CLOSED DOOR COACHING PART 2

NURSING PRACTICE 1
Situation: Nurse Vera made a home visit to a newly married couple whom the wife is a primigravida
and three months pregnant. The would be mother asked questions about pregnancy and prenatal
care.
1. In assessing the health condition of the pregnant patient, Nurse Vera should focus on the ____.
A. Last menstrual period
B. Number of days of menstruation
C. Age of patient during menarche
D. Amount of menstrual flow

2. The patient asked Nurse Vera when is the best time to visit the clinic for her 1st prenatal care.
Which should be the appropriate answer of the nurse?
A. Second trimester
B. Before delivery
C. Third trimester
D. First trimester

3. The patient seems indecisive whether to breastfeed her baby or not. Which is the desired nursing
action of Nurse Vera to help the pregnant patient make a decision on breastfeeding?
A. Give pamphlets and book to read.
B. Provide ample time for the patient to decide
C. Refer the patient to the nutritionist
D. Assist to identify breast feeding goal and plan

4. The patient asks Nurse Vera, when could you hear the fetal heart of my baby? Which of the
following should be the BEST answer of Nurse Vera?
A. Ninth month
B. Fifth month
C. Third month
D. First month

5. Nurse Vera informs the patient she should be screened for pre-eclampsia during this term of
pregnancy ___.
A. First
B. Second
C. Third
D. Before delivery

Situation: In the practice of her profession as a public health nurse, Nurse Mary is guided by ethical
and moral principles.
6. The nurse in the practice of her profession is guided by ______.
A. Code of ethics
B. Standard of care
C. Local Government Code
D. Nursing Process
7. In the ethical principle of beneficence, which is the Basis of every nursing action in all work
settings?
A. Treating all patients selectively
B. Informing patient of hospital bills
C. Respecting refusal of treatment
D. Doing good at all times

8. In handling all information about the families in the community, which of the following principle
should the nurse consider ethical?
A. Confidentiality
B. Fair treatment
C. Justice
D. Beneficence

9. Nurse Mary randomly selected individuals in the community who will be part of a project. Which of
the following ethical principle is observed by the nurse?
A. Autonomy
B. Beneficence
C. Confidentiality
D. Fair Treatment

10. Identify the primary indicator that Nurse May observes fidelity in the practice of her profession.
A. Faithfully promotes health and prevents disease.
B. Frequently assists in providing health services.
C. Fairly evaluated health programs and initiatives
D. Collaborates and works with barangay officials

Situation: Nurse Gina is assigned to supervise the home for the aged in the barangay.
11. In planning the care of the elderly, which should be the important consideration that Nurse Gina
has to consider, ____.
A. The educational qualification
B. Family support
C. Activities of daily living
D. Residence of the elderly

12. Nurse Gina also has to consider in terms of financial status most of the elderly are _____.
A. Sufficient
B. Disoriented
C. Dependent to others financially
D. Have pension

13. In planning their care Nurse Gina should consider _____.

A. Socialization is more important
B. Hollistic Care
C. Physically Dependent
D. Spiritual healing
14. In her recommendation, Nurse Gina stated, elderly should be given independence. This means
____.
A. They must live in their own
B. They environment should be safe for them
C. They are free what to do
D. They have rights

15. The elderly should be afforded health protection by

A. Avoid end hazards
B. Pollution environment
C. Placing them in the home for the aged
D. Regular health check up

16. Which of the following is NOT a step of record keeping?

A. Structuring
B. Storing
C. Securing
D. Easy Disposal

17. In the community setting which is the essential record about the patient?
A. Treatment Record
B. Tally Sheet
C. Chart
D. Kardex

18. Which of the following is the purpose of record keeping

A. Quantify medication usage
B. Historical background
C. Archive
D. Quality health care

19. Records are important in health care for ____.

A. Counting hospital bills
B. Evidence of health care
C. Quantifying services provided
D. For the physician to read

20. What is the ultimate purpose of record keeping

A. Safeguard information
B. Archive
C. History
D. Store information

Situation: Nurse Emma was informed that a family who has just moved in has family members who
are infested with Scabies.
21. Which infection control measure should Nurse Emma observe during her visit to the family.
A. Wear mask C. Use face shield
B. Use gloves D. Wear gown
22. During the history taking, which of the following is the most common symptom of Scabies that
the family would report to Nurse Emma?
A. Rashes
B. Swelling
C. Scaling
D. Itchiness

23. In providing health teaching to the family, Nurse Emma would include in her teachings the
etiology of Scabies which is _____.
A. Virus
B. Fungi
C. Bacteria
D. Parasite

24. The mother of the family asked Nurse Emma how to apply the anti-scabies lotion. The nurse
should teach the family to apply the anti-scabies lotion to _____.
A. All skin areas
B. Affected skin
C. Open Lesions
D. Reddened areas

25. In order to prevent the spread of Scabies infestation to other residents in the community, Nurse
Emma should teach the family, which of the following?
A. Boil the utensils used by the patients.
B. Avoid sharing items used by the infected person.
C. Take a bath three or more times a day.
D. Wear mask and shield at all times even at home.

Situation: As nurse supervisor of the health center Nurse Ellen intends to enhance her competencies
regarding resource management and care of the environment.
26. Which type of plan should the nurse employ to assess the strengths and weaknesses of the
organization?
A. Nursing care
B. Operational
C. Strategic
D. Program

27. Which BEST describes the planning function of Nurse Ellen in her role as nurse manager?
A. Get and develop people to do the work.
B. Distributes and arranges work to ensure smooth operation of the unit.
C. Determines the actual performance compared with the desired output.
D. Determine how to achieve the mandate of work

28. To assist them enhance their performance at work, the nurse manager should review regularly
pertaining to the staff's ____.
A. Number of submitted incident report
B. Academic performance in college
C. Job description
D. Family dynamics.
29. Doing year end performance evaluation of the staff is an example of
A. Planning
B. Controlling
C. Organizing
D. Staffing

30.Which is the MOST important criterion in budgeting?

A. Flexibility
B. Standardized
C. Consistency
D. Cost effectiveness

Situation: Nurse Melyconsiders teamwork and collaboration as important components of Community

Health Nursing.
31. Which of the following is the PRIMARY goal of collaboration
A. Less number of people is needed
B. Camaraderie
C. Accomplish goals
D. Work is faster

32.Which are KEY ELEMENTS of collaboration

1. Shared vision
2. Partnership
3. Working together
4. Unity
A. 1,2,3
B. 3,4
C. 1,2
D. 1,2,3,4

33. Which of the following is the MOST important purpose of teamwork

1. Work is faster
2. Promotes trust
3. Sense of security,
4. Unity
A. 1,2
B. 1,2,3,4
C. 3,4
D. 1,2,3

34. Which of the following BEST describe a strong team?

A. Cohesive
B. Shared goal
C. Driven
D. Sense of mission.

35. Collaboration and teamwork as essential in public health to improve

A. Staff performance. C. Equity in services
B. Proper use of resources D. Quality health care
Situation: An 18 year old, female college student was accompanied by her mother for consultation at
the Municipal Health Center. According to her mother the patient had been having difficulty
concentrating with her lesson, had tendency to isolate inside her room and frequently in an angry
mood. The physician ordered for psychiatric consult.
36. In order to determine the patient's ability to concentrate and focus, which would be the
PRIORITY nursing action?
A. Ask for the academic performance
B. Conduct paper and pencil test
C. Assess the mental status of the patient.
D. Refer the patient to the psychiatrist

37. While the nurse was taking her blood pressure, the patient suddenly stated “They are talking
about me!". She was referring to other patients who were waiting for their consultation .Which of the
following should be the APPROPRIATE nursing action?
A. Present the reality situation.
B. Distract patient's attention.
C. Disagree with the patient.
D. Validate the statement.

38. In taking the patient's history from the mother, the nurse should ask the mother information
related to the daughters’ _______________.
A. Schooling
B. Menarche
C. Pregnancy
D. Immunization

39. Nurse May is alarm by the incidence of number of young adults in the community with mental
problems. Which of the following should be her PRIORITY nursing initiative?
A. Refer all to tertiary hospital.
B. Request for psychiatric drugs.
C. Set up debriefing center.
D. Set up mental health program

40. In giving health teaching to the mother how to manage the patient athome, which of the
following she should emphasize?
A. Give the patient more time for self
B. Impose strict discipline
C. Do traditional parenting style.
D. Need for emotional support.

Situation: When prioritizing problems in the community, the problems are categorized as health
status, health resource or health related.
41. Nurse Maris is correct in identifying which of the following is a health resource problem?
A. Increase in number of deaths from Pneumonia
B. Feud between the Midwife and Head of the Sanitation Committee
C. Absence of Midwife in the community to render health services
D. High Maternal Mortality Rate.
42. There are five criteria in prioritizing community health problems. If Nurse Maris is estimating the
proportion of the population affected bythe problem, she is using what criterion in prioritization?
A. Social Concern
B. Nature of the Problem.
C. Magnitude of the Problem
D. Modifiability of the Problem

43. Nurse Maris oftentimes encounter barriers Select a barrier to goal setting between the nurse and
the family.
A. Educational attainment
B. Nature of employment
C. Failure of family to perceive existence of problem.
D. Socio economic status

44. Which is the MOST appropriate intervention should the nurse do to help family perform the
health tasks?
A. Allow family to decide to use health resources
B. Help the family recognize the problem
C. Leave the family what action take on their problem
D. Refer family to barangay officials for guidance

45. Choose the step of nursing process that identifies the family health seeking behavior.
A. Assessment
B. Implementation
C. Planning
D. Evaluation.

Situation: Nurse Jane is the team leader of group of nurses who plans to utilize Community
Organizing Participative Action Research (COPAR).
46. Which of the following BEST describes the PRIMARY goal of COPAR?
A. Enhances the skills of the nurse in research.
B. Makes the community empowered and self-reliant
C. Increases funding of the community programs
D. Helps clean up and beautify the community

47. At the pre-entry phase, which of the following is the FIRST step inthe COPAR-process
A. Survey the community
B. Train technical working group
C. Hold a community assembly
D. Create a core group

48. In Participative Action Research [PAR], Which step will empower the community?
A. The nurse performs most of the task
B. Health team directs all the activities of the place
C. Participation and engagement of the community
D. Barangay head appoints people in charge
49. The nurse, as the community organizer, immerses self by joining localfolks in their usual everyday
activities in order to ________.
A. Gain trust and rapport of people.
B. Make self-popular among people
C. Identify and spot leaders.

50. In COPAR, which is the MOST important role of the public health nurse?
A. Caregiver
B. Expert
C. Financer
D. Adviser

NURSING PRACTICE 2
Situation: Nurse Trining has been assigned to the Pediatric Ward for two years. She wants to join the
team of nurses who will be conducting a study on sleep. The Team Leader wants to be assured that
Nurse Trining is equipped with the basic knowledge of nursing research.
1. The team leader decided to ask Nurse Trining the meaning of informed consent. After being able
to define what the term means, she was further asked the reasons for its use. Nurse Trining's answer
should be, which
of the following?
1. To fully understand what the research is all about and what will happen should the participants opt
to involve themselves in the research study
2. To get assurance that participants have the right to withdraw from participating in the research at
any given time.
3. To get a complete and full information as to the objective of the study, procedures to be
implemented, data collection, benefits and harm and options in the method of treatment.
4. To get assurance how anonymity and confidentiality will be maintained.
A. 1, 2 & 3
B. 2 only
C. 1, 2, 3 & 4
D. 3 only

2. As to the observance of respecting privacy, Nurse Trining explained about

A. breach of contract.
B. anonymity
C. ethical dilemma
D. confidentiality

3. In nursing, Nurse Trining explained that the MAIN goal of conducting a research is to _______.
A. justify the role of nurses as health care provider
B. establish a credible body of evidence to support and improve the delivery of care.
C. identify research priorities that will justify the oversupply of nurses.
D. develop a body of knowledge to address non-nursing problems

4. In conducting a study on sleep, Nurse Trining was asked which of the types of research will be
used should it involve collecting numerical data which is most often under considerable control. Her
answer should be ___.
A. Ethnographic C. Qualitative
B. Phenomenological D. Quantitative
5. Should a 24-hour period clinical observations and activities be considered in conducting the
research on sleep, the type of study that Trining will be conducting is ______.
A. Quantitative
B. Descriptive
C. Ethnological
D. Exploratory

Situation: Presley enters the labor and delivery unit in probable preterm labor at 36 weeks' gestation.
The patient was informed that the fetus is in breech presentation. She has a catheterized urine
specimen ordered.
6. Patient Presley asks the nurse why such a diagnostic procedure is required. What is the MOST
APPROPRIATE answer can the nurse give?
A. Urinary tract infections are strongly associated with the occurrence of preterm
labor
B. Reduced sensation to urinate usually occur during preterm labor
C. Preterm labor treatment usually causes women a bladder infection because of restricted fluid
intake
D. Catheterized urine is usually ordered for any woman admitted to the labor and delivery unit

7. Betamethasone (Celestone) is prescribed to be administered and the patient asks nurse Hope
about the purpose of this medication?
A. Promote fetal lung maturity.
B. Prevent the premature closure of the ductus arteriosus.
C. Delay delivery for at least 48 hours.
D. Stop the premature uterine contractions.

8. Patient Presley who is ordered for diagnostic pelvic ultrasound asks what preparation she'll take.
Appropriate preparations for this procedure include __________.
A. explanation of the procedure
B. NPO 6 hours before
C. informed consent
D. voiding

9. Pelvic ultrasound can detect, which of the following?

A. Congenital defects in the structure, fetal gender, H-mole
B. Fetal DM, multiple pregnancies, fetal age of gestation
C. Fetal sex, number and lung maturity
D. Fetal congenital defects, placenta previa, fetal lung maturity

10. The labor progress and the physician performed amniotomy. Nurse Hope should FIRST assess for
____.
A. bladder distention
B. maternal blood pressure
C. cervical dilatation
D. fetal heart rate (FHR) pattern
Situation: Sienna, a patient with severe preeclampsia is admitted to the hospital. She is a student
from one of the local universities and insists on continuing her studies while in the hospital, despite
being instructed to rest. The patient studies approximately 10 hours a day and has numerous visits
from fellow students, family and friends.
11. Which intervention should the nurse use to promote rest?
A. Develop a routine with the patient to balance her studies and her rest needs.
B. Include a significant other in helping the patient understand the need for rest.
C. Instruct the patient that the baby's health is more important than her studies at this time.
D. Ask her why she is not complying with the prescription of bed rest.

12. Patient Sienna who seems to be irritated with the nurse said "I don't want to talk with you
because you're only a nurse. I will wait for my doctor." Which of the following should the nurse say in
response to the patient?
A. Your doctor prescribed this for us to do nursing care.
B. I understand. I should call your doctor.
C. I'm angry with the way you dismiss me.
D. So then you would prefer to speak with your doctor?

13. Nurse Mauve is now on ethical dilemma. This occurs when ______.
A. a decision had to be made quickly under stressful situation
B. choices are unclear
C. there is a conflict between the nurse's decision and that of his/her superior
D. there is a conflict of two or more ethical principles

14. Despite the reaction of the patient, which of the ethical' principles that the nurse is responsible of
providing all patients with caring attention and information?
A. Beneficence.
B. Nonmaleficence.
C. Veracity
D. Advocacy

15. Nurse Mauve should plan to initiate which action to provide a safe environment?
A. Take the patient's vital signs every 4 hours.
B. Encourage visits from family and friends for psychosocial support.
C. Maintain fluid and sodium restrictions.
D. Take off the room lights and draw the window shades.

Situation: Nurse Nanie is admitting five-year-old Krini due to cough, respiratory distress, anxiety and
signs of dehydration. The working diagnosis is pneumonia.
16. Nurse Nanie is aware that history taking and physical exam are critical to the diagnostic process
and often provide more information than can gained by broad testing strategies. History taking
includes the following, EXCEPT ____________.
A. History of present illness.
B. Religious Affiliation
C. Social & Family history
D. Past medical history
17. The objective of taking the history of present illness is to illicit chronologic description and
duration of the chief complaint. Which of the following questions would try to answer what Nurse
Nanie wishes to illicit?
1. History of immunizations.
2. Aggravating and alleviating factors
3. Duration of disease onset
4. Any treatment and response to treatment
A. 1, 2 & 3
B. 2,3 & 4
C. 1, 2, 3 & 4
D. 1, 2 & 3

18. Past medical history section of Krini contains the following, but NOT ___________.
A. Prenatal history. C. Current history
B. Child hood illness D. Birth history

19. Which of the following statements is TRUE?

A. History taking must be long regardless if the child appears to be well.
B. No proper history can be obtained without observation of child and the mother.
C. Nurse Nanie should refrain from asking about the illness of other members of the family.
D. An example of what can be elicited from a social history is how the disease started.

20. In order not to frighten small children, it is best to examine things that are uncomfortable or
frightening to them last so as not to lose their cooperation. This means the LAST thing do child which
of the following, EXCEPT _________.
A. Inspection of the throat with a throat stick.
B. Inspection of the ears with an otoscope
C. Auscultation of the heart
D. Undressing the child

Situation: Ximena a Christian 29-year-old pregnant woman was admitted to the hospital with a
complaint of moderate hypogastric pain. She intends to visit the clinic for her first prenatal check-up
and informs nurse Parker that she did not realize she's pregnant until a week ago. As a result, she
has been on a diet, weightlifting at the health gym.
21. Patient Ximena was seen by the physician and was ordered for a medication that is larger than
the standard dose. What should the nurse do?
A. Give the drug as prescribed.
B. Inform the supervisor.
C. Give the average dose of the medication.
D. Discuss the prescription with the physician.

22. The patient refuses to take the medication because it causes diarrhea. Nurse Parker explains the
action of the drug but the patient vehemently refuses the medication. What should be the INITIAL
action of the nurse?
A. Discuss with a family member the need for the patient to take the medication.
B. Document the patient's refusal to take the medication.
C. Notify the physician of the patient's refusal to take the medication.
D. Explain again to the patient the consequences of refusing to take the medication.
23. As a strong believer of her faith and the need for spiritual guidance, patient Ximena requests that
she wants that clergy will visit her. How did nurse Parker function when she initiated the visit?
A. Dependently
B. Collegially
C. Interdependently
D. Independently

24. Patient Ximena sought referral to an abortion clinic from the nurse. She reasons out that her
pregnancy a burden to her work and daily routines. What should be the BEST RESPONSE of the
nurse?
A. It will cause discrimination from friends and relatives.
B. Inform her that abortion is morally and legally wrong by virtue of the law.
C. It will cause infection.
D. It is against any religion.

25. The incoming nurse on duty reported, the nurse is administering a medication, the patient says,
"This pill looks different from the one I had taken before." What is the APPROPRIATE action of the
nurse?
A. Explain the purpose of the medication.
B. Encourage the patient to take the medication.
C. Check the original medication prescription.
D. Ask what the other pill looked like.

Situation: A newly hired nurse is assigned in the OB ward. She was supervised by a senior nurse.
26. She was asked by the nurse supervisor about her concern and what are the considered ideal fetal
positions for a healthy delivery?
A. Right occipitoposterior with no flexion.
B. Right occipitoposterior with full flexion.
C. Left transverse anterior in moderate flexion
D. Left sacroanterior with full flexion

27. The physician ordered sonography. The nurse informs the ultrasound unit in charge and prepares
the patient for the procedure. The patient asks the importance of the procedure, the nurse's
CORRECT response is
A. to determine diameters of the fetal skull
B. increase sensitivity for common bile duct of the fetus
C. useful to a visualized cystic duct of the fetus
D. to assess fetus’ well-being

28. The newly hired nurse asks for advice from the supervisor. The supervisor notices that the newly
hired nurse felt uneasy upon learning that the fetus is on breech presentation. Which of the following
is the BEST RESPONSE by the supervisor?
A. "I understand how you feel. Tell me more."
B. "Is this your first time to witness a breech presentation"
C. "Are you afraid to assist the case"
D. "Don't worry. There's always a first time"
29. After the successful vaginal delivery, medication was ordered to be given immediately. The
supervisor reassured the newly hired nurse that everything will be fine because the medication will
______.
A. promote vasoconstriction of uterine muscles
B. hasten uterine contractility and control bleeding
C. facilitate the return of pregnancy vital signs
D. promote vasodilation of uterine muscles

30. The newly-hired nurse oriented the caregiver hired by the couple. Which of the following should
the nurse encourage the parents to do?
A. Relate to each twin individually to enhance the attachment process.
B. Avoid assistance from other family members and support groups.
C. Bottle-feed the twins to prevent maternal exhaustion.
D. Plan for each parent to spend equal amounts of time with each twin.

Situation: Lillian, 2-week postpartum mother is seen in the health center. On further assessment,
Nurse Addison noted a localized area of redness on the left breast, and the mother is diagnosed with
mastitis.
31. Which additional finding confirms the diagnosis that the patient has mastitis?
a. Enlarged glands in the axilla
b. Normal temperature
c. Engorged both breasts
d. Hard mass and reddened area

32. Lillian asks the nurse the cause of this ailment. Which of the following would the nurse explain as
predisposing factors of mastitis? (Select a that apply)
I. Milk stasis
II. Nipple trauma
III. Using alcohol in cleaning nipples
IV. Baby's sitting position
A. II and IV C. I and II
B. I and IV D. II and III

33. Lillian complains of unbearable pain. Which of the following characteristics are EMPHASIZED in a
culturally sensitive nursing care? (Select all that apply)
I. The expression of pain is affected by learned behavior.
II. Physiologically, all individuals experience pain in a similar manner.
III. Some Asian people has high response to pain medications.
IV. Patients should be assessed for pain regardless of overt symptomatology.
A. III and IV C. I and III
B. I and II D. II and III

34. Nurse Addison provides instructions about measures to prevent postpartum mastitis who is breast
feeding her newborn. Which of the following would indicate that the mother needs further
instruction? "I should____.”
A. wash my hands well before breastfeeding
B. breastfeed every 2 3 hours
C. change the breast pads frequently
D. wash my nipples with soap and water prior to feeding
35. Considering her level of knowledge and the anxiety of her condition, Patient Lillian raised
questions on possible ways of relieving her breast discomfort. Which of the statements NEEDS further
instructions?
A. "I have to stop breastfeeding until this condition resolves."
B. "I can take antibiotics, and should begin to feel better in 24 to 48 hours."
C. "I can use analgesics to assist in alleviating some of these discomforts."
D. "I have to wear a supportive bra to relieve the discomfort."

Situation: Nurse Lyca is assigned in the Nursery. She is performing newborn assessment on Baby Boy
Pratts born at 40 weeks gestation.
36. Using APCAR Score, Nurse Lyca should bear in mind that this method of evaluating a newborn's
condition is used at how many minutes after birth?
A. 1 to 10
B. 1 to 3
C. 1 to 7
D. 1 to 5

37. Nurse Lyca is aware that testing of vision in infants and children has been treated separately from
the testing of adult. Which of the statement is NOT true?
A. Infants and children often cannot be tested with the same materials and techniques as adults.
B. Special techniques often must be used, especially to test infants and preschoolers, that cannot
be held to the same standards that apply to tests for adults
C. Some infants who appear visually impaired early in life will not show normal visual
responses several weeks or months later.
D. Course of visual and cognitive development must be taken into account in evaluating infants
and children's visual abilities

38. The false statement about physiologic jaundice in the statements below is
A. Caused by impairment in the removal of bilirubin deficiency in the production of
glucoronide transferase.
B. Begins to decrease by the 6th or 7th day.
C. Is visible in skin and sclera.
D. Begins after 48 hours of life.

39. Neonatal jaundice FIRST becomes visible in which of the following parts? (Select all that apply.)
1. Face
2. Forehead
3. Trunk
4. Extremities
A. 3 & 4 C. 1 & 4
B. 1 & 2 D. 2 & 3

40. When caring for patients with hyperbilirubinemia, the nursing care plan should focus on the
following, EXCEPT ____.
A. informing appropriately the significant others.
B. preventing injury
C. maintaining physiological homeostasis with bilirubin levels increasing
D. preventing complications.
Situation: Lily, 23-year-old pregnant woman, 37th week's gestation, is admitted in the intensive care
unit due to paroxysmal ventricular tachycardia. The patient is conscious; cervix is open so they
decided to induce labor.
41. When the patient was informed about induction, she asks Nurse Aurora what it is all about.
Which of the following statement by the nurse is correct? Induction is a _______.
A. local anesthesia used for blocking pain during episiotomy
B. deliberate initiation of uterine contractions that stimulates labor
C. medication injected into the subarachnoid space and has a rapid onset of action
D. procedure performed by artificial rupture of the membranes

42. Which of the following statement is NOT an indication for any uterine stimulants (Oxytocin)?
A. Preinducting cervical ripening
B. Controlling postpartum bleeding
C. Inducing or augmenting labor
D. Manages an incomplete abortion

43. Oxytocin drip was started to induce labor. Which assessment findings should cause the nurse to
IMMEDIATELY discontinue the oxytocin infusion? (Select all that apply)
I. Fatigue and drowsiness
II. Early decelerations of the fetal heart rate.
III. Uterine hyperstimulation
IV. Late decelerations of the fetal heart rate
a. III and IV
b. II and III
c. I and III
d. I and II

44. Simultaneous with the oxytocin drip (left arm) is the prescribed intravenous (IV) lidocaine
(Xylocaine). Nurse Aurora should dilute the concentrated solution of lidocaine (right arm) with which
solution?
A. 5 percent Dextrose in water
B. Normal saline 0.99 percent
C. Normal saline 0.45 percent.
D. Lactated Ringer's

45. Take home medications given to Patient Lily includes digitalis therapy which was given to patient
since she was pregnant. Which of the following would the nurse anticipate with patient's drug
therapy?
A. Switching to a more potent drug.
B. Continuation of the same dosage.
C. Need for change in medication.
D. Addition of diuretic to the regimen.

Situation: The indication of tracheostomy in children has changed substantially in the last two
decades. Nurse Robert is taking care of Patient Irma, an eight year old female child, who was
admitted to the Pediatric Ward due to pneumonia. The child is hooked to a tracheostomy tube. Nurse
Robert is quite anxious in taking care of this patient being her first day of duty in the Pediatric Ward.
46. When preparing the patient for suctioning, what is the FIRST step?
A. Perform hand hygiene
B. Gather equipment
C. Assess lung sounds, heart rate and rhythm
D. Check physician's order and patient care plan

47. Patient Irma will be placed in which of the following position? Select all that apply.
1. Fowler
2. Semi-Fowler
3. Supine
4. Sim
A. 1, 2 & 3
B. 2 only
C. 1 & 2
D. 1 only

48. Usually the common indication (s) for the tracheostomy in Patient Irma's condition is which of the
following? (Select all that apply.)
1. Prolonged intubation.
2. Sepsis
3. Hypoventilation associated with neurologic disorders.
4. Severe Sleep Obstructive Apnea Syndrome (SOAS)
A. 2 only
B. 1 & 2
C. 1, 2, 3 & 4
D. 1 only.

49. The PRIORITY nursing objective when caring a patient with a tracheostomy is ______.
a. To increase tissue oxygenation
b. To provide patent airway
c. To decrease tissue oxygenation
d. To improve ventilation

50. The TOP nursing expected outcome when performing suctioning is ______.
A. Lessened amount of secretions leading to decreased frequency of suctioning.
B. Secretions removed without complication.
C. Tube-fed patient does not aspirate feeding.
D. Prevention of occurrence of hypoxemia and bradycardia.

Nursing Practice 3
Situation: Ethical and moral issues are becoming a common scenario in practice setting so health
care providers have to be equipped with this competency.
1. In the clinical setting, when nurses are confronted with ethical dilemmas the BEST practical guide
she can use of is__.
A. PRC oath for professionals
B. Code of Ethics
C. theological doctrine
D. Florence Nightingale oath
2. Mr. RAD is admitted to the hospital complaining of chest pain due to clogged in his coronary
arteries. He is diabetic hypertensive and considered by the physician to be a high risk for
cardiovascular surgery. What PRIORITY action should the members of the health team do in this
situation?
A. Consult the family members and let them give their decision.
B. Proceed with the planned surgery, as this will save the patient.
C. Consult the Ethics committee on what to do with the patient.
D. Discuss with Mr. RAD his health status & let him decide.

3. Mrs. Agnes, 77 y/o is suffering from dementia and demonstrates unruly behavior. When Nurse Gigi
describes the patient in her shift report, as "That awful, dirty old woman in Bed 14" is an example of
what ethical behavior being employed by the nurse?
A. Stigma
B. Ageism
C. Gender bias
D. Depersonalization

4. Mr. Rey, who is on an end-stage of life has an order of "Do Not Resuscitate" and passed away in
your shift. He was declared dead by his physician at 8:30 AM. What should be your PRIORITY
nursing action in this situation?
A. Prepare the death certificate for the physician to sign.
B. Allow the family to have private moments with the deceased.
C. Request your nurse attendant to call the funeral parlor atonce.
D. Clean the body and remove all the IV lines, tubes and other appliances.

5. When a nurse is in full support of patient's care safety and personal rights throughout her hospital
stay, she is implementing what ethical principle?
A. Responsibility
B. Empathy
C. Advocacy
D. Accountability

Situation: A manager of an accounting firm is admitted to the hospital due to an acute abdominal
pain and passing out of bloody stools. After several diagnostic and laboratory examinations the
physician ordered him form exploratory laparotomy. You are the nurse on duty that day.
6. While performing your assessment you are guided that the organs found in the epigastrium
include which of the following?
A. A Portion of duodenum & jejunum, left kidney, appendix & ovary
B. Duodenum, pancreas, portion of the liver and pyloric end of the stomach.
C. Stomach, spleen, tail of pancreas and adrenal gland.
D. Gallbladder, duodenum, gallbladder and portion of the right kidney.

7. When conducting a nursing history on the Health Perception, Health Management pattern of
functioning what is the APPROPRIATE question to be asked pre-operatively?
A. Do you experience your wounds to heal quickly?
B. Do you have shortness of breath when exercising?
C. Are you aware of risk factors for your disease?
D. Have you experience weight changes in the past?
8. Patient was visited by the anesthesiologist and explained the anesthesia for his surgery. Which of
the following type of anesthesia would you expect to be ordered?
A. Spinal
B. Caudal
C. Local
D. General

9. There are pre-operative medications given to the patient. Which of the following drugs are given in
order to decrease intra-operative anesthetic requirements and pain?
A. Celebrex (Celecoxib)
B. Ibuprofen (Motrin)
C. Acetaminophen (Tylenol)
D. Demerol (Meperidine HC1)

10. The goals for patient's safety in the operating room is imperative for all members of the surgical
team. Which of the following Universal Safety Protocol are adopted and validated PRIOR to surgery?
I. Patient's identity
II. Surgical procedure
III. Surgical site
IV. Surgical equipment
A. II & III
B. I & II
C. I, II & IV
D. I, II & III

Situation: Crisostomo a 40 years old employee has been complaining of difficult painful urination for
almost a week now. He said he saw some fresh blood in his urine but was afraid to see a physician,
instead, he went to his neighbor who is a herbalist. After a week his condition worsen and his wife
brought him to a community clinic.
11. A community clinic does primary care for patients. Most often the one who manages this is which
of the following?
A. Physician
B. Barangay health worker
C. Nurse
D. Midwife

12. Upon assessment, the patient was referred immediately to a 25-bed-capacity hospital, which does
not have any capacity to do intensive diagnostic examinations. You are a nurse in this hospital, which
you know is a LEVEL _________.
A. 3 C. 4
B. 1 D. 2

13. In the tertiary hospital where the patient was again referred, he was considered an emergency
case. The nurse immediately called for a specialist who is ________.
A. Neurologist
B. Urologist
C. Phlebotomist
D. Nephrologist
14. After a thorough assessment by the physician-specialist, an order for an immediate stonogram
was made. The nurse was instructed to call which of the following section of the hospital?
A. Operation Room
B. Laboratory
C. Intervention
D. CT scan

15. After the procedure the patient was ordered for Lithotripsy, under spinal anesthesia. The nurse
has to call the department of ________.
A. Internal medicine
B. Anesthesia
C. Surgery
D. Imagery

Situation: An alert 67 year-old woman with diabetes mellitus is discharged from the hospital. A
referral is made to a community nursing agency. You are asked to reinforce the teaching program
started in the hospital. The patient is using sulfonylurea compound tolbutamide (Orinase).
16. When the patient turned 69 years old. Orinase was discontinued and NPH insulin is prescribed for
her. After several months, she is determined to be suffering from the Somogyi effect. Which of the
following conditions will most likely result when the patient is receiving too much insulin?
A. Developing an elevation of the blood glucose level
B. Producing even more insulin
C. Becoming resistant to insulin
D. Conserving excessive amount of fluid

17. A few days later, the patient comes into the emergency department via ambulance stretcher and
reveals a work-up of a blood sugar level at 800mg/dl, ketones are absent in the urine, she is
dehydrated, and has an altered mental status. Based on the data, the patient is most likely suffering
from what specific medical condition?
A. Hyperosmolar nonketotic coma (HNKC)
B. Diabetic retinopathy
C. Acute renal failure
D. Diabetic ketoacidosis (DKA)

18. Upon interview, the patient reported that she often felt nauseated, restless, perspired a lot, felt
fatigued, and was often hungry when she was younger. What do these signs indicate?
A. Diabetic nephropathy
B. Hyperglycemia
C. Hypoglycemia
D. Diabetic retinopathy

19. Upon further assessment, you noticed that she had many scratches on her right ankle, a resulting
infection and cellulitis. When you ask her about the scratches the patient states. "Oh, my cat must
have been using my leg as a scratching post again and I did not even feel it”. Which diabetic
complications suspect the patient to have?
A. Neuropathy
B. Macroangiopathy
C. Retinopathy
D. Ephropathy
20. You should check the patient for suspect disturbed thought processes related to depressed
metabolism and altered cardiovascular and respiratory status. What is the rationale for orienting the
patient to time, place, date, and events?
A. Shows improved cognitive functioning
B. Provides reality orientation to patient
C. Permits evaluation of the effectiveness of treatment
D. Lets the patient identify the time, place, date and events correctly

Situation: Nurse Pat is a newly hired Registered Nurse together with 5 licensed graduate nurses
coming from different regions. It is their first day of orientation in a big health facility. The continuing
nurse educator started the session by projecting the organizational structure of the medical center.
21. Which of the following is the MAJOR PURPOSE of an organizational structure? It is a ______.
A. blueprint representing committees for delegation of roles and functions
B. flow chart that shows interaction among members of major and minor groups
C. framework of relationship of units, departments and channels of communication
D. design that identifies roles, collaboration, interdependence between functions of people

22. Line and staff functions are identified in the presented Organizational Chart. What does line
authority mean?
A. Staff relationship in the organization is advisory in nature
B. Staff mix of personnel reporting to the "Boss".
C. Decisions are made from bottom to top in an organization.
D. A direct responsibility over a subordinate within an organization.

23. Which of the following statements is CORRECT of nursing service system in health care?
A. Informed leaders are more effective than formal leaders in an organization.
B. A shared governance tends to be controlling and with less autonomy.
C. Institutional policies are more powerful tool in nursing practice than laws and regulations.
D. A situational leadership style provides effective means in achieving patient
outcomes.

24. The mode of nursing service delivery system is being revisited in respond to patient's outcome.
Which of the following is NOT TRUE of the manager’s role in the health care delivery system?
A. Provides direct nursing care when needed.
B. Manages resource utilization.
C. Act as a liaison in litigation cases in court.
D. Collaborates with members of the health.

25. Budgeting is an important aspect of financial management. When a unit manager allocates
expenses for unit supplies, stocks and medical-surgical supplies. This is considered _________.
A. cash budget
B. operational budget
C. capital budget
D. flexible budget.

Situation: Mely, 68 -year-old, was admitted to the hospital because of decreased appetite, easy
fatigability, dehydration and weight loss of about 15 lbs for the past weeks. She was examined by the
physician and advised to be admitted. You are the nurse assigned to take care of her.
26. The physician ordered to start Ms. Mely on Total Parenteral Nutrition(TPN). What Is your INITIAL
step to be undertaken PRIOR to this intervention?
A. Determine if the family can afford the whole treatment.
B. Evaluate the tolerance of the patient to glucose.
C. Identify allergies of patient to the supplemental nutrition.
D. Assess the basic understanding of the patient regarding TPN

27. Choose from the following the primary goals of TPN?

I. promote weight gain
II. improve nutritional status
III. maintain muscle mass
IV. establish nitrogen balance
V. enhance healing process
A. I, II, & III
B. I, II, III, & IV
C. I& II
D. I, II, III, IV & V

28. When a patient is undergoing TPN, you have to monitor closely for the _______.
A. serum creatinine
B. potassium level
C. serum glucose level
D. sodium level

29. While Mrs. Mely is on TPN she suddenly complained of slight chest pain, dyspnea and appears
cyanotic. You suspect that she is experiencing what possible IMMEDIATE complication?
A. Sepsis due to IV line
B. Air embolism
C. Hyperglycemia
D. Allergic reaction to TPN

30. What PRIORITY nursing action should you do with the presenting clinical manifestations of the
patient?
A. Report to the physician status of the patient at once.
B. Take Blood pressure and respiratory rate.
C. Stop temporarily the Total Parenteral Nutrition
D. Administer Oxygen inhalation.

Situation: Ms. Monina is a retired Community Health nurse in barangay San Pablo. Due to her
commitment to the nursing profession, she has volunteered in their community to conduct health
education classes. One Saturday morning, several patients who are hypertensive and with pulmonary
health problems attended her session.
31. Mang Luis, is a newly diagnosed patient with Chronic Obstructive Lung Disease (COPD). Which of
the following PRIORITY teaching instructions should he be given in relation to his condition?
A. He should assume supine position when resting.
B. Know early signs of respiratory infection.
C. He has to be taught how to do Bronchial clapping.
D. Family should be advised that patient should sleep in a warm room.
32. Which of the following health interventions should be included in your teaching plan for Mang
Luis?
A. Be on prolonged corticosteroid therapy.
B. Lung exercises must be done with longer inhalation than exhalation.
C. Reduce risk for infection.
D. Have a high flow of oxygen administration.

33. Pulmonary Rehabilitation for COPD has a duration of at least 4 to 12weeks. Which of the
following should be avoided while patient is having this program?
A. Pursed lip breathing
B. Smoking cessation
C. Aerobic, upper and lower body conditioning
D. Peripheral muscle wasting

34. Weight loss and Malnutrition are commonly observed among patients with COPD. They should be
taught to avoid ________.
A. have full stomach even when in dyspneic condition
B. keeping body mass between 21-25 kg
C. a high caloric and high protein diet
D. exercise one hour before and after eating

35. Which of the following energy conserving strategies should NOT be done by COPD patients?
A. Exhale when pushing or exerting effort when doing daily activities
B. Assume tripod position with elbows supported on the table when shaving or combing
C. Inhale when resting, sitting and lying down.
D. Stand in front of the mirror while shaving or combing hair

36. When performing an interview, which is the BEST initial question should you ask when a patient
is on pain?
A. How often do you feel the pain?
B. How would you describe your pain?
C. Did you take any drug to relieve the pain?
D. When did you first feel the abdominal pain?

37. Which of the following imaging test that uses transducer will be likely be ordered by the physician
to detect gallstones?
A. Computed Tomography C. Abdominal Ultrasound
B. Abdominal X-ray D. Doppler sonography

38. The test revealed presence of gallstones and inflamed gall bladder. The patient was advised to
undergo open cholecystectomy. This operation compared to laparoscopic cholecystectomy are
_________.
I. invasive
II. less pain
III. longer recovery
IV. shorter hospital stay
A. I, II, & IV C. I, II & III
B. I & II D. I & III
39. After 2 hours post-operatively, the nurse observed reddish drainage from the operative area of
the patient. Which of the following nursing actions should you performed FIRST?
A. Check if stitches from the operation have come apart.
B. Check where is the source of possible bleeding.
C. Cover the operative area with sterile gauze bandage.
D. Put hand as a pressure on the operative area.

40. After several days in the hospital, the physician ordered for the patient to be discharged. Which
of the following is PRIORITY restriction that you should emphasize when he goes home?
A. Stool softener to induce bowel elimination.
B. Driving while using narcotic drug.
C. Take shower even if still with surgical drain.
D. Lifting of objects not more than 10 lbs.

Situation: Sarah, 18 year old, a teller from a bank is admitted to a tertiary hospital due to
hypertension and frequent hematoma of the lower extremities every time she bumps herself in the
workplace. The physician who examined her gave an impression of Cushing disease.
41. Which of the following characteristics of Cushing disease is TRUE?
I. The disease occurs in women between 20 to 40 year of age.
II. The use of corticosteroids for multiple immune conditions is a cause of the disease process.
III. Condition is aggravated by excessive production of ACTH.
IV. The surgical treatment of choice in Transphenoidal hypophysectomy
A. II & III
B. I, II, & III
C. I, II, III, & IV
D. I & II

42. When one has a Cushing disease the focal structure affected is the __________.
A. hypothalamus C. adrenal gland
B. pituitary gland D. para thyroid gland

43. Which of the following clinical manifestations will NOT be a complaint from Sarah's condition?
A. Edema of the extremities
B. Poor wound healing
C. Decrease libido
D. Absence of growth in the pubic area

44. The attending physician ordered a Magnetic Resonance Imaging (MRI) to patient Sarah in order
to validate the medical impression. This imaging technique is done to detect ________.
A. hemorrhagic injury in the brain C. level of oxygen in the brain
B. electrical impulse in the brain D. non-hemorrhagic injury in the brain

45.While patient Sarah is confined in the hospital, the safety measure to be observed by the nurses is
prevention from fall. This is brought about by the patient being prone to fracture as a result of ____.
A. aging process
B. change in vision
C. osteoporosis
D. hematologic condition
Situation: Mr. Alda, 50 year old company driver is admitted in the Emergency Room (ER) because of
pain of the left chest and difficulty of breathing. History revealed that the patient smokes one half to
1 pack of cigarette per day especially when he goes on overtime. Vital signs: BP is 150/90, PR-
110/min. RR 38/ beats. Has clammy perspiration and quite restless. The physician ordered chest X-
ray and revealed patient has Pneumothorax. You are the nurse in-charge of the patient.
46. As a nurse you are guided that pain is usually described BEST as a phenomenon which is a
______.
A. Neurologic activation of norciceptors
B. Subjective unpleasant experience
C. Adaptive mechanism to a stimulus
D. Creation of one's imagination

47. When a patient has a pneumothorax, the nurse's assessment findings will likely reveal_______.
I. absent breath sounds on the affected side
II. decreased chest expansion unilaterally
III. sharp chest pain
IV. burning chest pain
A. I, II,III
B. III &IV
C. I, II, IV
D. I & II

48. Which of the following statements is NOT true of Pneumothorax?

A. Atmospheric air within the pleural space can result to a rise in intra thoracic pressure and
reduce vital capacity in the lungs.
B. The loss of positive intra-pleural pressure can produce pneumothorax
C. The loss of negative intra pleural pressure can result to collapse of the lungs.
D. A spontaneous pneumothorax can occur with the rupture of pulmonary bleb.

49. The physician inserted a chest tube drainage to Mr. Alda in order to help re-expand the lungs.
Which of the following should you prepare FIRST as a nurse in case of emergency when the tube is
accidentally disconnected?
A. sterile clamps.
B. Another chest tube.
C. Sterile dressing.
D. A bottle of sterile water.

50. In order to relieve Mr. Alda of pain, the physician prescribed morphine. So4 2mg/IV PRN for
untolerable pain. The overall goal of the Health Care Professional is to provide adequate control so
the patient can breathe easily. Which of the following would indicate successful attainment of this
goal?
A. Anxiety level of patient will be reduced.
B. Respiratory rate will be decreased to 20 breadths /min.
C. Oxygen saturation is at 76% level.
D. Pain scale will show 1to 2,in a rating scale of 10(highest, 0-lowest)
Nursing Practice 4
Situation: The Mr. Bello, Hospital Research Coordinator, is discussing the basics of research with the
members of the Research Committee as part of continuing education. Questions and answers were
also part of the program.
1. During the open forum, the Mr. Bello raised the question as to who among the following provides
information in the questionnaires.
A. Participants
B. key informants
C. respondents
D. subjects

2. One of the members of the Research Committee wishes to conduct a study involving an
interdisciplinary team of colleagues. This study is termed as ____.
A. clinical
B. exploratory
C. collaborative
D. applied

3. In conducting a qualitative research, a nurse should follow the logical reasoning process termed
as, which of the following?
A. Deductive
B. Intuition.
C. Causal
D. Inductive.

4. The lecturer reminded the committee members that bias is an influence that distorts study
results. In quantitative research, which will eliminate bias?
A. Trustworthiness
B. Credibility
C. Randomness.
D. Triangulation

5. One of the committee members raised the question on how to make an abstract. The question
was followed by how many words are required in an abstract should (APA) style be followed?
What is the CORRECT answer?
A. 450-550
B. 250-350
C. 150-250
D. 350-40

Situation: The Clinical Instructor (CI) is conducting a ward class on how to perform the breast self-
examination (BSE)
6. The CI is expected to set the atmosphere by welcoming everyone and by _____.
A. showing every one the picture of the breast
B. discussing the objectives of the ward class
C. giving an anecdote about an old man
D. going ahead with the first part of the lecture
7. For the students' better understanding about the anatomy of the breast, the CI shares
A. various pictures of the breast, external and internal views
B. pictures of different types of mastectomies
C. the experiences of breastfeeding mothers
D. artistic drawings of the breasts

8. The clinical instructor proceeded with the lecture to the students using the ____.
A. Question and Answer method
B. Entertainment style of presentation
C. Students as the resource persons
D. Outline of the lecture she just presented

9. When the lecture presentation was finished, the CI proceeded with the ____.
A. evaluation of the activity
B. Q and A portion on anything the students are interested to tackle
C. open forum to solicit questions related to the topic under discussion.
D. cracking of humorous anecdotes to keep the class alive.

10. The last and necessary part of the activity is ______.

A. informing the students their next day's assignment.
B. the joke portion for good vibes
C. evaluation so that future but similar activities can be improved
D. after care of the venue, an earlier reminder by the Head Nurse

Situation: Hypovolemic Shock. The adult patient on his way to the office met a vehicular accident and
was continuously bleeding from the head. He was brought to the nearest hospital by the bystanders.
11. What must the Emergency Room Nurse do FIRST?
A. Start an intravenous line at once.
B. Position with head lower than extremities.
C. Request for laboratory examinations.
D. Stop the bleeding immediately.

12. Due to continuous bleeding the patient goes into the second stage of shock with BP 80/60. What
are the possible effects on the heart in this stage?
I. Increased heart rate
II. Chest pain
III. Increased cardiac troponin
IV. Myocardial infarction
A. I, II, III, and IV
B. I and II
C. I, II, and III
D. II, III, and V

13. The BEST position for the patient to assume in case of shock is ________.
A. modified Trendelenburg
B. high Fowler's
C. recumbent
D. low Fowler's
14. What isotonic electrolyte solutions are COMMONLY used as fluid replacement in hypovolemic
shock?
I. Dextrose 5 percent in water
II. 0.9 percent sodium chloride
III. Lactated Ringer's solution
IV. Dextrose 10 percent in water
A. II, III, and IV
B. I, III, and IV
C. II and III
D. I and IV

15. In case the patient would go into cardiovascular overload as a result of the intravenous fluid
therapy the PRIORITY nursing action should focus on ______.
A. respiratory distress
B. increase in total urine output
C. increase in body temperature
D. edema in the lower extremities

Situation: Patient Lola, a 55-year-old mother of 7, has been having involuntary urine leaks
aggravated whenever she sneezes or coughs. She is diagnosed with urinary Incontinence. The next
5questions refer to this case.
16. The type of incontinence Patient Lola manifests, where there is involuntary loss of urine as a
result of sneezing, coughing or even changing position is called _____.
A. overflow
B. reflex
C. stress
D. functional

17. The nurse is aware that urinary incontinence brings about psychosocialcosts, including the
following, EXCEPT ______.
A. increased expenses .
B. social isolation
C. embarrassment
D. loss of self-esteem

18. The nurse instructs the patient that the BEST time for an incontinentpatient to take his diuretics is
___.
A. Any time of the day
B. After 4:00 PM
C. In the morning
D. At bedtime

19. When providing health teaching to the patient with urinary incontinence, the nurse must STRESS
that it is __.
A. Only surgery can alleviate the condition
B. Often reversible and treatable.
C. Treatable with drugs all of the time
D. Controlled with the aid of alcohol
20. The aim of pelvic muscle exercises for the patient with urinary incontinence is to strengthen the
muscles that control the _____.
A. vagina and rectum
B. perineal area
C. bowel and the bladder
D. vagina and urethra

Situation: Nurses should not only abide by the laws, but be guided by the Code of Ethics for Nurses
as well.
21. The Code of Ethics for Nurses have articles relating to the relationship of nurses on ____. (Select
all that apply.)
I. people
II. practice and the profession
III. co-workers
IV. society and environment
A. I, III, and IV
B. I, II, III, and IV
C. II, III, and IV
D. I, II, and III

22. The Code of Ethics adopted all the principles under the
A. Code of Good Governance
B. Patient's Bill of Rights
C. ICN Code of Ethics
D. American Nurses Association (ANA) Code of Ethics

23. According to the Code of Ethics, WHO determines the coverage and scope of the examination for
the practice of nursing in the Philippines?
A. Professional Regulation Commission
B. Association of Deans of Philippine Colleges of Nursing
C. Professional Regulatory Board of Nursing (PRBON)
D. Professional Association of Philippine Regulatory Boards (PAPRB)
24. What are the three important legal principles in nursing professional ethics?
I. Autonomy
II. Informed consent
III. Confidentiality
IV. Truthtelling
A. I, II, and IV
B. II, III, and IV
C. I, III, and IV
D. I, II, and III

25. The "end- justifies-the-means” ethic is described as ____.

A. having no correct or wrong conclusion
B. basically without any ethical issue
C. conclusively unethical
D. unavoidable during these modern times
Situation: Ms. Lorna, aged 46, has varying degrees of weakness on the lower extremities, inability to
perform voluntary movements and paresthesias. Her physician gives a tentative diagnosis of Guillain-
Barre Syndrome (GBS)
26. Which is a common verbalization of the patient with GBS regarding the EARLY ONSET of
symptoms?
A. Acute hemiplegia
B. Ascending motor weakness.
C. Weakness of the four lower extremities
D. Acute hemiparesis.

27. The nurse is aware that which occurrence in the patient's health history suggests the diagnosis of
GBS?
A. viral illness few weeks before C. severe bacterial infection
B. encephalitis D. meningitis

28. A PRIORITY nursing diagnosis in Guillain Barre Syndrome is ____.

A. Ineffective breathing pattern
B. Impaired verbal communication
C. Imbalanced nutrition
D. Impaired physical mobility

29. If the patient is unable to talk, how should the nurse BEST communicate to the patient?
A. Enunciating the words slowly and well.
B. By using picture cards.
C. Just stop as he could no longer understand.
D. Talking loudly face-to-face with the patient.

30. The nurse informs the patient and family that rehabilitation prior to discharge is BEST described
as ___.
A. a period of ups and downs, physically and emotionally
B. long and one requiring involvement of significant others
C. easy and smooth from discharge onwards.
D. a rapid process towards recovery

Situation: Jollibee, 69 years of age, is diagnosed with Benign Prostatic Hyperlasia (BPH).
31. The nurse anticipates that the signs and symptoms of BPH do NOT include ______.
A. frequency of urination C. dribbling of urine
B. pain on urination D. hesitancy in starting urination.

32. Elmo asks the nurse to explain his condition (BPH). Which statements an CORRECT explanations
by the nurse?
I. It blocks the urethra
II. It obstructs the bladder.
III. It spreads to other parts of the body
IV. It leads to urinary retention
A. I and IV
B. II, III, and IV
C. I, II, and III
D. I and III
33. What IMMEDIATE danger should the nurse anticipate post Transurethral Resection of the Prostate
(TURP)?
A. Infection
B. Bleeding
C. Thrombosis
D. Shock

34. The nurse knows that the normal color of the bladder irrigation drainage right after TURP is ____.
A. reddish pink
B. bright red
C. light pink
D. yellowish

35. Sexual dysfunctions like impotence, erectile dysfunction, and lack of libido are likely possibilities in
what prostatic surgery?
A. Suprapubic prostatectomy
B. Transurethral resection of the prostate
C. Laparoscopic prostatectomy
D. Perineal prostatectomy

Situation: General concepts of immunology must be learned bythe nurse appreciate the management
of her patients.
36. Immunity that the baby gets from the immune mother through breastfeeding is:
A. Passive natural
B. Active artificial
C. Active natural
D. Passive artificial

37. Cell-mediated immunity is NOT usually associated with what condition

A. Rejection of tissue graft
B. Production of antibodies.
C. Skin hypersensitivity reaction.
D. Surveying for malignant cells

38. When a person vaccinated with a Covid-19 vaccine produces antibodies the disease, the immunity
is termed:
A. Active artificial
B. Passive natural
C. Active natural
D. Passive artificial

39. The blood protein involved in the immune system is:

A. Thrombin
B. Globulin
C. Albumin
D. Hemoglobin
40. The immunity conferred by tetanus toxoid is best described as:
A. Lifelong passive C. Temporary passive
B. Long-lasting active D. Lifelong active

Situation: Even if still a staff nurse Tori can well contribute to the management of the resources and
environment of her unit.
41. The electric fan in the unit sparks occasionally but continues to function relatively well. Nurse Tori
though knows that she ____.
A. has to ask one of the staff to preliminary check it
B. will just wait until the fan stops to function immediately
C. should alert the unit staff to closely observe the fan
D. must have it checked by the Maintenance Department immediately

42. The electric fan now stops every now and then and continues to spark at intervals. The best thing
to Do NEXT is to ______.
A. turn off the fan immediately.
B. call the maintenance immediately.
C. Let it continue to function and monitor
D. request for another fan as soon as possible (ASAP)

43. The last fire in the hospital was due to a malfunctioning equipment. The fire extinguisher was no
where to be found. What should have been practiced?
A. A dedicated fire extinguisher must be in every strategic place.
B. Place one fire extinguisher between two units.
C. A fire extinguisher can be replaced with fire sensors
D. Borrowing fire extinguishers may be tolerated if on the same floor.

44. The staff assigned to check the fire extinguisher failed to monitor the "whereabouts" of assigned
equipment. The following statements are true, EXCEPT _______.
A. all employees are lazy
B. monitoring staff is important.
C. not all staff are diligent in their tasks
D. two errors added together can be potentially devastating

45. Because of the failure to replace the defective electric fan immediately, a fire broke out and it
became big enough to burn a major portion of the unit because the fire extinguisher was missing.
What lesson can be gained from this?
A. Punishment must be imposed on erring employees.
B. Reorientation of the new staff.
C. Refer the erring employee to HR.
D. Every protocol must be followed.

46. Milo, the patient with Urinary Tract Infection (UTI) is on his 3rd day of antibiotic but is still having
high fever. There is a need for the nurse to refer her observation to which of the following?
A. Intern
B. Resident-on-duty
C. Attending Physician
D. Head nurse
47. Urine for culture and sensitivity (C& S) was ordered and the nurse was told by the secretary the
Laboratory that the result will be due in 5-7 days. The nurse knows from her readings that
bacterial Culture and Sensitivity may be reported in three days' time. Thus, she plans to follow up
the result from which of the health allied professionals?
A. Head nurse
B. Intern
C. Medical technologist
D. Physician

48. The patient developed worsening cough and was given an anti-cough elixir. After 30 minutes he
developed itchiness with hives. The nurse is hesitant to call anyone since it is already midnight,
and there was no one else since it is a holiday. Who will she refer the patient to?
A. Head Nurse
B. Nurse Supervisor
C. Consultant- in- Charge
D. Head intern

49. The patient suddenly developed chest pain. The result of the stat TrophI revealed high result.
What steps are CORRECT and according to protocol in this situation?
I. The medical technologist immediately calls up the physician to update him of the result.
II. The nurse waits for the doctor to call to confirm the result.
III. The nurse calls up the physician to inform him of the just-in lab result.
IV. The doctor waits for the update of the result from the hospital.
A. I, II, and III
B. I, III, and IV
C. I, II, and IV
D. II, III, and IV

50. The patient was prescribed a number of stat medications to prevent any untoward complications.
The nurse closely coordinates with which professional to facilitate the immediate release of the
necessary medicines and supplies?
A. Attending Physician
B. Nurse Supervisor
C. Pharmacist
D. Head Nurse
Nursing Practice 5
Situation: Sandro 8 years old, 1st grader child has always been the subject of her mother's prompting
and care. He always test his mom's rule in preparing for school. Although this has been for five months
now , Sandro still has to be reminded in getting dress completely and dilly dally eating his breakfast.
He still plays with his toys and interferes with her sister in playing blocks. The mother is so anxious in
reminding Sandro that his school bus will be arriving in 10 minutes every day.
1. Attention deficit hyperactivity disorder (ADHD) is characterized by NOT of the following?
A. Mental retardation
B. Overactivity
C. Inattentiveness
D. Impulsiveness

2. Which of the following would the nurse expect to see as symptoms in child with ADHD, except:
A. Moody, sullen and pouting behavior
B. Interrupts others and can’t take turns
C. Excessive running, climbing and fidgeting
D. Easily distracted and forgetful

3. Sandro is taking pemoline(Cylert) for ADHD. The nurse must be aware which of the following side
effects?
A. Decreased thyroid stimulating hormones
B. Decreased red blood cell count
C. Elevated white blood cell count
D. Elevated liver function test results

4. An effective nursing intervention for the impulsive and aggressive behaviors that accompany
conduct disorder is _______.
A. open expression of feelings
B. assertiveness training
C. negotiation of rules
D. consistent limit setting

5. Nursing diagnosis commonly used when working with Sandro is __________.

A. ineffective role performance
B. impaired social interaction
C. compromised family coping
D. risk for injury

Situation: The nurse is teaching a client taking an MAOI about foods tyramine that he or she should
avoid.
6. Which of the following statements indicates that the client needs further teaching?
A. "I will have to avoid drinking non- alcoholic beer."
B. "I will be able to eat cottage cheese without worrying."
C. "I can eat green beans on this diet."
D. I'm so glad I can have pizza as long as I don't order pepperoni.

7. Patient's health teaching for Lamotrigine (Lamictal) should include which of the following?
A. Take each dose with food to avoid nausea.
B. Eat a balanced diet to avoid weight gain.
 C. Report any rashes to your doctor immediately.
D. This drug may cause psychological dependence.

8. Which of the following health teaching concern for the nurse as discharged plan for suicidal patient
who had been taking tricyclic antidepressant drugs for 2 weeks and now ready to go home?
A. The nurse will need to include teaching regarding signs of neuroleptic malignant syndrome.
B. The patient will need regular laboratory work to monitor therapeutic drug levels.
C. The nurse will evaluate the risk for suicide by overdose of tricyclic antidepressant.
D. The patient may need a prescription for Benadryl to use for side effects.

9. A patient is to take regularly Lithium after discharged. The MOST important information to impart
to the patient and his family is that the patient should _______.
A. not eat foods which has high tyramine content like cheese, wine and liver
B. limit his fluid intake
C. have a limited intake of sodium
D. have an adequate intake of sodium

10. The patient with diagnosis of Schizophrenia who has been taking Clozapine will inform the
patients family that the positive effect of this drug is ______.
A. monthly liver Function studies change moderately
B. b. psychotic symptoms, such as hearing loss are reduced
C. c. patient develops leukopenia.
D. patients energy level and involvement in activities goes up.

Situation: Patrick, Charge nurse, is aware that the uses of resource essential for patient care.
11. A safe patient environment includes following factors EXCEPT _______.
A. socio-economic needs
B. basic needs are met
C. sanitation is maintained
D. physical hazards are reduced

12. As an individual, which of the following is an INTERNAL variable affecting health status, belief, or
practices?
A. Genetics C. Family structure
B. Socioeconomic status D. Living situation

13. Falls are one of the leading environmental hazards reported in her facilities. One of the MOST
common occurrences that precipitate a patient fall is _______.
A. experiencing stress, anxiety, and fatigue
B. leaving the side rails down
C. reaching item at the bedside
D. performing activities of daily living

14. If case a patient falls, the nurse FIRST responsibility is to _______.

A. assess the patient's injury
B. write an incident report
C. report the incident to the head nurse.
D. notify the physician at once
15. In healthcare facility, a planned program of loss prevention and liability control refers to _______.
A. quality assurance
B. critical pathways
C. risk management
D. peer review

Situation: Mark, a 25 year old student suddenly had convulsive movements with loss of
consciousness during their lecture. After the episode he was rushed to the nearest hospital.
16. A nurse is conducting physical assessment, which of the following is INAPPROPRIATE action in
this stage?
A. Insert intravenous cannula
B. Assess patient's lifestyle
C. Assess patient source of stress
D. Identify the patient's daily activity

17. Mark is scheduled for an EEG after having a seizure for the first time. What is the BEST patient
preparation instruction before the procedure?
A. "Avoid thinking and personal matters for 12 hours before the test."
B. "Do not shampoo your hair for 24 hours before the test. "
C. "Do not eat anything for 12 hours before the test.”
D. "Avoid stimulants and alcohol for 24 to 48 hours before the test."

18. Which of the following manifestation should the nurse APPROPRIATELY observe during
generalized seizures?
A. Loss of consciousness, dilated pupils, and muscular stiffening
B. Jerking movements of all extremities.
C. Facial grimace with patting and smacking.
D. Vacant stare with a brief loss of consciousness

19. What is the FIRST Priority which the nurse must observe in caring for patient with seizure?
A. Safety C. Nutrition
B. Airway D. Mobility

20. Phenytoin (Dilantin) has been prescribed for a patient. Based on an understanding of the
medicine, what is the APPROPRIATE nursing instruction of the nurse?
A. Give Dilantin intramuscularly
B. Administer good oral hygiene
C. Dilute IV Dilantin with 5% dextrose
D. Maintain a Dilantin level of 30-50 ug/ml

Situation: Gloria is a nurse researcher in the Department of Health. She is assigned to conduct
research on patient's safety practices of nurses in the psychiatric unit. She is given 6 months to
conduct the study.
21. After formulating and delimiting the research problem, which following will be a PRIORTTY action
of Gloria?
A. Develop the theoretical framework of the study
B. Formulate the hypothesis
C. Plan the research design of the study
D. Conduct a literature search on the topic
22. Gloria decides to include only nurses who have a minimum three year’s experience as psychiatric
nurses. Which of the following terms refer to this?
A. Concept
B. Variable
C. Limitation
D. Delimitation

23. The statement “The length of service is not associated with the degree of patient safety practices
of staff nurses" is an example of a/an ________.
A. Variable
B. Assumption
C. Hypothesis
D. Theory

24. Which of the following research designs is MOST APPROPRIATE for this study if the aim is to find
a relationship between two variables in the study?
A. Phenomenological study C. Exploratory
B. Experimental D. Correlational

25. She plans to interview the Psyche Nurse Manager about the patient safety practices of the
nurses. What type of sampling includes those who happens to be in the conference room where the
activity is scheduled?
A. Random C. Convenience
B. Purposive D. Quota

Situation: Belle is a 30-year-old single mother who is dependent on her family for support. Her
diagnosis is mild mental retardation with post-traumatic disorder with depressive episodes related to
her mother's death. Her current symptoms include depressed mood with irritability, difficulty
tolerating frustration, difficulty falling asleep, increased appetite and weight gain, hypervigilance, and
worry that something terrible will happen to her child.
26. A cognitive assessment of Belle indicated that according to Piaget's theory she was functioning at
the concrete operational stage. Which of these behaviors would the nurse observe in Belle?
A. Thinks logically and sees possibilities.
B. Understands only her own viewpoint.
C. Feels her own reasoning should agree with the reasoning of others.
D. Makes and tests hypothesis.

27. Belle has difficulty tolerating frustration. The GOAL of the nurse is to assist Belle to ________.
A. increase her self-esteem
A. cope with anxiety
B. recognize her needs
C. mobilize her resources

28. Which of the following historical data MOST probably led to a post-traumatic stress disorder?
A. Unstable relationship with ex-fiancé.
B. Suicide of her mother.
C. No gang-relationship with peers
29. Given her problems of hyper vigilance and worry that something terrible will happen to her child,
nursing interventions should be aimed at addressing her needs for _________.
A. love and belongingness C. psychological security
B. biological integrity D. self-esteem

30. In terms of social support therapy, which of these is the MOST APPROPRIATE and therapeutic?
A. with appropriate support, lives in the community, either Independently or in
supervised setting.
B. Individualized relationship with a caregiver.
C. High structured environment with constant aid and supervision.
D. Vocational training with moderate supervision but not beyond second grade academic
challenges.

Situation: The following scenarios are potential routines that could check work ethics of a
professional nurse.
31. A patient asks to be discharged from the health care facility against medical advice(AMA). What
should the nurse do?
A. Notify the physician.
B. Prevent the patient from leaving.
C. Have the patient sign an AMA form.
D. Call a security guard to help detain the patient.

32. A nursing assistant in assigned to provide morning care to a patient. How should the nurse
document care given by the nursing attendant?
A. "Morning care rendered".
B. "Morning care rendered by Grace Go, NA"
C. "Morning care provided by G.G., nursing assistant".
D. "Morning care refused to be given by nursing assistant.

33. A nurse administers the wrong intravenous fluid to a patient. She should accomplish which of the
following documents to be submitted to her immediate supervisor?
A. Patient Kardex C. Progress report
B. Incident report D. Endorsement record

34. When developing a care plan for a patient with a do-not-resuscitate order, the nurse should NOT
Include which intervention on the care plan?
A. Allow access to individuals who can provide spiritual care.
B. Administer pain medications as ordered by physician.
C. Provide usual routine nursing care as ordered by physician.
D. Administer lethal doses of medication as patient request.

35. A patient is to undergo a laminectomy in the morning. The physician asks the nurse to witness
the patient's signing of the consent form. What is the BEST action the nurse?
A. Provide emotional support for the patient while the patient signs the consent.
B. Make sure the physician explains the risks of undergoing the procedure.
C. Make sure the physician thoroughly describes the procedure.
D. Make sure the patient is competent, awake and alert before he/she signs the
consent form.
Situation: Charge Nurse Tessie works at the surgical ward. She ensures g record management is
implemented in her unit at all times.
36. A patient is having elective surgery under general anesthesia. Who is responsible for obtaining
the informed consent?
A. Surgeon
B. Nurse
C. Nurse anesthetist
D. Anesthesiologist

37. Which statement by the patient indicates that the he understands the explanation of the
surgeon?
A. "I refuse to sign the consent form; another family member can sign for me."
B. “Now I know what alternative treatments and procedure are.”
C. "If I refuse to sign the consent form, other treatment will be withdrawn.”
D. "I can't refuse the procedure after the consent is signed."

38. The wait secretary who transcribes the physicians order asks the to interpret an order because
she cannot read the writing. The nurse BEST action in to _______.
A. Clarify the order with the pharmacies
B. clarify the order by calling the physician
C. interpret the order according to the patient’s previous medication record
D. clarify the order with junior staff

39. The physician orders to transfuse 500ml packed RBC blood post-operatively. The nurse must
check the name on the label of the blood with the name on the patient’s _____.
A. Medication administration record
B. Wristband in the presence of another nurse
C. Medical Chart
D. Wristband

40. The patient's wife is so anxious about the condition of her husband. The MOST appropriate
INITIAL intervention for the nurse to make is to _____.
A. Describe her husband's medical treatment since admission
B. reassure her that the important fact is her presence
C. explain the nature of the injury and reassure her that husband's condition is stable
D. allow her to verbalize her feelings and concern

Situation: Quality and safety are rooted in the daily work of a health care professional. Nurses in the
Orthopedic Unit attends monthly quality assurance meeting. The following questions were discussed.
41. Who should be involved in quality improvement measure?
A. Everyone C. Professional staff
B. Management staff D. Consumers

42. To start a nursing improvement project, what is the FIRST step that nurse most keep in mind?
A. Implement plan to correct the problem
B. Determine the nursing standards
C. Determine findings if warrant correction
D. Collect data, determine if standards are set
43. To achieve organized work flow in the unit the staff must be aware of the head nurse's role.
What is the PRIMARY purpose of supervision delegation?
A. Enhances the delivery of quality nursing care
B. Influences organization's approach in personnel evaluations
C. Improves staff attendance in seminars
D. Assigns any staff to do the tasks or project.

44. To ensure quality nursing care to a patient in skin traction, what in the PRIORITY Intervention
that a nurse has to assess frequently?
A. Signs of infection around the pin site.
B. Signs of skin breakdown
C. Urinary incontinence
D. Presence of bowel sounds

45. The nursing team plans to do chart audit project on post-op patients who had developed
pressure sores at the Orthopedic unit over the past year to present. What type of audit is?
A. Retrospective C. Concurrent
B. Process D. Outcome.

Situation: Incidence of drug abuse has greatly increased overtime. Korino has been using drugs for
the past three years.
46. You are a Drug Abuse Treatment and Rehabilitation Center Nurse. During the assessment of a
newly admitted Person Who Uses Drugs(RWUDS) named Korino, which of the following is the MOST
APPROPRIATE question to ask?
A. Ask Korino how long he thought that he could take drugs without someone finding it.
B. Ask Korino why he started taking illegal drugs.
C. Do not ask any questions for fear Korino will deny and may become assaultive.
D. Ask Korino about the amount of drug used and its effect and how long he had been
using.
47. Upon data collection he had been falling three times in his math class and Korino was known for
substance dependent for three years. What is the MOST APPROPRIATE nursing diagnosis for him?
A. Alteration in perception. C. Ineffective individual coping.
B. Alteration in social interaction. D. Impaired judgement.

48. Korino has been using meperidine and codeine for personal consumption. Which of the following
does the nurse understand as the effect of these drugs?
A. Increases sexual stimulation.
B. Relieves pain by increasing pain threshold.
C. Decrease craving for alcoholic intake.
D. Heightens concentration and alertness

49. Which assessment by the nurse would cause a concern for Meperidine overdose?
A. Respiration rate of 12 bpm. C. Dryness of the skin.
B. Hypercapnia D. Pinpoint pupils.

50. What drug should the nurse prepare for administration to reverse all signs of toxicity?
A. Digibind (Digoxin) C. Atropine sulfate
B. Naloxone (Narcan) D. Diazpam (Valium)