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Comprehensive Nursing
Exam Review, Practice
Questions & Study Guide
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PRE-BOARD I - NURSING PRACTICE IV - CARE OF A. Best non-verbal response
CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL B. Best motor response
ALTERATION (PART B) C. Spontaneity of eye opening
D. Best verbal response
Situation 1: Nurse Joanne just finished her training on Emergency
and Disaster Management for one month by the Disaster and Risk 9. The neurosurgeon determines that the patient has increasing
Management office by the Department of Health. intracranial pressure. Which of the following interventions would be
most appropriate for Nurse Mae to perform? She should:
1. To Nurse Joanne’s knowledge, the key difference between A. Provide a quiet and brightly lit environment.
emergencies and disaster is that: B. Elevate the head 15 to 30 degrees.
A. Emergencies can typically be handled by avoidable C. Encourage the victim to drink clear fluids.
emergency services. D. Teach controlled coughing and deep breathing.
B. Disaster results from man-made error.
C. Disasters typically involve local emergency services and no 10. The patient was assessed to have a Glasgow Coma Scale score
other agencies. of 3. In order to protect the airway, Nurse Mae collaborates with the
D. Emergencies are controlled. health care team to assist with which of the following?
A. Endotracheal intubation
2. Nurse Joanne understands that emergency is any threat to public B. Assessment of bowel sounds
safety or public health. Which of the following is not applicable? C. Questioning the patient regarding difficulty of breathing.
A. “Hostage crisis in Jolo Sulu last December 2018.” D. Monitoring oxygen saturation.
B. “I cannot find my mobile phone.”
C. “My son has not come home from school.” Situation 3: Nurse Donna cares for a male patient with HIV. She
D. “A plane is about to crash.” conducts a study on HIV.
3. During an earthquake, the impact is greatest in areas close to the 11. Nurse Donna wants to find out the lived experiences of a patient
epicenter. Injuries arise primarily from falling objects and collapsing with HIV. This is an example of phenomenology as a:
buildings. Direct impact on health includes high mortality from severe A. Phenomenon theory
crash injuries. Nurse Joanne arrives at the scene as the first B. Concept
responder. Which action is most appropriate to ensure safety? C. Research design
A. Clear the walking wounded using verbal instruction. “If you D. Philosophy
can walk, move over there.”
B. Give priority to dying victims. 12. A characteristic of a phenomenological study is for the
C. Tag patients. researcher to understand the lived experience from the point of view
D. Stop at each victim and quickly assess their respiration. of the/a:
A. Subject
4. Cardiopulmonary resuscitation maybe given to the victims. How B. Close family member
many seconds will Joanne consider for perfusion to be present? C. Nurse
A. Ten seconds D. Researcher
B. One second
C. Five seconds 13. A process in phenomenology where the researcher takes into
D. Two seconds account his/her own beliefs and feelings, identify which he/she
expects to discover and deliberately puts these ideas aside is called:
5. A group of passengers enters the emergency room with A. Recursive abstraction
complaints of cough, tightness in the throat, and extreme periorbital B. Saturation
swelling. There is a strong odor that exudes from their clothes. They C. Bracketing
report exposure to a “bomb” that was placed in the bus terminal. D. Coding
What is the priority action of the ER nurse?
A. Direct clients to the clean zone for immediate treatment. 14. Nurse Donna interviews her patient. She observes that he is
B. Assist clients in the decontamination area. hostile and does not respond openly toher questions. This is known
C. Readily transfer patients and visitors from the area. as _____ effect.
D. Check vital signs and auscultate lung sounds. A. Hawthorne
B. Rosenthal
Situation 2: Nurse Mae is part of the emergency team of hospital X. C. Phenomenological
She collaborates with other members of the health team to provide D. Experimenter
quality care to patients.
15. Nurse Donna collects data for the research. Which is the most
6. Nurse Mae understands that collaborative interventions are common technique of analyzing qualitative data?
therapies that require the participation of health professionals. Which A. Statistical analysis
of the following personnel participates in collaborative efforts? B. Content analysis
A. Physician and the nurse’s intervention C. Participant impression
B. Patient and the nurse’s intervention D. Observer impression
C. Patient and the physician’s intervention
D. Multiple health care professionals Situation 4: Dick, a 63-year old had been suffering from heart failure
for 3 years. He had been advised by his cardiologist for a pacemaker
7. Nurse Mae understands that health care professionals have a role to help control his heartbeat which is slow.
in collaboration. Which of the following statements best explains the
role of the nurse in the plan of care for patients? The nurse ___. 16. Dick asked Nurse Jane what it is that he will expect before,
A. Collaborates with colleagues and the patient’s family to during and after the procedure. Which among the health teachings is
provide combined expertise in planning care. not an appropriate response?
B. W orks independently to plan and deliver care and should not A. Your doctor will recommend that you avoid vigorous exercise
depend on other staff members for assistance. and heavy lifting for about a month.
C. Depends on the latest literature to complete and excellent plan B. You will likely be awake during the surgery to implant the
of care for patients. pacemaker and you will have an IV line for your medication.
D. Consults the physician for direction in establishing goals for C. Insulated wires will be inserted into the minor veins, and will be
the patients. guided using X-ray images.
D. You’ll stay a day in the hospital after having a pacemaker
8. In one of her shifts, Nurse Mae admits a 35-year-old female for implanted.
head injury sustained in a car accident. Nurse Mae notifies the
neurosurgeon. The latter assesses the condition of the patient using 17. Before the cardiologist decides that patient Dick to have his
the Glasgow Coma Scale. Nurse Mae understands that the scale pacemaker implanted, which one of the following tests is NOT done
provides objective measurement of three essential components of a to find the cause of his irregular heart beat?
neurological examination. Which of the following responses is not an A. Holter monitoring and smartwatch
essential component? B. Electrocardiogram and echocardiogram
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C. Stress tests Situation 6: The nurse cares for a teenage male with allergic rhinitis.
D. SGOT and SGPT
26. Which of the following clinical manifestations would the nurse
18. Patient Dick asked if he can travel by plane with his implantable expect to find in the client with rhinitis?
cardioverter defibrillator (ICD). Which of the following tests is an A. Nasal congestion, rhinorrhea and sneezing
appropriate response of Nurse Jane? B. Nasal congestion, pyrexic and rhinorrhea
A. “Be sure you have an ID card with you.” C. Headache, sore throat and sneezing
B. “Yes you can travel by airplane if cleared by your cardiologist.” D. Nasal congestion, headache and sore throat
C. “Let the airport security staff know you have a pacemaker.”
D. “You can travel immediately after the pacemaker is implanted.” 27. The physician prescribes decongestant intranasal spray. The
nurse instructs the client on the proper use of the spray. Whic h of
19. Patient Dick asked further “Do cellphones interfere with the following procedures is the correct method?
pacemaker?” Nurse Jane’s responses are the following EXCEPT: A. Finish instillation of spray into one nostril before spraying into
A. “Use the phone on the opposite ear.” the other nostril.
B. “It’s best to avoid keeping cellphones in your breast pockets on B. Inhale quickly to prevent irritation of the mucous membranes.
the side of the device.” C. Blow the nose after spraying to prevent medication from
C. “Cellphone less than 3 watts do not appear to interfere with entering the throat.
pacemaker.” D. Tilt the head slightly forward and angle the bottle toward the
D. “Cellphone more than 3 watts do appear to interfere with side of the nostril.
pacemaker.”
28. The client asks the nurse about using decongestant nasal sprays.
20. Nurse Jane’s health instruction to patient Dick is to contact the Which of the following statements by the nurse is correct regarding
doctor immediately if the following signs occur. Which one is NOT a its use?
priority? A. “Nasal sprays should be used sparingly because they can
A. W eight gain and swelling of the ankles exacerbate a cough.”
B. Fainting and dizzy spells B. “It would take several days of using nasal sprays before any
C. Frequent urination effect on congestion is noted.”
D. Difficulty in breathing C. “Nasal sprays should not be used for more than three days
because it can worsen congestion.”
Situation 5: Nurse Rona assists in the care of several male patients D. “They should be used along with corticosteroid nasal sprays
with fluid volume deficit. for maximum benefit.”
21. Nurse Rona reads the medical diagnoses of the patients 29. The nurse would determine that her teaching goal on the use of
assigned to her. Which patient with the following medical conditions a decongestant nasal spray has been met when the client says:
is at risk for fluid volume deficit? A patient with: A. “The spray should be used round-the-clock at equally spaced
A. Congestive heart failure intervals.”
B. Chronic Obstructive Pulmonary Disease B. “Nasal sprays must be combined with an oral antihistamine to
C. Cirrhosis achieve relief.”
D. Colostomy C. “Overuse can result in nosebleeds and mucosal ulceration.”
D. “Rebound rhinitis (rhinitis medicamentosa) is common with
22. Nurse Rona assesses the skin turgor on a 35-year-old male continued use.”
patient. Which of the following is an indicator of fluid volume deficit?
A. There is skin tenting. 30. The physician orders cromolyn sodium (nasal crom) for the client.
B. The skin immediately flattens after release. The nurse instructs the client that the most effective administration
C. The skin is dry and pale. schedule is:
D. The skin returns to a normal position within 1 or 2 seconds A. When manifestations peak only, with two or three doses per
after pinching and lifting the skin. day.
B. At the start of the allergy season, with a dose of once-a-day.
23. The physician prescribes an intravenous infusion of 750ml C. One week before the allergy season begins, with four to six
Normal Saline to a 78-year old male patient with fluid volume deficit doses per day.
and urinary tract infection. After a rapid IV infusion, the patient D. Just after manifestations begin, with a dose of twice-a-day
begins to cough. The nurse raises the head part of the bed to ease
the patient’s breathing. Nurse Rona observes that the patient’s Situation 7: Ms. Ramon is a newly registered nurse. She upgrades
jugular vein is distended and respiratory rate is increased. Which of her nursing competencies by attending seminars and workshops on
the following conditions is the patient experiencing? advanced nursing procedures. A workshop she recently participated
A. Beginning hypotonic water intoxication on, is physical assessment. She applies her skills in the female
B. W orsening of fluid volume deficit medical unit where she is assigned.
C. Developing hypervolemia
D. Respiratory compromise due to ascites 31. Ms. Ramon inspects the abdomen of a patient. Which of the
following sequences represent the order in assessing a patient’s
24. Nurse Rona inspects the tongue and oral mucosa of a 40-year- abdomen?
old patient and notes that they are dry. The patient had cough, fever, A. Palpate, percuss, auscultate, observe
nausea and vomiting which started three days before he was B. Observe, auscultate, percuss, palpate
admitted to the medical unit. The patient further complains of feeling C. Percuss, palpate, auscultate, observe
weak and dizzy. Which vital sign measurement would provide the D. Auscultate, observe, percuss, palpate
best indicator of the patient’s current fluid status?
A. Rate and depth of respiration 32. Ms. Ramon auscultates for breath sounds. What type of data
B. Body temperature should auscultation produce?
C. Pulse oximetry reading at rest A. Secondary
D. Blood pressure and pulse taken in lying and standing positions B. Subjective
C. Primary
25. Nurse Rona assesses a 50-year-old male with liver failure due to D. Objective
cirrhosis. The patient complains of a distended abdomen and
dizziness upon standing. The patient looks pale, has weak radial 33. Ms. Ramon proceeds to palpate a patient’s body to detect
pulse, and with delayed hand vein filling. Based on the assessment warmth. What part of her hand should she use?
data, Nurse Rona writes a nursing diagnosis. Which of the following A. Finger tips
is the most appropriate nursing diagnosis? Fluid volume: B. Back or dorsal surface
A. Deficit related to hormonal disturbances C. Ulnar surface
B. Deficit related to third space fluid shifts D. Finger pads
C. Excess related to hormonal disturbances
D. Excess related to third space fluid shifts 34. Ms. Ramon assesses a patient for a gag reflex. Which part of the
tongue should she place the tongue blade?
A. On the middle of the tongue and ask the patient to cough
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B. On the uvula
C. Lightly on the posterior aspect of the tongue 43. A child with fever has been admitted to the emergency
D. On the front of the tongue and ask the patient to say “ahh” department for several hours. Cooling measures are ordered by the
physician in order for the temperature to come down. Which task
35. Ms. Ramon takes and records the body temperature of a patient. would be appropriate for Nurse Gail to do?
The temperature registers a reading of 38oC. Which of the following A. Educate the need for giving cool fluids
conditions will the patient most likely demonstrate? B. Prepare and administer a tepid bath
A. Increased pulse rate C. Tell the parent to use acetaminophen instead of aspirin
B. Precordial pain D. Assist the child in removing outer garments
C. Dyspnea
D. Elevated blood pressure 44. Nurse Gail conducts primary assessment on a trauma patient.
Which of the following is considered one of the priority elements?
Situation 8: You are a nurse manager of a female and male medical A. Complete vital signs
unit. You realize that being a manager entails a great responsibility. B. Brief neurologic assessment
One of your major responsibilities is to implement quality C. Initiation of pulse oximetry
improvement initiatives in your unit. D. Client’s allergy history
36. You collaborate with the maintenance personnel to prepare a
safety program. The program includes periodic inspection of 45. Triage is the process of determining the priority of patient’s
electrical equipment, conduct of fire drills and proper disposal of treatment based on the severity of their condition. The purpose of
hazardous waste materials. These activities illustrate a component reverse triage is to:
of which quality program? A. Save those persons who are in the most critical condition
A. Total quality management B. Save scarce resources for future use
B. Quality assurance C. Do the greatest good for the greatest number with limited
C. Risk management resources
D. Quality improvement D. The first responders on the triage classification category
37. You call for a staff meeting. You remind the nurses to improve Situation 10: The nurse manager of the Oncology Unit invites an
the quality of care to patients. Which of the following activities is oncology nurse specialist to conduct an educational session to the
most important to safeguard nursing practice? nursing staff on the topic Hodgkin’s disease.
A. Know own strengths and limitations. 46. The nurse specialist explains the characteristics of Hodgkin’s
B. Provide nursing care competently and efficiently. disease. Which of the following is NOT a characteristic of Hodgkin’s
C. Document care accurately. disease?
D. Understand professional, legal, ethical obligations and A. There is presence of Reed-Sternberg cells.
responsibilities. B. The disease occurs most often in the older adult.
C. The lymph nodes, spleen, and liver are involved.
38. You take time to review reports from your staff. One report D. The prognosis depends on the stage of the disease.
records the incidence of patients falling from their beds and other
falls. Which of the following approaches is most appropriate to 47. The nurse specialist describes the stages of Hodgkin’s disease.
manage the situation? Which of the following symptoms is most commonly an early
A. Implement quality assurance measures. indicator of stage I?
B. Apply risk management principles. A. Chest and back pains
C. Apply total quality management principles in the unit. B. Subnormal body temperature
D. Implement a systems approach to the situation. C. Unexplained fever, night sweats
D. Swelling of extremities
39. A staff nurse in your unit administers a drug incorrectly to a
diabetic patient who needs more than one type of insulin. The staff 48. The nurse specialist emphasizes the importance of preventing
nurse’s action causes serious negative effects on the patient. What complications. Which of the following conditions are complications of
would be the most appropriate action that you as the nurse manager Hodgkin’s disease? 1. Nausea 2. Myocardial infarction 3. Anemia 4.
should take? Infection 5. Hypotension
A. Refer the staff nurse to the quality assurance committee. A. 1,2,3,5
B. Refer the staff nurse to the risk management committee. B. 1,2,3,4,5
C. Refer the patient to the attending physician immediately. C. 1,3,4
D. Ask the staff nurse to write a detailed incident report. D. 2,3,4,5
40. A patient in the unit had episodes of seizures. Sometime during 49. The nurse specialist cites a situation. If a patient experiences
the night, the patient fell off from the bed. The nurse on duty finds episodes of severe nausea and vomiting with more than 1000ml of
the patient on the floor. As a nurse manager, you ask the nurse vomitus with in a period of four hours, which of the following is the
involved in the incident to write an incident report. Which of the nurse’s most appropriate action?
following statements is not true about incident reports? The report A. Withhold the physician
A. Is a part of the patient’s medical record B. Notify the physician
B. Can be used in a court of law C. Observe the patient for another four hours
C. Identifies the people involved, the date, time and location of D. Place the patient on a liquid diet
the incident
D. Serves as a record of facts surrounding the incident 50. The nurse specialist explains that chemotherapy is extremely
toxic to the bone marrow and the patient may develop
Situation 9: Nurse Gail is assigned in the emergency department thrombocytopenia. What is the priority goal of the nurse? To take
and takes care of patients with different cases. precautions to control:
41. A client with multiple injuries is rushed after a head on car A. Bleeding
collision. Which assessment would Nurse Gail take priority? B. Hypotension
A. Unequal pupils C. Infection
B. Irregular apical pulse D. Diarrhea
C. A deviated trachea
D. Ecchymosis in the flank area Situation 11: Nurse Ciara assists in the care of a male patient who
has developed acute respiratory acidosis.
42. The ambulance has transported a male client with severe chest 51. Nurse Ciara recalls the causes of respiratory acidosis. Which of
pain. As the client is being transferred to the emergency stretcher, the following are causes of acute respiratory acidosis? 1. Chronic
Nurse Gail noted that the client is unresponsive not breathing and no obstructive pulmonary disease (COPD) 2. Pneumonia 3. Pulmonary
palpable pulse. Which of the following emergency measures will edema 4. Atelectasis 5. Bronchitis
Nurse Gail anticipates to do? A. 1,2,3,4,5
A. Starting bag valve mask ventilation B. 2,3,4,5
B. Performing chest compressions C. 1,3,4,5
C. Placing the defibrillator pads D. 1,2,3,4
D. Aiding with oral intubation
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NP4 & NP5 Reviewer |
Comprehensive Nursing
Exam Review, Practice
Questions & Study Guide
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PRE-BOARD I - NURSING PRACTICE IV - CARE OF A. Best non-verbal response
CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL B. Best motor response
ALTERATION (PART B) C. Spontaneity of eye opening
D. Best verbal response
Situation 1: Nurse Joanne just finished her training on Emergency
and Disaster Management for one month by the Disaster and Risk 9. The neurosurgeon determines that the patient has increasing
Management office by the Department of Health. intracranial pressure. Which of the following interventions would be
most appropriate for Nurse Mae to perform? She should:
1. To Nurse Joanne’s knowledge, the key difference between A. Provide a quiet and brightly lit environment.
emergencies and disaster is that: B. Elevate the head 15 to 30 degrees.
A. Emergencies can typically be handled by avoidable C. Encourage the victim to drink clear fluids.
emergency services. D. Teach controlled coughing and deep breathing.
B. Disaster results from man-made error.
C. Disasters typically involve local emergency services and no 10. The patient was assessed to have a Glasgow Coma Scale score
other agencies. of 3. In order to protect the airway, Nurse Mae collaborates with the
D. Emergencies are controlled. health care team to assist with which of the following?
A. Endotracheal intubation
2. Nurse Joanne understands that emergency is any threat to public B. Assessment of bowel sounds
safety or public health. Which of the following is not applicable? C. Questioning the patient regarding difficulty of breathing.
A. “Hostage crisis in Jolo Sulu last December 2018.” D. Monitoring oxygen saturation.
B. “I cannot find my mobile phone.”
C. “My son has not come home from school.” Situation 3: Nurse Donna cares for a male patient with HIV. She
D. “A plane is about to crash.” conducts a study on HIV.
3. During an earthquake, the impact is greatest in areas close to the 11. Nurse Donna wants to find out the lived experiences of a patient
epicenter. Injuries arise primarily from falling objects and collapsing with HIV. This is an example of phenomenology as a:
buildings. Direct impact on health includes high mortality from severe A. Phenomenon theory
crash injuries. Nurse Joanne arrives at the scene as the first B. Concept
responder. Which action is most appropriate to ensure safety? C. Research design
A. Clear the walking wounded using verbal instruction. “If you D. Philosophy
can walk, move over there.”
B. Give priority to dying victims. 12. A characteristic of a phenomenological study is for the
C. Tag patients. researcher to understand the lived experience from the point of view
D. Stop at each victim and quickly assess their respiration. of the/a:
A. Subject
4. Cardiopulmonary resuscitation maybe given to the victims. How B. Close family member
many seconds will Joanne consider for perfusion to be present? C. Nurse
A. Ten seconds D. Researcher
B. One second
C. Five seconds 13. A process in phenomenology where the researcher takes into
D. Two seconds account his/her own beliefs and feelings, identify which he/she
expects to discover and deliberately puts these ideas aside is called:
5. A group of passengers enters the emergency room with A. Recursive abstraction
complaints of cough, tightness in the throat, and extreme periorbital B. Saturation
swelling. There is a strong odor that exudes from their clothes. They C. Bracketing
report exposure to a “bomb” that was placed in the bus terminal. D. Coding
What is the priority action of the ER nurse?
A. Direct clients to the clean zone for immediate treatment. 14. Nurse Donna interviews her patient. She observes that he is
B. Assist clients in the decontamination area. hostile and does not respond openly toher questions. This is known
C. Readily transfer patients and visitors from the area. as _____ effect.
D. Check vital signs and auscultate lung sounds. A. Hawthorne
B. Rosenthal
Situation 2: Nurse Mae is part of the emergency team of hospital X. C. Phenomenological
She collaborates with other members of the health team to provide D. Experimenter
quality care to patients.
15. Nurse Donna collects data for the research. Which is the most
6. Nurse Mae understands that collaborative interventions are common technique of analyzing qualitative data?
therapies that require the participation of health professionals. Which A. Statistical analysis
of the following personnel participates in collaborative efforts? B. Content analysis
A. Physician and the nurse’s intervention C. Participant impression
B. Patient and the nurse’s intervention D. Observer impression
C. Patient and the physician’s intervention
D. Multiple health care professionals Situation 4: Dick, a 63-year old had been suffering from heart failure
for 3 years. He had been advised by his cardiologist for a pacemaker
7. Nurse Mae understands that health care professionals have a role to help control his heartbeat which is slow.
in collaboration. Which of the following statements best explains the
role of the nurse in the plan of care for patients? The nurse ___. 16. Dick asked Nurse Jane what it is that he will expect before,
A. Collaborates with colleagues and the patient’s family to during and after the procedure. Which among the health teachings is
provide combined expertise in planning care. not an appropriate response?
B. W orks independently to plan and deliver care and should not A. Your doctor will recommend that you avoid vigorous exercise
depend on other staff members for assistance. and heavy lifting for about a month.
C. Depends on the latest literature to complete and excellent plan B. You will likely be awake during the surgery to implant the
of care for patients. pacemaker and you will have an IV line for your medication.
D. Consults the physician for direction in establishing goals for C. Insulated wires will be inserted into the minor veins, and will be
the patients. guided using X-ray images.
D. You’ll stay a day in the hospital after having a pacemaker
8. In one of her shifts, Nurse Mae admits a 35-year-old female for implanted.
head injury sustained in a car accident. Nurse Mae notifies the
neurosurgeon. The latter assesses the condition of the patient using 17. Before the cardiologist decides that patient Dick to have his
the Glasgow Coma Scale. Nurse Mae understands that the scale pacemaker implanted, which one of the following tests is NOT done
provides objective measurement of three essential components of a to find the cause of his irregular heart beat?
neurological examination. Which of the following responses is not an A. Holter monitoring and smartwatch
essential component? B. Electrocardiogram and echocardiogram
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C. Stress tests Situation 6: The nurse cares for a teenage male with allergic rhinitis.
D. SGOT and SGPT
26. Which of the following clinical manifestations would the nurse
18. Patient Dick asked if he can travel by plane with his implantable expect to find in the client with rhinitis?
cardioverter defibrillator (ICD). Which of the following tests is an A. Nasal congestion, rhinorrhea and sneezing
appropriate response of Nurse Jane? B. Nasal congestion, pyrexic and rhinorrhea
A. “Be sure you have an ID card with you.” C. Headache, sore throat and sneezing
B. “Yes you can travel by airplane if cleared by your cardiologist.” D. Nasal congestion, headache and sore throat
C. “Let the airport security staff know you have a pacemaker.”
D. “You can travel immediately after the pacemaker is implanted.” 27. The physician prescribes decongestant intranasal spray. The
nurse instructs the client on the proper use of the spray. Whic h of
19. Patient Dick asked further “Do cellphones interfere with the following procedures is the correct method?
pacemaker?” Nurse Jane’s responses are the following EXCEPT: A. Finish instillation of spray into one nostril before spraying into
A. “Use the phone on the opposite ear.” the other nostril.
B. “It’s best to avoid keeping cellphones in your breast pockets on B. Inhale quickly to prevent irritation of the mucous membranes.
the side of the device.” C. Blow the nose after spraying to prevent medication from
C. “Cellphone less than 3 watts do not appear to interfere with entering the throat.
pacemaker.” D. Tilt the head slightly forward and angle the bottle toward the
D. “Cellphone more than 3 watts do appear to interfere with side of the nostril.
pacemaker.”
28. The client asks the nurse about using decongestant nasal sprays.
20. Nurse Jane’s health instruction to patient Dick is to contact the Which of the following statements by the nurse is correct regarding
doctor immediately if the following signs occur. Which one is NOT a its use?
priority? A. “Nasal sprays should be used sparingly because they can
A. W eight gain and swelling of the ankles exacerbate a cough.”
B. Fainting and dizzy spells B. “It would take several days of using nasal sprays before any
C. Frequent urination effect on congestion is noted.”
D. Difficulty in breathing C. “Nasal sprays should not be used for more than three days
because it can worsen congestion.”
Situation 5: Nurse Rona assists in the care of several male patients D. “They should be used along with corticosteroid nasal sprays
with fluid volume deficit. for maximum benefit.”
21. Nurse Rona reads the medical diagnoses of the patients 29. The nurse would determine that her teaching goal on the use of
assigned to her. Which patient with the following medical conditions a decongestant nasal spray has been met when the client says:
is at risk for fluid volume deficit? A patient with: A. “The spray should be used round-the-clock at equally spaced
A. Congestive heart failure intervals.”
B. Chronic Obstructive Pulmonary Disease B. “Nasal sprays must be combined with an oral antihistamine to
C. Cirrhosis achieve relief.”
D. Colostomy C. “Overuse can result in nosebleeds and mucosal ulceration.”
D. “Rebound rhinitis (rhinitis medicamentosa) is common with
22. Nurse Rona assesses the skin turgor on a 35-year-old male continued use.”
patient. Which of the following is an indicator of fluid volume deficit?
A. There is skin tenting. 30. The physician orders cromolyn sodium (nasal crom) for the client.
B. The skin immediately flattens after release. The nurse instructs the client that the most effective administration
C. The skin is dry and pale. schedule is:
D. The skin returns to a normal position within 1 or 2 seconds A. When manifestations peak only, with two or three doses per
after pinching and lifting the skin. day.
B. At the start of the allergy season, with a dose of once-a-day.
23. The physician prescribes an intravenous infusion of 750ml C. One week before the allergy season begins, with four to six
Normal Saline to a 78-year old male patient with fluid volume deficit doses per day.
and urinary tract infection. After a rapid IV infusion, the patient D. Just after manifestations begin, with a dose of twice-a-day
begins to cough. The nurse raises the head part of the bed to ease
the patient’s breathing. Nurse Rona observes that the patient’s Situation 7: Ms. Ramon is a newly registered nurse. She upgrades
jugular vein is distended and respiratory rate is increased. Which of her nursing competencies by attending seminars and workshops on
the following conditions is the patient experiencing? advanced nursing procedures. A workshop she recently participated
A. Beginning hypotonic water intoxication on, is physical assessment. She applies her skills in the female
B. W orsening of fluid volume deficit medical unit where she is assigned.
C. Developing hypervolemia
D. Respiratory compromise due to ascites 31. Ms. Ramon inspects the abdomen of a patient. Which of the
following sequences represent the order in assessing a patient’s
24. Nurse Rona inspects the tongue and oral mucosa of a 40-year- abdomen?
old patient and notes that they are dry. The patient had cough, fever, A. Palpate, percuss, auscultate, observe
nausea and vomiting which started three days before he was B. Observe, auscultate, percuss, palpate
admitted to the medical unit. The patient further complains of feeling C. Percuss, palpate, auscultate, observe
weak and dizzy. Which vital sign measurement would provide the D. Auscultate, observe, percuss, palpate
best indicator of the patient’s current fluid status?
A. Rate and depth of respiration 32. Ms. Ramon auscultates for breath sounds. What type of data
B. Body temperature should auscultation produce?
C. Pulse oximetry reading at rest A. Secondary
D. Blood pressure and pulse taken in lying and standing positions B. Subjective
C. Primary
25. Nurse Rona assesses a 50-year-old male with liver failure due to D. Objective
cirrhosis. The patient complains of a distended abdomen and
dizziness upon standing. The patient looks pale, has weak radial 33. Ms. Ramon proceeds to palpate a patient’s body to detect
pulse, and with delayed hand vein filling. Based on the assessment warmth. What part of her hand should she use?
data, Nurse Rona writes a nursing diagnosis. Which of the following A. Finger tips
is the most appropriate nursing diagnosis? Fluid volume: B. Back or dorsal surface
A. Deficit related to hormonal disturbances C. Ulnar surface
B. Deficit related to third space fluid shifts D. Finger pads
C. Excess related to hormonal disturbances
D. Excess related to third space fluid shifts 34. Ms. Ramon assesses a patient for a gag reflex. Which part of the
tongue should she place the tongue blade?
A. On the middle of the tongue and ask the patient to cough
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B. On the uvula
C. Lightly on the posterior aspect of the tongue 43. A child with fever has been admitted to the emergency
D. On the front of the tongue and ask the patient to say “ahh” department for several hours. Cooling measures are ordered by the
physician in order for the temperature to come down. Which task
35. Ms. Ramon takes and records the body temperature of a patient. would be appropriate for Nurse Gail to do?
The temperature registers a reading of 38oC. Which of the following A. Educate the need for giving cool fluids
conditions will the patient most likely demonstrate? B. Prepare and administer a tepid bath
A. Increased pulse rate C. Tell the parent to use acetaminophen instead of aspirin
B. Precordial pain D. Assist the child in removing outer garments
C. Dyspnea
D. Elevated blood pressure 44. Nurse Gail conducts primary assessment on a trauma patient.
Which of the following is considered one of the priority elements?
Situation 8: You are a nurse manager of a female and male medical A. Complete vital signs
unit. You realize that being a manager entails a great responsibility. B. Brief neurologic assessment
One of your major responsibilities is to implement quality C. Initiation of pulse oximetry
improvement initiatives in your unit. D. Client’s allergy history
36. You collaborate with the maintenance personnel to prepare a
safety program. The program includes periodic inspection of 45. Triage is the process of determining the priority of patient’s
electrical equipment, conduct of fire drills and proper disposal of treatment based on the severity of their condition. The purpose of
hazardous waste materials. These activities illustrate a component reverse triage is to:
of which quality program? A. Save those persons who are in the most critical condition
A. Total quality management B. Save scarce resources for future use
B. Quality assurance C. Do the greatest good for the greatest number with limited
C. Risk management resources
D. Quality improvement D. The first responders on the triage classification category
37. You call for a staff meeting. You remind the nurses to improve Situation 10: The nurse manager of the Oncology Unit invites an
the quality of care to patients. Which of the following activities is oncology nurse specialist to conduct an educational session to the
most important to safeguard nursing practice? nursing staff on the topic Hodgkin’s disease.
A. Know own strengths and limitations. 46. The nurse specialist explains the characteristics of Hodgkin’s
B. Provide nursing care competently and efficiently. disease. Which of the following is NOT a characteristic of Hodgkin’s
C. Document care accurately. disease?
D. Understand professional, legal, ethical obligations and A. There is presence of Reed-Sternberg cells.
responsibilities. B. The disease occurs most often in the older adult.
C. The lymph nodes, spleen, and liver are involved.
38. You take time to review reports from your staff. One report D. The prognosis depends on the stage of the disease.
records the incidence of patients falling from their beds and other
falls. Which of the following approaches is most appropriate to 47. The nurse specialist describes the stages of Hodgkin’s disease.
manage the situation? Which of the following symptoms is most commonly an early
A. Implement quality assurance measures. indicator of stage I?
B. Apply risk management principles. A. Chest and back pains
C. Apply total quality management principles in the unit. B. Subnormal body temperature
D. Implement a systems approach to the situation. C. Unexplained fever, night sweats
D. Swelling of extremities
39. A staff nurse in your unit administers a drug incorrectly to a
diabetic patient who needs more than one type of insulin. The staff 48. The nurse specialist emphasizes the importance of preventing
nurse’s action causes serious negative effects on the patient. What complications. Which of the following conditions are complications of
would be the most appropriate action that you as the nurse manager Hodgkin’s disease? 1. Nausea 2. Myocardial infarction 3. Anemia 4.
should take? Infection 5. Hypotension
A. Refer the staff nurse to the quality assurance committee. A. 1,2,3,5
B. Refer the staff nurse to the risk management committee. B. 1,2,3,4,5
C. Refer the patient to the attending physician immediately. C. 1,3,4
D. Ask the staff nurse to write a detailed incident report. D. 2,3,4,5
40. A patient in the unit had episodes of seizures. Sometime during 49. The nurse specialist cites a situation. If a patient experiences
the night, the patient fell off from the bed. The nurse on duty finds episodes of severe nausea and vomiting with more than 1000ml of
the patient on the floor. As a nurse manager, you ask the nurse vomitus with in a period of four hours, which of the following is the
involved in the incident to write an incident report. Which of the nurse’s most appropriate action?
following statements is not true about incident reports? The report A. Withhold the physician
A. Is a part of the patient’s medical record B. Notify the physician
B. Can be used in a court of law C. Observe the patient for another four hours
C. Identifies the people involved, the date, time and location of D. Place the patient on a liquid diet
the incident
D. Serves as a record of facts surrounding the incident 50. The nurse specialist explains that chemotherapy is extremely
toxic to the bone marrow and the patient may develop
Situation 9: Nurse Gail is assigned in the emergency department thrombocytopenia. What is the priority goal of the nurse? To take
and takes care of patients with different cases. precautions to control:
41. A client with multiple injuries is rushed after a head on car A. Bleeding
collision. Which assessment would Nurse Gail take priority? B. Hypotension
A. Unequal pupils C. Infection
B. Irregular apical pulse D. Diarrhea
C. A deviated trachea
D. Ecchymosis in the flank area Situation 11: Nurse Ciara assists in the care of a male patient who
has developed acute respiratory acidosis.
42. The ambulance has transported a male client with severe chest 51. Nurse Ciara recalls the causes of respiratory acidosis. Which of
pain. As the client is being transferred to the emergency stretcher, the following are causes of acute respiratory acidosis? 1. Chronic
Nurse Gail noted that the client is unresponsive not breathing and no obstructive pulmonary disease (COPD) 2. Pneumonia 3. Pulmonary
palpable pulse. Which of the following emergency measures will edema 4. Atelectasis 5. Bronchitis
Nurse Gail anticipates to do? A. 1,2,3,4,5
A. Starting bag valve mask ventilation B. 2,3,4,5
B. Performing chest compressions C. 1,3,4,5
C. Placing the defibrillator pads D. 1,2,3,4
D. Aiding with oral intubation
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