family regarding their behavior
C. ignore family’s behavior
D. use active-listening technique

57. The Senior Resident in the medical unit was making his regular rounds with the medical
interns and Nurse Berroya was called to receive his orders for Mr. Peeta who has been
confined in the unit for almost a week. Nurse Berroya could not understand some of the
written order orders of the physician in the chart. Which of the following is the appropriate
action of the nurse?
A. refer to the nurse supervisor to validate the Physician’s orders.
B. approach the physician and clarify his orders
C. call his junior resident to rewrite his orders
D. complete the orders by rewriting what is in the chart.

58. One of the patients of Mr. Berroya told him that according to his attending physician he
would be transferred to the surgical unit because of a suspected stone in the gall bladder
causing his on and off pain later in the evening. The wife however, told Mr. Berroya “No,
the physician told me, my husband will still be in this unit for 2 more days”. The BEST
action of the Nurse should ____________.
A. call the physician to clarify management of care for the patient.
B. instruct the couple and family members wait for the decision of the health team.
C. inform the patient that sometimes the physician need to have more data available.
D. inform the couple that the decision of the physician is sometimes not fixed.

59. The members of the health team in the medical unit has been reacting negatively to a
patient who has been branded as “Very demanding” He has a diagnosis of Emphysema
and had been confined for almost 2 weeks in the ward. Family members come and go to
visit him.
The best approach of the health team should be _______________.
A. request a chaplain to regularly visit the patient.
B. hold a team conference on how to approach the issue
C. request for a psychological counseling
D. talk with the family members and discuss the demanding behavior of the father.
60. Nurse Berroya is taking care of Ms. Gonzaga with a multi-organ disorder. The health
care team believes that patient’s survival rate is only 50%. Which of the following nursing
actions is MOST APPROPRIATE to be done by Nurse Berroya?
A. Avoid discussion of death when family members are present.
B. Arrange with the family the available funeral parlors incase of death of the patient.
C. Request the husband to prepare a living will.
D. Inform the family members that there is a palliative care available.

Situation 13
The coordinator of the In-Service nursing department prepared an enhancement program for a
newly board passers on Universal Health Precaution as part of their personal and professional
development.

61. Which of the following example is a well stated objectives for this proposal?
A. Utilize the Universal health precaution in dealing with self and environment.
B. Understand the health precaution in dealing with self and environment.
C. Know the value of Universal health precaution in dealing with self and environment.
D. Acquire knowledge on health precaution in dealing with self and environment.
62. The group came up with an effective Strategy in the teaching of Universal Health
precaution to the attendees. Which of the following is the BEST strategy for this program?
A. Film Showing
B. Case Analysis
C. Lecture with interactive discussion
D. demonstration and return demonstration

63. Before the implementation of the program, it is important to know pertinent

information about the participants. Which of the following INITIAL steps should be
undertaken by the organizing committee?
A. Prepare a budget plan for the program.
B. Organize the learners into groups per gender.
C. Present the detailed program to management.
D. Come up with the learning needs of the participant.

64. A Gantt Chart has been devised by the Organizing Committee as the program will be
conducted for 4 weeks’ time.
A. Determining possible budgetary implications.
B. Schedule for meeting the objectives for the program.
C. Coordination needed between and among the participants.
D. time frame for the completion of the program with set goals.

65. Which of the following statements of the participants indicate that the program is
effective?
A. Its good we have earned our CPD unites required.
B. We gain weight after the completion of the program.
C. There should be more time allotted to the session.
D. I am happy that we have met all the objectives set.

Situation 14
Nurse Kim, a research coordinator is aware of the concept of research as a competency expected
as a graduate nurse, especially in this era of evidence based nursing practice. The following
questions relate to research in nursing practice.

66. The ethical codes in research have greatly influenced the conduct of scientific studies
especially among human beings. The declaration of Helsinki includes which of the following
ethical standards?

1. Investigator should protect life, privacy and dignity of human subjects

2. Investigator should protect from harm in therapeutic studies

3. Informed consent is not essential when doing research among human subjects

4. Investigator should conduct research when objectives outweigh risks and burdens to the
subjects
A. 1, 2, 3 & 4
B. 1 & 2
C. 1, 2, & 4
D. 2 & 3

67. Nurse Kim, was sent by her chief nurse to attend a Forum conducted by the Philippine
Nursing Research Society on the topic “Effectiveness and Efficacy of the wound dressing to
patients with bed injury”. She would like to adopt intervention in their unit.
What is the MOST appropriate action to be done by Nurse Kim when she returns to their
hospital?
A. Pilot the study to determine if results will be the same
B. Incorporate the intervention into their hospital manual
C. Convince the chief nurse to change their wound management practices
D. Request investigator if she can adopt the research protocol in their unit

68. The quality assurance nurse who works closely with nurse Kim request her to conduct a
study by comparing the average length of hospitalization of cardiac patient in a regular
ward with that of patients with same disorders in an intensive care unit.
What statistical test is MOST appropriate to use in this study?

A. Analysis of variance
B. T-test
C. Chi-square
D. Coefficient of correlation

69. The research team together with the gastro-intestinal department also conducted a
study on the alcohol consumption of patients as heavy drinkers and developed liver
cirrhosis over a 20 year period.
A. Follow-up
B. Cross-sectional
C. Trend
D. Panel

70. Jenny with her team would like to conduct a research on “Perceptions of professional
Health practitioners on the competence and level of acceptance on Nurse-Led Clinic”.What
type of research design should nurses Kim and her team adopt?
A. Experimental
B. Correlational
C. Descriptive
D. Quasi-experimental S
Situation 15
Nurse Liza is assigned on a 3-11 shift in the female medical ward of a Tertiary Hospital. Patient
Alma has been complaining of excruciating abdominal pain and was asking for pain medication.
She was referred to the physician on duty (POD) for an immediate relief of pain
71. In addition to the identification bracelet worn by the patient, how can the nurse on duty
(NOD) verify the identity of her patient when administering the drugs?
A. Ask the question, “Are you Ms. Alma?”
B. Read the patient’s name at the foot of the bed
C. Ask the patient’s name from the watcher.
D. Ask the patient’s husband’s name

72. The physician orders a PRN pain medication to patient Alma. When will Nurse Liza
administer a PRN drug?
A. A standing order is carried out as specified until discontinued for another order.
B. When the physician writes the drug as needed in the order sheet.
C. A single dose of the drug, carried out by the nurse at a time specified by the physician.
D. An order written by the physician that has to be carried out immediately.

73. When a patient is in pain, what PRIORITY consideration should Nurse Liza observe?
A. Goal of treatment of the health professionals.
B. Perception of pain of the individual.
C. Harmful effects of the drugs.
D. Cost of the pain medication.

74. Prior to the administration of pain medication, Nurse Liza assesses the degree of the
pain of patient before and after the drug administration. Using the numeric scale of 0-10 (0
is the lowest and 10 is the highest) on pain, when the patient has rated her pain as 7 it
means it is ____________.

A. severe
B. tolerated
C. Slight
D. moderate

75. In educating effectively the patient and family on how to use a pain rating scale, the
following are the STEPS to be followed by the nurse __________.

1. discuss pain as a broad concepts

2. set goals for comfort and function

3. explain parts of the rating scale

4. show pain rating scale and purpose

5. verify if patient understands broad concepts of pain.

6. ask patient to practice the pain rating scale

A. 1, 2, 3, 4, 6 & 5
B. 4, 3, 1, 5, 6 & 2
C. 2, 4, 3, 1, 6 & 5
D. 3, 1, 2, 5, 4 & 6
76. Nurse Helen is taking of an older person and has been waiting for almost two hours for
her son to arrive. She is ready for discharge. Which of the following statements is an
example of a therapeutic communication?
A. “I can call your son by cellphone to remind him that you are waiting.”
B. “Your son must be in a traffic jam right now.”
C. “I’ll stay with you until your son arrives.”
D. “Would you want to watch the television while waiting?”

77. You are teaching a 66 year old male diabetic client about the effects of insulin. He is
ready for discharge the next week. Which of the following is a statement of a helping
relationship with the patient?
A. “In a few days I’ll review what you have S about actions and effects of your insulin.”
B. “You keep on forgetting what I said but will try to repeat some of them.”
C. “I already mentioned those actions and effects of insulin, I think you forgot some of them.
D. “Would you like me to discuss the information to your wife? She can assist you?”

78. A patient is scheduled for cholecystectomy. She verbalizes to the nurse in an anxious
manner “Will my surgery be too long?” The BEST response of the nurse is __________.
A. “I have undergone the same surgery, its a very quick operation.”
B. “Your doctor is an expert, don’t worry about how long.”
C. “Your surgery is at 9AM tomorrow. And you’ll stay in the recovery room for an hour. You will be
back in the room before 12 noon.”

D. “The operation will not last long. By the time you are awake you will be already in your room.”

79. When the nurse explores thoughts and feelings about the patient’s surgery, this phase
in the helping-relationship is in _______________.
A. introductory phase
B. termination phase
C. resolution phase
D. working phase

80. Which of the following major types of learning strategies can you offer for a Geriartric
patient who has difficulty in hearing?
A. practice
B. demonstration
C. printed learning materials
D. role playing
Situation 17
Nurse Zanjoe is assigned in the Medical Ward for 7 years. He is well appreciated by his colleagues
and patients because he intercedes with patient’s need, he has good decision making ability, and
respect the patients’ rights and cultural practices. He helps colleagues beyond call of duty.

81. A patient who has craniotomy was referred by Nurse Greg to Department of Social
Welfare (DSWD) because he has problem on paying his unsettled hospital bill amounting to
80 thousand pesos. The relatives are afraid the patient will not be discharged soon. Which
of the following function BEST describe the action of Nurse Greg?
A. Advocate
B. Caregiver
C. Educator
D. Clinician

82. Nurse Zanjoe notice a colleague taking frequent breaks, working over-time, inaccurate
drug accounts and displaying inappropriate behavior during meetings and conferences.
Nurse Zanjoe suspects her colleague is ___________.
A. a victim of domestic violence
B. with personality disorder
C. on substance abuse
D. not mindful of mindful work output

83. Nurse Zanjoeis assigned on night shift and noted a co-worker with a tourniquet
wrapped around the upper arm. The co-worker is about to insert needle attached to a
syringe containing a clear liquid into the antecubital area. Zanjoe’s initial action is to call
the ______________.
A. nurse supervisor
B. physician
C. security guard
D. watcher

84. Nurse Zanjoe made a conference with a preoperative patient on important data related
to her illness. To practice confidentiality of information, Nurse Zanjoe MUST consider which
of the following?
A. Documents the process of conservation to serve as proof for future reference.
B. Apply technology for easier and faster communication and documentation.
C. Conducts the conference in a private place where conversation is not heard.
D. Invites others to interpret the discussion if patient is deaf to unfamiliar with the language.

85. A patient refuses to undergo surgery after a conference with her doctor. Which of the
following ethical principle applies when Nurse Zanjoe and doctor respect the decision of
the patient in the spite encouragement and pieces of advise given?
A. Autonomy
B. Beneficence
C. Veracity
D. Self-Determination
Situation 18
Len, a 35 year old dressmaker has been experiencing recurrent episodes of abdominal pain, nausea
and vomiting and feels her stomach is bloated. She has been taking contraceptive pills in the past.
She is married with three children. She consulted the OPD and was advised by the physician to be
admitted for suspected Pancreatitis.

86. Nurse Gladys started her admission care to Ms. Len. Which of the following laboratory
examinations do you expect the physician to order for the patient?
A. Serum lipase and Amylase
B. Creatinine & Phospotase
C. Serum Transaminase
D. Urea Nitrogen Substance

87. As a nurse, which of the following assessment data you will MOST likely NOT to find on
patient Len?
A. Abdominal and back pain with tenderness
B. Cramping pains before intake of heavy meals.
C. Pain unrelieved by intake of antacids
D. Mid-epigastric pain acute in onset after heavy meals.

88. The MOST useful diagnostic test is to validate whether Ms. Len is suffering from
Pancreatitis is for her to undergo ___________.
A. Endoscopic Retrograde Cholangio Pancreatography
B. Endoscopic Ultrasonography
C. Percutaneous Transhepatic Cholangiography
D. Cholesterol Serum level

89. When managing a patient with acute pancreatitis the first priority is to ____________.
A. insert urinary catheter for adequate elimination.
B. encourage oral fluids to improve elimination.
C. insert nasogastric tube to decompress stomach
D. administer IV fluids to replace electrolytes lost.

90. One of the SAFETY alerts that the Nurse-on-duty (NOD) will have to watch for patient
with acute pancreatitis is ___________.
A. Diabetes insipidus
B. Respiratory distress
C. Hypercalcemia
D. Pericarditis
Situation 19
Norilee, an accountant, 29 years was rushed by her husband in the ER because of body weakness,
palpitation, confusion and diaphoresis. Her blood glucose is 450 mg./dl with fruity acetone smell on
her breath. She was diagnosed to be suffering from type I diabetes mellitus 6 months ago.

91. Which of the following the clinical characteristics are of Type I diabetes mellitus EXCEPT
_________________.
A. often have islet cell antibodies
B. Ketosis prone when insulin is absent.
C. Onset any age, above 30 year old, usually obese
D. Onset any age, below 30 year old, usually thin

92. Patient Norilee upon admission has a breath characteristics of fruity acetone, this is
brought about by the presence of ______________.
A. lactic acids
B. uric acid
C. nitric acid
D. ketoacids

93. Based on the presenting manifestations of patient Norilee you expect that the
physician will likely order which of the following treatment?
A. 50% dextrose
B. 5% Lactated ringers
C. Dextrose 10% in water
D. normal Saline solution

94. When caring for patient Norilee, which of the following should be included in your
teaching plan?

1. Signs and symptoms of hypoglycemia

2. Self-glucose monitoring

3. Administration of insulin

4. Meal planning and exercise

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

95. When formulating a Nursing diagnosis for Ms. Norilee who is suffering from type I
diabetes mellitus with ketoacidocis, which of the following will be the top priority?
A. impaired tissue integrity
B. deficient fluid volume
C. Imbalance nutrition
D. Risk for infection
Situation 20
Ms. Arce is the Research Coordinator of the Medical Center who is concerned about the increased
incidence of nosocomial infection in the hospital and has convinced the management to allot a
budget for the conduct of research on the clinical problem.

96. What type of research is appropriate for this study?

A. Quasi-experimental
B. Experimental
C. Historical
D. Descriptive-correlational

97. Which of the following is the best tool for data gathering?
A. use of laboratory data
B. questionnaire
C. interview schedule
D. observation

98. During the data collection, Ms. Rita encountered a patient who does not want to talk to
him. Which of the following is a limitation of the study?
A. Contacts of patients with history of fever and cough.
B. Patient’s refusal to fully divulge information.
C. Patient’s with the history of fever and cough
D. Patients admitted or who seek consultation at the ER and doctor’s offices.

99. In the statement, “Frequent hand washing of health workers decreases the incidence of
nosocomial infections among post-surgery patients”, the dependent variable is __________.
A. frequent hand washing
B. incidence of nosocomial infection
C. health workers
D. post-surgery patients

100. Her colleague asks about the EXTERNAL validity of the research findings. Which of the
following is the APPROPRIATE response of Ms. Rita?
A. it is reflected as a result of extraneous variables.
B. the findings are free of selection biases.
C. the result is shown only from the effect of the independent variable.
D. it is generalized to other settings or samples.
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