Professional Documents
Culture Documents
Comprehensive Exams
Comprehensive Exams
while crossing a train railway. The old woman fell at the railway. Devon rushed at
the scene.
1. As a registered nurse, Devon knew that the first thing that he will do at the
scene is
A. Stay with the person, Encourage her to remain still and Immobilize the leg while
While waiting for the ambulance.
B. Leave the person for a few moments to call for help.
C. Reduce the fracture manually.
D. Move the person to a safer place.
2. Devon suspects a hip fracture when he noticed that the old womans leg is
3. The old woman complains of pain. Devon noticed that the knee is reddened, warm
to touch and swollen. John interprets that this signs and symptoms are likely
related to
A. Infection
C. Thrombophlebitis
B. Inflammation
D. Degenerative disease
4. The old woman told Devon that she has osteoporosis; Devon knew that all of the
following factors would contribute to osteoporosis except
A. Hypothyroidism
B. End stage renal disease
C. Cushings Disease
D. Taking Furosemide and Phenytoin.
5. The old woman was now immobilized and brought to the emergency room. The X-ray
shows a fractured femur and pelvis. The ER Nurse would carefully monitor the old
woman for which of the following sign and symptoms?
SITUATION: Mr. Roxas, an obese 35 year old MS Professor is admitted due to pain in
his weight bearing joint. The diagnosis was Osteoarthritis.
6. As a nurse, you instructed Mr. Roxas how to use a cane. Mr. Roxas has a weakness
on his right leg due to self immobilization and guarding. You plan to teach Mr.
Roxas to hold the cane
8. Mr. Roxas was discharged and 6 months later, he came back to the emergency room
of the hospital because he suffered a mild stroke. The right side of the brain was
affected. At the rehabilitative phase of your nursing care, you observed that Mr.
Roxas uses a cane and you intervene if you see him
SITUATION: Alfred, a 40 year old construction worker developed cough, night sweats
and fever. He was brought to the nursing unit for diagnostic studies. He told the
nurse he did not receive a BCG vaccine during childhood
9. The nurse performs a Mantoux Test. The nurse knows that Mantoux Test is also
known as
A. PPD
B. PDP
C. PDD
D. DPP
A. IM
B. IV
C. ID
D. SC
A. 5 mm wheal
B. 5 mm Induration
C. 10 mm Wheal
D. 10 mm Induration
A. a week
B. 48 hours
C. 1 day
D. 4 days
13. Mang Alfred returns after the Mantoux Test. The test result read POSITIVE. What
should be the nurses next action?
15. Mang Alfred is now a new TB patient with an active disease. What is his
category according to the DOH?
A. I
B. II
C. III
D. IV
16. How long is the duration of the maintenance phase of his treatment?
A. 2 months
B. 3 months
C. 4 months
D. 5 months
17. Which of the following drugs is UNLIKELY given to Mang Alfred during the
maintenance phase?
A. Rifampicin
B. Isoniazid
C. Ethambutol
D. Pyridoxine
18. According to the DOH, the most hazardous period for development of clinical
disease is during the first
19. This is the name of the program of the DOH to control TB in the country
A. DOTS
B. National Tuberculosis Control Program
C. Short Coursed Chemotherapy
D. Expanded Program for Immunization
21. Direct sputum examination and Chest X-ray of TB symptomatic is in what level of
prevention?
A. Primary
B. Secondary
C. Tertiary
D. Quarterly
SITUATION: Marvin, A male patient diagnosed with colon cancer was newly put in
colostomy.
22. Marvin shows the BEST adaptation with the new colostomy if he shows which of
the following?
23. The nurse plans to teach Marvin about colostomy irrigation. As the nurse
prepares the materials needed, which of the following item indicates that the nurse
needs further instruction?
24. The nurse should insert the colostomy tube for irrigation at approximately
A. 1-2 inches
B. 3-4 inches
C. 6-8 inches
D. 12-18 inches
A. 5 inches
B. 12 inches
C. 18 inches
D. 24 inches
26. Which of the following behavior of the client indicates the best initial step
in learning to care for his colostomy?
27. While irrigating the clients colostomy, Marvin suddenly complains of severe
cramping. Initially, the nurse would
28. The next day, the nurse will assess Marvins stoma. The nurse noticed that a
prolapsed stoma is evident if she sees which of the following?
A. Eat eggs
B. Eat cucumbers
C. Eat beet greens and parsley
D. Eat broccoli and spinach
30. The nurse will start to teach Marvin about the techniques for colostomy
irrigation. Which of the following should be included in the nurses teaching plan?
31. The nurse knew that the normal color of Marvins stoma should be
A. Brick Red
B. Gray
C. Blue
D. Pale Pink
32. Wilma, His sister and a nurse is suctioning the tracheostomy tube of John
Lloyd. Which of the following, if made by Wilma indicates that she is committing an
error?
A. Hyperventilating John Lloyd with 100% oxygen before and after suctioning
B. Instilling 3 to 5 ml normal saline to loosen up secretion
C. Applying suction during catheter withdrawal
D. Suction the client every hour
33. What size of suction catheter would Wilma use for John Lloyd, who is 6 feet 5
inches in height and weighing approximately 145 lbs?
A. Fr. 5
B. Fr. 10
C. Fr. 12
D. Fr. 18
34. Wilma is using a portable suction unit at home, What is the amount of suction
required by John Lloyd using this unit?
A. 2-5 mmHg
B. 5-10 mmHg
C. 10-15 mmHg
D. 20-25 mmHg
35. If a Wall unit is used, What should be the suctioning pressure required by John
Lloyd?
A. 50-95 mmHg
B. 95-110 mmHg
C. 100-120 mmHg
D. 155-175 mmHg
36. Wilma was shocked to see that the Tracheostomy was dislodged. Both the inner
and outer cannulas was removed and left hanging on John Lloyd neck. What are the
two (2) equipments at John Lloyds bedside that could help Wilma deal with this
situation?
37. Which of the following method if used by Wilma will best assure that the
tracheostomy ties are not too tightly placed?
38. Wilma knew that John Lloyd have an adequate respiratory condition if she
notices that
39. Wilma knew that the maximum time when suctioning John Lloyd is
A. 10 seconds
B. 20 seconds
C. 30 seconds
D. 45 seconds
SITUATION : John Smith was diagnosed with Acute Close Angle Glaucoma. He is being
seen by Nurse Jet.
40. What specific manifestation would nurse Jet see in Acute close angle glaucoma
that she would not see in an open angle glaucoma?
41. Nurse jet knew that Acute close angle glaucoma is caused by
42. Nurse jet performed a TONOMETRY test to Mr. Smith. What does this test measures
A. IRIS
B. PUPIL
C. RODS [RETINA]
D. CONES [RETINA]
A. 8-21 mmHg
B. 2-7 mmHg
c. 31-35 mmHg
D. 15-30 mmHg
46. Nurse Jet wants to measure Mr. Smiths CN II Function. What test would Nurse
Jet implement to measure CN IIs Acuity?
A. Slit lamp
B. Snellens Chart
C. Woods light
D. Gonioscopy
47. The Doctor orders pilocarpine. Nurse jet knows that the action of this drug is
to
48. The doctor orders timolol [timoptic]. Nurse jet knows that the action of this
drug is
49. When caring for Mr. Smith, Jet teaches the client to avoid
50. Mr. Smith has undergone eye angiography using an Intravenous dye and
fluoroscopy. What activity is contraindicated immediately after procedure?
A. Reading newsprint
B. Lying down
C. Watching TV
D. Listening to the music
51. If Mr. Smith is receiving pilocarpine, what drug should always be available in
any case systemic toxicity occurs?
A. Atropine Sulfate
B. Pindolol [Visken]
C. Naloxone Hydrochloride [Narcan]
D. Mesoridazine Besylate [Serentil]
SITUATION : Wide knowledge about the human ear, its parts and its functions will
help a nurse assess and analyze changes in the adult clients health.
52. Nurse Anna is doing a caloric testing to his patient, Aida, a 55 year old
university professor who recently went into coma after being mauled by her
disgruntled 3rd year nursing students whom she gave a failing mark. After
instilling a warm water in the ear, Anna noticed a rotary nystagmus towards the
irrigated ear. What does this means?
53. Ear drops are prescribed to an infant, The most appropriate method to
administer the ear drops is
A. Pull the pinna up and back and direct the solution towards the eardrum
B. Pull the pinna down and back and direct the solution onto the wall of the canal
C. Pull the pinna down and back and direct the solution towards the eardrum
D. Pull the pinna up and back and direct the solution onto the wall of the canal
54. Nurse Jenny is developing a plan of care for a patient with Menieres disease.
What is the priority nursing intervention in the plan of care for this particular
patient?
55. After mastoidectomy, Nurse John should be aware that the cranial nerve that is
usually damage after this procedure is
A. CN I
B. CN II
C. CN VII
D. CN VI
56. The physician orders the following for the client with Menieres disease. Which
of the following should the nurse question?
A. Dipenhydramine [Benadryl]
B. Atropine sulfate
C. Out of bed activities and ambulation
D. Diazepam [Valium]
57. Nurse Anna is giving dietary instruction to a client with Menieres disease.
Which statement if made by the client indicates that the teaching has been
successful?
A. I will try to eat foods that are low in sodium and limit my fluid intake
B. I must drink atleast 3,000 ml of fluids per day
C. I will try to follow a 50% carbohydrate, 30% fat and 20% protein diet
D. I will not eat turnips, red meat and raddish
58. Peachy was rushed by his father, Steven into the hospital admission. Peachy is
complaining of something buzzing into her ears. Nurse Joemar assessed peachy and
found out It was an insect. What should be the first thing that Nurse Joemar should
try to remove the insect out from peachys ear?
59. Following an ear surgery, which statement if heard by Nurse Oca from the
patient indicates a correct understanding of the post operative instructions?
60. Nurse Oca will do a caloric testing to a client who sustained a blunt injury in
the head. He instilled a cold water in the clients right ear and he noticed that
nystagmus occurred towards the left ear. What does this finding indicates?
61. A client with Cataract is about to undergo surgery. Nurse Oca is preparing plan
of care. Which of the following nursing diagnosis is most appropriate to address
the long term need of this type of patient?
62. Nurse Joseph is performing a WEBERS TEST. He placed the tuning fork in the
patients forehead after tapping it onto his knee. The client states that the fork
is louder in the LEFT EAR. Which of the following is a correct conclusion for nurse
Josph to make?
63. Aling myrna has Menieres disease. What typical dietary prescription would nurse
Oca expect the doctor to prescribe?
A. A low sodium , high fluid intake
B. A high calorie, high protein dietary intake
C. low fat, low sodium and high calorie intake
D. low sodium and restricted fluid intake
65. Approximately how much fluid is lost in acute weight loss of 0.5kg?
A. 50 ml
B. 750 ml
C. 500 ml
D. 75 ml
A. A drop in systolic pressure less than 10 mmHg when patient changes position from
lying to sitting.
B. A drop in systolic pressure greater than 10 mmHg when patient changes position
from lying to sitting
C. A drop in diastolic pressure less than 10 mmHg when patient changes position
from lying to sitting
D. A drop in diastolic pressure greater than 10 mmHg when patient changes position
from lying to sitting
67. Which of the following measures will not help correct the patients condition
68. After nursing intervention, you will expect the patient to have
A. 1,3
B. 2,4
C. 1,3,4
D. 2,3,4
SITUATION: A 65 year old woman was admitted for Parkinsons Disease. The charge
nurse is going to make an initial assessment.
A. Disturbed vision
B. Forgetfulness
C. Mask like facial expression
D. Muscle atrophy
70. The onset of Parkinsons disease is between 50-60 years old. This disorder is
caused by
71. The patient was prescribed with levodopa. What is the action of this drug?
72. You are discussing with the dietician what food to avoid with patients taking
levodopa?
73. One day, the patient complained of difficulty in walking. Your response would
be
SITUATION: Mr. Dela Isla, a client with early Dementia exhibits thought process
disturbances.
74. The nurse will assess a loss of ability in which of the following areas?
A. Balance
B. Judgment
C. Speech
D. Endurance
75. Mr. Dela Isla said he cannot comprehend what the nurse was saying. He suffers
from:
A. Insomnia
B. Aphraxia
C. Agnosia
D. Aphasia
76. The nurse is aware that in communicating with an elderly client, the nurse will
77. As the nurse talks to the daughter of Mr. Dela Isla, which of the following
statement of the daughter will require the nurse to give further teaching?
78. Which of the following is most important discharge teaching for Mr. Dela Isla
A. Emergency Numbers
B. Drug Compliance
C. Relaxation technique
D. Dietary prescription
80. What should the nurse caution the client when using this medication
81. Which of the following drugs are not compatible when taking Probanthine?
A. Caffeine
B. NSAID
C. Acetaminophen
D. Alcohol
82. What should the nurse tell clients when taking Probanthine?
83. Which of the following disease would Probanthine exert the much needed action
for control or treatment of the disorder?
A. Urinary retention
B. Peptic Ulcer Disease
C. Ulcerative Colitis
D. Glaucoma
SITUATION : Mr. Francisco, 70 years old, suddenly could not lift his spoons nor
speak at breakfast. He was rushed to the hospital unconscious. His diagnosis was
CVA.
84. Which of the following is the most important assessment during the acute stage
of an unconscious patient like Mr. Francisco?
86. What is the rationale for giving Mr. Francisco frequent mouth care?
87. One of the complications of prolonged bed rest is decubitus ulcer. Which of the
following can best prevent its occurrence?
88. If Mr. Franciscos Right side is weak, What should be the most accurate
analysis by the nurse?
SITUATION : a 20 year old college student was rushed to the ER of PGH after he
fainted during their ROTC drill. Complained of severe right iliac pain. Upon
palpation of his abdomen, Ernie jerks even on slight pressure. Blood test was
ordered. Diagnosis is acute appendicitis.
89. Which result of the lab test will be significant to the diagnosis?
90. Stat appendectomy was indicated. Pre op care would include all of the following
except?
A. Spinal
B. General
C. Caudal
D. Hypnosis
A. Early ambulation
B. Diet as tolerated after fully conscious
C. Nasogastric tube connect to suction
D. Deep breathing and leg exercise
94. Peritonitis may occur in ruptured appendix and may cause serious problems which
are
A. 1 and 2
B. 2 and 3
C. 1,2,3
D. All of the above
95. If after surgery the patients abdomen becomes distended and no bowel sounds
appreciated, what would be the most suspected complication?
A. Intussusception
B. Paralytic Ileus
C. Hemorrhage
D. Ruptured colon
96. NGT was connected to suction. In caring for the patient with NGT, the nurse
must
A. Inorganic Stroke
B. Inorganic Psychoses
C. Organic Stroke
D. Organic Psychoses
99. The main difference between chronic and organic brain syndrome is that, the
former
A. Memory deficit
B. Disorientation
C. Impaired Judgement
D. Inappropriate affect
Here are the answers and rationale for this exam. Counter check your answers to
those below and tell us your scores. If you have any disputes or need more
clarification to a certain question, please direct them to the comments section.
3. B. Inflammation
After a trauma, Inflammation will start almost instantly. Infection occurs 24-48
hours after bone fracture and not immediately. Thrombophlebitis occurs within 4 to
7 days of hospitalization after prolonged immobilization. There is no evidence that
the client has a degenerative disease and degenerative diseases will manifest in
variety of ways and not after a trauma.
4. A. Hypothyroidism
B,C,D all contributes to bone demineralization except HYPOTHYROIDISM.
Hyperthyroidism will contribute to bone demineralization as well as
Hyperparathyroidism due to the increase in PTH, It will cause the movement of
calcium from the bone to the blood causing HYPERCALCEMIA. ESRD will cause increase
in PHOSPHATE due to its poor excretion. The amount of phosphate is inversely
proportional to the amount of calcium. Cushing disease promotes bone
demineralization as well as medications like diuretics and anti convulsants.
9. A. PPD
PPD stands for purified protein derivative. It is used to check for TB exposure.
All clients who had BCG need not perform this test because they will always be +.
10. C. ID
A Wheal is created intradermally and then it is marked and timed. reading will be
done within 2 to 3 days.
11. D. 10 mm Induration
10 mm Induration [ redness ] is considered positive for individuals with
competitive immune response. Wheals are not measured, they will not anymore
enlarge. A 5 mm induration is considered positive for patients with AIDS or
immunocompromised.
12. B. 48 hours
Clients are asked to comeback within 2 to 3 days for the reading.
14. D. Almost all Filipinos will test positive for Mantoux Test
almost all filipinos tests positive for mantoux test due to the fact that BCG are
required and TB exposure in the country is fulminant. All individuals vaccinated
with BCG will test POSITIVE for mantoux test all their lives.
15. A. I
Category I patients are those with a newly diagnosed TB whose sputum culture are
positive. II are for those who have relapses while III are those with negative
sputum culture but positive chest x ray, or PTB Minimal.
16. C. 4 months
Clients in category I will have 2 months INTENSIVE and 4 months maintenance
treatment.
17. C. Ethambutol
Drugs given in the maintenance phase includes Rifampicin and Isoniazid. Ethambutol
is given on the intensive phase along with rifampicin and isoniazid. Pyridoxine is
given during Isoniazid treatment to prevent peripheral neuritis in contrast in
treatment of parkinsonism with levodopa, Pyridoxine or VB6 is restricted.
21. B. Secondary
National board exam loves asking about level of prevention. Mastery with the
primary, secondary and tertiary levels of prevention is a must. All diagnostic,
case finding and treatment belongs to the secondary level of prevention.
Kinchay and Pechay helps lessen the odor of the colostomy. Spinach, broccoli,
Cabbage, Cucumbers, Patola or bottle gourd also help lessen the odor BUT are gas
formers. Eggs are not recommended because they are known to cause unpleasant odors
in patients with colostomy.
33. D. Fr. 18
The height is given and it looks like james is a very tall individual. The maximum
height of suction tube is used. fr 12-18 are used for adults while 6-8 are used in
children.
39. A. 10 seconds
According to our reviewers and lecturers, 10 to 15 seconds is the maximum suction
time. But according to almost all foreign books I read, it should only be 10
seconds at max. I prefer following Saunders,Mosby and Lippinncots when they are all
united.
40. D. Pain
There is NO PAIN in open angle glaucoma. A,B,C are all present in both glaucomas
including the low pressure glaucoma. Pain is absent because the increase in intra
ocular pressure is not initiated abruptly. It is gradual and progressive and will
lead to unnoticed loss of peripheral vision. Pain is present in acute close angle
glaucoma because there is a sudden closure or narrowing of the canal of schlemm.
Therefore if you will be ask what s/s is common in both, answer IRREVERSIBLE LOSS
OF PERIPHERAL VISION.
41. A. Sudden blockage of the anterior angle by the base of the iris
Sudden blockage of the angle will cause s/s of acute angle closure glaucoma. B and
C are all related to open angle glaucoma. D is insignificant, If the client bends
or cough, IOP can increase from 8 to as much as 30 mmHg but then return again to
normal.
52. C. Normal
Rotary nystagmus towards the ear [ if warm ] or away from it [ if cool ] is a
normal response. It indicates that the CN VIII Vestibular branch is still intact.
53. B. Pull the pinna down and back and direct the solution onto the wall of the
canal
Instillation for children under age 3 is CHILD : DOWN AND BACK. Directing the
solution towards the eardrum might perforate or damage the infants fragile tympanic
membrane.
54. D. Safety
Although A is priority according to maslow, it is not specific in clients with
menieres disease. The client has an attack of incapacitating vertigo and client is
high risk for injury due to falls. The client will perceive the environment moving
due to disruption of the vestibular system of the ears normal function.
55. C. CN VII
The facial nerve branches from the back of the ear and spread towards the mouth,
cheeks, eyelids and almost all over the face. In mastoidectomy, Incision is made at
the back of the ears to clear the mastoid air cells of the mastoid bone that is
infected. Clients are at very high risk for CN VII injury because of this.
Observation during the post op after mastoidectomy should revolve around assessing
the clients CN VII integrity.
57. A. I will try to eat foods that are low in sodium and limit my fluid intake
Clients are advised to limit fluid and sodium intake as not to further cause
accumulation of fluids in the endolymph. C is the diabetic diet. D are the foods
not eaten when clients are about to have a guaiac test.
Why does conductive hearing produces a louder sound ?Conductive hearing loss is a
type of hearing loss where in, the ossicles hypertrophies, as in OTOSCLEROSIS. The
stape is permanently attached to the oval window and it would not bulge causing a
permanent LOUD conduction of sound using the bone because the stapes is already
attached permanently into the inner ear. In a normal state, It will not touch the
oval window unless a sound is transmitted. [ refer to the ear anatomy and
physiology ]
65. C. 500 ml
1L = 1kg
66. B. A drop in systolic pressure greater than 10 mmHg when patient changes
position from lying to sitting
Postural hypotension is exhibited by a drop of systolic BP when client changes
position from lying to sitting or standing.
67. A. Offer large amount of oral fluid intake to replace fluid lost
The patient will not tolerate large amount of oral fluid due to incessant vomiting.
68. D. 2,3,4
Client need not maintain a temperature of 36.5 C. As long as the client will
exhibit absence of fever or hypothermia, Nursing interventions are successfully
carried out.
74. D. Endurance
There will be alteration in balance because coordination and spatial ability
gradually deteriorates. Judgement is also impaired as the client exhibits poor
memory and concentration. Speech is severely altered. Client develops aphasia,
agnosia and in at end, will lose all the ability to speak without any manifestation
of motor problem.
75. D. Aphasia
This question was RECYCLED during the last 2006 NLE. Aphasia is the INABILITY to
speak or understand. Apraxia is the inability to carry out purposeful tasks.
Agnosia is the inability to recognize familiar objects. Insomnia is the inability
to fall asleep.
77. B. I told her she is wrong and I explained to her what is right
Hallucinations and delusions are part of DEMENTIA and is termed as ORGANIC
PSYCHOSES. The daughter needs further teaching when she try to bargain, explain,
disapprove or advise a client with dementia. the client has an impaired judgement,
concentration, thinking, reasoning and memory and has inability to learn that is
why institutional care for clients with dementia is always required. The disease is
progressive and is not preventable.
81. D. Alcohol
Probanthine on its own already cause severe dizziness and drowsiness. Addition of
alcohol will further depress the CNS and might lead to potentiation of the side
effects of probanthine. A,B,C are not contraindicated when taking probanthine
EXCEPT when the disease entity itself do not permit intake of such drugs like in
Pancreatitis, NSAID is not use. Pain is controlled using probanthine and meperidine
[ demerol ] in cases of acute pancreatitis.
86. D. Mouth breathing is used by comatose patient and itll cause oral mucosa
drying and cracking.
Client will be on NGT once comatose, A is removed first. Client with CVA MAY have
seizures, but it is RARE enough that it must require a frequent mouth care, B is
eliminated next. Knowing that tactile stimulation is done by touching the patient
and not by performing mouth care will lead you to letter D. Comatose patient uses
the mouth to breathe predisposing himself to drying, cracking and infections.
92. A. Spinal
Spinal anesthesia is the most common method used in appendectomy. Using this
method, Only the area affected is anesthetized preventing systemic side effects of
anesthetics like dizziness, hypotension and RR depression.