Fundamentals of Nursing Exam 1: Illness, Infection, & Asepsis

Questions

1. When the General adaptation syndrome is activated, FLIGHT OR FIGHT response sets
in. Sympathetic nervous system releases norepinephrine while the adrenal medulla secretes
epinephrine. Which of the following is true with regards to that statement?

A. Pupils will constrict

B. Client will be lethargic
C. Lungs will bronchodilate
D. Gastric motility will increase

2. Which of the following response is not expected to a person whose GAS is activated and
the FIGHT OR FLIGHT response sets in?

A. The client will not urinate due to relaxation of the detrusor muscle
B. The client will be restless and alert
C. Clients BP will increase, there will be vasodilation
D. There will be increase glycogenolysis, Pancrease will decrease insulin secretion

3. State in which a person’s physical, emotional, intellectual and social development or

spiritual functioning is diminished or impaired compared with a previous experience.

A. Illness
B. Disease
C. Health
D. Wellness

4. This is the first stage of illness wherein, the person starts to believe that something is
wrong. Also known as the transition phase from wellness to illness.

A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role

5. In this stage of illness, the person accepts or rejects a professionals suggestion. The
person also becomes passive and may regress to an earlier stage.

A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role
6. In this stage of illness, the person learns to accept the illness.

A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role

7. In this stage, the person tries to find answers for his illness. He wants his illness to be
validated, his symptoms explained and the outcome reassured or predicted

A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role

8. The following are true with regards to aspect of the sick role except

A. One should be held responsible for his condition

B. One is excused from his societal role
C. One is obliged to get well as soon as possible
D. One is obliged to seek competent help

9. Refers to conditions that increases vulnerability of individual or group to illness or

accident

A. Predisposing factor
B. Etiology
C. Risk factor
D. Modifiable Risks

10. Refers to the degree of resistance the potential host has against a certain pathogen

A. Susceptibility
B. Immunity
C. Virulence
D. Etiology

11. A group of symptoms that sums up or constitute a disease

A. Syndrome
B. Symptoms
C. Signs
D. Etiology

12. A woman undergoing radiation therapy developed redness and burning of the skin
around the best. This is best classified as what type of disease?
A. Neoplastic
B. Traumatic
C. Nosocomial
D. Iatrogenic

13. The classification of CANCER according to its etiology Is best described as:

1. Nosocomial
2. Idiopathic
3. Neoplastic
4. Traumatic
5. Congenital
6. Degenrative

A. 5 and 2
B. 2 and 3
C. 3 and 4
D. 3 and 5

14. Term to describe the reactiviation and recurrence of pronounced symptoms of a disease

A. Remission
B. Emission
C. Exacerbation
D. Sub acute

15. A type of illness characterized by periods of remission and exacerbation

A. Chronic
B. Acute
C. Sub acute
D. Sub chronic

16. Diseases that results from changes in the normal structure, from recognizable
anatomical changes in an organ or body tissue is termed as

A. Functional
B. Occupational
C. Inorganic
D. Organic

17. It is the science of organism as affected by factors in their environment. It deals with
the relationship between disease and geographical environment.

A. Epidemiology
B. Ecology
C. Statistics
D. Geography

18. This is the study of the patterns of health and disease. Its occurrence and distribution in
man, for the purpose of control and prevention of disease.

A. Epidemiology
B. Ecology
C. Statistics
D. Geography

19. Refers to diseases that produced no anatomic changes but as a result from abnormal
response to a stimuli.

A. Functional
B. Occupational
C. Inorganic
D. Organic

20. In what level of prevention according to Leavell and Clark does the nurse support the
client in obtaining OPTIMAL HEALTH STATUS after a disease or injury?

A. Primary
B. Secondary
C. Tertiary
D. None of the above

21. In what level of prevention does the nurse encourage optimal health and increases
person’s susceptibility to illness?

A. Primary
B. Secondary
C. Tertiary
D. None of the above

22. Also known as HEALTH MAINTENANCE prevention.

A. Primary
B. Secondary
C. Tertiary
D. None of the above

23. PPD In occupational health nursing is what type of prevention?

A. Primary
B. Secondary
C. Tertiary
D. None of the above

24. BCG in community health nursing is what type of prevention?

A. Primary
B. Secondary
C. Tertiary
D. None of the above

25. A regular pap smear for woman every 3 years after establishing normal pap smear for
3 consecutive years Is advocated. What level of prevention does this belongs?

A. Primary
B. Secondary
C. Tertiary
D. None of the above

26. Self monitoring of blood glucose for diabetic clients is on what level of prevention?

A. Primary
B. Secondary
C. Tertiary
D. None of the above

27. Which is the best way to disseminate information to the public?

A. Newspaper
B. School bulletins
C. Community bill boards
D. Radio and Television

28. Who conceptualized health as integration of parts and subparts of an individual?

A. Newman
B. Neuman
C. Watson
D. Rogers

29. The following are concept of health:

1. Health is a state of complete physical, mental and social wellbeing and not merely an absence
of disease or infirmity.
2. Health is the ability to maintain balance
3. Health is the ability to maintain internal milieu
4. Health is integration of all parts and subparts of an individual
A. 1,2,3
B. 1,3,4
C. 2,3,4
D. 1,2,3,4

30. The theorist the advocated that health is the ability to maintain dynamic equilibrium is

A. Bernard
B. Selye
C. Cannon
D. Rogers

31. Excessive alcohol intake is what type of risk factor?

A. Genetics
B. Age
C. Environment
D. Lifestyle

32. Osteoporosis and degenerative diseases like Osteoarthritis belongs to what type of risk
factor?

A. Genetics
B. Age
C. Environment
D. Lifestyle

33. Also known as STERILE TECHNIQUE

A. Surgical Asepsis
B. Medical Asepsis
C. Sepsis
D. Asepsis

34. This is a person or animal, who is without signs of illness but harbors pathogen within
his body and can be transferred to another

A. Host
B. Agent
C. Environment
D. Carrier

35. Refers to a person or animal, known or believed to have been exposed to a disease.

A. Carrier
B. Contact
C. Agent
D. Host

36. A substance usually intended for use on inanimate objects, that destroys pathogens but
not the spores.

A. Sterilization
B. Disinfectant
C. Antiseptic
D. Autoclave

37. This is a process of removing pathogens but not their spores

A. Sterilization
B. Auto claving
C. Disinfection
D. Medical asepsis

38. The third period of infectious processes characterized by development of specific signs
and symptoms

A. Incubation period
B. Prodromal period
C. Illness period
D. Convalescent period

39. A child with measles developed fever and general weakness after being exposed to
another child with rubella. In what stage of infectious process does this child belongs?

A. Incubation period
B. Prodromal period
C. Illness period
D. Convalescent period

40. A 50 year old mailman carried a mail with anthrax powder in it. A minute after
exposure, he still hasn’t developed any signs and symptoms of anthrax. In what stage of
infectious process does this man belongs?

A. Incubation period
B. Prodromal period
C. Illness period
D. Convalescent period

41. Considered as the WEAKEST LINK in the chain of infection that nurses can
manipulate to prevent spread of infection and diseases
A. Etiologic/Infectious agent
B. Portal of Entry
C. Susceptible host
D. Mode of transmission

42. Which of the following is the exact order of the infection chain?

1. Susceptible host
2. Portal of entry
3. Portal of exit
4. Etiologic agent
5. Reservoir
6. Mode of transmission

A. 1, 2, 3, 4, 5, 6
B. 5, 4, 2, 3, 6, 1
C. 4, 5, 3, 6, 2, 1
D. 6, 5, 4, 3, 2, 1

43. Markee, A 15 year old high school student asked you. What is the mode of transmission
of Lyme disease. You correctly answered him that Lyme disease is transmitted via

A. Direct contact transmission

B. Vehicle borne transmission
C. Air borne transmission
D. Vector borne transmission

44. The ability of the infectious agent to cause a disease primarily depends on all of the
following except

A. Pathogenicity
B. Virulence
C. Invasiveness
D. Non Specificity

45. Contact transmission of infectious organism in the hospital is usually cause by

A. Urinary catheterization
B. Spread from patient to patient
C. Spread by cross contamination via hands of caregiver
D. Cause by unclean instruments used by doctors and nurses

46. Transmission occurs when an infected person sneezes, coughs or laugh that is usually
projected at a distance of 3 feet.
A. Droplet transmission
B. Airborne transmission
C. Vehicle transmission
D. Vector borne transmission

47. Considered as the first line of defense of the body against infection

A. Skin
B. WBC
C. Leukocytes
D. Immunization

48. All of the following contributes to host susceptibility except

A. Creed
B. Immunization
C. Current medication being taken
D. Color of the skin

49. Graciel has been injected TT5, her last dosed for tetanus toxoid immunization. Graciel
asked you, what type of immunity is TT Injections? You correctly answer her by saying
Tetanus toxoid immunization is a/an

A. Natural active immunity

B. Natural passive immunity
C. Artificial active immunity
D. Artificial passive immunity

50. Agatha, was hacked and slashed by a psychotic man while she was crossing the railway.
She suffered multiple injuries and was injected Tetanus toxoid Immunoglobulin. Agatha
asked you, What immunity does TTIg provides? You best answered her by saying TTIg
provides

A. Natural active immunity

B. Natural passive immunity
C. Artificial active immunity
D. Artificial passive immunity

51. This is the single most important procedure that prevents cross contamination and
infection

A. Cleaning
B. Disinfecting
C. Sterilizing
D. Handwashing
52. This is considered as the most important aspect of handwashing

A. Time
B. Friction
C. Water
D. Soap

53. In handwashing by medical asepsis, hands are held…

A. Above the elbow, The hands must always be above the waist
B. Above the elbow, The hands are cleaner than the elbow
C. Below the elbow, Medical asepsis do not require hands to be above the waist
D. Below the elbow, Hands are dirtier than the lower arms

54. The suggested time per hand on handwashing using the time method is

A. 5 to 10 seconds each hand

B. 10 to 15 seconds each hand
C. 15 to 30 seconds each hand
D. 30 to 60 seconds each hand

55. The minimum time in washing each hand should never be below

A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 30 seconds

56. How many ml of liquid soap is recommended for handwashing procedure?

A. 1-2 ml
B. 2-3 ml
C. 2-4 ml
D. 5-10 ml

57. Which of the following is not true about sterilization, cleaning and disinfection?

A. Equipment with small lumen are easier to clean

B. Sterilization is the complete destruction of all viable microorganism including spores
C. Some organism are easily destroyed, while other, with coagulated protein requires longer time
D. The number of organism is directly proportional to the length of time required for sterilization

58. Karlita asked you, How long should she boil her glass baby bottle in water? You
correctly answered her by saying
A. The minimum time for boiling articles is 5 minutes
B. Boil the glass baby bottler and other articles for atleast 10 minutes
C. For boiling to be effective, a minimum of 15 minutes is required
D. It doesn’t matter how long you boil the articles, as long as the water reached 100 degree
Celsius

59. This type of disinfection is best done in sterilizing drugs, foods and other things that are
required to be sterilized before taken in by the human body

A. Boiling Water
B. Gas sterilization
C. Steam under pressure
D. Radiation

60. A TB patient was discharged in the hospital. A UV Lamp was placed in the room where
he stayed for a week. What type of disinfection is this?

A. Concurrent disinfection
B. Terminal disinfection
C. Regular disinfection
D. Routine disinfection

61. Which of the following is not true in implementing medical asepsis

A. Wash hand before and after patient contact

B. Keep soiled linens from touching the clothings
C. Shake the linens to remove dust
D. Practice good hygiene

62. Which of the following is true about autoclaving or steam under pressure?

A. All kinds of microorganism and their spores are destroyed by autoclave machine
B. The autoclaved instruments can be used for 1 month considering the bags are still intact
C. The instruments are put into unlocked position, on their hinge, during the autoclave
D. Autoclaving different kinds of metals at one time is advisable

63. Which of the following is true about masks?

A. Mask should only cover the nose

B. Mask functions better if they are wet with alcohol
C. Masks can provide durable protection even when worn for a long time and after each and
every patient care
D. N95 Mask or particulate masks can filter organism as mall as 1 micromillimeter

64. Where should you put a wet adult diaper?

A. Green trashcan
B. Black trashcan
C. Orange trashcan
D. Yellow trashcan

65. Needles, scalpels, broken glass and lancets are considered as injurious wastes. As a
nurse, it is correct to put them at disposal via a/an

A. Puncture proof container

B. Reused PET Bottles
C. Black trashcan
D. Yellow trashcan with a tag “INJURIOUS WASTES”

66. Miranda Priestly, An executive of RAMP magazine, was diagnosed with cancer of the
cervix. You noticed that the radioactive internal implant protrudes to her vagina where
supposedly, it should be in her cervix. What should be your initial action?

A. Using a long forceps, Push it back towards the cervix then call the physician
B. Wear gloves, remove it gently and place it on a lead container
C. Using a long forceps, Remove it and place it on a lead container
D. Call the physician, You are not allowed to touch, re insert or remove it

67. After leech therapy, Where should you put the leeches?

A. In specially marked BIO HAZARD Containers

B. Yellow trashcan
C. Black trashcan
D. Leeches are brought back to the culture room, they are not thrown away for they are reusable

68. Which of the following should the nurse AVOID doing in preventing spread of
infection?

A. Recapping the needle before disposal to prevent injuries

B. Never pointing a needle towards a body part
C. Using only Standard precaution to AIDS Patients
D. Do not give fresh and uncooked fruits and vegetables to Mr. Gatchie, with Neutropenia

69. Where should you put Mr. Alejar, with Category II TB?

A. In a room with positive air pressure and atleast 3 air exchanges an hour
B. In a room with positive air pressure and atleast 6 air exchanges an hour
C. In a room with negative air pressure and atleast 3 air exchanges an hour
D. In a room with negative air pressure and atleast 6 air exchanges an hour

70. A client has been diagnosed with RUBELLA. What precaution is used for this patient?
A. Standard precaution
B. Airborne precaution
C. Droplet precaution
D. Contact precaution

71. A client has been diagnosed with MEASLES. What precaution is used for this patient?

A. Standard precaution
B. Airborne precaution
C. Droplet precaution
D. Contact precaution

72. A client has been diagnosed with IMPETIGO. What precaution is used for this patient?

A. Standard precaution
B. Airborne precaution
C. Droplet precaution
D. Contact precaution

73. The nurse is to insert an NG Tube when suddenly, she accidentally dip the end of the
tube in the client’s glass containing distilled drinking water which is definitely not sterile.
As a nurse, what should you do?

A. Don’t mind the incident, continue to insert the NG Tube

B. Obtain a new NG Tube for the client
C. Disinfect the NG Tube before reinserting it again
D. Ask your senior nurse what to do

74. All of the following are principle of SURGICAL ASEPSIS except

A. Microorganism travels to moist surfaces faster than with dry surfaces

B. When in doubt about the sterility of an object, consider it not sterile
C. Once the skin has been sterilized, considered it sterile
D. If you can reach the object by overreaching, just move around the sterile field to pick it rather
than reaching for it

75. Which of the following is true in SURGICAL ASEPSIS?

A. Autoclaved linens and gowns are considered sterile for about 4 months as long as the bagging
is intact
B. Surgical technique is a sole effort of each nurse
C. Sterile conscience, is the best method to enhance sterile technique
D. If a scrubbed person leaves the area of the sterile field, He/she must do handwashing and
gloving again, but the gown need not be changed.

76. In putting sterile gloves, Which should be gloved first?

A. The dominant hand
B. The non dominant hand
C. The left hand
D. No specific order, Its up to the nurse for her own convenience

77. As the scrubbed nurse, when should you apply the goggles, shoe cap and mask prior to
the operation?

A. Immediately after entering the sterile field

B. After surgical hand scrub
C. Before surgical hand scrub
D. Before entering the sterile field

78. Which of the following should the nurse do when applying gloves prior to a surgical
procedure?

A. Slipping gloved hand with all fingers when picking up the second glove
B. Grasping the first glove by inserting four fingers, with thumbs up underneath the cuff
C. Putting the gloves into the dominant hand first
D. Adjust only the fitting of the gloves after both gloves are on

79. Which gloves should you remove first?

A. The glove of the non dominant hand

B. The glove of the dominant hand
C. The glove of the left hand
D. Order in removing the gloves Is unnecessary

80. Before a surgical procedure, Give the sequence on applying the protective items listed
below

1. Eye wear or goggles

2. Cap
3. Mask
4. Gloves
5. Gown

A. 3, 2, 1, 5, 4
B. 3, 2, 1, 4, 5
C. 2, 3, 1, 5, 4
D. 2, 3, 1, 4, 5

81. In removing protective devices, which should be the exact sequence?

1. Eye wear or goggles

2. Cap
3. Mask
4. Gloves
5. Gown

A. 4, 3, 5, 1, 2
B. 2, 3, 1, 5, 4
C. 5, 4, 3, 2, 1
D. 1, 2, 3, 4, 5

82. In pouring a plain NSS into a receptacle located in a sterile field, how high should the
nurse hold the bottle above the receptacle?

A. 1 inch
B. 3 inches
C. 6 inches
D. 10 inches

83. The tip of the sterile forceps is considered sterile. It is used to manipulate the objects in
the sterile field using the non sterile hands. How should the nurse hold a sterile forceps?

A. The tip should always be lower than the handle

B. The tip should always be above the handle
C. The handle and the tip should be at the same level
D. The handle should point downward and the tip, always upward

84. The nurse enters the room of the client on airborne precaution due to tuberculosis.
Which of the following are appropriate actions by the nurse?

1. She wears mask, covering the nose and mouth

2. She washes her hands before and after removing gloves, after suctioning the client’s secretion
3. She removes gloves and hands before leaving the client’s room
4. She discards contaminated suction catheter tip in trashcan found in the clients room

A. 1, 2
B. 1, 2, 3
C. 1, 2, 3, 4
D. 1, 3

85. When performing surgical hand scrub, which of the following nursing action is
required to prevent contamination?

1. Keep fingernail short, clean and with nail polish

2. Open faucet with knee or foot control
3. Keep hands above the elbow when washing and rinsing
4. Wear cap, mask, shoe cover after you scrubbed
A. 1, 2
B. 2, 3
C. 1, 2, 3
D. 2, 3, 4

86. When removing gloves, which of the following is an inappropriate nursing action?

A. Wash gloved hand first

B. Peel off gloves inside out
C. Use glove to glove skin to skin technique
D. Remove mask and gown before removing gloves

87. Which of the following is TRUE in the concept of stress?

A. Stress is not always present in diseases and illnesses

B. Stress are only psychological and manifests psychological symptoms
C. All stressors evoke common adaptive response
D. Hemostasis refers to the dynamic state of equilibrium

88. According to this theorist, in his modern stress theory, Stress is the non specific
response of the body to any demand made upon it.

A. Hans Selye
B. Walter Cannon
C. Claude Bernard
D. Martha Rogers

89. Which of the following is NOT TRUE with regards to the concept of Modern Stress
Theory?

A. Stress is not a nervous energy

B. Man, whenever he encounters stresses, always adapts to it
C. Stress is not always something to be avoided
D. Stress does not always lead to distress

90. Which of the following is TRUE with regards to the concept of Modern Stress Theory?

A. Stress is essential
B. Man does not encounter stress if he is asleep
C. A single stress can cause a disease
D. Stress always leads to distress

91. Which of the following is TRUE in the stage of alarm of general adaptation syndrome?

A. Results from the prolonged exposure to stress

B. Levels or resistance is increased
C. Characterized by adaptation
D. Death can ensue

92. The stage of GAS where the adaptation mechanism begins

A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion

93. Stage of GAS Characterized by adaptation

A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion

94. Stage of GAS wherein, the Level of resistance are decreased

A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion

95. Where in stages of GAS does a person moves back into HOMEOSTASIS?

A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion

96. Stage of GAS that results from prolonged exposure to stress. Here, death will ensue
unless extra adaptive mechanisms are utilized

A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion

97. All but one is a characteristic of adaptive response

A. This is an attempt to maintain homeostasis

B. There is a totality of response
C. Adaptive response is immediately mobilized, doesn’t require time
D. Response varies from person to person
98. Andy, a newly hired nurse, starts to learn the new technology and electronic devices at
the hospital. Which of the following mode of adaptation is Andy experiencing?

A. Biologic/Physiologic adaptive mode

B. Psychologic adaptive mode
C. Sociocultural adaptive mode
D. Technological adaptive mode

99. Andy is not yet fluent in French, but he works in Quebec where majority speaks
French. He is starting to learn the language of the people. What type of adaptation is Andy
experiencing?

A. Biologic/Physiologic adaptive mode

B. Psychologic adaptive mode
C. Sociocultural adaptive mode
D. Technological adaptive mode

100. Andy made an error and his senior nurse issued a written warning. Andy arrived in
his house mad and kicked the door hard to shut it off. What adaptation mode is this?

A. Biologic/Physiologic adaptive mode

B. Psychologic adaptive mode
C. Sociocultural adaptive mode
D. Technological adaptive mode

Answers and Rationale

Here are the answers and rationale for this 100-item Fundamentals of Nursing exam. If you have
any disputes or questions, direct them to the comments section below! Tell us also your scores!

1. ANSWER: C. Lungs will bronchodilate

To better understand the concept, the autonomic nervous system is composed of

the sympathetic and parasympathetic nervous system. It is called autonomic because it is
involuntary and stimuli-based. You cannot dictate your heart to beat 60 per minute, nor tell your
blood vessels when to constrict and dilate. Sympathetic nervous system is the “fight or flight”
mechanism.

2. ANSWER: C. Clients BP will increase, there will be vasodilation

If vasodilation will occur, the BP will not increase but decrease.

3. ANSWER: A. Illness
Disease is a proven fact based on a medical theory, standards, diagnosis and clinical features.
Illness, on the other hand, is a subjective state of not feeling well based on subjective appraisal,
previous experience, peer advice and etc.

4. ANSWER: A. Symptom Experience

Assumption of the sick role is when a client accepts he is ill. Medical care contact is where the
client asks someone to confirm what he is experiencing. During this stage, the client seeks
professional advice for validation, reassurance clarification and explanation of the symptoms he
is experiencing. Last stage of illness is the recovery stage where the patient gives up the sick role
and assumes the previous normal functions.

5. ANSWER: D. Dependent patient role

In the dependent patient role stage, patients needs professionals for help. They have a choice
either to accept or reject the professional’s decisions but patients are usually passive and
accepting. Regression tends to occur more in this period.

6. ANSWER: B. Assumption of sick role

Rationale: Acceptance of illness occurs in the assumption of sick role phase of illness.

7. ANSWER: C. Medical care contact

At this stage, The patient seeks for validation of his symptom experience. He wants to find out if
what he feels are normal or not normal. He wants someone to explain why is he feeling these
signs and symptoms and wants to know the probable outcome of this experience.

8. ANSWER: A. One should be held responsible for his condition

The nurse should not judge the patient and not view the patient as the cause or someone
responsible for his illness. A sick client is excused from his societal roles, oblige to get well as
soon as possible and obliged to seek competent help.

9. ANSWER: C. Risk factor

10. ANSWER: A. Susceptibility

Immunity is the absolute resistance to a pathogen considering that person has an intact immunity.
Susceptibility is the degree of resistance or how well would the individual combat the pathogens
and repel infection or invasion of these disease causing organisms. A susceptible person is
someone who has a very low degree of resistance to combat pathogens. An immune person is
someone that can easily repel specific pathogens.

11. ANSWER: A. Syndrome

Symptoms are individual manifestation of a certain disease (i.e., tics in Tourette syndrome) but a
symptom alone is not enough to diagnose the patient as other diseases may have the symptom
manifestation. Syndrome, on the other hand, means collection of these symptoms that occurs
together and has a pattern that characterizes a certain disease.

12. ANSWER: D. Iatrogenic

Iatrogenic diseases refers to those that resulted from treatment of a certain disease. For example,
a child develops redness and partial thickness burns over his chest area due to frequent exposure
to X-ray. Neoplastic diseases are malignant diseases caused by proliferation of abnormally
growing cells. Traumatic are brought about by injuries like vehicular accidents. Nosocomial are
infections that are acquired inside the hospital.

13. ANSWER: B. 2 and 3 (Idiopathic and Neoplastic)

14. ANSWER: C. Exacerbation

15. ANSWER: A. Chronic

Chronic diseases are characterized by periods of remissions and exacerbations and persists
longer than six (6) months that is why remissions and exacerbations are observable. The duration
of acute and sub acute diseases are too short to manifest remissions.

16. ANSWER: D. Organic

Organic diseases are caused by a change in structure of a certain organ and organ systems.
Inorganic diseases, on the other hand, are synonymous with functional diseases where there is no
evident structural, anatomical or physical change in the structure of the organ or organ system
but its function is altered due to other causes.

17. ANSWER: B. Ecology

Ecology is the science that deals with the ecosystem and its effects on living things in the
biosphere. It deals with diseases in relationship with the environment. Epidemiology is simply
the study of diseases and its occurrence and distribution in man for the purpose of controlling
and preventing diseases.

18. ANSWER: A. Epidemiology

19. ANSWER: C. Inorganic

20. ANSWER: C. Tertiary

Primary refers to the measures that aim in preventing the diseases (i.e., healthy lifestyle, good
nutrition, knowledge seeking behaviors, etc). Secondary prevention are those measures that deal
with early diagnostics, case finding treatments (i.e, breast self exam, X-rays, antibiotic treatment
to cure infection, iron therapy for anemia, etc). Tertiary prevention aims on maintaining optimum
level of functioning during or after the impact of disease that threatens to alter the normal body
functioning (i.e., prosthesis fitting for an amputated leg, glucose monitoring among diabetics,
and TPA therapy after stroke).

21. ANSWER: D. None of the above.

The nurse never increases the person’s susceptibility to illness but rather, LESSEN the person’s
susceptibility to illness.

22. ANSWER: B. Secondary

Secondary prevention is also known as health maintenance prevention.

23. ANSWER: A. Primary

Personal Protective Devices or PPD are worn by workers in a hazardous work environment to
protect them from injuries. This is considered as primary prevention because the nurse prevents
the occurrence of injuries.

24. ANSWER: A. Primary

25. ANSWER: B. Secondary

Pap-smear is a diagnostic procedure thus falls under the secondary level of prevention.

26. ANSWER: C. Tertiary

27. ANSWER: D. Radio and Television

The best way to disseminate information to the public is via television followed by radio. The
two media outlets have the widest reach and this is how the Department of Health (DOH)
establishes its IEC programs.

28. ANSWER: B. Neuman

The supra and subsystems are theories of Martha Rogers but the parts and subparts are Betty
Neuman’s. She stated that health is a state where in all parts and subparts of an individual are in
harmony with the whole system. Margarex Newman defined health as an expanding
consciousness.

29. ANSWER: D. 1,2,3,4

Rationale:All of the following are correct statement about health. The first one is the definition
by World Health Organization (WHO). The second is taken from Walter Cannon’s Homeostasis
Theory. The third is from Claude Bernard’s concept of Health as Internal Milieu. The last one is
from Neuman’s theory.

30. ANSWER: C. Cannon

Walter Cannon advocated health as homeostasis or the ability to maintain dynamic equilibrium.
Hans Selye postulated concepts about stress and adaptation. Bernard defined health as the ability
to maintain internal milieu and Rogers defined Health as Wellness that is influenced by
individual’s culture.

31. ANSWER: D. Lifestyle

32. ANSWER: B. Age

33. ANSWER: A. Surgical Asepsis

Surgical Asepsis is otherwise known as the “sterile technique,” while Medical Asepsis is
synonymous with the “clean technique.”

34. ANSWER: D. Carrier

35. ANSWER: B. Contact

36. ANSWER: B. Disinfectant

Disinfectants are used on inanimate objects. Antiseptics are intended on persons and other living
things. Both can kill and inhibit growth of microorganisms but cannot kill spores. Autoclaving or
steam under pressure kills almost all types of microorganisms including their spores.

37. ANSWER: C. Disinfection

38. ANSWER: C. Illness period

In incubation period, the disease has been introduced to the body but no sign and symptom
appear because the pathogen is not yet strong enough to cause it and may still need to multiply.
The second period is called prodromal period where appearance of non-specific signs and
symptoms sets in. Illness period is characterized by appearance of specific signs and
symptoms. Acme is the peak of an illness while convalescent period is characterized by the
abatement of the disease or its gradual dissipation.

39. ANSWER: B. Prodromal period

40. ANSWER: A. Incubation period

Anthrax can have an incubation period of hours to seven (7) days with an average of 48 (hours).
Since the question stated exposure, we can assume that the mailman is in the incubation phase.
41. ANSWER: D. Mode of transmission

Mode of transmission is the weakest link in the chain of infection. It is easily manipulated by the
nurses using the tiers of prevention, either by instituting transmission based precautions,
universal precaution or isolation techniques.

42. ANSWER: C. 4,5,3,6,2,1

Source is the etiological agent itself, this is where the chain of infection starts. The source will
first proliferate on a reservoir and will need a portal of exit to be able to transmit itself using a
portal of entry to a susceptible host.

43. ANSWER: D. Vector borne transmission

Lyme’s disease is caused by borrelia burgdorferi and is transmitted via a tick bite.

44. ANSWER: D. Non Specificity

To be able to cause a disease, a pathogen should have a target organ and should be specific to
these organs to cause an infection.

45. ANSWER: C. Spread by cross contamination via hands of caregiver

A caregiver’s hands like any other healthcare workers is the main cause of cross-contamination
in a hospital setting. Handwashing is the single most important procedure to prevent the
occurrence of cross-contamination and nosocomial infections.

46. ANSWER: A. Droplet transmission

47. ANSWER: A. Skin

Remember that intact skin and mucous membrane is our first line of defense against infection.

48. ANSWER: A. Creed

Creed, Faith or religious belief do not affect person’s susceptibility to illness. Medication like
corticosteroids could supress a person’s immune system that will lead to increase susceptibility.
Color of the skin could affect person’s susceptibility to certain skin diseases. A dark skinned
person has lower risk of skin cancer than a fair skinned person. Fair skinned person also has a
higher risk for cholecystitis and cholelithiasis.

49. ANSWER: C. Artificial active immunity

TT1 and TT2 are considered the primary doses while TT3, TT4 and TT5 are booster doses. A
woman with a complete immunization of DPT need not to receive the primary doses TT1 and
TT2. Tetanus toxoid is an actual but weakened and inactivated toxin produced by clostridium
tetani. It is artificial because it did not occur in the course of an actual illness or infection.

50. ANSWER: D. Artificial passive immunity

In this scenario, Agatha was already wounded and has injuries. Giving the Tetanus Toxoid
vaccine itself would not be beneficial to her as it will take time before the body can produce
antitoxins. What Agatha needs now is a ready made antitoxin in the form of ATS or TTIg which
is considered artificial because her body did not produce it and passive because her immune
system was not stimulated but rather, given a ready-made immunoglobulin to immediately
suppress the infection.

51. ANSWER: D. Handwashing

TIP: Most of the time, when you see the word handwashing as one of the options, there is a big
chance that it is the correct answer.

52. ANSWER: B. Friction

The most important aspect of handwashing is friction. The rest of the components will just
enhance friction. Soap lowers the surface tension thereby increasing the effectiveness of friction.
Water helps remove transient bacteria by working with soap to create lather that reduces surface
tension. Time, on the other hand, is of the essence but friction is the most essential aspect of
handwashing. It’s friction whether you like it or not.

53. ANSWER: D. Below the elbow, Hands are dirtier than the lower arms

Hands are put below the elbow in medical asepsis in contrast with surgical asepsis where hands
are required to be kept above the waist. In medical asepsis, hands are considered dirtier than the
elbow and therefore, to limit contamination of the lower arm, the hands should always be below
the elbow.

54. ANSWER: C. 15 to 30 seconds each hand

Each hand requires 15 to 30 seconds of hand washing as a minimum to effectively remove

transient germs.

55. ANSWER: B. 10 seconds

According to Kozier, the minimum time required for watching each hands is 10 seconds and
should not be lower than that. The recommended time, again, is 15 to 30 seconds.

56. ANSWER: C. 2-4 ml

If a liquid soap is to be used, 1 tsp (5 ml) of liquid soap is recommended for handwashing
procedure.
57. ANSWER: A. Equipment with small lumen are easier to clean

Equipment with large lumen are easier to clean compared to those with small lumen. Other
choices are correct.

58. ANSWER: C. For boiling to be effective, a minimum of 15 minutes is required

Boiling is the most common and least expensive method of sterilization used in home. For it to
be effective, you should boil articles for at least 15 minutes.

59. ANSWER: D. Radiation

If food and drugs are to be sterilized by boiling water, ethylene oxide gas and autoclave, most
probably they’ll be ineffective after the process. Ethylene oxide gas is toxic to humans, boiling
food will alter its consistency and lower it nutritional value. Autoclaving food may sound fun but
it is the dumbest thing to do. Radiation using a microwave oven or an ionization penetrate foods
and drugs thus, sterilizing them.

60. ANSWER: B. Terminal disinfection

Terminal disinfection refers to practices to remove pathogens that stayed in the belongings or
immediate environment of an infected client who has been discharged. Concurrent disinfection
refers to ongoing efforts implemented during the client’s stay to remove or limit pathogens in his
supplies, belongings, immediate environment in order to control the spread of the disease.

61. ANSWER: C. Shake the linens to remove dust

Never shake soiled linens. Once soiled fold it inwards with the clean surface facing out. Shaking
the linen can dislodge and further spread pathogens harbored in its fabric.

62. ANSWER: C. The instruments are put into unlocked position, on their hinge, during the
autoclave

Metals with locks, like clamps and scissors should be unlocked in order to minimize stiffening
caused by autoclaving the hinges. Not all microorganisms are destroyed by autoclaving, there are
still microorganisms that are invulnerable to extreme heat. Autoclaved instruments are to be used
within two (2) weeks. Only the same type of metals should be autoclaved as this will alteration in
plating of these metals.

63. ANSWER: D. N95 Mask or particulate masks can filter organism as mall as 1
micromillimeter

Mask should cover both nose and mouth and will not function optimally when wet. They should
never be worn greater than four (4) hours and will gradually lose its effectiveness after four (4)
horus. N95 masks or particulate masks can filter organisms as small as one (1) micromillimeter.
64. ANSWER: D. Yellow trashcan

Infectious waste like blood and blood products, wet diapers and dressings are thrown in yellow-
colored trashbins.

65. ANSWER: A. Puncture proof container

Needles, scalpels and other sharps are to be disposed in a puncture proof container.

66. ANSWER: C. Using a long forceps, Remove it and place it on a lead container

A dislodged radioactive cervical implant in brachytherapy are to be picked by a long forceps and
to be stored in a lead container in order to prevent damage on the client’s normal tissue. Calling
the physician is the most appropriate action among the choices, a nurse should never attempt to
put it back nor touch it with her bare or even gloved hands.

67. ANSWER: A. In specially marked BIO HAZARD Containers

Leeches, in leech therapy or leech phlebotomy are to be disposed on a BIOHAZARD container.

They are never re used as this could cause transfer of infection. These leeches are hospital grown
and not the usual leeches found in swamps because that would just be disgusting.

68. ANSWER: A. Recapping the needle before disposal to prevent injuries

Never recap needles. After using, they are directly disposed in a puncture proof container after
used. Recapping could cause injury to the nurse and spread infection. Choices B, C and D are all
appropriate. Standard precaution is sufficient for a patient with HIV. A client with neutropenia
are not given fresh and uncooked fruits and vegetables as it may cause severe infection due to
immunosuppression.

69. ANSWER: D. In a room with negative air pressure and atleast 6 air exchanges an hour

Patients with tuberculosis should have a private room with a negative air pressure and at least 6
to 12 air exchanges per hour. Negative pressure rooms will prevent air inside from escaping. Air
exchanges are necessary since the client’s room do not allow air to get out of the room.

70. ANSWER: C. Droplet precaution

Droplet precaution is sufficient on client’s with RUBELLA or german measles.

71. ANSWER: B. Airborne precaution

Measles is highly communicable and more contagious than Rubella. It requires airborne precaution as it is
spread by small particle droplets that remains suspended in air and dispersed by air movements.

72. ANSWER: D. Contact precaution

Impetigo causes blisters or sores in the skin. It is generally caused by GABS or Staph Aureaus. It
is spread by skin to skin contact or by scratching the lesions and touching another person’s skin.

73. ANSWER: A. Don’t mind the incident, continue to insert the NG Tube

The digestive tract is not sterile, and therefore, simple errors like this would not cause harm to the patient.
NGT tube need not be sterile, and so is colostomy and rectal tubes. Clean technique is sufficient during NGT
and colostomy care.

74. ANSWER: C. Once the skin has been sterilized, considered it sterile

Human skin is impossible to be sterilized. It contains normal flora of microorganism. A, B and D

are all correct.

75. ANSWER: C. Sterile conscience, is the best method to enhance sterile technique

Sterile conscience, or the moral imperative of a nurse to be honest in practicing sterile technique,
is the best method to enhance sterile technique. Autoclaved linens are considered sterile only
within two (2) weeks even if the bagging is intact. Surgical technique is a team effort of each
nurse. If a scrubbed person leave the sterile field and area, he must do the process all over again.

76. ANSWER: B. The non dominant hand

Gloves are put on the non dominant hands first and then, the dominant hand. The rationale is
simply because humans tend to use the dominant hand first before the non dominant hand. Out of
10 humans that will put on their sterile gloves, 8 of them will put the gloves on their non
dominant hands first.

77. ANSWER: C. Before surgical hand scrub

The nurse should put his goggles, cap and mask prior to washing the hands. If he wash his hands
prior to putting all these equipments, he must wash his hands again as these equipments are said
to be unsterile.

78. ANSWER: D. Adjust only the fitting of the gloves after both gloves are on

The nurse should only adjust fitting of the gloves when they are both on the hands. Not doing so
will break the sterile technique. Only 4 fingers are slipped when picking up the second gloves.
You cannot slip all of your fingers as the cuff is limited and the thumb would not be able to enter
the cuff. The first glove is grasp by simply picking it up with the first 2 fingers and a thumb in a
pinching motion. Gloves are put on the non dominant hands first.

79. ANSWER: A. The glove of the non dominant hand

Gloves are worn in the non dominant hand first, and is removed also from the non dominant
hand first. Rationale is simply because in 10 people removing gloves, 8 of them will use the
dominant hand first and remove the gloves of the non dominant hand.
80. ANSWER: D. 2,3,1,4,5

81. ANSWER: A. 4,3,5,1,2

When removing protective devices, one must remove the gloves first, followed by the mask and
gown, then other devices like cap, shoe cover, and etc. Doing it in this manner will prevent
contamination of hair, neck and face area. Go ahead, try removing your mask, hair cap and
others before removing your soiled and bloodied gloves.

82. ANSWER: C. 6 inches

Even if you do not know the answer to this question, you can answer it correctly by imagining. If
you pour the NSS into a receptacle 1 to 3 inch above it, chances are, the mouth of the NSS bottle
would dip into the receptacle as you fill it, making it contaminated. If you pour the NSS bottle
into a receptacle 10 inches above it, that is too high, chances are, as you pour the NSS, most will
spill out because the force will be too much for the buoyant force to handle. It will also be
difficult to pour something precisely into a receptacle as the height increases between the
receptacle and the bottle. 6 inches is the correct answer. It is not too low nor too high.

83. ANSWER: A. The tip should always be lower than the handle

Sterile forceps are usually dipped into a disinfectant or germicidal solution. If the tip is higher
than the handle, the solution will flow down into the handle and into your hands, and as you use
the forceps, you’ll eventually lower its tip making the solution in your hand flow to the tip thus
contaminating the sterile area of the forceps. To prevent this, the tip should always be lower than
the handle.

84. ANSWER: C. 1,2,3,4

All soiled equipment used in an infectious patient are disposed inside the client’s room to
prevent contamination outside the room. Using the mask to cover both nose and mouth is correct.
Hands are washed before removing the gloves and before and after your enter the client’s room.
Gloves and contaminated suction tip are thrown in the trash found in the client’s room.

85. ANSWER: C. 1,2,3

Caps, masks and shoe covers are worn before scrubbing in.

86. ANSWER: D. Remove mask and gown before removing gloves

Gloves are the dirtiest personal protective device used and therefore, should be the first to be
removed to prevent spread of microorganisms as you remove your masks and gown.

87. ANSWER: C. All stressors evoke common adaptive response

All stressors evoke common adaptive response. A psychologic fear like nightmare and a real fear
or real perceive threat evokes common manifestation like tachycardia, tachypnea, sweating,
increase muscle tension etc. ALL diseases and illness causes stress. Stress can be both real or
imaginary. Hemostasis refers to the arrest of blood flowing abnormally through a damage vessel.
Homeostasis is the one that refers to dynamic state of equilibrium according to Walter Cannon.

88. ANSWER: A. Hans Selye

Hans Selye is the only theorist who proposed an intriguing theory about stress that has been
widely used and accepted by professionals today. He conceptualized two types of human
response to stress, The GAS or general adaptation syndrome which is characterized by stages of
ALARM, RESISTANCE and EXHAUSTION. The local adaptation syndrome controls stress
through a particular body part.

89. ANSWER: B. Man, whenever he encounters stresses, always adapts to it

Man do not always adapt to stress. Sometimes, stress can lead to exhaustion and eventually,
death. Choices A, C and D are all correct.

90. ANSWER: A. Stress is essential

Stress is ESSENTIAL. No man can live normally without stress. It is essential because it is
evoked by the body’s normal pattern of response and leads to a favorable adaptive mechanism
that are utilized in the future when more stressors are encountered by the body. Man can
encounter stress even while asleep (i.e., nightmares).

Disease are multifactorial and are not caused by a single stressor. Stress is sometimes favorable
and are not always a cause for distress.

91. ANSWER: D. Death can ensue

Death can ensue as early as the stage of alarm. Exhaustion results to a prolonged exposure to
stress. Resistance is when the levels of resistance increases and characterized by being able to
adapt.

92. ANSWER: A. Stage of Alarm

Adaptation mechanisms begin in the stage of alarm. This is when the adaptive mechanism are
mobilized.

93. ANSWER: B. Stage of Resistance

94. ANSWER: A. Stage of Alarm

Resistance are decreased in the stage of alarm. Resistance is absent in the stage of exhaustion. Resistance is
increased in the stage of resistance.
95. ANSWER: B. Stage of Resistance

96. ANSWER: D. Stage of Exhaustion

97. ANSWER: C. Adaptive response is immediately mobilized, doesn’t require time

Aside from having limits that leads to exhaustion, adaptive response requires time for it to act. It
requires energy, physical and psychological taxes that needs time for our body to mobilize and
utilize.

98. ANSWER: D. Technological adaptive mode

99. ANSWER: C. Sociocultural adaptive mode

Sociocultural adaptive modes include language, communication, dressing, acting and socializing
in line with the social and cultural standard of the people around the adapting individual.

100. ANSWER: B. Psychologic adaptive mode