5.

You are caring fo

sustained massive
1. Nurse Marie is assigned in the Neurological ward. She is taking thickness circumf
care of Bob with spinal cord injury. The goals of management for Following the bu
Bob should include which of the following: debridement should
A. Skeletal fracture reduction and traction, pharmacological A. Only during the
therapy B. At your own dis
B. Continuous monitoring of vital signs and immobility C. After cardiopul
C. Prevent further injury and observe for symptoms of D. Immediately upo
progressive neurological deficit
D. Pharmacological and physical therapy 6. Bimby, 18 months,
is the treatment o
2. Nurse Cary is caring for several clients in the medical ward. the best time for
One of her patients has had scanty urine output for 8 hours now. A. Is weaned from
The physician evaluated the client for renal failure. Nurse Cary B. Is toilet train
is aware that which of the following may trigger a renal failure
7. Henry, 65 years
of intrarenal cause?
(TURP). He was adm
A. Bacterial meningitis leading to septic shock
The Operating Roo
B. Benign prostatic hyperplasia
infusion of Dextr
C. Angina treated with nitroglycerin
40ml per hour at t
D. CT scan with contrast media
client in the PAC
to be consumed at:
3. Heejun, a 56-year-old diabetic, has recently been treated for A. 2400H
chronic renal failure. He decided on a kidney transplant next B. 0100H
month. For the meantime, he has been cleared for discharge. In
providing discharge teaching, Nurse Philipp should reinforce 8. When the circulat
which dietary instruction? pack, it slipped
A. “Be sure to eat meat at every meal.” the following is t
B. “Eat plenty of bananas.” A. Return it to th
C. “Increase your carbohydrate intake.” scrub nurse.
D. “Drink plenty of fluids, and use a salt substitute.” B. Disinfect the s
table.
C. Discard the sut
4. The newly hired nurse observed Lucila perform assessment on a to the scrub nu
50 year old female who sustained partial and full thickness D. Pick up the sut
burns on both lower extremities due to fire. Which of the nurse.
following questions asked by Lucila will the newly hired nurse
consider as an attempt to determine full thickness burns? 9. The surgeon asks f
A. “Can you move both extremities?” of the procedure
B. “How long were your extremities exposed to the flames?” amount of drug bei
C. “Did you cover extremities with any material like a blanket?” A. Scrub nurse re
D. “Do you experience pain?” dosage.
B. Scrub nurse r
circulating nur
 C. Circulating nurse shows the vial of the medication to the B. Axis II
nurse so she can read the label.
D. Scrub nurse receives the medication in a medicine glass. 14. Taylor, a 34-ye
Schizophrenia. C
10. A nurse in the Cancer Unit is in a quandary in carrying out planning is to :
a DNR order due to personal beliefs. Which of the following A. Provide structu
should be the appropriate action of the nurse in this situation? B. Maintain client
A. Seek counseling session with the nurse supervisor on duty. C. Maintain safety
B. Seek comfort and allay ones fears through stress management. D. Avoid damage to
C. Ignore personal beliefs and feelings in the situation.
D. Consider a change of assignment. 15. The clinical p
with schizophrenia
11. While performing a physical examination to an 82 year old each client is
male client, the nurse modifies her examination to consider the appropriate needs
client’s general weakness and reduce ability to move in bed. students were assi
Which of the following is the MOST appropriate nursing action? Hospital. The cli
A. Sequencing the examination to minimize changing client’s identify some p
position Schizophrenia. Th
B. Examining client only in the position where he is comfortable says which group o
C. Avoid touching the client so as not to alienate the client A. Illusion, Hallu
D. Speaking loudly and close to the ear when talking to client. B. Hallucination,
C. Delusion, Anhed
12. Andy is a nurse working in a long-term care facility. During D. Apathy, Illusio
her shift, she admitted a 68 year old female client named Maria.
Maria was accompanied by her daughter in the facility. She told 16. Neuropsychiatri
Andy that for the past few weeks, Maria changed. Maria used to are characterize
visit a Senior Citizen’s Assembly every week, but nowadays, she cognition or memo
refuses to go outside the house and would prefer to stay alone previous level of
sitting in the terrace. She claimed that the client frequently home, you know tha
loses things inside the house or sometimes misplaces Maria’s is that the former
daughter reported that she frequently misplaces things inside A. Onset is insidi
the house. Maria’s manifestations are classified under what B. Sensory percept
cognitive deficit of dementia. C. Slurring of spe
A. Apraxia C. Agnosia D. Clouding of con
B. Amnesia D. Aphasia
17. Kim Chie, a 19
13. The Diagnostic and Statistical Manual of Mental Disorders, Room of the Unive
4th edition, Text Revision (DSM-IV-TR) is a taxonomy published and calls an ambu
by the APA. The DSM-IV-TR describes all mental disorders, she drifts in an
70/42 mmHg, is bar
outlining specific diagnostic criteria for each based on
and difficult to
clinical experience and research. Allan, who has a Borderline 1,000 D5W is start
Personality Disorder would be assessed and classified in what This is characteri
axis? A. Excessive anxie
A. Axis I C. Axis III practitioners t
 B. Eating larger amounts of food than most people do under
similar time and circumstances 21. The clinical p
C. Uncontrolled urge to seek secondary gain from other people with schizophrenia
D. Eating unusual and non nutritive kinds of foods and substances each client is
appropriate needs
18. The difference between the mechanism of action of the typical nurse’s rounds in
and atypical antipsychotic helps to explain their differences shouted, “The NBI
in terms of effect on target symptoms and in the degree of side Which of the follo
effects they produce. Atypical antipsychotics block both A. “Go to sleep, t
serotonin and dopamine receptors. A nurse is to administer B. “. I will not
Chlorpromazine (Thorazine) to his female schizophrenic client. yourself”
Prior to administration of the drug, to ensure client safety, C. “You seem afrai
the nurse should not do all of the following, except: D. “What were they
A. Assess the color of the client’s skin and sclera 22. Schizophrenia
B. Obtain a baseline blood pressure management strate
C. Assess the radial pulse disease of the b
D. Review client’s liver function test person’s thought
behaviors. A 55 y
19. Pharmacologic treatment in substance abuse has two main due to bizarre beh
purposes: to permit safe withdrawal from alcohol, seen wandering o
sedative/hypnotics, and benzodiazepines and to prevent relapse. giggling by himse
Disorganized type.
Manny, an alcoholic was prescribed with Cyanocobalamin and folic
should have achiev
acid supplement by his physician. These are given primarily to A. Trust vs. Mistr
prevent or treat which of the following? B. Ego integrity v
A. Wernicke’s syndrome C. Alcohol withdrawal
B. Nutritional deficiencies D. Korsakoff’s syndrome 23. Nurse Aiden tal
him that Spencer
20. Delirium is a syndrome that involves a disturbance of a race against thi
consciousness accompanied by a change in cognition. It almost “He went home and
always results from an identifiable physiologic, metabolic, or What kind of ego d
cerebral disturbance or disease or from drug intoxication or A. rationalization
withdrawal. Nurse Juliet is assigned in the detoxification area. B. displacement
During her shift, a client suddenly shouted “A snake! A snake!
Get it off me!” The nurse attended to the client and found that 24. Psychiatric N
the client mistaken his IV tubing as a snake. The following are institutionalized
non-therapeutic statements of the nurse aside from: mental illness, h
A. “Stop shouting! You’re disturbing the other client, there is challenge roles o
no snake, it’s just your IV tubing.” these nurse creat
B. “Calm down sir, there is no snake here, this is just your IV and learn the cons
tubing. You are in a hospital, I am your nurse.” A. Remotivation gr
C. “You seem afraid. I can’t see the snake, I think it already B. Activity groups
got away so no need to worry about that, you can go back to
sleep now.”
D. “Tell me where is it”
25. Neglect is malicious or ignorant withholding of physical, 30. There are othe
emotional, or educational necessities for the child’s well- gathering of data
being. Child abuse by neglect is the most prevalent type of In this situation,
action to be under
maltreatment and includes refusal to seek health care or delay
A. Nurse and phy
doing so. A school nurse notices bruises and scars on Mika’s amenable to col
body, but she refuses to say how she got them. The most B. Give priority
successful way in which the nurse can get information from Mika candidates for
is through: C. Immediate actio
A. Have her evaluated by the school counselor. health problems
B. Tell her that you would give her chocolates if she tells you. D. Prioritize prob
C. Let her be and call the attention of her parents regarding
31. As the nurse a
the issue. Nurse Erna must i
D. Use a family of dolls to role play the child’s family with of enema administr
her. A. Isotonic soluti
26. to use.
27. Mrs.Mirasol, recently diagnosed with chronic bronchitis, has B. The solution c
been regularly taking her due medications. She also believes above the rectu
that she can improve her pulmonary functions with proper diet C. Administration
and exercise, and constantly visits an internet website to check assistive perso
for videos related to COPD management. Mrs.Mirasol’s action is D. If the client c
most representative of the: for at least 3
A. Adaptation model C. Clinical model slower rate.
B. Health belief model D. Role performance model
32. Because of the
28. You are assigned to care for a client with a different culture ordered the nurse
from you. In initiating care, which of the following would be following would mo
an appropriate statement? in his stomach?
A. “Please let me know if I do anything that is not acceptable A. The ph level of
in your culture.” B. The nurse notes
B. “While you are in the hospital, it is best for you set aside C. Mr. Corona cann
your usual customs and practices while you are in the D. A whooshing so
hospital.” injecting 20 mL
C. “I heard that in your culture, people don’t eat hot foods.
I’ll bring you cold dessert instead. 33. A patient who
D. “Can you suggest any references or books that I could read to fatigue, anorexia
study your culture?” motility. Which of
to the patient to
29. Mr. Rivera had blood extraction for hematology, blood A. Banana
chemistry, lipid profile, FBS. The laboratory results are in. B. Apple
Of the following, which is NOT within normal?
A. Cholesterol: 4.28 mmol/L C. HBA1C: 5.7 % 34. A methylxanthi
B. FBS: 6.5 mmol/L D. Hematocrit: 39.7/L nurse caring for
effect of this dru
 A. Increased urine output C. Informatics ca
B. Increased cardiac rate national, and
C. Increased pulmonary function empowering nurs
D. Increased peristalsis D. All nurse info
health care set
35. Nurse Maya utilizes the most reliable indicators of
Teresita’s fluid balance status which include the following 40. Nursing informa
EXCEPT: nursing administra
A. Her daily weight record the following ar
B. The measurement of intake and output except?
C. Complete blood count. I. Human Resour
D. Results of urinalysis II. Medical Reco
III. Facilities M
36. While assessing Lola’s skin, nurse Maya noted that the skin IV. Budget and F
flattens more slowly after the pinch is released. This is an V. Quality Assu
indication that the client is manifesting sign of: VI. Accreditatio
A. 2+ pitting edema C. Shift of body fluids
B. Fluid volume deficits D. Fluid overload A. 1,2,5,6
B. 1,2,3,4
37. Upon assessment, a 5-year old child exhibits weight loss,
41. If their study
poor skin turgor, distended abdomen, and has a characteristic
Games to Board Pe
"old man look". The patient is more likely has a deficiency on
of the followin
which of the following?
variable/s?
A. Protein C. Vitamin A
A. Plying online g
B. Calories D. Vitamin D
B. LormaNLE takers
38. Mr. Corona was brought into the Recovery Room after an
42. If the research
abdominal surgery. The physician order reads that the patient
is most common
should be on a full liquid diet. Which of the following would
you not expect to be given to Manny? tendencies would b
A. Median
A. Vegetable juice C. Tea
B. Apple sauce D. A glass of milk B. Range

39. Several definitions of nursing informatics have been used to 43. A super typhoo
describe this young science. Which of the following is not an her staff of a lo
accurate description of nursing informatics? hospital and prep
A. Nursing informatics is the integration of nursing, its team react with he
information and information management with information leadership style t
processing and communication technology to support the health A. Authoritarian
of people worldwide. B. Democratic
B. Nursing Informatics as a specialty that integrates nursing
science, computer science, and information science to manage 44. There are princ
and communicate data information and knowledge in nursing to Unlicensed Ass
information. included, except?
 A. The client must be in a chronic condition. government agency
B. The task must have a predictable outcome. health and the b
C. The client must be medically stable. public health nu
D. The task must require a substantial amount of scientific
representation of
knowledge or technical skill.
A. Improvement of
45. A patient was admitted into the hospital after suffering the economic li
from multiple lacerations due to an accident. The patient shows B. Partnership amo
acceptance of all the necessary treatments except for any C. Affordable heal
injections. The nurse believes that Tetanus Toxoid should be D. Emphasizes reli
administered so she decided to give it against the patient's
will. Which of the following ethical principles has been clearly 49. Health Sector
violated by the nurse? DOH. In order to g
A. Assault C. Autonomy the DOH adopted wh
B. Battery D. Beneficence A. Sentrong Sigla
B. FOURmula One fo
46. In ethics, what may be legal may not be necessarily ethical, C. National Health
and vice-versa. Among these nurses, whose act will be best D. Field Health Se
considered to be ethically good?
A. Lala, who steals money from her mother to give it to his
patient who cannot afford his due meds. 50. Nurse Ryan is
B. Lele, who becomes productive whenever the nurse supervisor is strategy includes
around. coordination with
C. Lili, who caused the death of a terminally-ill client as labor to the nea
requested by the patient himself. following services
D. Lulu, who took the responsibility of performing physical i. Assisted bree
assessment of another nurse who feels sick and tired.
ii. Administratio
47. Public health is a core element of governments’ attempts to iii. Administratio
improve and promote the health and welfare of their citizens. iv. Manual remova
The classic definition of public health comes from C.E. Winslow. v. Administratio
Nurse Eponine comprehends that according to C. E. Winslow, the vi. Performance o
goal of public health is:
A. For promotion of health and prevention of disease A. None except ii,
B. For people to have access to basic health services and free B. Only i and vi
services
C. For people to attain their birthrights of health and longevity 51. Nurse Lexie ha
D. For people to be organized in their health efforts to prevent years now. One
disease utilization of ap
this principle if
48. Public Health Nursing in the Philippines evolved alongside A. Fostering the u
the institutional development of the Department of Health, the
 B. Working with health workers and other government agencies to D. Undertake meas
improve health of the people. community
C. Gathering community members to eliminate breeding sites of
mosquitoes. 55. Mothers have be
in Sitio Curly T
D. Performing DSSM solely on TB symptomatics present in the area.
concerns since mo
have been infecte
52. Health workers in general should be guided by the principle include which of t
“the greatest good for the greatest number” or “distributive A. Rashes are con
justice” in prioritizing health services and activities, develop are of
primarily because resources are limited. In prioritizing health B. Rashes appear
problems, Nurse Eugene should assign the highest weight on: palms of the ha
C. Rashes develop
A. Present wellness state or potential, health threat, health
D. Development of
deficit or foreseeable crises
B. Probability of success in enhancing wellness state, improving 56. A 10-year-old
the condition, minimizing or totally alleviating or totally manifests with hi
eradicating the problem through intervention nausea and vomit
C. Preventive potential teaching, you wo
D. Client’s perception and evaluation of the condition or transmission of th
problem in terms of seriousness and urgency of attention A. Direct contact
needed or readiness B. Direct contact
C. Indirect contac
53. Registry Nurse Lanie is planning to conduct a community D. Vector-borne
diagnosis composed of Demographic variables, Socio-Economic
variables, Health and Illness patterns, Health resources and 57. Which statement
Political/Leadership patterns. Nurse Lanie is planning to to pertussis?
conduct what type of community diagnosis? A. If the mother
A. Individualized Nursing Diagnosis immunity.
B. Population Focused Diagnosis B. Most infants an
C. The newborn wi
C. Comprehensive Community Diagnosis months of life.
D. Problem Oriented Community Diagnosis D. Infants under 1

54. To ensure collective participation of the people, community 58. Nurse Yodrick i
organization should be formed through a community assembly. All patient with measl
but one of the following are purposes of having community crying. Nurse Yod
true regarding pre
assembly:
A. If only Mela wa
A. Gain cooperation, pledge support and work together on their 9, she would ha
own B. Mela must be i
B. Help people identify their own problem rashes on her s
C. Plan for the solution of identified problem/s
 C. Mela’s position in bed should be frequently changed, usually understood the pu
every one to two hours. placenta:
D. If some persons come into contact with Mela, they must be A. Cushions and pr
vaccinated within 2 days after exposure. B. Maintains the t
C. Is the way the
59. Samuel, a public health nurse, is doing health teaching to a D. Prevents all th
mother who brought her 9-year-old son to the RHU due to slight baby
intermittent fever. There is a dengue outbreak in the community,
64. Arianna, a 21
so Tourniquet test was performed. The child tested positive with
prostitute, infor
no other signs and symptoms. Samuel is correct to advise the secretions since
mother which of the following: client that the in
A. “Go to the nearest hospital for close monitoring and early A. Are a result of
treatment.” B. Can be highly i
B. “Use mosquito nets at home.” C. Help prevent ex
C. “Persistent vomiting is normal at this course of disease.” D. Control growth
D. “Take aspirin to manage the fever.”
65. Nurse Bren is t
60. A 19 – year old male client was rushed to the Health Unit and examination shows
reported that a stray dog bit him on his left leg. The nurse Bren correctly int
inspected the bite mark and found that the client has a punctured A. Presenting part
wound and other small scratches. Before deciding on what vaccine B. Biparietal diam
should be given, the nurse should properly categorize the bite C. Presenting part
as: D. Biparietal diam
A. Category I C. Category III
B. Category II D. Category IV 66. On December 7,
Administrative Ord
61. Local government units are transformed into active partners of rapidly reduc
and self-reliant communities through a system of Philippines. Wit
decentralization that is mandated in: Intrapartal care
A. RA 7610 C. RA 7160 program under the
B. RA 6710 D. RA 6170 and fallacies incl
1. Use of enema
62. Reina, 14 weeks old, is brought to the RHU by her mother for the duration
their scheduled immunization. You are aware that she will receive
2. Shaving the
which of the following vaccines by this time?
A. 2nd dose of Hep B, 0.5 mL IM at upper outer portion of thigh practice to m
B. 3rd dose of OPV, 5 gtts PO 3. Restricted in
C. 1st dose of measles, 0.5 mL SQ at outer part of upper arm possible ris
D. 3rd dose of DPT, 0.5 mL IM at upper outer portion of thigh anesthesia
4. Application o
63. The nurse explains to the patient the purpose of the placenta
during her prenatal visit. The nurse determines that the client drink restric
 5. Use of fundal pressure to help the mother in the expulsion is by giving Mebe
of her fetus is contraindicated
A. Ella, who is 16
6. Early amniotomy and oxytocin augmentation in order to
ago.
prevent operative delivery B. Vanessa, 20 w
infection.
A. 4, 5, and 6 C. 1, 2, and 3 C. Debbie, 12 w
B. None of these D. All of these vomiting, and f
D. Jenny, 38 weeks
67. Rachel Berry had a normal vaginal delivery 12 hours ago and
is to be discharged from the birthing center. You evaluated that 71. Among the many
Jasmin understands the teaching related to the episiotomy and which is the most
perineal area when she states: A. Bilateral Tubal
A. “The ice pack should be removed for 10 minutes before B. Vasectomy
C. Lactating Ammen
replacing it.” D. Injectables
B. “The anesthetic spray, then the heat lamp, will help a lot.”
C. “The water for the Sitz bath should be warm, about 102-105 72. As a community
F.” is family planni
D. “I know the stiches will be removed at my postpartum clinic contraceptive met
visit.” following actions
clients regarding
A. Explaining ful
68. A client named Heidi, G2P1 was admitted with complaints of methods
hypertension. She even remarked that her wedding band was tight. B. Helping clients
In doing your assessment, which of the following directs you to C. Asking clients
entertain early pre-eclampsia? D. Telling clients
A. Pain in her epigastrium together with headache
B. Swelling of her face with proteinuria 73. Nurse Jesselle
C. Blurring of vision with proteinuria Nurse Jesselle mus
D. Hypertonic reflexes together with polyuria most common compli
A. Hemorrhage
69. Upon quick assessment of your patient, Katy Perry, you noticed B. Aspiration of m
that she was not breathing. Which of the following interventions
is done first? 74. In the immediat
A. Ventilate with bag and mask until she starts breathing which were debunk
spontaneously are they?
B. Inspect her mouth for foreign body and remove it if any is 1. Routine suct
found baby’s airwa
C. Position patient in a flat, right-side lying position. 2. Foot printin
D. Refer urgently to a nearby hospital for intubation 3. Early bathin
4. Routine Sepa
70. IMPAC aims to decrease high prevalence of hookworm infection. is in her ro
One way is to ensure health of the pregnant women and her fetus
 5. Continuance to providing artificial feeding (starts with D. Conducting clas
pre-lacteals then artificial milk substitutes) accidents at ho

79. Nurses have big

A. 2 and 5
Nurse John is to ex
B. 1, 3, and 4 to clients. He k
C. Only 2 precaution in ensur
D. All 5 are taken now as wrong beliefs A. Reduction of th
B. Prevention of h
75. To relieve teething discomfort which measure would you C. Prevention of s
suggest an infant’s mother to use? D. Protection of
A. Provide her with a fluid diet for 2 days infections.
B. Offer her Aspergum to chew
C. Ask her pediatrician for a sedative for her 80. Nurse Smith is
notices that there
D. Give her a cold teething ring to chew
medication room in
action is to:
76. A 34-year old single mother dropped by your FCNC and tells A. Seek help from
you that she always have difficulty forming relationships. The B. Escort the clie
mother conveyed to you the message that she is worried that her C. Use the fire ex
7-year old daughter might have the same problems later. Of the D. Turn off the o
following statements, which do you think is BEST to make? them from the r
A. “Children develop trust from 6-12 years of age.”
81. During enema
B. “Children develop trust from birth to 18 months of age.” abdominal cramping.
C. “Children develop trust from 18 months to 3 years of age.” to:
D. “Children develop trust from 3-6 years of age.” A. Slowly pull the
B. Clamp the tubin
then continue w
77. Patricia Benner’s Model of Clinical Expertise includes C. Stop the proced
five stages of nursing expertise and can serve as a guide for physician
nurses to identify their abilities in the practice. According D. Lower the heig
to this model, which of the following stages begins in nursing solution
school?
A. Advanced beginner C. Expert 82. Nurse Joshua i
B. Proficient D. Novice NGT. He makes sure
NGT placement, EXCE
78. Nurse Vida is planning to conduct a seminar on the different A. Visual assessme
levels of prevention. She includes all of the following activities B. Measurement of
under primary level of prevention, EXCEPT: C. Auscultation of
A. Family planning sessions to newly-married couples D. Ph measurement
B. Providing immunizations to children under 1-year old
C. Referring cancer patients and terminally-ill clients to
support groups
83. You are to hook 1L of NSS to your adult patient to run for 24
hours. Given the drop rate of the IV tubing is 15 gtts./mL, you 89. Computers have
should infuse the IVF at? been utilized for
A. 48 milliliters per hour; 15 gtts./min research through a
B. 36 milliliters per hour; 7 gtts./min A. Problem identi
C. 50 milliliters per hour; 18 gtts./min B. Collection and
D. 42 milliliters per hour; 10 gtts./min C. Dissemination
D. None of the ab
84. You are to care for a patient who has undergone an abdominal
surgery under general anesthesia. You expect that this client is 90. Mr. Padilla, a
most likely to experience: has been known to
A. Immediate return of GI motility in computer techn
B. Excessive gas formation informatics theory
C. No signs of peristalsis on nursing informa
D. Tolerance to soft diet right after the surgery A. Beginner nurse
B. Experienced nu
85. Mr. Charles Thompson, 50, is admitted in the hospital for C. Informatics nu
general check-up. Assessment reveals, Temp: 37.1, Pulse: 80 bpm, D. Innovator nurs
RR: 16 cpm, BP: 160/100 mmHg. The most important INITIAL nursing
intervention would be to: 91. Nurse Princess
A. Tour him around the area to show him the unit set up project serves whi
B. Let Mr. Thompson be introduced to other staffs A. States the foc
C. Obtain Mr. Thompson’s history B. Identifies pop
D. Identify the patient’s need that require immediate attention C. Determines sta
D. Explains why t
86. Upon assessment, you observed that the client has bipedal
edema. This can be best verified by:
92. During her job
A. Asking questions to the client
type of research i
B. Performing palpation
“meaning’? Her bes
C. Inspection A. Phenomenologic
D. Reviewing laboratory results
B. Qualitative re
C. Quantitative r
87. Mrs. Jones asked the nurse about foods that are rich in good
D. Anthropology b
cholesterol. The nurse must include all of the following, EXCEPT:
A. Fish fillet C. Soya
B. Beef steak D. Olive oil 93. To improve qua
solving committees
88. Terrence, 36 years old, is diagnosed with peptic ulcer and standards of care
asks you what food is best to add to his diet so as not to desired result is
exacerbate his symptoms. Your BEST response would be for him to A. Continuous eva
take: relation to de
A. Leafy green vegetable dishes B. Allowing chang
B. Citrus fruit juices or shakes personal needs
C. Mocha, café latte and other similar drinks C. Increasing sta
D. Milk regularly 3-4 times board for shar
 D. More nurses participating in doctor’s rounds and giving medicines and other
immediate information to doctors regarding patient status exemplifies which
A. Health financin
94. The nursing department’s organizational chart illustrates B. Health regulati
structure and relationships of the nursing leaders and staff of
the organization. The following are the functions of an 100. Support for imm
organizational chart EXCEPT: and management of
A. Lists functions and duties of the staff strategic instrume
B. Illustrates centrality of control in the organization and Health Care for All
chain of command of this strategy,
C. Indicates relationship of leaders to other management staff policies regarding
D. Identifies managerial levels (FHSIS). All of the
A. Individual Trea
95. It is unethical to tell one’s friends and family members data B. Target Client L
about patients because doing so is a violation of patient’s rights C. Summary Table L
to: D. Weekly Consolid
A. Informed consent C. Civil liberty
B. Confidentiality D. Secrecy 101. Nursing Assessm
process. It incl
96. The nurse must see to it that the written consent of interpretation and
mentally ill patients must be taken from: starts to assess he
A. Law enforcement agencies C. Doctor level assessment,
B. Social worker D. Parents or legal guardian following data, ex
A. Structure of th
97. The vision of poverty reduction and sustainable development B. Values and prac
is exemplified by the Millenium Development Goals (MDGs) which C. Family’s percep
are based on the fundamental values of freedom, equality, D. Health status o
solidarity, tolerance, health, respect of nature and shared
responsibility. The following MDGs are health or health related, 102. The typology o
except for: from health tasks
A. 2 and 3 C. 4 and 6 Freeman. April is
B. 1 and 7 D. 3 and 5 She conducted home
concentrate on the
98. There are four cornerstones or pillars in primary health 30 sq. bungalow ho
care. All but one of the following is included, except: the Santos family.
A. Passive community participation was recently diagn
B. Intra and inter-sectoral linkages made him really il
C. Use of information technology all the responsibi
D. Support mechanism made accessible and sells vegetabl
already has his ow
99. FOURmula One for Health as a framework for the implementation still lives in the
of HSRA has four elements: health financing, health regulation, job for the fifth
health service delivery and good governance. The Municipal Health mother to the marke
Officer of Brgy. Barnabas submitted a proposal for the service. Eight mon
construction of their Botika ng Barangay for the cheaper has no pre-natal c
 kilometrong paglalakad papunta sa health center”, says Tina. Lan nurse about the l
(10) and Rose (8) takes care for their father and their younger precautions. The nu
siblings Thesa (5) and Ivy (3). None of the children has received A. “Droplet preca
immunization. And none of them even reached the 3rd grade. Which appears.”
among the following will Nurse April consider as threats to the B. “Droplet preca
health of the family? begins.”
i. Active Tuberculosis of Raymund C. “Droplet preca
ii. Loss of job communicability
iii. Eight children, three grandchildren D. “Droplet precau
iv. Pregnancy in teen years onset of paroti
v. Inadequate living space
vi. Lack of immunization 107. Pikachu, 3 year
vii. Inappropriate role assumption and a father, was a
viii. Improper garbage disposal 101 F, a sore thro
swallowing and a
A. All except ii, iv, viii C. All except i, iii, nasopharyngeal dip
v, vi, vii chart, you read t
B. All except i, ii, iv D. All except iii, v, vi , findings the term
vii, viii means?
A. Tender lymph no
103. Carrying out the planned activities involving maximum B. Increase tone i
community participation is referred to as C. Involuntary spa
A. Mobilization C. Community organization D. Temporary swell
B. Integration D. Community assembly
108. A nurse provide
child hospitalize
104. Community organizing ends when the community exhibits self- convalescent stage
reliance. This signals that the community organizers are now statement by a pare
ready to pull out of the community because: A. “We need to enc
A. Organizers can expand to other poor communities B. “Coughing spell
B. Their absence can provide a more accurate evaluation of C. “Vomiting may o
D. “We need to
outcomes of developed programs
environment for
C. It indicates that community organization is finished
D. It will prevent the community from going back to a state of 109. Which of the fo
dependence to the community organizers for prevention of
A. Use of sterile
105. The primary diagnostic examination for a suspected TB case B. Safe food prepa
is: C. Proper disposal
A. Sputum culture C. Tine’s test D. Immediate repor
B. Sputum exam D. Mantoux test connections

106. A nurse provides instructions to the mother of a child with 110. Taylor Lautner
mumps regarding respiratory precautions and the mother asks the community members
aiming to implemen
 breeding sites and preventing contact. They are correct if they B. More intense, m
do the following, except: C. Constant intens
A. Avoiding outdoor day activities and wearing long-sleeved D. Constant in int
clothing.
116. In evaluating t
B. Soak mosquito nets in insecticide solutions. the following obs
C. Planting Neem trees around the community. correct understand
D. Cutting of trees overhanging along stream banks. A. Breastfeed infa
infants
111. In immunizing school entrants with BCG, you are not obliged B. Stools of breas
to secure parental consent. This is because of which legal C. Breastfed infa
document? infants
A. P.D. 996 C. Presidential Proclamation No. 6
B. R.A. 7846 D. Presidential Proclamation No. 46 D. Stools of breas
bottle-fed infa
112. Republic Act 7719 is otherwise known as the “Blood Services
Act of 1994”. To ensure the safety of blood supply, donors must 117. Selena Gomez d
meet certain requirements before donating. Mirasol, an 18 year- Ceasarean section,
action
old student nurse, wishes to donate her blood to those who are
A. Complaints of a
in need. Upon assessment, she weighs 115 lbs., and her blood B. Slight vaginal
pressure is 90/70 mmHg. Which of the following would disqualify C. Bright-red bloo
her as an eligible blood donor? D. Tachycardia and
A. Age C. Blood pressure
B. Weight D. None of the above 118. An assisted bir
performed to ineff
labor, or for a ma
113. What is the period in which males cannot respond to sexual
following an assis
stimulation no matter how intense the stimulation is?
in mind?
A. Orgasmic period C. Refractory period
A. A vacuum extrac
B. Sexual dysfunction D. Resolution period
less trauma to
B. The baby will
114. Mary Anne, a 25 year old mother came to the family planning
instrumentation
clinic and started asking questions about the menstrual cycle.
C. The use of ins
She tells Nurse Al that her average cycle lasts for 31 days. Mary
rare
Anne demonstrates understanding on menstruation and menstrual
D. Additional nur
cycle when she states:
uncomplicated p
A. “I need a condom whenever I reach the fourteenth day of my
cycle to avoid getting pregnant”
119. Integrated Man
B. “I will probably ovulate on the seventeenth day of my cycle”
used to indicate s
C. “I’m ovulating every twelfth day of my cycle”
assign Lea Salonga
D. “I ovulate every seventeenth day of the month”
and follow up?
115. As labor progress, the nurse expects to find contractions
A. Red C.
becoming:
B. Pink D.
A. More intense, less frequent, and of longer duration
120. High doses of Vitamin A should not be given during pregnancy 125. Joy, a 12 month
unless severe deficiency develops. Nurse Jerome is taking care assessment the ch
of pregnant mothers. To whom will he give Vitamin A? result, you know t
A. Kimber who is 38 weeks pregnant and complains of urinary A. Appropriate for
frequency B. Below the expec
B. Glee who is 14 weeks pregnant and experiences frequent nausea C. Above the expec
and vomiting
D. Individualized
C. Raye who is 9 weeks pregnant and has problems at bedtime
D. Joren who is 24 weeks pregnant and with diarrhea and fever
126. In planning car
121. The pillars of family planning include all of the following, mother that the
except: development task f
A. Birth spacing of 1 year C. Informed choice A. Respond to her
B. Respect for life D. Responsible parenthood B. Expose her to m
C. Keep her stimul
122. A client is using a rhythm (calendar-basal body temperature)
method of family planning. In this method, the unsafe period for D. Talk to her at
sexual intercourse is indicated by:
A. Return to preovulatory basal body temperature 127. The parents of
B. Basal body temperature increase 0.1F to 0.2F on the second ductus arteriosus m
and third day of the cycle when she states:
C. Three full days of elevated basal body temperature and clear, A. A narrowing of
thin cervical mucus B. An enlarged aor
D. Breast tenderness and mittelschmerz C. A connection be
D. An abnormal ope
123. Nurse Anika is caring for a newborn. She knows that the
highest priority in the care of the newborn is: 128. A 4-week old i
A. Provide warmth C. Provide stimulation brought by her mo
B. Provide adequate nutrition D. Patent airway statements would y
symptoms?
124. On ESSENTIAL CARE OF THE NEWBORN, the three (3) new major A. “My son’s bowel
RECOMMENDED PRACTICES are B. “My son spits g
1. Practice Rooming-in C. “My son seems h
2. Skin to skin contact D. “I really have
3. Strict Handwashing of Carers handling the newborn child
4. Use of partograph 129. Among the follo
5. Properly timed cord clamping following, except:
6. Initiation of Breastfeeding A. If not able to
A. 1, 3, and 4 B. If child vomits
C. If the child ha
B. 4, 6, and 2
D. If the child is
C. 2, 5, and 6
D. 4, 5, and 1 130. What are the t
immediately in Pla
 A. 100 ml/kg body weight Lactated Ringers or D5W D. “This suggests
B. 100 ml/kg body weight Lactate Ringers or 0.9 NaCl sodium phosphat
C. 100 ml/kg body weight NSS or D5W
D. 100 ml/kg body weight NSS or Dextrose 135. Hector, with
count of 10,000/ul
131. You are performing chest auscultation to a patient admitted an appropriate nur
for routine physical examination. Upon assessment of the trachea, A. Encourage fluid
you heard high-pitch sounds of loud amplitude. The quality of B. Check al stools
the lung sounds was a bit harsh. You know that this type of normal C. Check the tempe
breath sounds is called: D. Provide oral hy
A. Bronchial C. Pleural friction rub
136. Fantene, a 26
B. Vesicular D. Bronchovesicular lymphoma asks you
response is:
132. When documenting results of client’s post cardioversion A. “Most patients
rhythm, the nurse recognized that the P wave in the treated success
electrocardiogram strip represents which of the following? B. “It will depen
A. Depolarization and contraction of the atrium but most patien
B. Ventricular depolarization and contraction C. “You know, no o
C. Ventricular repolarization try to focus on
D. Beginning of ventricular repolarization D. “With ongoing
survival rate i
133. Niall Payne, 85 years old, has congestive heart failure. He
was admitted to the hospital due to increasing edema. He was 137. Lucila adminis
frightened, slightly confused, and dyspneic on exertion. His toxoid to a client
weight 2 days ago was 165 lbs. The nurse weighed him today and were the newly hir
got 80 kg. The nurse understands that this represents a fluid will you consider
A. Tetanus toxoid
gain of:
B. Amount of antiv
A. 6 L C. 4 L that weight of
B. 5 L D. 3 L C. Complications m
D. Antivenom is an
134. Nurse Kate is caring for Anna Fitzgerald who was admitted due
to DKA. Once she regained her consciousness, she says that her 138. Peter, a 30 ye
doctor told her that she has low phosphorus levels. When Anna emergency departm
asks the nurse what this implies, Nurse Kate correctly answers avulsion of the ri
conveyor belt. Whe
by saying which statement? “I’ve never had
A. “This means that phosphorus levels in your blood are below administration of:
4.5 mg/dL.” A. Tetanus toxoid
B. “This indicates that you should increase your intake of organ B. Immunoglobulin
meats, nuts, and fish.” C. Immunoglobulin
C. “This implies that you will manifest with GI-related D. Immunoglobulin,
vaccine
symptoms.”
139. COPD patients may be taught the following pulmonary hygiene B. Palms and finge
measures to improve clearance of airway secretion, EXCEPT:
A. Measure fluid intake C. Postural drainage 144. To establish a
B. Effective coughing D. Complete bed rest laboratory tests t
A. Iron studies
B. Complete blood
140. The new nurse encouraged the client to assume a comfortable
position while maintaining body alignment despite the presence 145. Herminio, 70 ye
of the drainage system. While the patient was looking for a more abdominal aortic a
comfortable position, the tubing was accidentally disconnected. abdomen, which of
The INITIAL and APPROPRIATE action of the nurse is to: A. Pulsating mass
A. Clamp the tubing at once B. Bruit over a ma
B. Place the open end of the tubing in a sterile water C. Rebound tendern
C. Pull out the tubing and apply an air tight dressing to the D. Rigid board lik
site
D. Immediately reconnect the tube 146. The developmen
that correlates w
141. Lucila instructed the newly hired nurse to inform the client understands that t
with congestive heart failure to avoid Valsalva-type maneuvers. fluid secreted by
The newly hired nurse understands that these include the A. Fibrotic change
following, except? B. Obstruction of
A. Walking to and from the bathroom C. Impairment of b
B. Coughing and straining D. Proliferation o
C. Moving from supine to lateral position
D. Getting out of bed to a wheelchair 147. Andrew, a 12-ye
admitted in the me
142. Mr. Sta. Ana, a post-acute myocardial infarction (AMI) on his having recovered fr
2nd day post attack is assigned to you. The physician said his has been diagnosed
recovery is uneventful. Morphine sulfate intravenous (I.V) was History showed tha
prescribed for pain. The nurse understands that morphine sulfate of his insulin inj
I.V. was preferred because of two reasons. These are: tennis. Which of
1. Rapid onset of action nurse consider as
2. Elevated enzyme levels administer his ins
3. Increases cardiac output A. “Will you allow
4. Bypasses the variable rates of absorption B. “Let me hold th
C. “When I go home
A. 2 and 3 C. 1 and 2 D. “Are you sure I
B. 3 and 4 D. 1 and 4
148. Nurse Daisy has
Editha, 22 years old, was brought to the hospital by her mother for of the P.M. shift.
chief complaints of pallor, shortness of breath and weakness. The of any admission du
doctor’s impression was anemia. in for thyroid w
143. The nurse knows that the BEST areas used to assess pallor sodium 0. 15 mg
that are characteristics of anemia are the: hypothyroidism wa
A. Conjunctivae and lips C. Lips and fingernails
 medication at which time to obtain the drug optimum therapeutic
Level? 153. Juanchito, 5 ye
A. In the morning before breakfast has generalized ed
B. At the patient’s most convenient time edematous legs. B
C. At various times of the day hypoalbuminemia. T
D. Before bedtime the patient. Which
sample will the nu
149. Which of the following is the MOST important part of assessing A. Fruity odor
a client with hearing loss? B. Increased amoun
A. Change in style of communication
B. Weariness or unexplained irritability 154. Leon has been
C. History of a client physician prescribe
D. Use of simple noninvasive way to test hearing three times a week
Postoperatively, w
150. Which of the following is an appr0priate nursing intervention as a PRIORITY nurs
for the client with hearing impairment? A. Auscultate for
A. Get an interpreter every time the nurse makes contact with B. Elevate the aff
the client. C. Observe finger
B. Prepare set of questions and write responses of client D. Keep dressing i
C. Minimize environment noise before speaking with the client
D. Place the client in a quiet well ventilated room 155. You are to cond
has nonbullous imp
151. One of the clients assigned to Nurse Marie is Dylan, who is
in the plan of car
in halo Traction. While administering the 8:00 A.M. medication,
she notices that one of the pins was detached. Which of the A. Administration
following should be her INITIAL action? B. Wearing gloves
A. Ask assistance from the other staff nurses to immobilize the C. Avoid using pov
client D. Teaching the pa
B. Leave the client in his position and call for help with other all the lesions
staff
C. Call the neurosurgeon
156. A 53-year old
D. Stabilize the head in a neutral position and ask another nurse
to notify the neurosurgeon complaining of sev
nurse assigned to a
152. Nursing care of Dylan with Halo traction requires meticulous be implemented, ex
care under the halo vest. Which of the following nursing measures A. Administer anal
MUST be done in providing care to Dylan? B. Administering s
A. Inspect for excessive perspiration, redness and skin C. Encourage the p
blistering, wash the torso and change liner periodically
B. Inspecting skin for redness and blistering, and open the vest
teach him some
periodically to promote comfort D. Administering
C. Wash the torso and leave the liner in the body of the client eruption has oc
and apply powder especially on the bony prominences
D. Applying powder inside the vest to prevent skin breakdown 157. Nurse Karen is
after washing the torso parents are plan
 discharge. When teaching the parents about their baby’s 4. Keeping the
condition, Nurse Karen will mention which of the following? procedure
A. “The baby can still be circumcised as planned.” 5. Limiting the
6. Placing roll
B. “The foreskin will be needed at the time of surgical
skin prepara
correction.”
C. “Circumcision is necessary because the foreskin obstructs the A. All except 2 an
meatus.” B. 1, 2, 4, and 5
D. “We have to wait until adolescence before we can correct the
defect.” 161. Nurse Sofia is
severe COPD with
158. Henry, 65 years old, underwent Transurethral Prostatectomy might be of bene
(TURP). He was admitted to the Post Anesthesia Care Unit (PACU). statements is TRUE
The client has an indwelling triple catheter to a continuous A. In hospice care
bladder irrigation (CBI) with Normal Saline Solution (NSS) wishes of a cli
infusing at 200ml per hour. After four hours, the nurse empties B. Health care wo
the drainage bag and obtained an output of 1,080 ml. which of they don’t like
the following will the nurse record as the client’s urinary them
output? C. Hospice is a p
A. 180 ml C. 800 ml dignified indiv
B. 1,080 ml D. 280 ml D. Hospice care c
hopeless cases
159. The scrub nurse and the circulating nurse must be conscious
of the serious complications that result from poor aseptic 162. Mrs. Lally, a 6
technique. The scrub nurse has to unwrap a sterile linen pack on 4 cancer of the b
the back table in preparation for an exploratory laparotomy. spine and lungs. S
Which of the following is the CORRECT technique of unwrapping activities of dail
the sterile linen pack? are assigned to t
A. Unfold layers gently towards the other side of the table. questions regardin
B. Handle only the edge of the linen. much knowledge sh
C. Place the sterile linen pack on the edge of the table close client’s needs and
to the person opening the pack. plan of care shoul
D. Layers are always pulled away from the person opening the A. Continuous asse
pack. comfortable
B. Providing suppo
160. The circulating nurses are aware that many factors combine to C. Ensuring her t
contribute hypothermia or hyperthermia in the surgical patients. nutrition
Below are options that the perioperative nurse can adopt to D. Assessing the c
maintain the desired temperature. Select all that apply: about dying
1. Adjusting the OR suite temperature
2. Limiting area of skin preparation and surface surgical 163. It is the fir
draping Psychiatry Ward.
3. Applying warm blankets to clients upon arrival in the OR the responsibility
and after sterile drapes have been removed to safeguard patie
 people not authorized to read it. The MOST significant events 167. Panic disorde
the nurse records regarding psychosocial well- being are: recurring severe p
A. The patient’s sleeping, eating and elimination patterns behavioral change
B. The behavior patterns and interpersonal interactions of the about the implicat
client graduating nursing
C. Somatic treatments, medications and their effects disorder. During h
D. Signs and symptoms and physical appearance statements about p
A. Common symp
164. Mr. Shaggy, a 78 year old male was admitted to the hospital heartbeat, pers
to rule out any injury that may have resulted from a fall while uncontrollable
going up the stairs of his home. He has no recollection of what going crazy, th
caused him to fall. While in the hospital, Mr. Shaggy exhibited B. Symptoms are s
mental status changes including disorientation and confusion. choking, chest
Which of these questions would the nurse ask to gather data about hot flashes, fa
Mr. Shaggy’s orientation status? C. The person usua
A. Ask client the brothers’ and sisters’ names, children’s and are predictable
grandchildren’s names. D. Panic attacks u
B. Ask the client to repeat 6 to 7 digits forward
C. Ask the client’s name, address, current location, date, time 168. Rihanna was a
and year father would always
D. Name 3 objects (e.g., table spoon, shirt) and have client As an effect of th
repeat the three objects. Ask client to repeat them again for weeks, inabili
after 5 minutes. for more than a mo
A. Anxiety disorde
165. Nicki Minatch is a 28 year old, female patient admitted to B. Adjustment diso
the psychiatry unit with a diagnosis of chronic undifferentiated
schizophrenia. She described herself as “Binibining Pilipinas 169. Lady Gagaugh w
Universe” and her mission is to represent the country and be an following are effe
ambassador of good will for the Filipino people. She was observed A. Akathisia
to be talking a lot and laughing by herself. Her thoughts were B. Pseudoparkinso
incoherent and disorganized. She was also aloof in relating with C. Control of affe
others. Nicki Minatch’s claim of being “Binibining Pilipinas D. Voices decrease
Universe” is a/an:
A. Delusion C. Obsession 170. Lithium has lon
B. Imagination D. Illusion the manic phase of
is prescribed 600m
166. Symptoms can vary, depending on the type of schizophrenia. times per day. Th
The __________subtype of schizophrenia often characterized by a (Haldol) P.O. at be
childlike “silliness” and is generally characterized with poor meq/L. Which actio
prognosis, whereas the __________ subtype is the most common A. Administer the
subtype and is generally associated with better prognosis. B. Question the ph
A. Undifferentiated; catatonic C. Disorganized; paranoid C. Administer the
B. Catatonic; paranoid D. Catatonic; disorganized D. Consult with th
medications
171. Nurse Detty is a young promising nurse who chose to start a 175. The therapeutic
professional career as a mental health psychiatric nurse. Part and maintained as a
of her orientation and training as a beginning professional nurse clients. Milieu t
is enhancing facilitative personal characteristics. Lorenzo is a interactions. Nurs
new client of Nurse Detty. He offers Detty a gift. Nurse Detty client. As part of
responds therapeutically by: to do which of the
A. Clarifying client’s intent, “I wonder why you are offering me A. Express feeling
a gift.” B. Vote on policie
B. Reacting emphatically, “No, it is unethical to receive gifts C. Revise rules ac
from clients.” D. Select daily sc
C. Citing a hospital policy, “It is against hospital policies.”
D. Accepting with an acknowledgement, “I feel uncomfortable 176. Chronic schizo
doing this but I don’t want to disappoint you. “ help behaviors by
are used to presen
172. Exhibitionism is the exposure of genitals to unsuspecting an intervention us
strangers. Victims are usually women or children. The nurse on A. Social therapy
duty sees a patient masturbating along the hallway of the B. Relationship th
hospital. Which of the following statements by the nurse is
appropriate?
A. “That is not acceptable here, go inside your room.”
B. “Why are you doing that here?”
C. “You are not allowed to do that.”
D. “Do you feel good everytime you do that?”
177. Billy, 1 year o
173. The nurse works in a half-way house where children at risk room status: post
are taken care of. The following situations are encountered. At of the following p
night when the children were being prepared to go to sleep, the
nurse heard from a frightened child, “Ayaw ko matulog mag-isa. A. Lateral
May multo!” ( I don’t want to sleep alone. There’s a ghost!”. B. Fowler’s
The nurse assesses this behavior as need for:
A. Biological integrity C. Safety & security 178. One early morni
B. Love and belongingness D. Trust 5-year old boy was
a bottle of baby
174. It is believed that human intelligence progresses signs and symptoms
through a series of stages based on age with the child at A. Tinnitus and ga
each successive stage demonstrating a higher level of B. Dysrhythmia and
functioning than at previous stages. In the developmental C. Nausea and vert
theories, Four year old Jelly belongs to what stages of
D. Epistaxis and p
development?
1. phallic 3. sensory motor
2. latency 4. Preoperational 179. The three gener
except:
A. 1,3 B. 1,4 C. 2,3 D. 2,4 A. Assess
B. Classify
180. If dehydration is present and if diarrhea is 14 days or more,
the treatment protocol includes the following, except: 185. Gerry, who is
A. Treat dehydration before referral unless the child has why you are weari
another severe classification drugs to him. What
B. Give vitamin A A. “These clothing
C. Refer to hospital drugs through t
D. Give co-trimoxazole or Nalidixic acid for 5 days B. “I am preventin
other clients.”
181. John Paul has a venous access device such as an external C. “Our hospital
central venous catheter. The nurse recognizes that the tip of drugs should we
the catheter is found in which of the following? D. “These protecti
A. Superior vena cava C. Subclavian vein infection comin
B. Jugular vein D. Antecubital vein
186. Nessy, a staf
182. During the physical examination of Anna, you palpated the PMI pediatric oncolo
(point of maximum impulse) in the 5th intercostal space lateral instruction to mot
to the midclavicular line. Which of the following is the MOST Which of the foll
appropriate action for you to do? interfered with Fo
A. Assess Ana for symptoms of left ventricular hypertrophy A. Vincristine
B. Ask Anna about risk factors for coronary artery disease B. Prednisone
C. Auscultate both the carotid arteries for a bruit
D. Document that the PMI is in the normal location 187. You are called
in pain and with s
183. Brenda, 30 years old, was brought to the Emergency Department A. Administer the
(ED) with nausea, confusion, dehydration and oliguria. Her B. Remove the stin
mother informs you that Brenda has been depressed after losing C. Administer Tyle
her job as a bank executive. An empty bottle of aspirin was D. Apply ice to th
found in her bathroom sink. Her laboratory values revealed the
following: pH= 7.35, PaCO2= 16 mmHg, PaO2= 130 mmHg, and HCO3 = 188. Anthony, 20 y
15 mEq/L. What is the correct acid base interpretation of her admitted to the ED
ABG? 30 Diazepam (vali
A. Partially compensated respiratory acidosis lavage. As a nur
B. Uncompensated metabolic acidosis order is to:
C. Partially compensated metabolic acidosis A. Insert a large—
D. Compensated metabolic acidosis B. Position Anthon
C. Assist the phys
184. Which of the following conditions may cause metabolic D. Prepare a 50 mL
acidosis due to a decrease in bicarbonate level?
1. Loss of gastric fluids from vomiting or nasogastric suction 189. You set the go
2. Loss of body fluids from drains below the umbilicus pattern that maxim
3. Gastrointestinal fistulas lungs,” From the f
4. Aspirin ingestion consider as most a
A. Administer oxyg
A. 3 and 4 C. 1 and 4 B. Maintain on ort
B. 1 and 2 D. 2 and 3 C. Auscultate for
 D. Monitor oxygenation status 2. Reticulocyte
3. Hemoglobin
190. You are assigned one new nurse to work with during the shift. 4. Hematocrit
An admission from the Post Anesthesia Care Unit (PACU) of a 5. Hemoglobin
post-thoracostomy with the wedge resection with a chest tube 6. Hematocrit
came in and you assigned the nurse to do initial assessment.
Which assessment if observed will you report to the surgeon A. 1, 2, 3, 6
right away? B. 1, 3, 5, 6
A. 80 mL of dark red output from the drainage
B. Intermittent bubbling in the suction control 194. Karen, 35 year-
C. Intact and dry dressings with pernicious a
D. The drainage system is hanged at the bed side below the in the stomach. Yo
client’s chest which of the follo
A. Monthly intram
191. Kristine is working in the Cardiac unit with a nurse lifetime
“floater”. Together they made their round while Kristine B. Temporary injec
assessed the nurse’s knowledge on the commonly used cardiac C. Lifelong admini
drugs. Kristine asked the “floater” why nitroglycerine is given D. Temporary oral
to a client with angina. The CORRECT response of the nurse is
that: Nitroglycerine 195. You are caring
A. increases preload because of severe
B. increases afterload jaundice. Laborato
C. dilates the veins platelet count. M
D. constricts the arteries Admitting diagnos
shifting dullness
192. While doing assessment on Grace, who has heart failure, you positive for ascit
note that she has jugular venous distention (JVD) when lying A. The level of d
flat in bed. Your next action will be to: recumbent posit
A. Palpate the jugular veins and compare the volume and pressure B. The borders be
on both sides constant despit
B. Use a centimeter ruler to measure and document accurately the C. With Arsenio o
level of the JVD dullness increa
C. Elevate Grace gradually to an upright position and continue to the left low
to examine the JVD D. With Arsenio on
D. Ask her to perform the valsalva maneuver and observe the left lower qua
jugular veins upper quadrant.

193. A nurse admitted a 20 year old college student. Her chief 196. Ginger, 45 year
complaints are fatigue, weakness and sometimes dizziness. The admitted to the P
patient is pale. The admitting diagnosis is iron deficiency gastrectromy and
anemia. The nurse prepared the client for complete blood count patient responds
(CBC) testing. The complete blood count is normal if the result nurse identified
is: patient starts to
1. Red blood cells - 3.6 to 5.0 million / mm3 symptoms should t
stimulation?
 A. Nausea and vomiting epigastric pain, borborygmus C. Rock back and f
B. Tachycardia, diaphoresis, hypoglycemia D. Buy clothes wit
C. Abdominal cramping, light headedness, confusion
D. Orthostatic hypotension, dizziness, palpitations 201. Conrado sought
Nurse Karmela was
197. Arnel, 58 years old, post total thyroidectomy with modified attack, the pain
neck dissection due to papillary carcinoma of the thyroid gland even the weight
with lymph node metastasis was admitted for radioactive iodine appropriate nursin
therapy. Prior to admission, the client underwent a scan with a A. apply splint on
test amount of active radioactive iodine. If you were the nurse B. place a foot cr
who admitted the client, which of the following will you consider C. elevate the aff
as the reason for this intervention? D. apply bandage a
A. To determine existence of known distant metastatic tumor
B. To measure size of remaining thyroid tissue
C. To explore the operative site for baseline data
D. To mark the site where the radioactive iodine will be
administered

198. The nurse is assigned to admit a 27 year old female patient

with protruding eyeballs and an enlarged neck. Physician’s
diagnosis is Grave’s disease. Following thyroidectomy, the nurse
notes the very weak and hoarse voice of the client. Which nursing
intervention is most appropriate at this time?
A. Caution the client not to force herself talk.
B. Notify the surgeon immediately.
C. Reassure the client that this is usually a temporary
condition.
D. Offer the client warm NSS gargle.

199. Related literature claims that carotid massage is indicated

for supraventricular tachycardia. The nurse recognizes that such
intervention may terminate SVT through stimulation of which of
the following cranial nerves?
A. Cranial nerve X
B. Cranial nerve XII
C. Cranial nerve XI
D. Cranial nerve IX

200. The nurse has given instructions to the client with

Parkinson’s disease about maintaining mobility. He determines
that the client understands the directions if the client states
the he or she will:
A. Sit in soft, deep chairs
B. Exercise in the evening to combat fatigue