NURSING PRACTICE III part 1

NURSING PRACTICE III

Situation: Leo lives in the squatter area. He goes to

nearby school. He helps his mother gather molasses

after school. One day, he was absent because of fever,

malaise, anorexia and abdominal discomfort.

1. Upon assessment, Leo was diagnosed to have

hepatitis A. Which mode of transmission has the

infection agent taken?

a. Fecal-oral

b. Droplet

c. Airborne

d. Sexual contact

2. Which of the following is concurrent disinfection

in the case of Leo?

a. Investigation of contact

b. Sanitary disposal of faeces, urine and

blood

c. Quarantine of the sick individual

d. removing all detachable objects in the

room, cleaning lighting and air duct

surfaces in the ceiling, and cleaning

everything downward to the floor

3. Which of the following must be emphasized

during mother’s class to Leo’s mother?

a. Administration of Immunoglobulin to

families

b. Thorough hand washing before and

after eating and toileting

c. Use of attenuated vaccines

d. Boiling of food especially meat

4. Disaster control should be undertaken when

there are 3 or more hepatitis A cases. Which of

these measures is a priority?

a. Eliminate faecal contamination from

foods

b. Mass vaccination of uninfected

individuals

c. Health promotion and education to

families and communities about the

disease it’s cause and transmission

d. Mass administration of Immunoglobulin

5. What is the average incubation period of

Hepatitis A?

a. 30 days

b. 60 days

c. 50 days

d. 14 days

Situation: As a nurse researcher you must have a very

good understanding of the common terms of concept

used in research.

6. The information that an investigator collects

from the subjects or participants in a research

study is usually called;

a. Hypothesis

b. Variable

c. Data

d. Concept

7. Which of the following usually refers to the

independent variables in doing research

a. Result

b. output

c. Cause

d. Effect

8. The recipients of experimental treatment is an

experimental design or the individuals to be

observed in a non experimental design are

called;

a. Setting

b. Treatment

c. Subjects

d. Sample

9. The device or techniques an investigator

employs to collect data is called;

a. Sample

b. hypothesis

c. Instrument

d. Concept

10. The use of another person’s ideas or wordings

without giving appropriate credit results from

inaccurate or incomplete attribution of materials

to its sources. Which of the following is referred

to when another person’s idea is inappropriate

credited as one’s own;

a. Plagiarism

b. assumption

c. Quotation

d. Paraphrase

Situation – Mrs. Pichay is admitted to your ward. The

MD ordered “Prepare for thoracentesis this pm to

remove excess air from the pleural cavity.”

11. Which of the following nursing responsibilities is

essential in Mrs. Pichay who will undergo

thoracentesis?

a. Support and reassure client during the

procedure

b. Ensure that informed consent has been

signed

c. Determine if client has allergic reaction

to local anesthesia

d. Ascertain if chest x-rays and other tests

have been prescribed and completed

12. Mrs. Pichay who is for thoracentesis is assigned

by the nurse to which of the following positions?

a. Trendelenburg position

b. Supine position

c. Dorsal Recumbent position

d. Orthopneic position

13. During thoracentesis, which of the following

nursing intervention will be most crucial?

a. Place patient in a quiet and cool room

b. Maintain strict aseptic technique

c. Advice patient to sit perfectly still

during needle insertion until it has been

withdrawn from the chest

d. Apply pressure over the puncture site as

soon as the needle is withdrawn

14. To prevent leakage of fluid in the thoracic cavity,

how will you position the client after

thoracentesis?

a. Place flat in bed

b. Turn on the unaffected side

c. Turn on the affected side

d. On bed rest

15. Chest x-ray was ordered after thoracentesis.

When your client asks what is the reason for

another chest x-ray, you will explain:

a. To rule out pneumothorax

b. To rule out any possible perforation

c. To decongest

d. To rule out any foreign body

Situation: A computer analyst, Mr. Ricardo J. Santos, 25

was brought to the hospital for diagnostic workup after

he had experienced seizure in his office.

16. Just as the nurse was entering the room, the

patient who was sitting on his chair begins to

have a seizure. Which of the following must the

nurse do first?

a. Ease the patient to the floor

b. Lift the patient and put him on the bed

c. Insert a padded tongue depressor

between his jaws

d. Restraint patient’s body movement

17. Mr Santos is scheduled for CT SCAN for the next

day, noon time. Which of the following is the

correct preparation as instructed by the nurse?

a. Shampoo hair thoroughly to remove oil

and dirt

b. No special preparation is needed.

Instruct the patient to keep his head

still and stead

c. Give a cleansing enema and give fluids

until 8 AM

d. Shave scalp and securely attach

electrodes to it

18. Mr Santos is placed on seizure precaution.

Which of the following would be

contraindicated?

a. Obtain his oral temperature

b. Encourage to perform his own personal

hygiene

c. Allow him to wear his own clothing

d. Encourage him to be out of bed

19. Usually, how does the patient behave after his

seizure has subsided?

a. Most comfortable walking and moving

about

b. Becomes restless and agitated

c. Sleeps for a period of time

d. Say he is thirsty and hungry

20. Before, during and after seizure. The nurse

knows that the patient is ALWAYS placed in what

position?

a. Low fowler’s

b. Side lying

c. Modified trendelenburg

d. Supine

Situation: Mrs. Damian an immediate post op

cholecystectomy and choledocholithotomy patient,

complained of severe pain at the wound site.

21. Choledocholithotomy is:

a. The removal of the gallbladder

b. The removal of the stones in the

gallbladder

c. The removal of the stones in the

common bile duct

d. The removal of the stones in the kidney

22. The simplest pain relieving technique is:

a. Distraction

b. Deep breathing exercise

c. Taking aspirin

d. Positioning

23. Which of the following statement on pain is

TRUE?

a. Culture and pain are not associated

b. Pain accompanies acute illness

c. Patient’s reaction to pain Varies

d. Pain produces the same reaction such as

groaning and moaning

24. In pain assessment, which of the following

condition is a more reliable indicator?

a. Pain rating scale of 1 to 10

b. Facial expression and gestures

c. Physiological responses

d. Patients description of the pain

sensation

25. When a client complains of pain, your initial

response is:

a. Record the description of pain

b. Verbally acknowledge the pain

c. Refer the complaint to the doctor

d. Change to a more comfortable position

Situation: You are assigned at the surgical ward and

clients have been complaining of post pain at varying

degrees. Pain as you know, is very subjective.

26. A one-day postoperative abdominal surgery

client has been complaining of severe throbbing

abdominal pain described as 9 in a 1-10 pain

rating. Your assessment reveals bowel sounds on

all quadrants and the dressing is dry and intact.

What nursing intervention would you take?

a. Medicate client as prescribed

b. Encourage client to do imagery

c. Encourage deep breathing and turning

d. Call surgeon stat

27. Pentoxidone 5 mg IV every 8 hours was

prescribed for post abdominal pain. Which will

be your priority nursing action?

a. Check abdominal dressing for possible

swelling

b. Explain the proper use of PCA to

alleviate anxiety

c. Avoid overdosing to prevent

dependence/tolerance

d. Monitor VS, more importantly RR

28. The client complained of abdominal distention

and pain. Your nursing intervention that can

alleviate pain is:

a. Instruct client to go to sleep and relax

b. Advice the client to close the lips and

avoid deep breathing and talking

c. Offer hot and clear soup

d. Turn to sides frequently and avoid too

much talking

29. Surgical pain might be minimized by which

nursing action in the O.R.

a. Skill of surgical team and lesser

manipulation

b. Appropriate preparation for the

scheduled procedure

c. Use of modern technology in closing the

wound

d. Proper positioning and draping of clients

30. Inadequate anesthesia is said to be one of the

common cause of pain both in intra and post op

patients. If General anesthesia is desired, it will

involve loss of consciousness. Which of the

following are the 2 general types of GA?

a. Epidural and Spinal

b. Subarachnoid block and Intravenous

c. Inhalation and Regional

d. Intravenous and Inhalation

Situation: Nurse’s attitudes toward the pain influence

the way they perceive and interact with clients in pain.

31. Nurses should be aware that older adults are at

risk of underrated pain. Nursing assessment and

management of pain should address the

following beliefs EXCEPT:

a. Older patients seldom tend to report

pain than the younger ones

b. Pain is a sign of weakness

c. Older patients do not believe in

analgesics, they are tolerant

d. Complaining of pain will lead to being

labeled a ‘bad’ patient

32. Nurses should understand that when a client

responds favorably to a placebo, it is known as

the ‘placebo effect’. Placebos do not indicate

29

whether or not a client has:

a. Conscience

b. Disease

c. Real pain

d. Drug tolerance

33. You are the nurse in the pain clinic where you

have client who has difficulty specifying the

location of pain. How can you assist such client?

a. The pain is vague

b. By charting-it hurts all over

c. Identify the absence and presence of

pain

d. As the client to point to the painful are

by just one finger

34. What symptom, more distressing than pain,

should the nurse monitor when giving opioids

especially among elderly clients who are in pain?

a. Forgetfulness

b. Drowsiness

c. Constipation

d. Allergic reactions like pruritis

35. Physical dependence occurs in anyone who

takes opiods over a period of time. What do you

tell a mother of a ‘dependent’ when asked for

advice?

a. Start another drug and slowly lessen the

opioid dosage

b. Indulge in recreational outdoor activities

c. Isolate opioid dependent to a restful

resort

d. Instruct slow tapering of the drug

dosage and alleviate physical

withdrawal symptoms

Situation: The nurse is performing health education

activities for Janevi Segovia, a 30 year old Dentist with

Insulin dependent diabetes Miletus.

36. Janevi is preparing a mixed dose of insulin. The

nurse is satisfied with her performance when

she:

a. Draw insulin from the vial of clear

insulin first

b. Draw insulin from the vial of the

intermediate acting insulin first

c. Fill both syringes with the prescribed

insulin dosage then shake the bottle

vigorously

d. Withdraw the intermediate acting

insulin first before withdrawing the short

acting insulin first

37. Janevi complains of nausea, vomiting,

diaphoresis and headache. Which of the

following nursing intervention are you going to

carry out first?

a. Withhold the client’s next insulin

injection

b. Test the client’s blood glucose level

c. Administer Tylenol as ordered

d. Offer fruit juice, gelatine and chicken

bouillon

38. Janevi administered regular insulin at 7 A.M and

the nurse should instruct Jane to avoid

exercising at around:

a. 9 to 11 A.M

b. Between 8 A.M to 9 A.M

c. After 8 hours

d. In the afternoon, after taking lunch

39. Janevi was brought at the emergency room after

four month because she fainted in her clinic. The

nurse should monitor which of the following test

to evaluate the overall therapeutic compliance

of a diabetic patient?

a. Glycosylated hemoglobin

b. Ketone levels

c. Fasting blood glucose

d. Urine glucose level

40. Upon the assessment of Hba1c of Mrs. Segovia,

The nurse has been informed of a 9% Hba1c

result. In this case, she will teach the patient to:

a. Avoid infection

b. Prevent and recognize hyperglycaemia

c. Take adequate food and nutrition

d. Prevent and recognize hypoglycaemia

41. The nurse is teaching plan of care for Jane with

regards to proper foot care. Which of the

following should be included in the plan?

a. Soak feet in hot water

b. Avoid using mild soap on the feet

c. Apply a moisturizing lotion to dry feet

but not between the toes

d. Always have a podiatrist to cut your toe

nails; never cut them yourself

42. Another patient was brought to the emergency

room in an unresponsive state and a diagnosis of

hyperglycaemic hyperosmolar nonketotic

syndrome is made. The nurse immediately30

prepares to initiate which of the following

anticipated physician’s order?

a. Endotracheal intubation

b. 100 unites of NPH insulin

c. Intravenous infusion of normal saline

d. Intravenous infusion of sodium

bicarbonate

43. Jane eventually developed DKA and is being

treated in the emergency room. Which finding

would the nurse expect to note as confirming

this diagnosis?

a. Comatose state

b. Decreased urine output

c. Increased respiration and an increase in

pH

d. Elevated blood glucose level and low

plasma bicarbonate level

44. The nurse teaches Jane to know the difference

between hypoglycaemia and ketoacidosis. Jane

demonstrates understanding of the teaching by

stating that glucose will be taken if which of the

following symptoms develops?

a. Polyuria

b. Shakiness

c. Blurred Vision

d. Fruity breath odour

45. Jane has been scheduled to have a FBS taken in

the morning. The nurse tells Jane not to eat or

drink after midnight. Prior to taking the blood

specimen, the nurse noticed that Jane is holding

a bottle of distilled water. The nurse asked Jane

if she drink any, and she said “yes.” Which of the

following is the best nursing action?

a. Administer syrup of ipecac to remove

the distilled water from the stomach

b. Suction the stomach content using NGT

prior to specimen collection

c. Advice to physician to reschedule to

diagnostic examination next day

d. Continue as usual and have the FBS

analysis performed and specimen be

taken

Situation: Elderly clients usually produce unusual signs

when it comes to different diseases. The ageing process

is a complicated process and the nurse should

understand that it is an inevitable fact and she must be

prepared to care for the growing elderly population.

46. Hypoxia may occur in the older patients because

of which of the following physiologic changes

associated with aging.

a. Ineffective airway clearance

b. Decreased alveolar surfaced area

c. Decreased anterior-posterior chest

diameter

d. Hyperventilation

47. The older patient is at higher risk for

incontinence because of:

a. Dilated urethra

b. Increased glomerular filtration rate

c. Diuretic use

d. Decreased bladder capacity

48. Merle, age 86, is complaining of dizziness when

she stands up. This may indicate:

a. Dementia

b. Functional decline

c. A visual problem

d. Drug toxicity

49. Cardiac ischemia in an older patient usually

produces:

a. ST-T wave changes

b. Chest pain radiating to the left arm

c. Very high creatinine kinase level

d. Acute confusion

50. The most dependable sign of infection in the

older patient is:

a. Change in mental status

b. Fever

c. Pain

d. Decreased breath sounds with crackles