CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS Part II

CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS Part II

51. Irma is terminally ill she speaks to you in

confidence. You now feel that Irma's family could be

helpful if they knew what Irma has told you. What

should you do first?

a. Tell the physician who in turn could tell the family

b. Obtain Irma's permission to share the information

with the family

c. Tell Irma that she has to tell her family what she told

you

d. Make an appointment to discuss the situation with

the family

52. Ruby who has been told she has terminal cancer

turns away aha refuses to respond to you. You can best

help her by:

a. Coming back periodically and indicating your

availability if she would like you to sit with her

b. Insisting that Ruby should talk with you because it is

not good to Keep everything inside

c. Leaving her atone because she is uncooperative and

unpleasant to be with

d. Encouraging her to be physically active as possible

53. Leo who is terminally ill and recognizes that he is in

the process of losing, everything and everybody he

loves, is depressed. Which of the following would best

help him during depression?

a. Arrange for visitors who might cheer him

b. Sit down and talk with him for a while

c. Encourage him to look at the brighter side of things

d. Sit silently with him

54. Which of the following statements would best

indicate that Ruffy; who is dying has accepted this

impending death?

a. "I'm ready to do."

b. "I have resigned myself to dying"

c. "What's the use"?

d: "I'm giving up"

55. Maria, 90 years old has planned ahead for herdeath-

philosophically, socially, financially and

emotionally. This is recognized as:

a. Acceptance that death is inevitable

b Avoidance of the true sedation

c. Denial with planning for continued life

d. Awareness that death will soon occur

Situation 12 - Brain tumor, whether malignant or benign,

has serious management implications nurse, you should

be able to understand the consequences of the disease

and the treatment.

56. You are caring for Conrad who has a brain tumor

and increased intracranial Pressure (ICP). Which

intervention should you include in your plan to reduce

ICP?

a. Administer bowel! Softener

b. Position Conrad with his head turned toward the side

of the tumor

c. Provide sensory stimulation

d. Encourage coughing and deep breathing

57. Keeping Conrad's head and neck in alignment

results in:

a. increased intrathoracic pressure

b. increased venous outflow

c. decreased venous outflow

d. increased intra abdominal pressure

58. Which of the following activities may increase

intracranial pressure (ICP)?

a. Raising the head of the bed

b. Manual hyperventilation

c. Use of osmotic Diuretics

d. Valsava's maneuver

59. After you assessed Conrad, you suspected increased

ICP! Your most appropriate respiratory goal is to:

a. maintain partial pressure of arterial 02 (PaO2) above

80 mmHg

b. lower arterial pH

c. prevent respiratory alkalosis

d. promote CO2 elimination

60. Conrad underwent craniotomy. As his nurse; you

know that drainage on a craniotomy dressing must be

measured and marked. Which findings should you

report immediately to the surgeon?

a. Foul-smelling drainage

b. yellowish drainage

c. Greenish drainage

d. Bloody drainage

Situation 13 -As a Nurse, you have specific

responsibilities as professional. You have to demonstrate

specific competencies.

61. The essential components of professional nursing

practice are all the following EXCEPT:

a. Culture

b. Care

c. Cure

d. Coordination

62. You are assigned to care for four (4) patients. Which

of the following patients should you give first priority?

a. Grace, who is terminally ill with breast cancer

b. Emy, who was previously lucid but is now unarousable

c. Aris, who is newly admitted and is scheduled for an

executive check-up

d. Claire, who has cholelithiasis and is for operation on

call

63. Brenda, the Nursing Supervisor of the intensive care

unit (ICU) is not on duty when a staff nurse committed

a serious medication error. Which statement accurately

reflects the accountability of the nursing supervisor?

a. Brenda should be informed when she goes back on

duty

b. Although Brenda is not on duty, the nursing supervisor

on duty decides to call her if time permits

c. The nursing supervisor on duty will notify Brenda at

home

d. Brenda is not duty therefore it is not necessary to

inform her

64. Which barrier should you avoid, to manage your

time wisely?

a. Practical planning

b. Procrastination

c. Setting limits

d. Realistic personal expectation

65. You are caring for Vincent who has just been

transferred to the private room. He is anxious because

he fears he won't be monitored as closely as he was in

the Coronary Care Unit. How can you allay his fear?

a. Move his bed to a room far from nurse's station to

reduce

b. Assign the same nurse to him when possible

c. Allow Vincent uninterrupted period of time

d. Limit Vincent's visitors to coincide with CCU policies

Situation 14 - As a nurse in the Oncology Unit, you have

to be prepared to provide efficient and effective care to

your patients.

66. Which one of the following nursing interventions

would be most helpful in preparing the patient for

radiation therapy?

a. Offer tranquilizers and antiemetics

b. Instruct the patient of the possibility of radiation burn

c. Emphasis on the therapeutic value of the treatment

d. Map out the precise course of treatment

67. What side effects are most apt to occur to patient

during radiation therapy to the pelvis?

a. Urinary retention

b. Abnormal vaginal or perineal discharge

c. Paresthesia of the lower extremities

d. Nausea and vomiting and diarrhea

68. Which of the following can be used on the

irradiated skin during a course of radiation therapy?

a. Adhesive tape

b. Mineral oil

c. Talcum powder

d. Zinc oxide ointment

69. Earliest sign of skin reaction to radiation therapy is:

a. desquamation

b. erythema

c. atrophy

d. pigmentation

70. What is the purpose of wearing a film badge while

caring for the patient who is radioactive?

a. Identify the nurse who is assigned to care for such a

patient

b. Prevent radiation-induced sterility

c. Protect the nurse from radiation effects

d. Measure the amount of exposure to radiation

Situation 15 - In a disaster there must be a chain of

command in place that defines the roles of each

member of the response team. Within the health care

group there are pre-assigned roles based on education,

experience and training on disaster.

71. As a nurse to which of the following groups are you

best prepared to join?

a. Treatment group

b. Triage group

c. Morgue management

d. Transport group

72. There are important principles that should guide

the triage team in disaster management that you have

to know if you were to volunteer as part of the triage

team. The following principles should be observed in

disaster triage, EXCEPT:

a. any disaster plan should have resource available to

triage at each facility and at the disaster site if possible

b. make the most efficient use of available resources

c. training on disaster is not important to the response in

the event of a real disaster because each disaster is

unique in itself

d. do the greatest good for the greatest number of

casualties

73. Which of the following categories of conditions

should be considered first priority in a disaster?

a. Intracranial pressure and mental status

b. Lower gastrointestinal problems

c. Respiratory infection

d. Trauma

74. A guideline that is utilized in determining priorities

is to assess the status of the following, EXCEPT?

a. perfusion

b. locomotion

c. respiration

d. mentation

75. The most important component of neurologic

assessment is:

a. pupil reactivity

b. vital sign assessment

c. cranial nerve assessment

d. level of consciousness/responsiveness

Situation 16 - You are going to participate in a Cancer

Consciousness Week. You are assigned to take charge of

the women to make them aware of cervical cancer. You

reviewed its manifestations and management.

76. The following are risk factors for cervical Cancer

EXCEPT:

a. immunisuppressive therapy

b. sex at an early age, multiple partners, exposure to

socially transmitted diseases, male partner's sexual

habits

c. viral agents like the Human Papilloma Virus

d. smoking

77. Late signs and symptoms of cervical cancer include

the following EXCEPT:

a. urinary/bowel changes

b. pain in pelvis, leg of flank

c. uterine bleeding

d. lymph edema of lower extremities

78. When a panhysterectomy is performed due to

cancer of the cervix, which of the following organs are

moved?

a. the uterus, cervix, and one ovary

b. the uterus, cervix, and two-thirds of the vagina

c. the uterus, cervix, tubes and ovaries

d. the uterus and cervix

79. The primary modalities of treatment for Stage 1 and

IIA cervical cancer include the following:

a. surgery, radiation therapy and hormone therapy

b. surgery

c. radiation therapy

d. surgery and radiation therapy

80. A common complication of hysterectomy is:

a. thrombophlebitis of the pelvic and thigh vessels

b. diarrhea due to over stimulating

c. atelectasis

d. wound dehiscence

Situation 17 - The body has regulatory mechanism to

maintain the needed electrolytes. However there are

conditions/surgical interventions that could compromise

life. You have to understand how management of these

conditions are done.

81. You are caring for Leda who is scheduled to undergo

total thyroidectomy because of a diagnosis of thyroid

cancer. Prior to total thyroidectomy, you should

instruct Leda to:

a. Perform range and motion exercises on the head and

neck

b. Apply gentle pressure against the incision when

swallowing

c. Cough and deep breath every 2 hours

d. Support head with the hands when changing position

82. As Leda's nurse, you plan to set up an emergency

equipment at her beside following thyroidectomy. You

should include:

a An airway and rebreathing tube

b. A tracheostomy set and oxygen

c. A crush cart .with bed board

d. Two ampules of sodium bicarbonate

83. Which of the following nursing interventions is

appropriate after a total thyroidectomy?

a. Place pillows under your patient's shoulders

b. Raise the knee-gatch to 30 degrees

c. Keep your patient in a high-fowler's position

d. Support the patient's head and neck with pillows and

sandbags

84. If there is an accidental injury to the parathyroid

gland during a thyroidectomy which of the following

might Leda develops postoperative?

a. Cardiac arrest

b. Dyspnea

c. Respiratory failure

d. Tetany

85. After surgery Leda develops peripheral numbness,

tingling and muscle twitching and spasm. What would

you anticipate to administer?

a. Magnesium sulfate

b. Calcium gluconate

c. Potassium iodine

d. Potassium chloride

Situation 18 - NURSES are involved in maintaining a safe

and health environment. This is part of quality care

management.

86. The first step in decontamination is:

a. to immediately apply a chemical decontamination

foam to the area of contamination

b. a thorough soap and water was and rinse of the

patient

c. to immediately apply personal protective equipment

d. removal of the patients clothing and jewelry and then

rinsing the patient with water

87. For a patient experiencing pruritus, you recommend

which type of bath:

a. Water

b. colloidal (oatmeal)

c. saline

d. sodium bicarbonate

88. Induction of vomiting is indicated for the accidental

poisoning patient who has ingested.

a. rust remover

b. gasoline

c. toilet bowl cleaner

d. aspirin

89. Which of the following term most precisely refer to

an infection acquired in the hospital that was not

present or incubating at the time of hospital

admission?

a. Secondary bloodstream infection

b. Nosocomial infection

c. Emerging infectious disease

d. Primary bloodstream infection

90. Which of the following guidelines is not appropriate

to helping family members cope with sudden death?

a. Obtain orders for sedation of family members

b. Provide details of the factors attendant to the sudden

death

c. Show acceptance of the body by touching it and giving

the family permission to touch

d. Inform the family that the patient has passed on

Situation 19 - As a nurse you are expected to participate

in initiating or participating in the conduct of research

studies to improve nursing practice. You have to be

updated on the latest trends and issues affecting

profession and the best practices arrived at by the

profession

91. You are interested to study the effects of

meditation and relaxation on the pain experienced by

cancer patients. What type of variable is pain?

a. Dependant

b. Correlational

c. Independent

d. Demographic

92. You would like to compare the support system of

patients with chronic illness to those with acute illness.

How will you best state your problem?

a. A descriptive study to compare the support system of

patients with chronic illness and those with acute illness

in terms of demographic data and knowledge about

interventions

b. The effect of the Type of Support system of patients

with chronic illness and those with acute illness

c. A comparative analysis of the support: system of

patients with chronic illness and those with acute illness

d. A study to compare the support system of patients

with chronic illness and those with acute illness

93. You would like to compare the support, system of

patients with chronic illness to those with acute illness.

What type of research it this?

a. Correlational

b. Descriptive

c. Experimental

d. Quasi-experimental

94. You are shown a Likert Scale that will be used in

evaluating your performance in the clinical area. Which

of the following questions will you not use in critiquing

the Likert Scale?

a. Are the techniques to complete and score the scale

provided?

b. Are the reliability and validity information on the scale

described?

c. If the Likert Scale is to be used for a study, was the

development process described?

d. Is the instrument clearly described?

95. In any research study where individual persons are

involves, it is important that an informed consent for

the Study is obtained. The following are essential

information about the consent that you should disclose

to the prospective subjects EXCEPT:

a. Consent to incomplete disclosure

b. Description of benefits, risks and discomforts

c. Explanation of procedure

d. Assurance of anonymity and confidentiality,

Situation 20 - Because severe burn can affect the

person's totality it is important that you apply

interventions focusing on the various dimensions of

man. You also have to understand the rationale of the

treatment.

96. What type of debribement involves proteolytic

enzymes?

a. Interventional

b. Mechanical

c. Surgical

d Chemical

97. Which topical antimicrobial is most frequently used

in burn wound care?

a. Neosporin

b. Silver nitrate

c. Silver sulfadiazine

d. Sulfamylon

98. Hypertrophic burns scars are caused by:

a. exaggerated contraction

b. random layering of collagen

c. wound ischemia

d. delayed epithelialization

99. The major disadvantage of whirlpool cleansing of

burn wounds is:

a. patient hypothermia

b. cross contamination of wound

c. patient discomfort

d. excessive manpower requirement

100. Oral analgecis are most frequently used to control

burn injury pain:

a. upon patient request

b. during the emergent phase

c. after hospital discharge

d. during the cute phase