“Victory belongs to those who are most persevering.

Ad Majorem Dei
Gloriam.”

Bullets
FOCUS: Glaucoma 5. A client taking synthroid develops cold 5.How many centimeters is the distance
1. A client received mydriatic drug, intolerance, constipation, dry skin, weight gain, between injection site?
Phenylephrine, for an eye examination, this and puffy eyes. The nurse will expect which *2.5 cm
causes: change in prescription?
* Pupil dilation *Increase in dosage after checking the level of 6. Not a symptom of hypoglycemia:
thyroxine *Warm flush dry skin
2. After the administration of a mydriatic drug,
the client experienced eye pain, blurring vision, 6. Expected to note in the assessment of goiter 7. The following are characteristic of NIDDM
nausea and vomiting. A diagnosis of glaucoma *Enlarged thyroid gland except:
has been made. This glaucoma is caused by: * Absolute deficiency of insulin
*Blockage of outflow of aqueous humor 7. Goiter is usually due to the deficiency of
which of the following? 8. Polyphagia is due to:
3. Tonometer reading indicative of glaucoma? *Iodine *Tissue breakdown causes state of starvation
*> 21 mmHg normal IOP: 10-21 mm Hg
8. After thyroidectomy, Calcium gluconate is 9. Polydypsia is due to:
4. Sign of glaucoma: prescribed to treat: *Excess fluid loss due to polyuria
*Halos around lights, dilated and fixed pupil, *Hypocalcemic tetany
peripheral vision loss 10. The chief life threatening hazard for surgical
9. In a client diagnosed with myxedema, the patient with uncontrolled diabetes is:
5. Which of the following drug is classified as nurse will expect which of the following? *Dehydration
mydriatic and thus contraindicated in *Dry skin
glaucoma? 11. Polyuria is due to:
*Atropine Sulfate 10. Upon assessment of a client with *Excessive glucose causes osmotic diuresis
hyperthyroidism, the nurse will expect to see:
6. Rationale for using miotics: *Bulging of eye ball / Exophthalmos 12. Fluid shifting in clients with DM:
*Pupil constriction increases aquaeous humor *Intracellular going to
outflow / drainage 11. After thyroidectomy, the nurse is intravascular/interstitial/extracellular due to
monitoring signs of hypocalcemia and takes hyper osmolarity
7. When instilling an eye medication, the nurse note of which of the following earliest sign of
will: hypocalcemia: 13. Acid base disturbance in DM:
*Place the medication at the middle lower *Tingling around the mouth and fingers *Metabolic Acidosis
eyelid and press the nasolacrimal duct
12. Thyroidectomy 3rd day, the nurse notes the 13. A client with DKA will develop which form
8. Glaucoma is usually due to: development of tremors and checked for? of respiration:
*Increase production of aqueous humor *Calcium level *Kussmaul’s respiration

9. Acetazolamide/Carbonic anhydrase inhibitor 13. After thyroidectomy, which will concern the FOCUS: Pancreatitis
is given to: nurse? 1. In acute pancreatitis, patient understood
*Decrease aqueous humor production *Noisy respiration (stridor) instruction when she said what position that
would decrease pain?
10. Population prone to glaucoma: 14. Prior to thyroidectomy, it is very important *Supine while drawing the legs up to the chest
*Diabetic and Hypertensives to teach the client to:
*Support the head and neck 2. Which position would increase the pain in
FOCUS: Hyperthyroidism / Hypothyroidism pancreatitis?
1. A client is taking PTU/ Metimazole should be 15. Teaching has been successful in head and *Lying flat
monitored for: neck support when:
* Signs and symptoms of hypothyroidism *He raises his elbow and places the hands 3. Acute pancreatitis dietary instruction:
behind the neck *NPO
2. Levothyroxine Sodium (Synthroid) 0.15mg
orally was administered, the nurse will make FOCUS: Insulin and Diabetes 4. Assessment on a client with acute
sure that the drug is administered: 1.Reason for rotation insulin injection: pancreatitis:
*In the morning to prevent Insomia *Prevent lipodystrophy that causes erratic level * Steatorrhea, fever and elevated serum
of insulin amylase
3. In a client with hyperthyroidism, the nurse 2. Regular insulin administered at 7 am,
will include which of the following in the plan of hypoglycemia can occur at: 5. Food that the nurse instructs to avoid in a
care? *11 am before lunch client recovering from pancreatitis:
*Provide a restful environment *Spicy food
3. Insulin vial in used is stored at:
4. After thyroidectomy, the client develops *Room temperature 6. Type of pain in pancreatitis
voice hoarness and weakness of the voice the *Visceral pain-pain felt at the internal organs
nurse would: 4. Fastest absorption in insulin occurs in the:
* Reassure the client that this is normal and *Abdomen 7. Best description of pain associated with
temporary acute pancreatitis:
*Epigastric pain radiating at the back

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FINALE BULLETS - Sir Melted Sales
 6. Diet for Dumping Syndrome:
FOCUS: Cholecystitis *Small meal, low in carbohydrate and fats FOCUS: Anesthesia

1. Cholecystitis: severe abdominal pain, 7. Peptic ulcer disease, possible contributory 1. IV and inhalation anesthesia are types of:
extreme nausea and vomiting the priority factors: *General anesthesia
nursing diagnosis is: *smoke 2 packs of cigarette a day
*Pain related to gallbladder inflammation 2. In bone marrow biopsy, Tetracaine, cocaine
2. Highest priority for a client with cholecystitis: 8. Upper GI series preparation and epinephrine as an EMLA are given:
*Administer pain medication *Keep NPO for 10 hours *Topically

3. Characteristic of pain in Cholecystitis: 9. Andy with PUD, vomits moderate amount of 3. Most common side effect of epidural and
*Right upper quadrant pain radiating to right blood. Nursing intervention is to: spinal anesthesia is:
scapula and shoulder *Place andy in a side lying position *Hypotension

4. Diet for client’s with cholecystitis: 10. Nutritional measure to decrease acid 4. Spinal anesthesia is also known as:
*Low fat diet secretion is to: * Subarachnoid block
*Limit alcohol consumption
5. Drug given to a client with cholecystitis to 5. Priority nursing diagnosis in a client after
decrease spasm: FOCUS: Deep Vein Thrombosis/ general anesthesia:
*Probanthine Thrombophlebitis * Ineffective airway clearance

6. Probantine side effect: 1. Assessment finding for DVT includes: FOCUS: Colon Cancer
*Urinary retention *A red and tender painful area on the leg
1. What is the cause of colon cancer?
7. If gallstone is lodge in the common bile duct 2. Nursing intervention includes: *Unknown
the color of the stool is: *Elevate the leg and do not massage
*Gray/pale/clay 2. Risk factor for colon cancer includes:
3. To prevent thrombophlebitis you need to *Increasing age, family history, Inflammatory
8. Purpose of T-Tube after cholecystectomy: encourage Mrs Sison to: Bowel Disease (IBD) breast cancer
* To drain bile from common bile duct *Ambulate early
3. Diet associated with colon cancer:
9. A client is scheduled for cholecystogram, 4. Drug of choice for DVT in a pregnant client: *High fat, high protein, low fiber
your instruction to the client the evening *Heparin
before the test is: 4. Symptoms of colon cancer includes:
*Low fat diet 5. Which of the following is a predisposing *Melena (black tarry stool)
factor in the development of DVT?
10. Highest priority in preop teaching plan of *Immobility 5. Diagnostic examination that is best to predict
client that will undergo cholecystectomy: prognosis:
*Coughing and deep breathing exercise FOCUS: Renal Failure *Carcino Embryonic Antigen (CEA)

FOCUS: Hepatitis B 1.Oliguria is defined as: 6. Screening for colon cancer:

*Urine output of less 400ml in 24 hrs *Digital rectal Exam (DRE)
1. Hepatitis B safety when obtaining a blood
specimen: 2. In a client with renal failure, hypertonic 7. Diagnostic for colon cancer
*Wear clean gloves glucose and insulin administration is used to * Proctosigmoidoscopy
treat:
2. Hepatitis B is spread by: *Hyperkalemia 8. Colostomy begins to function:
*Contaminated needles * 3rd to 6th days after operation
3. ECG tracing suggestive of hyperkalemia:
3. Hepatitis B vaccine produces: *Tall T-wave 9. 24 hours after colostomy stool does not
*Artificial active immunity drain:
4. In a client with chronic renal failure with AV *Normal due to absence of motility
4. Teaching plan for a client with Hepatitis B. shunt, you need to avoid using the arm for BP
*Avoid sexual intercourse monitoring and instruct the client to have a diet 10. NGT after colostomy is necessary for:
that is: *Prevent abdominal distention/ for
5. Correct understanding in acquiring hepatitis *Low salt decompression
B:
*I had hemodialysis because of kidney problem, 5. You advised to limit the use of salt substitute FOCUS: Colostomy
now I have this problem because:
*Salt substitute contain potassium and might 1. Which of the following best describe
FOCUS: Peptic Ulcer Disease lead cardiac arrhythmia colostomy?
* Cutting the colon and bringing the proximal
1.Peptic ulcer pain assessment: 6. In renal failure, if the drugs are ineffective in end through the abdominal wall
*Gnawing epigastric pain radiating to shoulder lowering the serum potassium level. The nurse
expects administration of: 2. In colostomy, further education is necessary
2. Duodenal ulcer pain LEAST likely: *Calcium gluconate when the client states:
*Epigastric pain during meal *I should wear the bag at all time
7. Prior to IVP, in order to provide good
3. A client with peptic ulcer vomits the visualization of the urinary tract, what 3. Successful adaptation to the stoma is seen
undigested antacid, absence of bowel sounds: procedure is performed? when:
*Place the client on NPO and prepare for *Cleansing enema *The patient start looking at the stoma
surgery
8. In IVP, an important information that the 4. Best method to assess for the client’s ability
4. Anastomosis of the gastric stump to the nurse obtain is: to perform colostomy care:
duodenum was performed (Billroth 1) Dumping *Allergy to iodine/shellfish *Have the client demonstrate colostomy care
Syndrome is caused by: before discharge
*Rapid passage of hyperosmolar food into the 9. Post IVP you should instruct the client to
small intestine enhance the elimination of the dye by: 5. Diet for colostomy clients:
*Increasing fluid intake *Anything he ate before operation while
5. Diet instruction to clients with Billroth 1 avoiding gas forming food
except: 10. Priority monitoring after IVP:
*Take a glass of water with meals *Signs and symptoms of delayed allergic FOCUS: Colostomy Irrigation
reaction 1. Normal characteristic of the stoma:

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*Red moist slightly protruding and might bleed 4. The nurse makes sure that immediately after
when touch 1. Initial nursing goal to a client with blood administration:
Myasthenia gravis: *Administer the blood slowly for 15 minutes
2. When to irrigate colostomy? *Maintain muscle strength
*When stool become formed at around 7th post 5. The nurse noticed transfusion reaction:
op day 2. MG alteration in: * Stop the infusion, infuse the NSS, call the
*Respiratory exchange and swallowing physician, notify the blood bank.
3. During colostomy irrigation, client complains
of cramps: 3. Pyridostigmine bromide started: priority FOCUS: Blood Pressure Monitoring
*Pinch the tubing temporarily nursing assessment:
4. Best position to perform colostomy *Evaluate muscle strength hourly 1. Before measuring the client’s blood pressure,
irrigation: 4. Priority nursing diagnosis for MG: it is necessary for the nurse to wait for:
*Sitting at the toilet *Ineffective breathing pattern *30 minutes

5. Need to report to the physician if: FOCUS: Prof Ad 2. The nurse knows that she should pump the
*Difficulty on inserting the tube cuff above:
1. Part of the patient’s bill of right: *30 mmHg base on palpatory systolic BP
FOCUS: Thoracentesis * Patient has the right to be informed of
hospital policies. 3. In reassessing the client for BP
1. Thoracentesis is best defined as: measurement, the nurse will wait:
*Aspiration of fluid, pus/air from the pleura 2. Signing of informed consent/ Advance *1 to 2 minutes
directive respect the ethical principle of:
2. Position of the client prior to thoracentesis *Autonomy 4. If the nurse will use a standard size cuff in an
EXCEPT: obese client or if the cuff is too narrow, it will to
*Side lying position on the affected side 3. Law that regulates the nursing profession: a reading that is:
*RA 9173 *false high reading
3. During thoracentesis, the nurse’s most
important responsibility is to: 4. Primary purpose of licensure exam: 5. If the client’s arm is elevated, the reading will
*Tell the client to sit still and avoid sudden *Protect the health of the public be:
movement *false low reading
5. Virtue Ethics: Raising the side rails of a
4. After thoracentesis, the best position is: confused elderly client: FOCUS: Pattern of Nursing Care
*Side lying on the unaffected side to prevent *Prudence
pleural leakage 1.24 hour nursing care from admission to
6. Explanation of findings of the physician about discharge:
5. Chest X-ray after thoracentesis is performed the illness is: *Primary nursing
to: *Veracity
*To rule out pneumothorax 2. Task oriented nursing care/ best used when
7. Code of ethics is implemented by the BON, there are many patients and few nurses/ best
FOCUS: Urine Specimen Collection which is not true? used when there is storm and only staff arrived:
*Personal standard of what is right/wrong *Functional nursing
1. Technique used for collecting urine
specimen: 8. Safe nursing practice requires: 3. One on One nursing care:
*Sterile technique * Professional competence *Case nursing

2. How will the nurse collect urine from the 9. A natural born Filipino citizen is: 4. Main advantage of primary nursing:
client without catheter? * Filipino citizen since birth *Holistic approach - provides continuity of care
*Clean catch midstream urine collection
10. Jus soli: 5. Number of patient for primary nursing:
3. How will the nurse collect urine from a client * Birth place determines the citizenship * 3 to 4 patients
with catheter?
*Insert a sterile needle with a syringe to the 11. Jus Sanguinis: 6. Needed for quality control and leadership in
port and aspirate the urine *Citizenship of parents determines citizenship the whole hospital:
*Chief Nurse/ Nursing Service Department
4. In 24 urine collection: 12. Which leadership style is best used by the
*Discard the first voided urine nurse to achieve the agencies goal? 7. Needed for quality control in the whole unit:
*Democratic *Nurse Supervisor
5. Urine specimen should be brought to the
laboratory immediately within: 13. A fellow worker is obviously drunk, the 8. Needed for quality and leadership in the
*30 minutes nurse would: ward:
*Have the nurse supervisor validate the *Head nurse
FOCUS: Huntington’s Disease observation.
9. Role of associate (secondary) nurse in
1.Huntington’s disease, formerly known as 14. A positive or negative feeling about a primary nursing:
Huntinton’s chorea is due to: person, object or ideas: * Takes care of client when primary nurse is off
*Genetics *Attitude duty

2. The onset is: 15. An enduring belief, attitude or ideal about a 10. Group of nurses is lead by a team leader
*30 to 50 years old worth of a persons, object or ideas: that organizes care for a client is known as:
*Values *Team nursing (8-12 pts)
3. Initial sign of Huntington’s disease is:
*Disturbance of gate and slurred speech FOCUS: Blood transfusion FOCUS: Organic Brain Syndrome, Dementia
1. First step before administering the blood: and Delirium
4. Nursing intervention during the first stage of * Verify physician order.
Huntintong’s disease is: 1.Primary problem in Dementia:
*Physical care and hygiene, keeping airway 2. Upon receiving from the blood bank the *Cognition
patent and adequate nutrition nurse will administer the blood within:
*30 minutes 2. Hallmark symptom of dementia:
5. Common complication associated with *Short term and long term memory loss
huntington’s disease is: 3. Maximum time of infusing the blood:
*Heart and pulmonary *4 hours 3. Delirium is similar to dementia in terms of:
*Short term memory loss
FOCUS: Myasthenia Gravis

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4. Priority nursing diagnosis in a client with *Drug compliance
dementia: 9. Appropriate nursing attitude in a substance
*Risk for injury abuse client: 10. Lithium is taken as:
*Firm and directive *Lifetime regimen
5. Drug used for clients with dementia to
improve cognition: FOCUS: Heroin addiction ( Also applicable to FOCUS: Anorexia Nervosa
*Donepezil (Aricept) Morphine/Demerol/Codeine)
1. Anorexia nervosa is characterized by a
6. Defense mechanism seen in Alzheimer’s 1. The nurse is most concerned in which of the chronic:
client to fill in memory gaps: following in heroine overdose? *Low self esteem
*Confabulation *Respiratory rate of 8
2. If an anorexic client becomes manipulative,
7. Dementia differs from delirium in terms of: 2. The antidote for heroine overdose is: the nurse should:
*Chronicity and irreversibility *Narcan/Naloxone *Be consistent and set limits.

8. Most common type of dementia: 3. Late sign of heroin withdrawal is: 3. Fatal complication of anorexia nervosa is the
*Alzheimer *Diarrhea occurrences of:
*Arrhythmia
9. Which of the following is true with regards to 4. Early sign of Opiate withdrawal:
Alzheimer’s disease? *Yawning/Lacrimation 4. Electrolyte disturbance that is fatal in
* A risk factor is a family history of Alzheimer anorexia is:
5. A client is addicted to heroin. The nurse will *Hypokalemia
10. Difficulty using simple words seen in look for which of the following sign of heroin
Alzheimer’s: addiction? 5. Common premorbid personality of anorectic
*Aphasia *Hypoactivity and constricted pupil individual is:
*Perfectionist
11. Appropriate therapy for client’s with 6. Increasing dose of heroine to achieve the
Alzheimer’s: same desired effect: 6. Anorexic client doing rigid exercise and push-
*Reminiscence *Tolerance ups, the nurse would:
* Interrupt the client and offer to take her for a
12. Nursing intervention during reminiscence: 7. Expected with a client with heroin addiction: walk.
*Encourage him to recall the past and listen *Decreased sex drive and decreased feeling of
with interest hunger 7. Psychomodality of choice in treatment of
anorexia nervosa:
13. Before planning care for client with 8. Opiates are the most common used by *Cognitive Behavioral therapy
Alzheimer’s you need to assess first: substance dependents because the individual:
*Extent of cognitive impairment *Attempts to blur reality and reduces stress 8. The dominant part of the structure of the
mind of clients with anorexia nervosa is:
14. Biochemical theory of dementia, 9. An impaired nurse returned after 3 months *Super ego (conscience, morality)
Alzheimer’s: of rehabilitation, as a nurse manager you will
*Decreased acetylcholine make sure that: 9. The environment in which rigid toilet training
*The nurse is assigned only to administer non is emphasized will produce a personality that is:
15. Pharmacology of Tacrine (Cognex) and narcotic medication *Anal Retentive
Donepezil (Aricept)
*Inhibit cholinesterase, thus increasing 10. An impaired nurse who craves for an 10. The priority of the nurse in clients with
acetylcholine intravenous administration of morphine is anorexia nervosa is:
experiencing: *Restoring fluids and electrolyte disturbance
FOCUS: Alcoholism * Recidivism (constant craving after
rehabilitation) 11. Management of clients with anorexia
1.Single most effective treatment in alcoholism nervosa includes:
is: FOCUS: Lithium *Stay with patient an hour after meals
*Alcoholic anonymous
1. Indicated for? 12. On admission, the nurse will expect which
2. Before being able to enter AA, the client *Mania of the following symptom:
must first: *Bradycardia, Hypotension
*Be aware of one’s problem and how it 2. Only acceptable route of administration:
negatively affect his life *Oral 13. Defense mechanism used by anorexic
clients/ An anorexia clients states “ Why am I
3. Characteristic of alcoholics according to 3. Therapeutic level of lithium : here? I don’t have any problem”:
psychosexual theory: *0.6-1.2 mEq/L *Denial
*Orally fixated
4. Specimen for checking the level of lithium: 14. A behavioral modification program was
4. The defense mechanism used by alcoholics *Blood instituted for a client with anorexia, the nurse
when they under-report the amount of alcohol knows that which of the following is a
consumed is: 5. Side effect of Lithium: characteristic of this therapy:
*Denial *Large output of diluted urine *Increasing phone calls for each pound gain,
keep positive reward for gaining weight
5. Thiamine is prescribed in an alcoholic client 6. Thorazine is given with lithium. Thorazine is
to prevent: given: 15. The treatment plan for anorexic clients
*Wernicke’s and korsakoff syndrome *Because it has an immediate effect should be characterized by what approach?
*Consistency
6. After 48 hours of alcohol withdrawal, the 7. She takes lithium, which would require
client states: You are all monsters! The nurse further teaching by the nurse?
considers this as an? *I will need to decrease my sodium intake
*Illusion
8. After 2 weeks of lithium therapy the patients
7. The nurse knows that the drug of choice use says, “I realize I hurt you when I pushed you to
in alcohol withdrawal is? the ER unit during admission.”
*Librium *”You feel sorry after what happen 2 weeks
ago?”
8. In alcohol aversion therapy, which of the
following drug is prescribed? 9. Important teaching in a psychiatric client
* Antabuse/Disulfiram during discharge:

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  Loop 29. During enema, the client
 Divided complained of cramping and pain.
 Double barreled This is the best nursing action:
 Stop the enema temporarily,
15. This type of colostomy is commonly continue when cramping
performed during emergency subsides
situations and usually situated in the
right transverse colon: 30. It is a sign that the client is
 Loop experiencing adverse effect of
enema:
16. It is the type of temporary  The client said her legs are
colostomy is usually constructed if weak after an enema
fecal contamination of the distal end
of the colon needs to be avoided: 31. An ECG tracing that will validate the
FUNDAMENTALS OF NURSING  Divided presence of a dangerous
complication of enema will reveal:
BULLETS 17. This temporary colostomy is more  Depressed T wave
difficult to manage during utilization
1. The nurse asks client when she but easier to return to its normal 32. Measurement of the solution that is
should empty the colostomy bag. state: typically used for carminative
Teaching is effective if client replies:  Loop enema:
 “I should empty the bag when  60-80ml
it’s about 1/3 to ½ full or if 18. It is the best time to perform
there is a sensation of colostomy irrigation: 33. The most commonly used type of
pressure.”  In the morning after meals enema according to purpose is:
 Cleansing
2. How much skin should remain 19. To ensure one-way flow of solution
exposed between the stoma and the to the stoma and prevent back flow 34. This position is utilized in enema
ring of the appliance? of it, a nurse must utilize: administration:
 1/8” (3.17mm)  Cone  Left side lying

3. Normal color of stoma: 20. it is the frequency changing the 35. This type of enema according to
 Red colostomy pouch: purpose is used when using
 Twice a week medications such as antibiotic to the
4. Which of the following statement colon:
about stoma in the colostomy is 21. Purposes of colostomy appliance:  Retention
true?  Contain stool odor
 Slight bleeding initially when  Protect the skin from irritation 36. The following solutions may cause
the stoma is touched is normal  Collect stool distention of the colon:
 PNSS
5. Purpose/s of colostomy irrigation: 22. It is the ideal height of solution  Tap water
 To expel flatus during colostomy irrigation:  Soapsuds
 To regulate defecation  Level of the shoulder
 To remove feces 37. The safest solution for enema
23. Condition that if experienced by the administration:
6. You would know after teaching client must be reported immediately  Isotonic
Fermin that dietary instruction for by the doctor:
him is effective when he states “It is  Difficulty inserting the 38. Minutes needed for PNSS and tap
important that I eat: irrigating tube water to take effect during enema
 “Everything that I ate before administration:
the operation, while avoiding 24. You plan to teach Fermin how to  5-10 minutes
foods that produce gas.” irrigate colostomy when:
 The stool starts to become 39. This enema solution is the fastest to
7. This stoma can be used as an formed, around the 5th to 7th take effect:
alternative feeding route: postoperative day  Fleet enema
 Jejunostomy
25. When preparing to teach Fermin 40. Enema is contraindicated to all of
8. This type of colostomy can be how to irrigate colostomy, you the following except:
regulated and controlled empty: should plan to do the procedure:  Preoperative operation for APR
 Descending and sigmoid  When Fermin would have
normal bowel movement 41. It increases bulk of the stool:
9. This condition can be expected if a  Metamucil
patient has permanent colostomy: 26. It is the single most important
 Imperforate anus nursing intervention to prevent 42. stool lubricants:
constipation:  Mineral oil
10. This colostomy can be expected in  Increase fluid in the diet  Cottonseed oil
patients who underwent APR:  Olive oil
 Permanent colostomy 27. When collecting a stool specimen,
the nurse knows that she should 43. The nurse knows that the laxative
11. An ileostomy can be expected after: use: that is the longest to take effect is:
 Colectomy  Sterile technique  Emollients

12. Which of the following is true about 28. Enema is an introduction of a 44. Docusate sodium colace is an
ileostomy? solution to the client's rectum. The example:
 It produces liquid fecal most common solution used is tap  Emollients
drainage constantly water. You should be very careful in
performing frequent enema as it 45. This is where you can tape the
13. This describes transverse colostomy: could lead to: catheter in a male client to prevent
 produces a malodorous mushy  Hypokalemia tension and pressure in the male
drainage urethra:
 Upper thigh
14. Examples of temporary colostomy:

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46. For female clients:  Tip of the nose to the  Electronic infusion pump
 Inner thigh earlobe to the xiphoid
process 81. The IV route that must be used if
47. This is how the nurse should hold TPN is to be used for more than 1
the penis of a male client to prevent 63. Length that the nurse inserts the month:
erection during catheter insertion: NGT per swallow:  PICC
 Perpendicular  2-4 inches
82. Discharged home on total parenteral
48. Examples of clear liquid diet: 64. The name of the gastric, single- nutrition (TPN). With each visit, a
 Gelatin lumen tube used in gavage: home care nurse assesses:
 Honey  Levin’s tube  Temperature and weight
 Bouillon
65. During auscultation of air
49. Nutrients found in full liquid diet but insufflations, the nurse should not 83. The nurse plans to obtain the most
not in clear liquid: place the diaphragm of stethoscope essential pieces of equipment
 Fats on: before hanging the first bag of TPN
 Location of the appendix solution:
50. Diet indicated for patients who  Electronic infusion pump
cannot tolerate solid to semi-solid 66. The nurse should tape the NGT after  Glucometer
food: checking its proper placement on:  Thermometer
 Full liquid  Bridge of the nose
84. A home care nurse is monitoring a
51. The client has a prescribed of full 67. Instruction to the patient during client’s response to total parenteral
liquid diet. The personnel from the removal of NGT: nutrition (TPN). The client’s weight 1
dietary department brought the  Inhale and hold breath week ago was 114 lbs. the nurse
following food: cheese, gelatin, clear determines that the client is not
broth, soft boiled egg, vegetable 68. This position is not used in NGT gaining weight too rapidly if this
juice and pudding. The nurse must feeding: morning’s weight was:
remove:  30 degrees head of bed  116lbs
 Cheese elevation, left side
85. A nurse is assigned to a client
52. The most ideal diet: 69. The most dreaded or fatal receiving total parenteral nutrition
 Regular complication of NGT feeding: (TPN) who had a blood glucose
 Aspiration measurement done at 06:00. The
53. An unconscious client who ingested nurse documents on the client’s
30 lorazepam tablets is for NGT 70. The client has a residual volume of clinical worksheet for the day that
insertion. The nurse knows that this 200ml, during the next feeding the the blood glucose level should be
is for: nurse must: checked at:
 Lavage  Withhold the next  12:00
feeding and notify the
54. Medication that is not allowed to be ordering physician 86. A nurse monitors the client for
given via NGT: complications of the TPN therapy
 Enteric coated 71. The complication that may occur if and assesses the client for signs of
medication the residual volume is not returned hyperglycemia:
after measurement:  Weakness, thirst and increase
55. Medication that will not be  Metabolic alkalosis urine output
questioned if ordered to be given via
NGT: 72. The best way to check and maintain 87. At 8AM, a nurse checks the amount
 Granules patency of NGT: of solution left in a total parenteral
 Instill 30ml of PNSS nutrition (TPN) infusion bag for an
56. Ideal setting for gastric assigned client. It is a 3000-ml bag
decompression: 73. The ideal duration of NGT feeding: with 1000ml remaining. The solution
 Low, intermittent suction  30 minutes is running at a rate of 100ml/hr. The
bag was hung the previous day at
57. The purpose of NGT for patient with 74. Ideal height of feeding for gavage is: noon. The nurse plans to change the
GCS of 3:  1 foot infusion bag and tubing today at:
 Medication  NOON
administration and 75. The nurse must warm feeding at
gavage room temperature. Cold feeding 88. A nurse is changing the central line
may cause: dressing of a client receiving total
58. The best position for NGT insertion  Abdominal cramping parenteral nutrition (TPN). The
(head of bed elevation in degrees): nurse notes that the catheter
 90 76. After feeding the patient, the nurse insertion site appears reddened. The
must ensure to: nurse next assesses:
59. A nurse must ensure to insert the  Maintain patient in semi-  Client’s temperature
NGT in a nose with: fowler’s position for at
 Greater airflow least 30 minutes 89. A nurse is preparing to hang fat
emulsion solution. The nurse notes
60. The best way to check for the tube 77. 3 mainstay components of TPN: that fat globules are present at the
placement:  Glucose, amino acids and top of the solution. The nurse takes
 Roentgen procedure of emulsified fats the following action:
the abdomen  Obtains a different bottle of
78. True statement about TPN: solution
61. The indicator that the nurse must  The most dominant
already tilt the head and neck of the component of TPN 90. A client is being weaned from total
patient forward during NGT solution is glucose parenteral nutrition (TPN) and is
insertion: expected to begin taking solid food
 Gagging or retching 79. The best position for TPN insertion: today. The ongoing solution rate has
 Trendelenburg, left side been 100ml/hr. A nurse anticipates
62. The best way to determine length of that this order regarding TPN
NGT insertion: 80. The most essential component for solution will accompany the diet
TPN therapy: order:

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  Decrease TPN rate to 50ml/hr has a weight gain of 5 lb in 1 week.  1:30
The nurse next assesses the client to
91. A nurse is preparing to change the detect the presence of: 109. Associated with blood transfusion
total parenteral nutrition (TPN) bag  Crackles on auscultation of the therapy:
and tubing. The client’s central lungs  Calcium gluconate
venous line is located in the right  Desferal
subclavian vein. The nurse asks the 100. A nurse is caring for a restless client  Tylenol
client to do this during the tubing who is beginning nutritional therapy
change: with total parenteral nutrition (TPN). 110. Correct statement about blood
 Take a deep breath, hold it and The nurse should plan to ensure that components:
bear down this is done to prevent the client  PRBC is the most commonly
from injury: used blood components
92. A client total parenteral nutrition  Secure all connections in the
(TPN) infusing has disconnected the TPN tubings 111. An Rh positive patient means that
tubing from the central line the client’s:
catheter. The nurse assesses the 101. A nurse has just obtained a unit of  RBC contains antigen D
client and suspects an air embolism. blood from the blood bank to
The nurse should immediately place transfuse into a client as ordered. 112. A unit of packed RBC contains:
the client in this position: Before preparing the blood for  250 ml
 On the left side with the head blood transfusion, the nurse next
lower than the feet looks for this member of the health 113. The family is very worried about BT.
care team to assist in checking the Your most appropriate nursing
93. A nurse notes that the client with unit of blood: intervention would be:
TPN has an increased blood  Registered nurse  Talk to the client and family
pressure, bounding pulse, jugular and inquire on their fears
vein distention and crackles 102. A nurse has obtained a unit of blood about BT
bilaterally. The nurse interprets that from the blood bank and has
the client is experiencing this checked the blood bag properly with 114. The nurse understands the NSS is
complication of TPN therapy: another nurse. Just before beginning used to initiate the IV infusion rather
 Fluid overload the transfusion, the nurse assesses: than dextrose before BT to:
 Vitals signs  Prevent hemolysis
94. A client receiving TPN suddenly
spikes a fever. A nurse notifies the 103. In planning coverage for the client 115. The nurse stays and observe the
physician, and the physician initially assignment, the nurse asks if client closely after the start of BT for
orders that the solution and tubing another nurse will be available to possible transfusion reaction which
be changed. The nurse should do check on the other assigned clients includes the following except:
this with the discontinued materials: when the unit of blood is hung for:  Hypovolemic reaction
 Send them to the laboratory  15 minutes
for culture 116. After starting the BT, the nurse
104. A client has an order to receive should make sure that the blood is
95. A nurse enters the room of a client packed red blood cells. A nurse transfused to the patient how many
receiving total parenteral nutrition should obtain this intravenous (IV) hours after it has been started?
(TPN) and discovers that the solution from the IV storage area to  4 hours
electronic infusion pump has been hang with the blood product at the
shut off. After checking the line for client’s bedside:
patency and restarting the infusion,  PNSS
the nurse assesses the client for
signs and symptoms like: 105. A nurse is assigned to care for a
PSYCHIATRIC NURSING
 Weakness, shakiness, client who was just admitted to the BULLETS
diaphoresis and complaints of hospital for the treatment of iron
hunger overload. The nurse review’s
physician’s orders and anticipates 1. Literal meaning of the prefix
96. A nurse is making initial rounds at that the physician will prescribe this “PSYCHE”:
the beginning of the shift. The total medication to treat the iron  Mind
parenteral nutrition (TPN) bag of an overload: 2. PRIORITY in the practice of
assigned client is empty. The nurse  Deferoxamine (Desferal) psychiatry:
should hang this solution wich is  Safety
readily available on the nursing unit 106. A client with severe blood loss 3. Psychotherapeutic management in
until another TPN solution is mixed resulting from multiple trauma psychiatric nursing:
and delivered to the nursing unit: requires rapid transfusion of several  Milieu, NPR, medications
 10% dextrose in water units of blood. A nurse asks another 4. 6 elements of milieu therapy:
health team member to obtain this  Safety, structure, norms,
97. At the beginning of a shift a nurse device for use during the transfusion limit, balance,
assesses a client receiving total procedure to help reduce the risk of environmental setting
parenteral nutrition (TPN) with fat cardiac dysrrhythmias: 5. Most important element in milieu
emulsion piggybacked to the line.  Blood warming device therapy:
The nurse notes that the fat  Safety
emulsion tubing has a 0.22- 107. A nurse has just received a unit of 6. Relationship of nurse and patient:
micrometer filter. The nurse should: packed red blood cells from the  NPR
 Replace the tubing without a blood bank for transfusion to an 7. Relationship of doctor and patient:
filter assigned client. The nurse is careful  Psychotherapy
to select a tubing especially made 8. Verbalization of feeling is healing:
98. A nurse is monitoring the status of a for blood products knowing that this  Catharsis
client’s fat emulsion infusion. The tubing is manufactured with: 9. EXACT CAUSE of any mental
nurse notes that the infusion is 1  An in-line filter disorders :
hour left behind. The nurse should:  Unknown/multifactoral
 Ensure that the fat emulsion 108. A nurse is signing for a unit of PRBC 10. Characteristic of nurse during NPI :
solution rate is infusing at the at the hospital blood bank. After  Active listening
prescribed rate putting the pen down, the nurse 11. Type of question that must be
glance at the clock, which reads avoided because it will make the
99. A client receiving total parenteral 1:00. The nurse calculates that the question defensive
nutrition (TPN) in the home setting transfusion must be started by:  Why

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12. Norms of a nurse  THORAZINE 64. “All behaviors are learned.”
 Accepting, non- 39. Antipsychothics: Earliest EPSE (Behaviors can be changed from
judgmental, empathy,  Dystonia negative to positive)
consistency 40. Antipsychothics: Most fatal EPSE  Behavioral therapy
13. Most important norm a nurse  NMS 65. “All behaviors have meaning.” (To
 CONSISTENCY 41. Antipsychothics: Most common HELP FIND MEANING IN THE
14. Biologic theory: Increased serotonin EPSE BEHAVIOR)
and norepinephrine  Akathisia  Psychoanalysis
 Mania 42. Antipsychothics: Last to appear and 66. The primary focus of this therapy is
15. Biologic theory: Decreased serotonin permanent/irreversible EPSE the PAST (CHILDHOOD) and the
and norepinphrine  TD structures of personality of the
 Major depression 43. Antidepressants: First line of drug patient (ID EGO SUPEREGO)
16. Biologic theory: Schizophrenia for depression  Psychoanalysis
 Increased dopamine and  SSRI 67. Best therapy for phobia
serotonin 44. Antidepressants: Safest of all the  Systematic (Serial)
17. Biologic theory: Anxiety antidepressants desensitization
 Decreased GABA  SSRI 68. Best therapy for children
18. Biologic theory: Alzheimer’s disease 45. Antidepressants: Oldest  Play therapy
 Decreased acetylcholine antidepressant 69. Best therapy for decreased self-
19. Biologic theory: OCD  TCA esteem
 Decreased serotonin 46. Antidepressants: Antidepressant  Assertiveness training
20. Biologic theory: Eating disorders that has the most severe adverse 70. Best therapy for ASD/PTSD
 Decreased serotonin effect  Individual psychotherapy
21. Biologic theory: Substance related  MAOi or group therapy
disorders 47. Antimanic: DOC for Mania 71. Best therapy for Alzheimer’s disease
 Increased dopamine  Lithium  Reminiscence
22. Most common route of 48. Antimanic: DOC for pregnant manic 72. Therapy: “Here and now”
antipsychotics and reason client and patient with lithium  Gestalt therapy
 Oral; safer and less side allergy 73. Therapy: Standing up for your rights
and adverse effect  Tegretol while respecting the rights of others
23. Other names for antipsychotics 49. Antimanic: Therapeutic blood  Assertiveness
 Major tranquilizers, lithium level 74. Therapy: Utilization of Disulfiram
neuroleptics, ataractics,  0.6 – 1.2 mEqs/L (Antabuse) in alcoholism so that the
psychic energizers 50. Antimanic: Relationship of Sodium patient will refrain from drinking
24. Types of antipsychotics and lithium alcohol
 Typical, atypical, DSS  Inversely proportional  Aversion therapy
25. Route of DECANOATES 51. Antimanic: SSx of Lithium toxicity 75. Main indication of ECT
 IM  DVDMC diarrhea  Major depression
26. 3 types of antipsychotics by vomiting diaphoresis 76. Volts/length of application/duration
composition muscle weakness coarse of seizure in ECT
 Phenothiazines, hand tremors  70-150 volts/0.2-
butyrophenones, 52. Antimanic: Drugs that increase 8seconds/30-60seconds
synthetic lithium level 77. Preparation of ECT is same with
27. Antipsychothics: fever plus sore  Lasix diuril  General anesthesia
throat 53. Antimanic: Drugs that decrease 78. Drug not used prior to ECT
 Agranulocytosis lithium level  Antiseizures like valium
28. Antipsychothics: fever plus muscle  Urea, mannitol, 79. Exact MOA of ECT
rigidity aminophylline diamox  Unknown
 NMS 54. Antimanic: Lithium determination 80. Is ECT contraindicated for pregnant
29. Antipsychothics: jaundice  Weekly; blood extraction woman?
 Hepatotoxicity done 8-12 hours after the  NO
30. 2 danger signs of antipsychotics last lithium intake 1. The nurse demonstrates ethics of
 Fever and jaundice 55. Anxiolytics: Antidote for OD/toxicity care when she plays the role of a
31. Antipsychothics: “Involuntary  FLumazenil (Romazicon)  Client’s advocate
movements” 56. Anxiolytics: Most dreaded and fatal
 EPSE complication 2. A delusional patient said, “I have no
32. Give 5 examples of anticholinergic  Respiratory depression head, no stomach.” The nurse would
side effects 57. Anxiolytics: Technique wherein a record this in this part of the mental
 CANT: sweat, see, spit, drug is gradually reduced before status:
shit, shoot stopping it to prevent  Content of thought
33. Medications to manage EPSE and  Tapering (10%/day)
examples 58. Anticholinesterase: MOA of 3. For proper documentation and
 Anticholinergics: artane, anticholinesterase accountability of all entries to the
akineton, Benadryl,  Increases acetylcholine client’s chart, it is important for the
cogentin 59. Anticholinesterase: Former DOC; nurse to inspect that:
34. Antipsychothics: management for changed because it is teratogenic  All notes must have signature
the teratogenic and amenorrhea  Tacrine (Cognex) and title of person making
effect 60. Anticholinesterase: DOC for entry
 Family planning – Alzheimer’s disease (dementia)
abstinence patients; Given OD PO HS 4. Facts about Processing Recording:
35. Antipsychothics: medication  Donepezil (Aricept)  It provides data from which
commonly causing agranulocytosis 61. 2 subdivisions of biologic/medical nurses can assess their own
 CLOZARIL therapy behavior in interactions with
36. Antipsychothics: medication  Psychopharmacology and clients
commonly causing NMS somatic therapy  It is a tool for assessing nurse-
 HALDOL 62. Therapy: Goal is to modify negative client interactions
37. Antipsychothics: medication views, thinking, cognition, thoughts,  It acquaints the student/nurse
commonly causing increased ideas with rudimentary applied
prolactin  Cognitive therapy research skills
 RISPERDAL 63. “What you believe, you will
38. Antipsychothics: medication achieve.” 5. Data: Client is pacing, crying, waving
commonly causing sunburn  Cognitive therapy his hands, yelling at nursing staff and

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 other patients. In the problem- intolerable to clients is called
oriented progress notes this data akathisia. This is: 31. Mrs. Samson has a dietary privilege
would be noted under:  Inability to sit or stand still of food preferences. This question is
 Objective effective to communicate with her:
19. Health instructions about Haldol  Do you want fried egg or
6. In order for the process recording to (haloperidol) has been given to boiled egg?
be an effective learning tool for Lester while in the hospital and
nurses, data should be: before his discharge. The client 32. An opening comment about the
 Brief and simple but focused correctly understood the health purpose of the group encouraged
on essentials techniques of the nurse when he clients to gather around the table
says: and select small toy cars to move
7. He tells you, “It is my fault. What  “I will wear long sleeve playfully around the racetrack game
kind of husband and father am I?” clothing and sun block when I board. The aim of this affective
He is expressing; go out.” learning approach is for the client
 Guilt to:
20. While giving Chlorpromazine  Share common feelings about
8. The nurse can be BEST intervene by (Thorazine) to client Miriam, the medications
mobilizing the client’s relatives, nurse remembers that she should
friends and people to provide: stop giving the medication when she 33. One objective of this group
 Social support observes this side effect: experience is for the clients to
 Yellow sclera describe the impact of these
9. A therapeutic attitude the nurse can medications on their symptoms and
convey to the client while he talks 21. Another client in the ward, Benjie, is day to day activities. Immediate
about his loss is: given thorazine (Chlorpromazine). discussion and interaction about
 Acceptance This medication has several side daily life situations utilizes the
effects. This side effect should cause principle of:
10. The nurse encourages the client to the nurse to be MOST concerned:  Reinforcement
communicate and socialize because  Sore throat, fever, decreased
internalized hostility can lead to: white blood cell count 34. This client behavior demonstrate
 Depression that interpersonal leaning occurred:
22. Clients on antipsychotic medications  One client said, “I feel that
11. The Comprehensive Dangerous Act usually receive anti-parkinson drugs way”.
(R.A. No.9165) challenges the nurse to reduce Parkinson like side effects.
in his/her role as a/an: The nurse should expect the client 35. One client shared her very
 Advocate to receive: infrequent experiences with alcohol,
 Cogentin (Benztropine) which she knew wee
12. The nurse is conducting Parent contraindicated with her
Education Classes. Aware of the 23. The most important role of the medications and then quietly stated,
scope of nursing practice he/she nurse as a member of the team is to: “I don’t want anyone to repeat this.”
recognizes the necessity to network  Meet the needs for the This experience included this
with other agencies to discuss this physical well-being of patients therapeutic factor:
area:  Altruism
 Legal implications of illegal 24. Activity therapy is a treatment that
drug use utilizes: 36. When the nurse asks Jorge to
 Behavioral therapy describe his physical experience,
13. This characteristic has the LEAST which of these assessment data are
potential success of treatment of 25. This nursing action belong to the appropriate?
drug dependency: secondary level of preventive  “I am tense, nervous and
 An individual who became intervention: exhausted all the time”
dependent on a drug before or  Providing emergency
during the teen years psychiatric services 37. Jorge admits that he has “always
been wound up” just like his father
14. The BEST model of drug abuse 26. When the nurse identifies a client and that he has negative thoughts of
prevention supports: who has attempt to commit suicide himself. He is having a problem of:
 Programs focusing on means the nurse should:  Role confusion
of dealing with problems and  Counsel the client
frustration of adolescents 38. The nurse teaches non-
27. The community health nurse was pharmacologic ways to induce sleep.
15. Clients says “I take drugs only when I invited by the principal of an She cautions Jorge to avoid
am under stress.” this client is elementary school and was asked to  Coffee after dinner
employing defense mechanism give a talk to parents. An
called: appropriate topic would be: 39. It describes the characteristic of free
 Rationalization  Marital crises floating anxiety:
 It is not conditioned by a
16. Unable to handle her emotions, 28. The staff is considering the specific trigger
Antonia hurls angry and explosive possibility of using restraint on Mrs.
outbursts toward those who are Samson, however, she repeatedly 40. A generalized anxiety disorder is
helpful to her. This behavior is an declares that she does not want to distinguished by:
example of: be restrained. The staff is faced with  Presence of excessive anxiety
 Displacement an ethical dilemma of autonomy for a period of 6 months or
versus: more
17. Hostility is distinct from anger in  Beneficence
that the former is: 41. At night when the children are being
 Destructive 29. With a history of osteoporosis and a prepared to go to sleep, the nurse
tendency to wander. This should be hears from a frightened child “ Ayaw
18. Clients may be shifted from typical a priority: ko matulog mag-isa, May multo!.”
to atypical antipsychotic  Prevention of fall (“I don’t want to sleep alone.
medications because of its minimal There’s a ghost!”). The nurse
extrapyramidal side effects. A 30. The nurse aims at highest level of conveys acceptance with this
common extrapyramidal symptom self-care. The nurse will minimize: response:
that is very unpleasant and  Using clothing with buttons
and zippers

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  “nakakatakot nga ang 67. When this incidence of fall is
pakiramdam na ganyan,” (that 54. The nurse will create this reviewed, this is the primary basis
must really be scary.”) opportunity to teach clients a sense for considering this to be a nursing
of responsibility and learn the negligence:
42. Most street children come from consequences of their actions:  Nurse practice act
broken families. The nurse is MOST  Client government
therapeutic in meeting their needs 68. Nurse Linda recognizes that
by being a: 55. At night when the children were therapeutic effectiveness is BEST
 Mother surrogate being prepared to go to sleep, the acquired through:
nurse heard from a frightened child,  Knowledge and practice of
43. With adequate rest, food, “Ayaw ko matulog mag-isa. May specific interpersonal skills in
cleanliness, shelter, warmth and multo!” (“I don’t want to sleep everyday life
safety, the child: alone. There’s a ghost!”). The nurse
 Learns to trust in self and in assesses this behavior as need for: 69. Anne is a new client of Nurse Linda.
others  Safety and security She offers Linda a gift. Nurse Linda
responds therapeutically by:
44. Preventive interventions for children 56. Most street children come from  Clarifying client’s intent, “I
at risk are BEST achieved through: broken families. The MOST effective wonder why you are offering
 Play and activity therapies for role for the nurse to facilitate me a gift.”
children development of trust is:
 Mother surrogate 70. With this client, Nurse Linda must
45. It is unethical to tell one’s friends refrain from ‘use of touch’?
and family members data about 57. When a child is called by her name,  Jacy who is aggressive and
patients because doing so is a clothed appropriately and given age hostile
violation of patients’ right to: appropriate tasks, she:
 Confidentiality  Develops sense of identity 71. Resistance is often mistakenly seen
as the client’s struggle against:
46. The nurse must see to it that the 58. Preventive interventions for children  Change
written consent of mentally ill at risk are BEST achieved through:
patients must be taken from:  Play and activity therapies 72. Establishing a therapeutic contract is
 Parents or legal guardian the goal of this phase of the nurse-
59. Mina was a frequent witness to patient relationship:
47. In an extreme situation and when no domestic violence. Her father would  Orientation phase
other resident or intern is available, always come home drunk and beat
should a nurse receive telephone up Mina’s mother. As an effect of 73. Karen admitted to the nurse that,
orders, the order has to be correctly this experience she had nightmares, “she took about a handful of
written and signed by the physician speechless for weeks, inability to laxatives over the course of 6
within: sleep, tension and palpitations hours… “to which the nurse
 24 hours lasting for more than a month. Mina responded, “That’s not too bright.
is experiencing: The chart says you’re a nursing
48. To facilitate identification of persons  Post-traumatic stress disorder student. You should know better
and relationship, the family nurse than that, hmm?” This approach is:
utilizes this diagrammatic 60. Georgina is diagnosed with  Not therapeutic because she is
representation of members of a schizophrenia. Her claim of being admonishing
family and their relationships. “Binibining Pilipinas Universe” is
 Genogram a/an: 74. Karen is diagnosed to have Bulimia
 Delusion Nervosa. This is characterized by
49. The MOST significant events the binging and a typical behavior is:
nurse records regarding 61. The nurse interprets Georgina’s  Eating larger amounts of food
psychosocial well-being are: thought of being an ambassador of than most people do under
 The behavior patterns and good will for the Filipino people as similar time and circumstances
interpersonal interactions of a/an:
the client  Attempt to overcome low self- 75. A nurse counselor talked to Karen
esteem after her emergency needs have
50. Psychiatric treatment encourages been attended to. The nurse should
client’s independence. The nurse 62. In order to assist Georgina to cope avoid asking:
recognized which of these setting to and be prepared for discharge, it is  Why do you take laxatives to
be LEAST restrictive. BEST for the nurse to focus on: feel thinner or to lose weight?
 Half-way homes  Skills for maintaining daily
living. 76. Clients like Karen conceal their
51. As the date for discharge illness because of:
approaches, a client becomes 63. The nurse’s negligence includes:  Fear of being judged
increasingly anxious and regresses,  Failure to assess and monitor
thus delaying staff’s decision to and failure to communicate 77. The long term goal of the nurse
discharge client. The client’s counselor is:
behavior, following this decision, 64. Failing to maintain a safe  Increase self-esteem essential
improves and this pattern gets environment in this instance is a to health
repeated. The staff’s decision to joint accountability of the nurse and
delay discharge acts as a: the: 78. Street children are introduced early
 Negative reinforce  Hospital to harmful substances such as
inhaling rugby. This observation
52. Chronic schizophrenic patients are 65. When the nurse testified that the underscores the need to address the
assisted to learn self-help behaviors patient appeared to be sleeping, she problem at its core. Nurses
by way of tokens for good grooming, failed this competency? contribute BEST at the preventive
which in turn are used to present a  Inspect level by promoting:
dinner to be served their meals. This  Early childhood education
is an intervention used in: 66. Full documentation of care on the
 Behavior modification patient’s chart in addition to being 79. Teen agers who join fraternities and
factual, accurate, and complete gangs are high risk groups for
53. Client is psychotic and confused. includes being: substance abuse. This psychosocial
Priority in planning is to:  Timely need is BEST met through peer
 Maintain client safety counseling:

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  Self-esteem Carpe Diem!

GONORRHEA SYPHILLIS HPV HSV CHLAMYDIA

“Gono”, “Clap”, “Jack” “Sy”, “Bad Blood” “Genital Wart” “Herpes Genitalis” “Silent STD”
“Morning Drop”

AGENT Neisseria Gonorrhea Treponema Pallidum Human Papilloma Virus HSV – II Chlamydia Trachomatis

S/Sx Burning sensation upon urination Chancre – painless lesion Wart “painful vesicles” Most cases: asymptomatic
“Yellowish” discharge Alopecia Areata – “patchy” - cauliflower-like lesions - fluid-filled rashes If symptomatic – burning
Condyloma Acuminata – wart sensation
Gumma – lesions in the deeper
organs of body

TEST PCR – Polymerase ELISA Cytological Exam PCR NAAT – Nucleic Acid
Chain Reaction PCR Pap Smear Amplification Test

Rx *Cefixime * Penicillin Laser Excision Acyclovir Azithromycin

*Azithromycin * Azithromycin + Doxycycline Cryosurgery (freezing) Doxycycline
*Ciprofloxacin TCA – trichloroacetic acid
ARG – Antibiotic-resistant
Gonorrhea
- no drug yet
- potential drug:
Solithromycin

COMPLICATION Sterility (M & F) Neurosyphillis Cervical Cancer If pregnant and nears PID (Pelvic Inflam Dse)
Ectopic Pregnancy ~ “stroke-like” syndrome ***vaccine: Cervarix term: CS Delivery
Gardasil

  ZIKA VIRUS MIDDLE EAST RESPIRATORY EBOLA VIRUS DISEASE

SYNDROME - CoV (EVD)
Other Term/s ZIKV MERS-CoV Ebola Hemorrhagic Disease
Origin Uganda (1947) Arabian Peninsula (2012) Democratic Republic of Congo
*Jordan (April) *formerly known as Zaire (1976)
*Saudi (September)
Agent Zika Virus (Flavivirus) MERS-CoV (Coronavirus) Ebola Virus (Filovirus)
Virulence Mild Severe (3 to 4 deaths out of 10 cases) Severe
Reservoir/Vector Mosquito Camels Fruit bats
*Aedes Aegypti Bats Primates (monkey, gorilla, chimpanzee)
*Aedes Albopictus Porcupines

Transmission Vector-borne Close Contact Direct contact (broken skin, blood, body fluids)
Sexual contact Objects contaminated by body fluid (needles)
Sexual contact
Not transmitted thru:
- air, water, food, mosquito bite
Incubation Not yet established 2 – 14 days (mostly 5 – 6 days) 2 – 21 days (mostly 8 – 10 days)
Manifestations Mostly asymptomatic Fever Fever
If symptomatic: Cough Severe headache
*fever Chills Muscle pain
*skin rashes SOB Weakness
*conjunctivitis GI symptoms Fatigue
*muscle/joint pain Diarrhea and vomiting
Unexplained hemorrhage
- Destruction of clotting factors in
the liver and vessel lining
Complication/s Microcephaly (congenital if pregnant woman is Pneumonia leading to Respi. Failure Hemorrhage  Shock
infected) Kidney Failure
Guillain Barre Syndrome (reported from Brazil in
2015)

Test/s NAT (Nucleic Acid Testing) RT-PCR (Reverse Transcription – Polymerase ELISA
Chain Reaction) PCR
Virus Isolation
Immunohistochemistry Test

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Management/s Symptomatic/Supportive Symptomatic/Supportive (same with ZIKA) Symptomatic/Supportive
*Rest Mechanical Ventilation No drug yet
*Increase OFI Do not eat undercooked/raw animal meat
*Acetaminophen for fever and pain No drug/vaccine yet
*Don’t give Aspirin
No drug to kill ZIKA as of now

OB Bullets  For your Eyes Only!!!

 Evidence-based standards recommended for adoption in the Philippine hospitals for maternal and newborn care services and birthing facilities by DOH,
Philhealth and WHO:
o Essential Intrapartum and NB Care (EINC)

 This is a highly effective tool for reducing complications during labor:

o Using the partograph

 Single most important and effective measure to prevent to prevent nosocomial infections in hospital settings:
o Hand hygiene

 Pain relief during labor in EINC practice:

o Use of non-pharmacologic methods before pain medications

 The following are components of AMTSL (Active Management of the Third Stage of Labor):
o Administration of oxytocin after delivery.
o Uterine massage after placenta is expelled
o Use of controlled cord traction, w/ counter traction

 The following are the disadvantages of the routine suctioning in the newborn, EXCEPT:
o May cause bradycardia and apnea
o Causes mucosal trauma
o Clears airways and aids in babies who are asphyxiated – answer 
o Associated risks of infection

 A newborn practice that increases the risks of cross contamination among babies:
o Foot printing

 Most common vaginal infection characterized by pruritus and curd-like secretions is:
o Moniliasis (Candidiasis)

 Three hours after delivery, the fundus of the primiparous client is at the midline. Upon inspection of the perineum, the nurse notices blood in constant
small trickles.
o Perineal lacerations

 Statement that indicates a successful teaching about episiotomy care:

o Wipe the area from front to back

 First postpartum day, the primiparous client complains of perineal pain unrelieved by ibuprofen 400 mg given 2 hours earlier, the nurse should assess for:
o Perineal Hematoma

 28 hours after cesarean delivery, a multiparous breast feeding client complains of severe postoperative cramping pains. The nurse explains that these are
caused by:
o Release of oxytocin during the breast-feeding session

 A 25 year old primiparous 2 hours postpartum has decided to breast-feed her neonate. This is what the nurse should expect in the teaching plan about
preventing nipple soreness:
o Placing as much of areola as possible in to the baby’s mouth.

 Shake Test on amniotic fluid is used to determine maturity of what fetal system:
o Pulmonary

 Pregnant with “leaking fluid” is tested with nitrazine paper. The nurse confirms that the client’s membranes have ruptured if the paper turns into what
color:
o Blue

 38 weeks gestation, primigravid with poorly controlled DM and severe pre-eclampsia is admitted for CS delivery. The CS helps to prevent:
o Stillbirth

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 Best nursing management of a woman with threatened abortion:
o Advise the mother bed rest to relax the uterus and avoid or minimize contractions.

 Assessment signs observed by the RN in threatened abortion:

o Uterine cramps, spotting, (+) BOW, Closed cervix

 Characteristics of inevitable abortion:

o Open cervix, ruptured BOW fetus and placental parts still intact

 Abortion is classified as:

o An expelled fetus weighing 500 gms and below
o Termination of products of conception at 20 weeks AOG and below

 Sign of pre-eclampsia that is not specific:

o Physiologic edema (other choices are proteinuria, hypertension and generalized edema)

 Associated with abruption placenta:

o Couvelaire Uterus, Hard contracting Uterus, DIC (HELLP is not associated ha. It is for PIH)

 Major cause of spontaneous abortion:

o Chromosomal abnormality of the zygote

 Urinalysis finding in PIH

o Proteinuria

 Action of Mg SO4 is classified as:

o CNS depressant

 Severe epigastric pain in pre-eclampsia is associated with problem in what organ:

o Liver

 G7P5 client is admitted to the hospital in labor. At 1 pm cervix is 6-7 cm dilated, BOW intact. Condition is: SATA.
o She is in active labor
o She will deliver at approximately 4pm
o She may go into hypotonic contractions

 Active labor - an epidural anesthesia is administered. Hypotension and pruritus are side effects. As she anticipates insertion of IV fluid she should prepare:
o Diphenhydramine

 She complains of fluid leaking from her vaginal orifice but is unsure whether that is fluid or urine. The RN in charge would:
o Perform Nitrazine test (kung wala, collect sample of amniotic for fern test)

 Methotrexate, a chemotherapeutic agent is given also in pregnancy for which conditions:

o Ectopic pregnancy and H-mole

 In the proposed nursing law, APN advanced practice nurse) is advocated. This statement is true about APN in the field of OB:
o The RN is autonomous in her practice, setting up his own birthing clinic in a community, making judgment calls and collaborating with the
health team

 The nurse monitors the mother closely for signs of cardiac overloading right after birth. The nurse knows that this is due to:
o Return of fluid and blood flow to general circulations

 An 8 weeks pregnant --- has weight loss, fever of 38 degree Celsius, LBM on and off for more than a month. The nurse suspects and recommends:
o Strong likelihood of HIV infection, an ELISA test is recommended

 A pregnant client has just been diagnosed with Trichomoniasis and has been prescribed Metronidazole. Signs:
o Strawberry cervix and green, foul frothy discharge.

 The RISK approach per BEMONC program in pregnancy includes:

o All mothers should deliver in health facility

 You are the nurse assigned at the LR-DR complex. This question “How do I know that my labor is progressing” is expected. Your answer is:
o “Your cervix will be measured regularly to check its progress and plotted in the partograph. We will inform you of such progress or deviation.”

 While watching her preterm infant son in the neonatal intensive care unit, a mother exclaims, “My baby is so little. How will I ever care for him?” The
nurse should explain to the mother that she:
o Will be encouraged to participate in his care as much as possible in the beginning

 Oral contraceptive --- most common side effect of estrogen would be:
o Nausea and vomiting

 Pitocin --- adverse effects of this oxytocic drug, should carefully observe the client for:
o Contractions occurring more frequently than every 2 min

 Low back pain during labor. The nurse replies, “This occurs most often when position of the baby is:”

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 o Occiput posterior

 Pregnant client suddenly turns pale and says she feels as if she’s going to faint even when lying flat on her back. Immediate action of the nurse:
o Turn her left side

 While having contractions every 2 minutes with duration of 60-90 seconds. A client complains of having rectal pressure. The nurse should:
o Inspect the client’s perineum for bulging

 Positive oxytocin challenge test may be indicative of potential fetal compromise. The test demonstrates that during contractions the fetal heart rate slows:
o Late decelerations

 To facilitate delivery in a client with class III heart disease, the nurse would expect that the physician will probably:
o Use forceps to assist delivery

 Elena, G1P0, was admitted at 8am to the Labor Room. To monitor the progress of the labor, a partograph was used. The center of the partograph is
focused on the:
o Cervical Dilatation

 How many times should the nurse do an IE in labor?

o Not to exceed 5 times

 All are true in the paragraph except for one:

o The best tool to monitor labor
o The center of the partograph is the cervical dilation
o There are two oblique lines in the graph
o An “X” mark going beyond to the right of the oblique line is satisfactory

 Foremost cause of maternal mortality is:

o Bleeding due to atony

 The overall program of DOH to rapidly reduce maternal and neonatal death is embodied in this program:
o MNCHN (Maternal, Newborn, Child Health and Nutrition

 Based on the Philippines clinical guidelines for intrapartum and immediate postpartum care, the total number of IE a woman receives during the course of
labor should be limited to:
o About 5

 Limiting the number of IE in labor results to decreased risk in:

o Endometritis & Neonatal Sepsis

 Good attachment and sucking during breastfeeding. These are the signs observed except for:
o Mouth wide open
o Upper lip turned outwards
o Baby’s chin touching breast
o Suckling is slow, deep with some pauses

 As a community based nurse you will schedule the 1st postnatal visit after:
o 48-72 hours

 One of the most important schemes taught to the mother of a preterm baby is KMC (Kangaroo Mother Care). KMC can be started:
o When the baby breathes spontaneously and is free of the life threatening disease or malformations.

 Battle cry for management of pregnancy & childbirth:

o All pregnant women are at risk during child birth

 Most common site for fertilization:

o Ampullar portion of the fallopian tube.

 Infertility is said to exist when a pregnancy has not occurred after at least one year of engaging to unprotected sexual intercourse. This condition would be
least likely to contribute to infertility:
o Pelvic inflammatory disease
o Excessively thick cervical mucus
o Alkalinity of vaginal PH (acidic dapat. Negative ang question ha) so negative answer din)
o Endometriosis

 Cervical mucus assessment finding suggests that a woman is about to ovulate:

o Highly stretchable mucus

 Drug the nurse would expect to administer to a woman with infertility secondary to Anovulation:
o Clomiphene (Clomid)

 Complaint of 2 missed menstrual periods --- reports taking a pregnancy test, and tested positive. This assessment data will alert you that client is probably
pregnant:
o (+) pregnancy test – (probable sign ito ah)

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 35th week of gestation, complains of heartburn. Best course of management to this situation.
o “I should eat small, frequent meals”

 Purplish discoloration of the vaginal mucosa :

o Chadwick’s Sign

 In assessing the fundal height and estimating the age of gestation the following landmarks are important: the symphysis pubis, umbilicus, and xiphoid
process. After assessing the fundic height of four clients, the nurse would decide to prioritize this client:
o A woman who is 12 weeks pregnant with a fundic height on the level of the umbilicus

 INCORRECT statement regarding client preparation:

o For Leopold’s maneuver, the bladder should be empty
o For a pelvic exam, the bladder should be full
o For abdominal ultrasound, ensure that the bladder is full
o For transvaginal ultrasound, the bladder must be empty

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