Jeffrey Ong Sumergido, B.S.N., R.N.

1. A 69 y.o. patient with Addisons was placed under the

care of the nurse. The patient asked what could have
caused the development of this disease. In response to
this, the nurse will tell the patient that the most
common cause is:
A. Idiopathic
B. Sudden cessation of Steroids use
C. Autoimmune
D. Chronic Steroids use

2. The nurse reviews the laboratories of the patient with
Addisons. Which of the following findings is the
priority of the nurse?
A. Glucose 70 mg/dL
B. K 5.6 mEq/L
C. Sodium 148 mEq/L
D. Calcium 9 mg/dL

3. The nurse reviews the chart of the patient with
Addisons admitted for 4 days. Which of the following
assessment would the nurse expect to find?
A. Hypocalcemia
B. Hypophosphatemia
C. Hyperkalemia
D. Hypertension

4. Which among the statements made by the patient
indicates the need for further teaching regarding
corticosteroid therapy?
A. I will eat foods high in calcium & vitamin D.
B. I will need to avoid crossing-legs.
C. I need to take low calories, low protein, low sodium
foods.
D. I need to have regular eye-check ups.

5. A nurse was given order to administer Solu-Cortef
to a Mexican patient with Addisons. The nurse
knows that the best time to give the medicine is
when?
A. Early morning, at about 7:00a.m.
B. After dinner, at 7:00p.m.
C. Before going to bed, at 10:00p.m.
D. After lunch, 12:30p.m.

6. The nurse was assigned to Mr. Smith, a 56 y.o.
Mexican with acute Pancreatitis. The nurse knows that
the major cause of this disease is:
A. Alcohol abuse and Idiopathic
B. Cholelithiasis and Autoimmune
C. Alcohol abuse and cholelithiasis
D. Tumors of the pancreas and Idiopathic

7. The nurse closely monitors Mr. Smith to avoid the
development of complications. She would be alerted
when the patient reported to experience which of the
following complication for pancreatitis?
A. Nausea & Vomiting
B. Cullens sign
C. Abdominal distention
D. Severe abdominal pain

8. Mr. Smiths condition worsened and progressed to
severe pancreatitis. Which among the following
assessments for Mr. Smith the nurse should
prioritize?
A. Cullens sign
B. Hypotension
C. Cyanosis
D. Renal failure

9. The nurse was assigned to 4 patients for the day.
Which of the following patients has a high risk for
developing pancreatitis?
A. A 49 y.o. patient with a father who died from
pancreatitis
B. A 40 y.o. man with a history of cholecystectomy
C. A 35 y.o. Class II obese woman
D. A 52 y.o. menopausal woman taking estrogen.

10. Mr. Smith complains of severe abdominal pain in the
morning during the nurses rounds. The nurse knows
that the drug of choice for this is:
A. Morphine
B. Meperidine
C. Buprenorphine
D. Nalbuphine

11. A 68-year-old with hyperthyroidism is admitted
presenting thyroid storm with a pulse of 135/min. The
nurse should prepare as ordered what drug to control
the symptom?
A. PTU
B. Propranolol
C. Tapazole
D. Lugols solution

12. Mrs. Montecarlo, 56 y.o. with hyperthyroidism received
Radioactive Iodine Therapy. After 4 weeks, the patient went
in for follow-up and complains that the symptoms are still
present. What is the nurse best response?
A. The first dose seems ineffective. You may need another
dose of the therapy.
B. That is the normal and expected side effect of the
radioactive therapy.
C. Theres nothing to be bothered about. Symptoms will
subside in 3 to 4 weeks.
D. You did not respond to the therapy. I will refer you to
your physician.

13. Mrs. Montecarlo was prescribed with Propranolol.
Which of the following side effect of the drug would
alert the nurse most?
A. Confusion
B. Wheezing
C. Weakness
D. Arrhythmias

14. The nurse is giving a discharge teaching to a patient
receiving Potassium Iodide to be cautious in drinking
OTC medications. The nurse instructs that she must
avoid the following drugs that may contain iodine
except:
A. Bronchodilator
B. Expectorants
C. Anti-tussive
D. Steroids

15. A client with Hyperthyroidism. After receiving
Tapazole for 3 days, she suddenly manifests fever, sore
throat & URTI. The nurse would suspect that the
patient is developing which side effect of the drug?
A. Leukopenia
B. Allergy to the drug
C. Thrombocytopenia
D. Aplastic anemia

16. The nurse closely monitors the patient with
hyperthyroidism to prevent Thyroid Storm. She knows
that which of the following is not a manifestation of a
developing thyroid storm?
A. Delirium
B. Fever of 38 degree Celsius
C. Tachycardia - 135/min.
D. Chest pain

17. The doctor orders medicines for the management of
Thyroid Storm for a 45 y.o. Chinese patient with
Hyperthyroidism who was just admitted at the
Medical Unit. Which of the following should the nurse
question?
A. Iodine compound
B. PTU
C. Aspirin for hyperthermia
D. Hydrocortisone for adrenal insufficiency


18. Mrs. Young went in to the Surgery unit 4 hours post-
thyroidectomy from the recovery room. The nurse
should prepare the following at bedside except:
A. Calcium Gluconate
B. Tracheostomy set
C. Lidocaine
D. Oxygen

19. The nurse monitors Mrs. Young for tetany, which is a
complication of thyroidectomy. The following are the
signs of tetany except:
A. Hypercalcemia
B. Carpopedal spasm
C. Seizure
D. Photophobia

20. A 25-year-old with Multiple Sclerosis was assigned to
the nurse. The nurse expects to see all of the following
except one for her assessment of the primary
symptoms of this disease.
A. Fatigue, weakness, numbness
B. Difficulty in coordination, loss of balance
C. Depression
D. Spasticity & drooping of the eyelids

21. The nurse knows that the etiology of Multiple
Sclerosis is:
A. Auto-immune
B. Genetic
C. Idiopathic
D. Triggered by infection

22. The nurse visited her patients after the endorsement.
The patient with Multiple sclerosis developed spasms
during the rounds. What is the medication of choice
the nurse anticipates to be ordered for treating spasms
for this disease?
A. Valium
B. Baclofen (Lioresal)
C. Tizanidine (Zanaflex)
D. Dantrolene (Dantrium)

23. The nurses goal for the day is to promote motor
function of a 25 y.o. male patient with Multiple
sclerosis. She instructed the CNA what activities they
will do. The nurse would question which of the
following interventions she saw written by the CNA in
a scratch?
A. Applying warm packs before stretching to reduce
spasticity.
B. Providing ROM exercises.
C. Helping the client to walk with a wide-based gait.
D. Turning the patient from time to time.

24. Beta-interferon (Betaseron) was prescribed for a
patient with MS. The nurse knows that the primary
purpose in giving this drug is to:
A. Decrease fatigue
B. Reduce exacerbations
C. Induce remission
D. Immunosuppression

25. The patient with MS is receiving Beta-Interferon
(Betaseron) SQ. He developed fever, chills, myalgia &
sweating. What should the nurse do?
A. Refer to the doctor immediately.
B. Withhold the next medication.
C. Administer NSAID as ordered.
D. Prepare antihistamine immediately.

26. The nurse is caring for a client with
Parkinsons. She knows that the cardinal
features of this disease are the following
except:
A. Masklike faces
B. Loss of postural reflexes
C. Freezing movement
D. Flexed posture of neck, trunk and limbs

27. The nurse is providing health teaching regarding diet
to the client with Parkinsons. Which of the ff. favorite
foods of the client she must avoid?
A. vegetable salad
B. low-fat yogurt
C. corn soup
D. mashed potatoes

28. The night duty nurse went in to clients room who is
just about to sleep. The nurse would recommend
which position in sleeping for Parkinons?
A. Low-fowlers
B. Prone Position
C. Side-lying position with pillows on the head
D. Any position preferred by the patient.

29. The nurse is teaching a Parkinsons patients some
exercises to avoid rigidity and development of
contractures. She instructs the patient that the best
time to exercise is when?
A. Early in the morning
B. After taking breakfast
C. 2-hours after eating lunch
D. An hour before dinner

30. Mr. Clark, a 64 y.o patient with Parkinsons manifests
tremors during the morning rounds. The nurse advises
to the patient to do the ff. to manage tremors except:
A. Hold a rubber ball
B. Use both hands to accomplish task
C. Lie face down on the floor and relax body
D. Sleep on the unaffected side

31. A client with CVA was rushed in to the ER. Upon
assessment, the nurse would expect what type of
abnormal respiration?
A. Kussmaul
B. Cheyne-Stokes
C. Biots
D. Rhonchi

32. Which among the causes of CVA the nurse should
prioritize regarding the onset of the manifestations?
A. Thrombosis
B. Embolism
C. Hemorrhage
D. TIA

33. Which among the causes of CVA should be
prioritized regarding the severity of its outcome?
A. Thrombosis
B. Embolism
C. Hemorrhage
D. TIA

34. The patient is experiencing ischemic attack. The
nurse knows that irreversible damages and cerebral
infarction will occur when cerebral anoxia lasts for how
many minutes?
A. 4 minutes
B. 6 minutes
C. 8 minutes
D. 10 minutes

35. To prevent cerebral anoxia, the priority intervention
for the client at this time is:
A. Clear respiratory tract
B. Thrombolytic therapy stat as ordered
C. Initiate a code
D. Provide Oxygen at 4L/min

36. The nurse knows that in ischemic stroke, the
Thrombolytic therapy must be started:
A. Immediately.
B. Within an hour of the onset of manifestations.
C. Within 3 hours of the onset of manifestations.
D. Within 6 hours of the onset of manifestations.

37. The nurse is preparing her care plan for a patient who
had a stroke. What would be the best nursing
Diagnosis for the client who had hemiplegia secondary
to stroke and is unaware of his paralyzed side?
A. Risk for injury
B. Unilateral Neglect
C. Impaired Physical Mobility
D. Knowledge deficit

38. Heparin is ordered for a patient with Ischemic stroke.
The following are true about heparin except:
A. Protamine at bedside
B. PT is monitored
C. Give thru IV
D. Non- teratogenic

39. A client was admitted complaining of heart burn.
She was diagnosed with GERD. Which of the following
drugs the nurse would anticipate the doctor will order
first?
A. Ranitidine & Metoclopramide
B. Antacids & Ranitidine
C. Metoclopramide & Antacids
D. Omeprazole & Metoclopramide

40. The nurse went in to clients room during lunchtime.
Which of the following meals on the table of the
patient indicates the need for further teaching to the
client?
A. Fresh Garden Salad
B. A slice of strawberry cake
C. Mashed potatoes
D. Spaghetti & garlic toast

41. The patient with GERD was prescribed with Reglan.
The nurse knows that the primary purpose for this is?
A. Promote gastric emptying
B. Block gastric secretion
C. Reduce gastric acidity
D. Decrease gastric acid secretion

42. Which of the statements made by the patient
indicates the need for further teaching?
A. I should avoid eating and drinking 3 hours before
sleeping.
B. I should decrease fluid intake at meals to prevent
reflux.
C. I should elevate the head of the bed 6-8inches.
D. I should eat 6 small meals per day.

43. The nurse caring for a client with GERD must
because cautious in giving medications because some
drugs may decrease LES pressure. The following drugs
should be avoided by the patient except:
A. Theophylline
B. Ca channel blockers
C. Bethanechol
D. Atropine SO4

44. A patient with Chrons was assigned to the nurse.
Upon assessment, the nurse would note that the stool
consistency from the patient is:
A. Liquid Stools
B. Bloody stools
C. Black Tarry stools
D. Semi-liquid stools

45. The nurse prepares the client with Regional Enteritis
for Barium Swallow. The patient is complaining of
crampy abdominal pain and is asking for his Demerol.
What should the nurse do?
A. Give Demerol as ordered.
B. Report to the physician immediately.
C. Withhold the pain medication.
D. Postpone the procedure for the next day.

46. The patient with Ulcerative Colitis suddenly develops
fever, leukocytosis, tachycardia & abdominal
distention. The nurse would suspect that the patient
has developed?
A. Toxic Megacolon
B. Ruptured Colon
C. Perforation
D. Hemorrhage

47. The characteristic pattern of progression of
Ulcerative Colitis is:
A. Involves entire thickness of the bowel wall.
B. Starting from the distal colon, spreading upward.
C. Develops anywhere in the GI tract
D. Characterized by periods of remissions and
exacerbations.

48. What is the priority nursing diagnosis for a patient
with an ileostomy exhibiting an irritated & reddened
skin around the stoma?
A. Disturbed Body Image
B. Risk for Impaired Skin Integrity
C. Imbalanced Nutrition, Less Than Body
Requirements
D. Fluid Volume Deficit

49. During the morning care, the patient verbalized her
concern regarding odor-formation of her ileostomy.
The correct nursing response would be:
A. Frequent cleaning will remove all odors.
B. You can put some aspirin in the pouch.
C. Bismuth is helpful and effective in reducing odor.
D. You just need to avoid eating gas formers but fishes
& meats are allowed.

50. A patient with colostomy experienced depression 2
days post-op because of the disturbance in her body
image. Which of the following indicates that the
patient has accepted what happened?
A. The patient reads Ostomy literatures.
B. The patient looks at her abdomen in the mirror.
C. The patient asks question to the nurse regarding
ostomy care.
D. The patient participates in ostomy care.

51. The nurse is providing a discharge teaching for a
client with ileostomy. Which among the following is a
common complication of ileostomy?
A. Peristomal skin irritation
B. Stomal Prolapse
C. Stomal Stenosis
D. Stomal Stricture

52. The nurse was assigned to a pt. with Miller-Abott
tube. Upon aspirating, the nurse found out that the
pH of the secretion is 6.2. The nurse knows that this
means?
A. the tube entered the respiratory tract
B. the tube is in the gastric area
C. the tube is in the intestinal area
D. needs further assessment

53. The nurse is about to feed a client with NGT. She
aspirated gastric residual amounting to 130cc. What
should the nurse do?
A. Continue feeding the client.
B. Withhold feeding for 30 minutes then check again.
C. Administer half of the feeding. After an hour,
administer the other half.
D. Do not administer feeding.

54. A client rushed-in to ER with hematemesis. The
endoscopy revealed esophageal varices. The nurse will
immediately prepare what tube?
A. Miller- Abott tube
B. Salem-Sump tube
C. Sengstaken-Blakemore tube
D. Levine tube

55. The nurse is administering NGT feeding for a client.
During NGT feeding, the client vomits. The nurse
would do the ff. except:
A. Stop the feeding.
B. Measure abdominal girth.
C. Place in side-lying position.
D. Administer anti-emetics as ordered.

56. The nurse was assigned to the following clients on
the Medical-Surgical floor. Who among the following
is not at risk to develop secondary hypertension?
A. A 29 y.o. patient with Hyperthyroidism
B. A 36 y.o. patient with Pheochromocytoma
C. A 65 y.o. patient with Arteriosclerosis
D. A 49 y.o. patient with Addisons disease

57. A patient with hypertension was assigned to the
nurse. The nurse knows that the complications of
HPN are the following except:
A. Angina/MI
B. RVH
C. Retinopathy
D. Accelerated HPN

58. The relative of a patient asks the nurse about the
importance of lifestyle modification to prevent HPN.
Which among the following lifestyle modifications to
manage HPN is the most important?
A. Maintaining normal body weight / BMI
B. DASH eating plan
C. Reducing sodium intake to 2.4g/day
D. Regular Aerobic physical activity

59. The patient with Hypertension is to be given
Lopressor. What should the nurse check before giving?
A. HR
B. RR
C. BP
D. Temparature
60. The nurse knows that Lopressor should not be given
to a patient who has a history of?
A. HPN
B. Angina
C. MI
D. RVF

61. A patient was determined to have a chronic kidney
disease that led to the development of HPN. In the
management of HPN, the goal blood pressure for this
patient is?
A. 140/90
B. 130/80
C. 130/70
D. 120/80

62. The patient had an anginal attack 8 hours ago. She
asks the nurse if she can have sexual intercourse with
her husband. What is the nurses best response?
A. You are limited to complete bed rest.
B. You need to take Nitroglycerin SL first.
C. Sexual activity can aggravate your condition.
D. You should ask your physician or sex counselor first.

66. The patient called for the nurse and complains of
unrelieved chest pain. She verbalized, I followed your
instructions carefully. I already took 3 NTG SL tablets
at 5-minute intervals from my plastic pillbox. But the
pain is still there. The nurses best action would be:
A. Oxygenate the patient immediately.
B. Administer morphine stat as ordered.
C. Get NGT SL tab from the E-Cart and give to patient.
D. Call the doctor and report infarction.

64. The patient with angina develops chest pain
radiating to the shoulders and neck while he was
ambulating at his room. The immediate nursing action
would be:
A. Give morphine as ordered.
B. Start oxygen at 3L/min.
C. Administer NTG as ordered
D. Provide rest.

65. A patient with suspected MI is to undergo Cardiac
Catheterization. What is the nursing management
after the procedure?
A. Position the client to Semi-fowlers
B. Strict bed rest for 6-12 hours.
C. Keep extremities extended for 4-6 hours.
D. Turn client form side to side.

66. The nurse is assessing a 59 y.o. male patient with
CHF who was just admitted on the Medical-Surgical
Unit. Which of the following is not a manifestation of
LVF:
A. Difficulty breathing
B. Sharp pain on the Upper Abdomen
C. Patient experiences sensation of suffocation
D. Patient assumes tripod position

67. A 35 y.o. patient with RVF was assigned to the nurse.
Which would be the priority assessment of the nurse?
A. Abdominal pain
B. Anorexia
C. Weight gain
D. Fatigue

68. The nurse is caring for a 75 y.o. client with LVF. The
nurse should be alerted when the patient experiences:
A. crackles
B. confusion
C. pallor
D. tachycardia

69. The patient is receiving Digoxin to treat CHF. The
nurse should monitor for the ff. laboratories. Which is
a priority?
A. BUN levels
B. Magnesium levels
C. Creatinine levels
D. Potassium levels

70. The nurse is caring for a client on oxygen therapy.
Which among the Oxygen administration devices
deliver the most highest Oxygen concentration?
A. Partial-Rebreather mask
B. Non-rebreather mask
C. Venturi mask
D. Face Mask

71. A patient with Emphysema rushed in to ER
complaining of difficulty breathing and shortness of
breath. The nurse will immediately give oxygen via?
A. Simple Mask at 6L/min
B. Nasal Cannula at 4L/min
C. Venturi mask at 4L/min
D. Nasal Cannula at 2L/min

72. A patient with Flail chest was assigned to the nurse.
Upon assessment of the respiratory patterns of the
client, the nurse would expect:
A. Mediastinal shift to the unaffected side during
inspiration.
B. No mediastinal shift.
C. Mediastinal shift to unaffected side on both
inspiration and expiration.
D. Mediastinal shift to affected side during inspiration.

73. The nurse is to provide a discharge health teaching to
a 7 y.o. patient with Asthma regarding the use of a
Metered dose Inhaler. Which of the following is not
true?
A. Place the mouthpiece 1 to 2 inches away from mouth.
B. Puff during inspiration.
C. Hold breath for 5-10 seconds.
D. Wait for 30 seconds before administering the next
dose.

74. What is the priority nursing diagnosis for a 50 y.o.
COPD client with dyspnea, wheezing, crackles, and a
productive cough?
A. Ineffective Airway Clearance
B. Impaired Gas Exchange
C. Altered Tissue Perfusion
D. Ineffective Breathing Pattern

75. Mr. Wayne, a 59 y.o. patient rushed in to ER and was
diagnosed with ARF. He registered tall peaked T-wave
in the ECG. The nurse immediately considered
hyperkalemia and would prepare what drug?
A. Bumetanide
B. Aldactone
C. Kayexalate
D. Lasix

76. Mr. Waynes condition worsened and developed to
Chronic Renal Failure. The nurse knows that the
leading cause of CRF is:
A. SLE
B. ARF
C. HPN
D. DM

77. The patient with renal insufficiency was admitted to
the renal unit 6 hours ago. The nurse reviews the chart
and questions what drug?
A. Aminoglycosides
B. Kayexelate
C. Propranolol
D. Aluminum OH

78. A patient with Sickle cell disease is assigned to the
nurse. The nurse is to give analgesic to the patient and
she knows that she must avoid giving Demerol
because this may induce:
A. Respiratory depression
B. Seizures
C. Sickle cell crisis
D. Hypotension

79. Which is the most common type of crisis in Sickle
cell disease?
A. Vasoocclusive crisis
B. Splenic sequestration
C. Aplastic Crisis
D. Hematologic crisis

80. A 6-day old neonate is diagnosed with Hip dysplasia.
To correct this, the nurse will anticipate to use:
A. BST
B. Hip spica cast
C. Bucks traction
D. Pavliks harness

81. After endorsement, the nurse visited her patients.
Which of the following patients is not at risk to
develop Osteoporosis?
A. a 40 y.o. Obese female Chinese
B. a 48 y.o. European on early menopausal period
C. a 56 y.o. Filipino who is a Chronic smoker
D. a 65 y.o. Spanish Librarian

82. A 2y.o. child with Cystic fibrosis was admitted to the
pediatric floor 2 days ago. The child frequently cries and
the parents cannot stop her. For this day, the goal of the
nurse is to promote the psychosocial development of the
child. What should the nurse do?
A. Allow the child to explore the surroundings.
B. Have the child join other children in the playpen.
C. Place the child in the playpen with favorite toys.
D. Bring the child to another room to play with another
child.

83 The nurse is preparing her care plan for a child with
cystic fibrosis. Which of the following interventions is
correct?
A. Give antitussives as ordered for cough.
B. Maintain negative pressure in the room.
C. Encourage a high calorie, high protein diet.
D. Discourage breast feeding.

84. A client with a history of diverticulitis complains of
abdominal pain, fever, and diarrhea. Which food is
responsible for the clients symptoms?
A. Mashed potatoes
B. Steamed carrots
C. Baked fish
D. Whole-grain cereal

85. A client with tuberculosis has a prescription for
Myambutol (ethambutol HCL). The nurse should tell
the client to notify the doctor immediately if he
notices:
A. Gastric distress
B. Changes in hearing
C. Red discoloration of body fluids
D. Changes in color vision

86. The primary cause of anemia in a client with chronic
renal failure is:
A. Poor iron absorption
B. Destruction of red blood cells
C. Lack of intrinsic factor
D. Insufficient erythropoietin

87. Which of the following nursing interventions has the
highest priority for the client scheduled for an
intravenous pyelogram?
A. Providing the client with a favorite meal for dinner
B. Asking if the client has allergies to shellfish
C. Encouraging fluids the evening before the test
D. Telling the client what to expect during the test

88. A client with tuberculosis who has been on
combined therapy with rifampicin and isoniazid asks
the nurse how long he will have to take medication.
The nurse should tell the client that:
A. Medication is rarely needed after 2 weeks
B. He will need to take medication the rest of his life.
C. The course of therapy is usually 6 months.
D. He will be re-evaluated in 1 month to see if further
medication is needed.

89. The nurse is caring for a client with irritable bowel
syndrome. Irritable bowel syndrome is characterized
by:
A. Development of pouches in the wall of the intestine
B. Alternating bouts of constipation and diarrhea
C. Swelling, thickening and abscess formation
D. Hypocalcemia and iron-deficiency anemia

90. The nurse is caring for a client with stage III
Alzheimers disease. A characteristic of this stage is:
A. Memory loss
B. Failing to recognize familiar objects
C. Wandering at night
D. Failing to communicate