NURSING PRACTICE – CARE OF CLIENTS WITH
PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS(2023)
100% ACCURATE GRADE A+
SITUATIONAL
Situation 1 – Concerted work efforts among members of the surgical team is essential to the
success of the surgical procedure.
1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there
is a need for sterile supply which is not in the sterile field, who hands out these items by opening
its outer cover?
A. Circulating Nurse
B. Anaesthesiologist
C. Surgeon
D. Nursing Aide
2. The OR team performs distinct roles for one surgical procedure to be accomplished within a
prescribed time frame and deliver a standard patient outcome. While the surgeon performs the
surgical procedure, who monitors the status of the client like urine output, blood loss?
A. Scrub Nurse
B. Surgeon
C. Anaesthesiologist
D. Circulating Nurse
3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the
nurse of the floor or ward where the patient is confined. For orthopedic cases, what department
is usually informed to be present in the OR?
A. Rehabilitation department
B. Laboratory department
C. Maintenance department
D. Radiology department
4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team,
who else has to be present when a client undergoes laparoscopic surgery?
A. Information technician
B. Biomedical technician
C. Electrician
D. Laboratory technician
5. In massive blood loss, prompt replacement of compatible blood is crucial. What department
needs to be alerted to coordinate closely with the patient’s family for immediate blood component
therapy?
A. Security Division
B. Chaiplaincy
C. Social Service Section
, D. Pathology department
Situation 2 – You are assigned in the Orthopedic Ward where clients are complaining of pain in
varying degrees upon movement of body parts.
6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain.
Which of the following observation would prompt you to call the doctor?
A. Dressing is intact but partially soiled
B. Left foot is cold to touch and pedal pulse is absent
C. Left leg in limited functional anatomic position
D. BP 114/78, pulse of 82 beats/minute
7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at
5 pm. The next dose of Demerol 50 mg I.M. is given:
A. When the client asks for the next dose
B. When the patient is in severe pain
C. At 11 pm
D. At 12 pm
8. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors
indicate appropriate adaptation?
A. The client reports pain reduction and decreased activity
B. The client denies existence of pain
C. The client can distract himself during pain episodes
D. The client reports independence from watchers
9. Pain in ortho cases may not be mainly due to the surgery. There might be other factors such
as cultural or psychological that influence pain. How can you alter these factors as the nurse?
A. Explain all the possible interventions that may cause the client to worry
B. Establish trusting relationship by giving his medication on time
C. Stay with the client during pain episodes
D. Promote client’s sense of control and participation in control by listening to his
concerns
10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is
your nursing priority care in such a case?
A. Instruct client to observe strict bed rest
B. Check for epidural catheter drainage
C. Administer analgesia through epidural catheter as prescribed
D. Assess respiratory rate carefully
Situation 3 – Records are vital tools in any institution and should be properly maintained for
specific use and time.
11. The patient’s medical record can work as a double edged sword. When can the medical
record become the doctor’s/nurse’s worst enemy?
A. When the record is voluminous
B. When a medical record is subpoenaed in court
C. When it is missing
D. When the medical record is inaccurate, incomplete, and inadequate
, 12. Disposal of medical records in government hospitals/institutions must be done in close
coordination with what agency?
A. Department of Interior and Local Government (DILG)
B. Metro Manila Development Authority (MMDA)
C. Records Management Archives Office (RMAO)
D. Department of Health (DOH)
13. In the hospital, when you need the medical record of a discharged patient for research you
will request permission through:
A. Doctor in charge
B. The hospital director
C. The nursing service
D. Medical records section
14. You readmitted a client who was in another department a month ago. Since you will need the
previous chart, from whom do you request the old chart?
A. Central supply section
B. Previous doctor’s clinic
C. Department where the patient was previously admitted
D. Medical records section
15. Records Management and Archives Office of the DOH is responsible for implementing its
policies on record disposal. You know that your institution is covered by this policy if:
A. Your hospital is considered tertiary
B. Your hospital is in Metro Manila
C. It obtained permit to operate from DOH
D. Your hospital is PhilHealth accredited
Situation 4 – In the OR, there are safety protocols that should be followed. The OR nurse should
be well versed with all these to safeguard the safety and quality of patient delivery outcome.
16. Which of the following should be given highest priority when receiving patient in the OR?
A. Assess level of consciousness
B. Verify patient identification and informed consent
C. Assess vital signs
D. Check for jewelry, gown, manicure, and dentures
17. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures
but considered ‘dirty cases’. When are these procedures best scheduled?
A. Last case
B. In between cases
C. According to availability of anaesthesiologist
D. According to the surgeon’s preference
18. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing
care during the intraoperative phase. As the circulating nurse, you make certain that throughout
the procedure…
PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS(2023)
100% ACCURATE GRADE A+
SITUATIONAL
Situation 1 – Concerted work efforts among members of the surgical team is essential to the
success of the surgical procedure.
1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there
is a need for sterile supply which is not in the sterile field, who hands out these items by opening
its outer cover?
A. Circulating Nurse
B. Anaesthesiologist
C. Surgeon
D. Nursing Aide
2. The OR team performs distinct roles for one surgical procedure to be accomplished within a
prescribed time frame and deliver a standard patient outcome. While the surgeon performs the
surgical procedure, who monitors the status of the client like urine output, blood loss?
A. Scrub Nurse
B. Surgeon
C. Anaesthesiologist
D. Circulating Nurse
3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the
nurse of the floor or ward where the patient is confined. For orthopedic cases, what department
is usually informed to be present in the OR?
A. Rehabilitation department
B. Laboratory department
C. Maintenance department
D. Radiology department
4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team,
who else has to be present when a client undergoes laparoscopic surgery?
A. Information technician
B. Biomedical technician
C. Electrician
D. Laboratory technician
5. In massive blood loss, prompt replacement of compatible blood is crucial. What department
needs to be alerted to coordinate closely with the patient’s family for immediate blood component
therapy?
A. Security Division
B. Chaiplaincy
C. Social Service Section
, D. Pathology department
Situation 2 – You are assigned in the Orthopedic Ward where clients are complaining of pain in
varying degrees upon movement of body parts.
6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain.
Which of the following observation would prompt you to call the doctor?
A. Dressing is intact but partially soiled
B. Left foot is cold to touch and pedal pulse is absent
C. Left leg in limited functional anatomic position
D. BP 114/78, pulse of 82 beats/minute
7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at
5 pm. The next dose of Demerol 50 mg I.M. is given:
A. When the client asks for the next dose
B. When the patient is in severe pain
C. At 11 pm
D. At 12 pm
8. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors
indicate appropriate adaptation?
A. The client reports pain reduction and decreased activity
B. The client denies existence of pain
C. The client can distract himself during pain episodes
D. The client reports independence from watchers
9. Pain in ortho cases may not be mainly due to the surgery. There might be other factors such
as cultural or psychological that influence pain. How can you alter these factors as the nurse?
A. Explain all the possible interventions that may cause the client to worry
B. Establish trusting relationship by giving his medication on time
C. Stay with the client during pain episodes
D. Promote client’s sense of control and participation in control by listening to his
concerns
10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is
your nursing priority care in such a case?
A. Instruct client to observe strict bed rest
B. Check for epidural catheter drainage
C. Administer analgesia through epidural catheter as prescribed
D. Assess respiratory rate carefully
Situation 3 – Records are vital tools in any institution and should be properly maintained for
specific use and time.
11. The patient’s medical record can work as a double edged sword. When can the medical
record become the doctor’s/nurse’s worst enemy?
A. When the record is voluminous
B. When a medical record is subpoenaed in court
C. When it is missing
D. When the medical record is inaccurate, incomplete, and inadequate
, 12. Disposal of medical records in government hospitals/institutions must be done in close
coordination with what agency?
A. Department of Interior and Local Government (DILG)
B. Metro Manila Development Authority (MMDA)
C. Records Management Archives Office (RMAO)
D. Department of Health (DOH)
13. In the hospital, when you need the medical record of a discharged patient for research you
will request permission through:
A. Doctor in charge
B. The hospital director
C. The nursing service
D. Medical records section
14. You readmitted a client who was in another department a month ago. Since you will need the
previous chart, from whom do you request the old chart?
A. Central supply section
B. Previous doctor’s clinic
C. Department where the patient was previously admitted
D. Medical records section
15. Records Management and Archives Office of the DOH is responsible for implementing its
policies on record disposal. You know that your institution is covered by this policy if:
A. Your hospital is considered tertiary
B. Your hospital is in Metro Manila
C. It obtained permit to operate from DOH
D. Your hospital is PhilHealth accredited
Situation 4 – In the OR, there are safety protocols that should be followed. The OR nurse should
be well versed with all these to safeguard the safety and quality of patient delivery outcome.
16. Which of the following should be given highest priority when receiving patient in the OR?
A. Assess level of consciousness
B. Verify patient identification and informed consent
C. Assess vital signs
D. Check for jewelry, gown, manicure, and dentures
17. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures
but considered ‘dirty cases’. When are these procedures best scheduled?
A. Last case
B. In between cases
C. According to availability of anaesthesiologist
D. According to the surgeon’s preference
18. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing
care during the intraoperative phase. As the circulating nurse, you make certain that throughout
the procedure…
