Search This Blog

Wednesday, January 30, 2008

StuffedNurse: ATTENTION : ALL BOARD EXAM 2008 TAKERS

MEMORANDUM CIRCULAR NO. 2008 - 01
January 18, 2008

T O : PRESIDENTS AND DEANS OF SCHOOLS, COLLEGES AND
UNIVERSITIES OFFERING NURSING COURSE

SUBJECT: CLARIFICATION ON THE EARLY DEADLINE IN FILING
APPLICATIONS FOR YEAR 2008 NURSES LICENSURE
EXAMINATIONS (NLE)

The Commission earlier issued Memorandum Circular No. 2007 – 15 dated November 29, 2007 on the early deadline in filing applications for Year 2008 Nurses Licensure Examination.

The schedules of the Nurses Licensure Examination for year 2008 and the revised deadline in filing applications are as follows:

Examination Dates:

June 1 and 2, 2008
Sunday & Monday
Deadline: April 18, 2008 (Friday)
No. of Days before Exam: 43 days

November 29 and 30, 2008
Saturday and Sunday
Deadline: October 17, 2008 (Friday)

No. of Days before Exam: 43 days

We reiterate that the Commission is expecting 80,000 to 100,000 or more examinees starting year 2008. With this increasing number of examinees, the 20 to 30 day-deadline,which we had for 15,000 to 30,000 examinees in previous years, is now very short for the Commission to complete all post-application activities such as batching of processed applications, encoding of applicants’ data, editing of proof lists, review of applications, sorting and alphabetizing of permanent examination and registration record cards (PERRCs), matching of PERRCs against the Lists of Examinees by Rooms, and posting of Lists of Examinees, and pre-examination activities such as the final list of schools/buildings/rooms and examination forms to be used in the printing of test booklets. Quarantine period for security printing is usually two (2) weeks before examination dates, and which may still be longer if there will be more than 80,000 examinees.

Some schools and other stakeholders have interpreted the earlier Memorandum Circular as “graduates of March or April 2008 will not be admitted in the June 2008 NLE and those in October 2008 will not be admitted in the November 2008 NLE” . Text messages are also going around that there will be no NLE in June. These interpretations/text messages are not true.

For clarification, graduates of March or April 2008 will be accepted in the June 2008 examination, provided, they will be able to submit, at the time of filing application on or before the deadline, all the documentary requirements, i.e. Transcript of records with scanned picture and remarks “For Board Examination Purposes Only”, Birth Certificate in NSO security paper, Notarized/Sworn Summary of Related Learning Experience and OR/DR cases. Those with incomplete documents will NOT be admitted in the June 2008 examination. They are advised to apply early for the November 2008 examination. Likewise, graduates of October 2008 may apply for the November 2008 NLE, if they have the complete documents at the time of filingapplications on or before the deadline. If not, they are also advised to apply early for the June 2009 NLE.

The Commission will strictly observe the deadline in filing applications starting with the examinations in 2008.

For your information and guidance.

(signed) LEONOR TRIPON-ROSERO
Chairperson

O-CH/O-COMI/PRB-BON/O-LIC
LTR/RRP/CMA/ATE

source: http://www.prc.gov.ph/documents/memocircular2008-01.pdf

StuffedNurse : FYI : ISSUES AND CONCERNS

All advertisements thru post here were done for free

We do not collect money or any material things.

All answers to practice exams here are suggested answers only. Some were taken from books and cds but were researched by ms diannemaydee, not copied from someone else.

March graduates will take d June exam if they can file for it before April 11, late registrants will automatically take d November exam.

Email me at stuffed.nurse@gmail.com for questions and suggestions.

We are welcoming contributors

Monday, January 28, 2008

StuffedNurse : BOGUS EMAIL FROM SOMEONE CLAIMING TO BE BON WANTS STUFFEDNURSE TO BE SHUTDOWN

Ms. diannemaydee received an email yesterday from someone claiming to be BON chairwoman Dr Carmencita Abaquin.

The prankster used the email address bonchairman@prc.gov.ph sent thru bogus email website xult.org/deadfake.com and he wanted ms diannemaydee to shut down StuffedNurse or else she will lose her license.

Read d complete details at http://speechlessnarcoleptic.blogspot.com

Its a good thing she checked its authenticity.

We are not violating any law.

Dont be fooled other nurse site owners!

Wednesday, January 23, 2008

StuffedNurse : NP1 practice exam

NURSING PRACTICE I – Foundation of PROFESSIONAL Nursing Practice

SITUATIONAL

Situation 1 – Mr. Ibarra is assigned to the triage area and while on duty, he assesses the condition of Mrs. Simon who came in with asthma. She has difficulty breathing and her respiratory rate is 40 per minute. Mr. Ibarra is asked to inject the client epinephrine 0.3 mg subcutaneously.

1. The indication for epinephrine injection for Mrs. Simon is to:

A. Reduce anaphylaxis
B. Relieve hypersensitivity to allergen
C. Relieve respiratory distress due to bronchial spasm
D. Restore client’s cardiac rhythm

2. When preparing the epinephrine injection from an ampule, the nurse initially:

A. Taps the ampule at the top to allow fluid to flow to the base of the ampule
B. Checks expiration date of the medication ampule
C. Removes needle cap of syringe and pulls plunger to expel air
D. Breaks the neck of the ampule with a gauze wrapped around it

3. Mrs. Simon is obese. When administering a subcutaneous injection to an obese patient, it is best for the nurse to:

A. Inject needle at a 15 degree angle over the stretched skin of the client
B. Pinch skin at the injection site and use airlock technique
C. Pull skin of patient down to administer the drug in a Z track
D. Spread skin or pinch at the injection site and inject needle at a 45-90 degree angle

4. When preparing for a subcutaneous injection, the proper size of syringe and needle would be:

A. Syringe 3-5 ml and needle gauge 21 to 23
B. Tuberculin syringe 1 ml with needle gauge 26 or 27
C. Syringe 2 ml and needle gauge 22
D. Syringe 1-3 ml and needle gauge 25 to 27

5. The rationale for giving medications through the subcutaneous route is:

A. There are many alternative sites for subcutaneous injection
B. Absorption time of the medicine is slower
C. There are less pain receptors in this area
D. The medication can be injected while the client is in any position

Situation 2 – The use of massage and meditation to help decrease stress and pain have been strongly recommended based on documented testimonials.

6. Martha wants to do a study on this topic: “Effects of massage and meditation on stress and pain”. The type of research that best suits this topic is:

A. Applied research
B. Qualitative research
C. Basic research
D. Quantitative research

7. The type of research design that does not manipulate independent variable is:

A. Experimental design
B. Quasi-experimental design
C. Non-experimental design
D. Quantitative design

8. This research topic has the potential to contribute to nursing because it seeks to

A. include new modalities of care
B. resolve a clinical problem
C. clarify an ambiguous modality of care
D. enhance client care

9. Martha does review of related literature for the purpose of

A. determine statistical treatment of data research
B. gathering data about what is already known or unknown about the problem
C. to identify if problem can be replicated
D. answering the research question

10. Client’s rights should be protected when doing research using human subjects. Martha identifies these rights as follows EXCEPT:

A. right of self-determination
B. right to compensation
C. right of privacy
D. right not to be harmed

Situation 3 – Richard has a nursing diagnosis of ineffective airway clearance related to excessive secretions and is at risk for infection because of retained secretions. Part of Nurse Mario’s nursing care plan is to loosen and remove excessive secretions in the airway.

11. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:

A. Client lying on his back then flat on his abdomen on Trendelenburg position
B. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his back and on his abdomen
C. Client lying flat on his back and then flat on his abdomen
D. Client lying on his right then left side on Trendelenburg position

12. When documenting outcome of Richard’s treatment Mario should include the following in his recording EXCEPT:

A. Color, amount and consistency of sputum
B. Character of breath sounds and respiratory rate before and after procedure
C. Amount of fluid intake of client before and after the procedure
D. Significant changes in vital signs

13. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:

A. Amount of food and fluid taken during the last meal before treatment
B. Respiratory rate, breath sounds and location of congestion
C. Teaching the client’s relatives to perform the procedure
D. Doctor’s order regarding position restrictions and client’s tolerance for lying flat

14. Mario prepares Richard for postural drainage and percussion. Which of the following is a special consideration when doing the procedure?

A. Respiratory rate of 16 to 20 per minute
B. Client can tolerate sitting and lying positions
C. Client has no signs of infection
D. Time of last food and fluid intake of the client

15. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

A. Percussion uses only one hand while vibration uses both hands
B. Percussion delivers cushioned blows to the chest with cupped palms while vibration gently shakes secretion loose on the exhalation cycle
C. In both percussion and vibration the hands are on top of each other and hand action is in tune with client’s breath rhythm
D. Percussion slaps the chest to loosen secretions while vibration shakes the secretions along with the inhalation of air

Situation 4 – A 61 year old man, Mr. Regalado, is admitted to the private ward for observation after complaints of severe chest pain. You are assigned to take care of the client.

16. When doing an initial assessment, the best way for you to identify the client’s priority problem is to:

A. Interview the client for chief complaints and other symptoms
B. Talk to the relatives to gather data about history of illness
C. Do auscultation to check for chest congestion
D. Do a physical examination while asking the client relevant questions

17. Upon establishing Mr. Regalado’s nursing needs, the next nursing approach would be to:

A. Introduce the client to the ward staff to put the client and family at ease
B. Give client and relatives a brief tour of the physical set up the unit
C. Take his vital signs for a baseline assessment
D. Establish priority needs and implement appropriate interventions

18. Mr. Regalado says he has “trouble going to sleep”. In order to plan your nursing intervention you will:

A. Observe his sleeping patterns in the next few days
B. Ask him what he means by this statement
C. Check his physical environment to decrease noise level
D. Take his blood pressure before sleeping and upon waking up

19. Mr. Regalado’s lower extremities are swollen and shiny. He has pitting pedal edema. When taking care of Mr. Regalado, which of the following interventions would be the most appropriate immediate nursing approach?

A. Moisturize lower extremities to prevent skin irritation
B. Measure fluid intake and output to decrease edema
C. Elevate lower extremities for postural drainage
D. Provide the client a list of food low in sodium

20. Mr. Regalado will be discharged from your unit within the hour. Nursing actions when preparing a client for discharge include all EXCEPT:

A. Making a final physical assessment before client leaves the hospital
B. Giving instructions about his medication regimen
C. Walking the client to the hospital exit to ensure his safety
D. Proper recording of pertinent data

Situation 5 – Nancy, mother of 2 young kids, 36 years old, had a mammogram and was told that she has breast cysts and that she may need surgery. This causes her anxiety as shown by increase in her pulse and respiratory rate, sweating and feelings of tension.

21. Considering her level of anxiety, the nurse can best assist Nancy by:

A. Giving her activities to divert her attention
B. Giving detailed explanations about the treatments she will undergo
C. Preparing her and her family in case surgery is not successful
D. Giving her clear but brief information at the level of her understanding

22. Nancy blames God for her situation. She is easily provoked to tears and wants to be left alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or go to church stating that God has abandoned her. The nurse understands that Nancy is grieving for her self and is in the stage of:

A. bargaining
B. denial
C. anger
D. acceptance

23. The nurse visits Nancy and prods her to eat her food. Nancy replies “what’s the use? My time is running out.” The nurse’s best response would be:

A. “The doctor ordered full diet for you so that you will be strong for surgery”
B. “I understand how you feel but you have to try for your children’s sake”
C. “Have you told your doctor how you feel? Are you changing your mind about your surgery?”
D. “You sound like you are giving up.”

24. The nurse feels sad about Nancy’s illness and tells her head nurse during the end of shift endorsement that “it’s unfair for Nancy to have cancer when she is still so young and with two kids”. The best response of the head nurse would be:

A. Advise the nurse to “be strong and learn to control her feelings”
B. Assign the nurse to another client to avoid sympathy for the client
C. Reassure the nurse that the client has hope if she goes through all treatments prescribed for her
D. Ask the other nurses what they feel about the patient to find out if they share the same feelings

25. Realizing that she feels angry about Nancy’s condition, the nurse learns that being self-aware is a conscious process that she should do in any situation like this because:

A. This is a necessary part of the nurse – client relationship process
B. The nurse is a role model for the client and should be strong
C. How the nurse thinks and feels affect her actions towards her client and her work
D. The nurse has to be therapeutic at all times and should not be affected

Situation 6 – Mrs. Seva, 52 years old, asks you about possible problems regarding her elimination now that she is in the menopausal stage.

26. Instruction on health promotion regarding urinary elimination is important. Which would you include?

A. Hold urine as long as she can before emptying the bladder to strengthen her sphincter muscles
B. If burning sensation is experienced while voiding, drink pineapple juice
C. After urination, wipe from anal area up towards the pubis
D. Tell client to empty the bladder at each voiding

27. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?

A. inhibition of the parasympathetic reflex
B. weakness of sphincter muscles of anus
C. loss of tone of the smooth muscles of the colon
D. decreased ability to absorb fluids in the lower intestines

28. The nurse understands that one of these factors contributes to constipation:

A. excessive exercise
B. high fiber diet
C. no regular time for defecation daily
D. prolonged use of laxatives

29. Mrs. Seva talks about fear of being incontinent due to a prior experience of dribbling urine when laughing or sneezing and when she has a full bladder. Your most appropriate instruction would be to:

A. tell client to drink less fluids to avoid accidents
B. instruct client to start wearing thin adult diapers
C. ask the client to bring change of underwear “just in case”
D. teach client pelvic exercise to strengthen perineal muscles

30. Mrs. Seva asked for instructions for skin care for her mother who has urinary incontinence and is almost always in bed. Your instruction would focus on prevention of skin irritation and breakdown by:

A. Using thick diapers to absorb urine well
B. Drying the skin with baby powder to prevent or mask the smell of ammonia
C. Thorough washing, rising and drying of skin area that get wet with urine
D. Making sure that linen are smooth and dry at all times

Situation 7 – Using Maslow’s need theory, Airway, Breathing and Circulation are the physiological needs vital to life. The nurse’s knowledge and ability to identify and immediately intervene to meet these needs is important to save lives.

31. Which of these clients has a problem with the transport of oxygen from the lungs to the tissues:

A. Carol with tumor in the brain
B. Theresa with anemia
C. Sonnyboy with a fracture in the femur
D. Brigitte with diarrhea

32. You noted from the lab exams in the chart of M. Santos that he has reduced oxygen in the blood. This condition is called:

A. Cyanosis
B. Hypoxia
C. Hypoxemia
D. Anemia

33. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of insertion of the tubing for an adult would be:

A. tip of the nose to the base of the neck
B. the distance from the tip of the nose to the middle of the neck
C. the distance from the tip of the nose to the tip of the ear lobe
D. eight to ten inches

34. While doing nasopharyngeal suctioning on Mr. Abad, the nurse can avoid trauma to the area by:

A. Apply suction for at least 20-30 seconds each time to ensure that all secretions are removed
B. Using gloves to prevent introduction of pathogens to the respiratory system
C. Applying no suction while inserting the catheter
D. Rotating catheter as it is inserter with gentle suction

35. Myrna has difficulty breathing when on her back and must sit upright in bed to breath effectively and comfortably. The nurse documents this condition as:

A. Apnea
B. Orthopnea
C. Dyspnea
D. Tachypnea

Situation 8 – You are assigned to screen for hypertension. Your task is to take blood pressure readings and you are informed about avoiding the common mistakes in BP taking that lead to false or inaccurate blood pressure readings.

36. When taking blood pressure reading the cuff should be:

A. deflated fully then immediately start second reading for same client
B. deflated quickly after inflating up to 180 mmHg
C. large enough to wrap around upper arm of the adult client 1 cm above brachial artery
D. inflated to 30 mmHg above the estimated systolic BP based on palpation of radial or bronchial artery

37. Chronic Obstructive Pulmonary Disease (COPD) in one of the leading causes of death world wide and is a preventable disease. The primary cause of COPD is

A. tobacco hack
B. bronchitis
C. asthma
D. cigarette smoking

38. In your health education class for clients with diabetes you teach them the areas for control of Diabetes which include all EXCEPT

A. regular physical activity
B. thorough knowledge of foot care
C. prevention nutrition
D. proper nutrition

39. You teach your clients the difference between, Type I (IDDM) and Type II (NDDM) diabetes. Which of the following is true?

A. both types diabetes mellitus clients are all prone to developing ketosis
B. Type II (NIDDM) is more common and is also preventable compared to Type I (IDDM) diabetes which is genetic in etiology
C. Type I (IIDM) is characterized by fasting hyperglycemia
D. Type II (NIDDM) is characterized by abnormal immune response

40. Lifestyle-related diseases in general share areas common risk factors. These are the following except:

A. physical activity
B. smoking
C. genetics
D. nutrition

Situation 9 – Nurse Rivera witnesses a vehicular accident near the hospital where she works. She decides to get involved and help the victims of the accident

41. Her priority nursing action would be to:

A. Assess damage to property
B. Assist in the police investigation since she is a witness
C. Report the incident immediately to the local police authorities
D. Assess the extent of injuries incurred by the victims of the accident

42. Priority attention should be given to which of these clients?

A. Linda who shows severe anxiety due to trauma of the accident
B. Ryan who has chest injury, is pale and with difficulty breathing
C. Noel who has lacerations on the arms with mild bleeding
D. Andy whose left ankle swelled and has some abrasions

43. In the emergency room, Nurse Rivera is assigned to attend to the client with lacerations on the arms. While assessing the extent of the wound the nurse observes that the wound is now starting to bleed profusely. The most immediate nursing action would be to:

A. Apply antiseptic to prevent infection
B. Clean the wound vigorously of contaminants
C. Control and reduce bleeding of the wound
D. Bandage the wound and elevate the arm

44. The nurse applies dressing on the bleeding site. This intervention is done to:

A. Reduce the need to change dressing frequently
B. Allow the pus to surface faster
C. Protect the wound from microorganisms in the air
D. Promote hemostasis

45. After the treatment, the client is sent home and asked to come back for follow-up care. Your responsibilities when the client is to be discharged include the following EXCEPT:

A. Encouraging the client to go to the outpatient clinic for follow up care
B. Accurate recording of treatment done and instructions given to client
C. Instructing the client to see you after discharge for further assistance
D. Providing instructions regarding wound care

Situation 10 – While working in the clinic, a new client, Geline, 35 years old, arrives for her doctor’s appointment. As the clinic nurse, you are to assist the client fill up forms, gather data and make an assessment.

46. The purpose of your initial nursing interview is to:

A. Record pertinent information in the client’s chart for health team to read
B. Assist the client find solutions to he her health concerns
C. Understand her lifestyle, health needs and possible problems to develop a plan of care
D. Make nursing diagnoses for identified health problems

47. While interviewing Geline, she starts to moan and doubles up in pain. She tells you that this pain occurs about an hour after taking black coffee without breakfast for a few weeks now. You will record this as follows:

A. Claims to have abdominal pains after intake of coffee unrelieved by analgesics
B. After drinking coffee, the client experienced severe abdominal pain
C. Client complained of intermittent abdominal pain an hour after drinking coffee
D. Client reported abdominal pain an hour after drinking black coffee for three weeks now.

48. Geline tells you that she drinks black coffee frequently within the day to “have energy and be wide awake” and she eats nothing for breakfast and eats strictly vegetable salads for lunch and dinner to lose weight. She has lost weight during the past two weeks. In planning a healthy balanced diet with Geline, you will:

A. Start her off with a cleansing diet to free her body of toxins then change to a vegetarian diet and drink plenty of fluids
B. Plan a high protein diet, low carbohydrate diet for her considering her favorite food.
C. Instruct her to attend classes in nutrition to find food rich in complex carbohydrates to maintain daily high energy level.
D. Discuss with her the importance of eating a variety of food from major food groups with plenty of fluids.

49. Geline tells you that she drinks 4-5 cups of black coffee and diet cola drinks. She also smokes up to a pack of cigarettes daily. She confesses that she is in her 2nd month of pregnancy but does not want to become fat that is why she limits her food intake. You warn or caution her about which of the following?

A. Caffeine products affect the central nervous system and may cause the mother to have a “nervous breakdown”
B. Malnutrition and its possible effects on growth and development problems in the unborn fetus
C. Caffeine causes a stimulant effect on both mother and the baby
D. Studies show conclusively that caffeine causes mental retardation

50. Your health education plan for Geline stresses proper diet for a pregnant woman and the prevention of non-communicable diseases that are influenced by her lifestyle. These include the following EXCEPT:

A. Cardiovascular diseases
B. Cancer
C. Diabetes Mellitus
D. Osteoporosis

answer key np1

note: guys pacensya na dont have time yet to post the rationales, super haba most of them, maybe later this month or maybe i'll post ung mga sources na lang na books so you can read them on your own.(^^,)

answers na lang muna for now po..

-diannemaydee

NURSING PRACTICE I – Foundation of PROFESSIONAL Nursing Practice

SITUATIONAL

Situation 1 – Mr. Ibarra is assigned to the triage area and while on duty, he assesses the condition of Mrs. Simon who came in with asthma. She has difficulty breathing and her respiratory rate is 40 per minute. Mr. Ibarra is asked to inject the client epinephrine 0.3 mg subcutaneously.

1. The indication for epinephrine injection for Mrs. Simon is to:

Relieve respiratory distress due to bronchial spasm

2. When preparing the epinephrine injection from an ampule, the nurse initially:

Checks expiration date of the medication ampule

3. Mrs. Simon is obese. When administering a subcutaneous injection to an obese patient, it is best for the nurse to:

Spread skin or pinch at the injection site and inject needle at a 45-90 degree angle

4. When preparing for a subcutaneous injection, the proper size of syringe and needle would be:

Syringe 1-3 ml and needle gauge 25 to 27

5. The rationale for giving medications through the subcutaneous route is:

Absorption time of the medicine is slower

Situation 2 – The use of massage and meditation to help decrease stress and pain have been strongly recommended based on documented testimonials.

6. Martha wants to do a study on this topic: “Effects of massage and meditation on stress and pain”. The type of research that best suits this topic is:

Qualitative research

7. The type of research design that does not manipulate independent variable is:

Non-experimental design

8. This research topic has the potential to contribute to nursing because it seeks to

enhance client care

9. Martha does review of related literature for the purpose of

A. athering data about what is already known or unknown about the problem

10. Client’s rights should be protected when doing research using human subjects. Martha identifies these rights as follows EXCEPT:

right to compensation

Situation 3 – Richard has a nursing diagnosis of ineffective airway clearance related to excessive secretions and is at risk for infection because of retained secretions. Part of Nurse Mario’s nursing care plan is to loosen and remove excessive secretions in the airway.

11. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:

Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his back and on his abdomen

12. When documenting outcome of Richard’s treatment Mario should include the following in his recording EXCEPT:

Amount of fluid intake of client before and after the procedure

13. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:

Teaching the client’s relatives to perform the procedure

14. Mario prepares Richard for postural drainage and percussion. Which of the following is a special consideration when doing the procedure?

Client can tolerate sitting and lying positions

15. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

Percussion delivers cushioned blows to the chest with cupped palms while vibration gently shakes secretion loose on the exhalation cycle

Situation 4 – A 61 year old man, Mr. Regalado, is admitted to the private ward for observation after complaints of severe chest pain. You are assigned to take care of the client.

16. When doing an initial assessment, the best way for you to identify the client’s priority problem is to:

Do a physical examination while asking the client relevant questions

17. Upon establishing Mr. Regalado’s nursing needs, the next nursing approach would be to:

Establish priority needs and implement appropriate interventions

18. Mr. Regalado says he has “trouble going to sleep”. In order to plan your nursing intervention you will:

Ask him what he means by this statement

19. Mr. Regalado’s lower extremities are swollen and shiny. He has pitting pedal edema. When taking care of Mr. Regalado, which of the following interventions would be the most appropriate immediate nursing approach?

Elevate lower extremities for postural drainage

20. Mr. Regalado will be discharged from your unit within the hour. Nursing actions when preparing a client for discharge include all EXCEPT:

Walking the client to the hospital exit to ensure his safety

Situation 5 – Nancy, mother of 2 young kids, 36 years old, had a mammogram and was told that she has breast cysts and that she may need surgery. This causes her anxiety as shown by increase in her pulse and respiratory rate, sweating and feelings of tension.

21. Considering her level of anxiety, the nurse can best assist Nancy by:

Giving her clear but brief information at the level of her understanding

22. Nancy blames God for her situation. She is easily provoked to tears and wants to be left alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or go to church stating that God has abandoned her. The nurse understands that Nancy is grieving for her self and is in the stage of:

anger

23. The nurse visits Nancy and prods her to eat her food. Nancy replies “what’s the use? My time is running out.” The nurse’s best response would be:

“You sound like you are giving up.”

24. The nurse feels sad about Nancy’s illness and tells her head nurse during the end of shift endorsement that “it’s unfair for Nancy to have cancer when she is still so young and with two kids”. The best response of the head nurse would be:

Advise the nurse to “be strong and learn to control her feelings”

25. Realizing that she feels angry about Nancy’s condition, the nurse learns that being self-aware is a conscious process that she should do in any situation like this because:

How the nurse thinks and feels affect her actions towards her client and her work

Situation 6 – Mrs. Seva, 52 years old, asks you about possible problems regarding her elimination now that she is in the menopausal stage.

26. Instruction on health promotion regarding urinary elimination is important. Which would you include?

Tell client to empty the bladder at each voiding

27. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?

loss of tone of the smooth muscles of the colon

28. The nurse understands that one of these factors contributes to constipation:

prolonged use of laxatives

29. Mrs. Seva talks about fear of being incontinent due to a prior experience of dribbling urine when laughing or sneezing and when she has a full bladder. Your most appropriate instruction would be to:

teach client pelvic exercise to strengthen perineal muscles

30. Mrs. Seva asked for instructions for skin care for her mother who has urinary incontinence and is almost always in bed. Your instruction would focus on prevention of skin irritation and breakdown by:

Thorough washing, rising and drying of skin area that get wet with urine

Situation 7 – Using Maslow’s need theory, Airway, Breathing and Circulation are the physiological needs vital to life. The nurse’s knowledge and ability to identify and immediately intervene to meet these needs is important to save lives.

31. Which of these clients has a problem with the transport of oxygen from the lungs to the tissues:

Theresa with anemia

32. You noted from the lab exams in the chart of M. Santos that he has reduced oxygen in the blood. This condition is called:

Hypoxemia

33. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of insertion of the tubing for an adult would be:

the distance from the tip of the nose to the tip of the ear lobe


34. While doing nasopharyngeal suctioning on Mr. Abad, the nurse can avoid trauma to the area by:
Applying no suction while inserting the catheter

35. Myrna has difficulty breathing when on her back and must sit upright in bed to breath effectively and comfortably. The nurse documents this condition as:

Orthopnea

Situation 8 – You are assigned to screen for hypertension. Your task is to take blood pressure readings and you are informed about avoiding the common mistakes in BP taking that lead to false or inaccurate blood pressure readings.

36. When taking blood pressure reading the cuff should be:

deflated fully then immediately start second reading for same client

37. Chronic Obstructive Pulmonary Disease (COPD) in one of the leading causes of death world wide and is a preventable disease. The primary cause of COPD is

cigarette smoking

38. In your health education class for clients with diabetes you teach them the areas for control of Diabetes which include all EXCEPT

prevention nutrition

39. You teach your clients the difference between, Type I (IDDM) and Type II (NDDM) diabetes. Which of the following is true?

Type II (NIDDM) is more common and is also preventable compared to Type I (IDDM) diabetes which is genetic in etiology

40. Lifestyle-related diseases in general share areas common risk factors. These are the following except:

genetics

Situation 9 – Nurse Rivera witnesses a vehicular accident near the hospital where she works. She decides to get involved and help the victims of the accident

41. Her priority nursing action would be to:

Assess the extent of injuries incurred by the victims of the accident

42. Priority attention should be given to which of these clients?

Ryan who has chest injury, is pale and with difficulty breathing

43. In the emergency room, Nurse Rivera is assigned to attend to the client with lacerations on the arms. While assessing the extent of the wound the nurse observes that the wound is now starting to bleed profusely. The most immediate nursing action would be to:

Bandage the wound and elevate the arm

44. The nurse applies dressing on the bleeding site. This intervention is done to:

Promote hemostasis

45. After the treatment, the client is sent home and asked to come back for follow-up care. Your responsibilities when the client is to be discharged include the following EXCEPT:

Instructing the client to see you after discharge for further assistance

Situation 10 – While working in the clinic, a new client, Geline, 35 years old, arrives for her doctor’s appointment. As the clinic nurse, you are to assist the client fill up forms, gather data and make an assessment.

46. The purpose of your initial nursing interview is to:

Understand her lifestyle, health needs and possible problems to develop a plan of care

47. While interviewing Geline, she starts to moan and doubles up in pain. She tells you that this pain occurs about an hour after taking black coffee without breakfast for a few weeks now. You will record this as follows:

Client reported abdominal pain an hour after drinking black coffee for three weeks now.

48. Geline tells you that she drinks black coffee frequently within the day to “have energy and be wide awake” and she eats nothing for breakfast and eats strictly vegetable salads for lunch and dinner to lose weight. She has lost weight during the past two weeks. In planning a healthy balanced diet with Geline, you will:

Discuss with her the importance of eating a variety of food from major food groups with plenty of fluids.

49. Geline tells you that she drinks 4-5 cups of black coffee and diet cola drinks. She also smokes up to a pack of cigarettes daily. She confesses that she is in her 2nd month of pregnancy but does not want to become fat that is why she limits her food intake. You warn or caution her about which of the following?

Malnutrition and its possible effects on growth and development problems in the unborn fetus


50. Your health education plan for Geline stresses proper diet for a pregnant woman and the prevention of non-communicable diseases that are influenced by her lifestyle. These include the following EXCEPT:

Cancer

StuffedNurse : NP2 practice exam

NURSING PRACTICE II – Community Health Nursing and Care of the Mother and Child

SITUATIONAL

Situation 1 – Nurse Minette is an Independent Nurse Practitioner following-up referred clients in their respective homes. Here she handles a case of POSTPARTIAL MOTHER AND FAMILY focusing on HOME CARE.

1. Nurse Minette needs to schedule a first home visit to OB client Leah. When is a first home-care visit typically made?

A. Within 4 days after discharge
B. Within 24 hours after discharge
C. Within 1 hour after discharge
D. Within 1 week of discharge

2. Leah is developing constipation from being on bed rest. What measures would you suggest she take to help prevent this?

A. Eat more frequent small meals instead of three large one daily
B. Walk for at least half an hour daily to stimulate peristalsis
C. Drink more milk, increased calcium intake prevents constipation
D. Drink eight full glasses of fluid such as water daily

3. If you were Minette, which of the following actions would alert you that a new mother is entering a postpartal taking-hold phase?

A. She urges the baby to stay awake so that she can breast-feed him or her
B. She tells you she was in a lot of pain all during labor
C. She says that she has not selected a name for the baby as yet
D. She sleeps as if exhausted from the effort of labor

4. At 6-week postpartum visit what should this postpartal mother’s fundic height be?

A. Inverted and palpable at the cervix
B. Six fingerbreadths below umbilicus
C. No longer palpable on her abdomen
D. One centimeter above the symphysis pubis

5. This postpartal mother wants to loose the weight she gained in pregnancy, so she is reluctant to increase her caloric intake for breast-feeding. By how much should a lactating mother increase her caloric intake during the first 6 months after birth?

A. 350 kcal/day
B. 500 kcal/day
C. 200 kcal/day
D. 1000 kcal/day

Situation 2 – As the CPE is applicable for all professional nurse, the professional growth and development of Nurses with specialties shall be addressed by a Specialty Certification Council. The following questions apply to these special groups of nurses.

6. Which of the following serves as the legal basis and statute authority for the Board of Nursing to promulgate measures to effect the creation of a Specialty Certification Council and promulgate professional development programs for this group of nurse-professionals?

A. R.A. 7610
B. P.D. 223
C. R.A. 9173
D. R.A. 7164
7. By force of law, therefore, the PRC-Board of Nursing released Resolution No. 14 Series of 1999 entitled: “Adoption of a Nursing Specialty Certification Program and Creation of Nursing Specialty Certification Council.” This rule-making power is called:

A. Quasi-Judicial Power
B. Regulatory Power
C. Quasi-Legislative Power
D. Executive/Promulgating Power

8. Under the PRC-Board of Nursing Resolution promulgating the adoption of a Nursing Specialty Certification Program and Council, which two (2) of the following serves as the strongest for its enforcement?

(a) Advances made in Science and Technology have provided the climate for specialization in almost all aspects of human endeavor; and
(b) As necessary consequence, there has emerged a new concept known as globalization which seeks to remove barriers in trade, industry and services imposed by the national laws of countries all over the world; and
(c) Awareness of this development should impel the nursing sector to prepare our people in the services sector to meet the above challenge; and
(d) Current trends of specialization in nursing practice recognized by the International Council of Nurses (ICN) of which the Philippines is a member for the benefit of the Filipino in terms of deepening and refining nursing practice and enhancing the quality of nursing care.

A. b & c are strong justifications
B. a & b are strong justifications
C. a & c are strong justifications
D. a & d are strong justifications

9. Which of the following IS NOT a correct statement as regards Specialty Certification?

A. The Board of Nursing intended to create the Nursing Specialty Certification Program as a means of perpetuating the creation of an elite force of Filipino Nurse Professionals.
B. The Board of Nursing shall oversee the administration of the NSCP through the various Nursing Specialty Boards which will eventually be created
C. The Board of Nursing at the time exercised their powers under R.A. 7164 in order to adopt the creation of the Nursing Specialty Certification Council and Program
D. The Board of Nursing consulted nursing leaders of national nursing associations and other concerned nursing groups which later decided to ask a special group of nurses of the program for nursing specialty Certification.

10. The NSCC was created for the purpose of implementing the Nursing Specialty policy under the direct supervision and stewardship of the Board of Nursing. Who shall comprise the NSCC?

A. A Chairperson who is the current President of the APO; a member from the Academe; and the last member coming from the Regulatory Board
B. The chairperson and members of the Regulatory Board ipso facto acts as the CPE Council
C. A Chairperson, chosen from among the Regulatory Board members; a Vice Chairperson appointed by the BON at-large; two other members also chosen at-large; and one representing the consumer group;
D. A Chairperson who is the President of the Association from the Academe; a member from the Regulatory Board; and the last member coming from the APO

No answer..maybe a bonus question…

Situation 3 –Nurse Anna is a new BSN graduate and has just passed her Licensure Examination for Nurses in the Philippines. She has likewise been hired as a new Community Health Nurse in one of the Rural Health Units in their City, which of the following conditions may be acceptable TRUTHS applied to Community Health Nursing Practice.

11. Which of the following is the primary focus of community health nursing practice?

A. Cure of illnesses
B. Prevention of illnesses
C. Rehabilitation back to health
D. Promotion of health

12. In community health nursing, which of the following is our unit of service as nurses?

A. The community
B. The extended members of every family
C. The individual members of the Barangay
D. The Family

13. A very important part of the Community Health Nursing Assessment Process includes:

A. the application of professional judgment in estimating importance of facts to family and community
B. evaluation structures and qualifications of health center team
C. coordination with other sectors in relation to health concerns
D. carrying out nursing procedures as per plan of action

14. In community health nursing it is important to take into account the family health data coupled with an equally important need to perform ocular inspection of the area as activities which are powerful elements of:

A. evaluation
B. assessment
C. implementation
D. planning

15. The initial step in PLANNING process in order to engage in any nursing project or activities at the community level involves

A. goal-setting
B. monitoring
C. evaluation of data
D. provision of data

Situation 4 – Please continue responding as a professional nurse in these other health situations through the following questions.

16. Transmission of HIV from an infected individual to another person occurs:

A. Most frequently in nurses with needlesticks
B. Only if there is a large viral load in the blood
C. Most commonly as a result of sexual contact
D. In all infants born to women with HIV infection

17. The medical record of a client reveals a condition in which the fetus cannot pass through the maternal pelvis. The nurse interprets this as:

A. Contracted pelvis
B. Maternal disproportion
C. Cervical insufficiency
D. Fetopelvic disproportion

18. The nurse would anticipate a cesarean birth for a client who has which infection present at the onset of labor?

A. Herpes-simplex virus
B. Human papilloma virus
C. Hepatitis
D. Toxoplasmosis

19. After a vaginal examination, the nurse determines that the client’s fetus is in an occiput posterior position. The nurse would anticipate that the client will have:

A. A precipitous birth
B. Intense back pain
C. Frequent leg cramps
D. Nausea and vomiting

20. The rationales for using a prostaglandin gel for a client prior to the induction of labor is to:

A. Soften and efface the cervix
B. Numb cervical pain receptors
C. Prevent cervical lacerations
D. Stimulate uterine contractions

Situation 5 – Nurse Lorena is a Family Planning and Infertility Nurse Specialist and currently attends to FAMILY PLANNING CLIENTS AND INFERTILE COUPLES. The following conditions pertain to meeting the nursing needs of this particular population group.

21. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer?

A. Prostaglandins released from the cut fallopian tubes can kill sperm
B. Sperm can not enter the uterus because the cervical entrance is blocked.
C. Sperm can no longer reach the ova, because the fallopian tubes are blocked
D. The ovary no longer releases ova as there is no where for them to go.

22. The Dators are a couple undergoing testing for infertility. Infertility is said to exist when:

A. a woman has no uterus
B. a woman has no children
C. a couple has been trying to conceive for 1 year
D. a couple has wanted a child for 6 months

23. Another client named Lilia is diagnosed as having endometriosis. This condition interferes with fertility because:

A. endometrial implants can block the fallopian tubes
B. the uterine cervix becomes inflamed and swollen
C. the ovaries stop producing adequate estrogen
D. pressure on the pituitary leads to decreased FSH levels

24. Lilia is scheduled to have a hysterosalphingogram. Which of the following instructions would you give her regarding this procedure?

A. She will not be able to conceive for 3 months after the procedure
B. The sonogram of the uterus will reveal any tumors present
C. Many women experience mild bleeding as an after effect
D. She may feel some cramping when the dye is inserted

25. Lilia’s cousin on the other hand, knowing nurse Lorena’s specialization asks what artificial insemination by donor entails. Which would be your best answer if you were Nurse Lorena?

A. Donor sperm are introduced vaginally into the uterus or cervix
B. Donor sperm are injected intra-abdominally into each ovary
C. Artificial sperm are injected vaginally to test tubal patency
D. The husband’s sperm is administered intravenously weekly

Situation 6 – There are other important basic knowledge in the performance of our task as Community Health Nurse in relation to IMMUNIZATION, these include:

26. The correct temperature to store vaccines in a refrigerator is:

A. between -4 deg C and +8 deg C
B. between 2 deg C and +8 deg C
C. between -8 deg C and 0 deg C
D. between -8 deg C and +4 deg C

27. Which of the following vaccines is not done by intramuscular (IM) injection?

A. Measles vaccine
B. DPT
C. Hepa-B vaccine
D. Tetanus toxoids

28. This vaccine content is derived from RNA recombinants.

A. Measles
B. Tetanus toxoids
C. Hepatitis B vaccines
D. DPT

29. This is the vaccine needed before a child reaches one (1) year in order for him/her to qualify as a :fully immunized child”.

A. DPT
B. Measles
C. Hepatitis B
D. BCG

30. Which of the following dose of tetanus toxoid is given to the mother to protect her infant from neonatal tetanus and likewise provide 10 years protection for the mother?

A. Tetanus toxoid 3
B. Tetanus toxoid 2
C. Tetanus toxoid 1
D. Tetanus toxoid 4

Situation 7 – Records contain those comprehensive descriptions of patient’s health conditions and needs and at the same serve as evidences of every nurse’s accountability in the care giving process. Nursing records normally differ from institution to institution nonetheless they follow similar patterns of meeting needs for specific types of information. The following pertains to documentation/records management.

31. This special form is used when the patient is admitted to the unit. The nurse completes the information in this record particularly his/her basic personal data, current illness, previous health history, health history of the family, emotional profile, environmental history as well as physical assessment together with nursing diagnosis on admission. What do you call this record?

A. Nursing Kardex
B. Nursing Health History and Assessment Worksheet
C. Medicine and Treatment Record
D. Discharge Summary

32. These are sheets/forms which provide an efficient and time saving way to record information that must be obtained repeatedly at regular and/or short intervals of time. This does not replace the progress notes; instead this record of information on vital signs, intake and output, treatment, postoperative care, post partum care, and diabetic regimen, etc. This is used whenever specific measurements or observations are needed to be documented repeatedly. What is this?

A. Nursing Kardex
B. Graphic Flow Sheets
C. Discharge Summary
D. Medicine and Treatment Record

33. These records show all medications and treatment provided on a repeated basis. What do you call this record?

A. Nursing Health History and Assessment Worksheet
B. Discharge Summary
C. Nursing Kardex
D. Medicine and Treatment Record

34. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2-parts: the activity and treatment section and a nursing care plan section. This carries information about basic demographic data, primary medical diagnosis, current orders of the physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in patient care and factors related to daily living activities. This record is used in the charge-of-shift reports or during the bedside rounds or walking rounds. What record is this?

A. Discharge Summary
B. Medicine and Treatment Record
C. Nursing Health History and Assessment Worksheet
D. Nursing Kardex

35. Most nurses regard this conventional recording of the date, time, and mode by which the patient leaves a healthcare unit but this record includes importantly, directs of planning for discharge that starts soon after the person is admitted to a healthcare institution. It is accepted that collaboration or multidisciplinary involvement (of all members of the health team) in discharge results in comprehensive care. What do you call this?

A. Discharge Summary
B. Nursing Kardex
C. Medicine and Treatment Record
D. Nursing Health History and Assessment Worksheet

Situation 8 – As Filipino Professional Nurses we must be knowledgeable about the Code of Ethics for Filipino Nurse and practice these by heart. The next questions pertain to this Code of Ethics.

36. Which of the following is TRUE about the Code of Ethics of Filipino Nurses?

A. The Philippine Nurses Association for being the accredited professional organization was given the privilege to formulate a Code of Ethics for Nurses which the Board of Nursing promulgated
B. Code for Nurses was first formulated in 1982 published in the Proceedings of the Third Annual Convention of the PNA House of Delegates
C. The present code utilized the Code of Good Governance for the Professions in the Philippines
D. Certificates of Registration of registered nurses may be revoked or suspended for violations of any provisions of the Code of Ethics.

37. Based on the Code of Ethics for Filipino Nurses, what is regarded as the hallmark of nursing responsibility and accountability?

A. Human rights of clients, regardless of creed and gender
B. The privilege of being a registered professional nurses
C. Health, being a fundamental right of every individual
D. Accurate documentation of actions and outcomes

38. Which of the following nurses behavior is regarded as a violation of the Code of Ethics of Filipino Nurses?

A. A nurse withholding harmful information to the family members of a patient
B. A nurse declining commission sent by a doctor for her referral
C. A nurse endorsing a person running for congress.
D. Nurse Reviewers and/or nurse review center managers who pays a considerable amount of cash for reviewees who would memorize items from the licensure exams and submit these to them after the examination.

39. A nurse should be cognizant that professional programs for specialty certification by the Board of Nursing accredited through the:

Professional Regulation Commission
Nursing Specialty Certification Council
Association of Deans of Philippine Colleges of Nursing
Philippine Nurse Association

40. Mr. Santos, R.N. works in a nursing home, and he knows that one of his duties is to be an advocate for his patients. Mr. Santos knows a primary duty of an advocate is to;

A. act as the patient’s legal representative
B. complete all nursing responsibilities on time
C. safeguard the well being of every patient
D. maintain the patient’s right to privacy

Situation 9 – Nurse Joanna works as an OB-Gyne Nurse and attends to several HIGH-RISK PREGNANCIES: Particular women with preexisting or Newly Acquired illness. The following conditions apply

41. Bernadette is a 22-year old woman. Which condition would make her more prone than others to developing a Candida infection during pregnancy?

A. Her husband plays golf 6 days a week
B. She was over 35 when she became pregnant
C. She usually drinks tomato juice for breakfast
D. She has developed gestational diabetes

42. Bernadette develops a deep vein thrombosis following an auto accident and is prescribed heparin sub-Q. What should Joanna educate her about in regard to this?

A. Some infants will be born with allergic symptoms to heparin
B. Her infant will be born with scattered petechiae on his trunk
C. Heparin can cause darkened skin in newborns
D. Heparin does not cross placenta and so does not affect a fetus

43. The cousin of Bernadette with sickle-cell anemia alerted Joanna that she may need further instruction on prenatal care. What statement signifies this fact?

A. I’ve stopped jogging so I don’t risk becoming dehydrated.
B. I take an iron pill every day to help grow new red blood cells
C. I am careful to drink at least eight glasses of fluid every day
D. I understand why folic acid is important for red cell formation

44. Bernadette routinely takes acetylsalicylic acid (aspirin) for arthritis. Why should she limit or discontinue this toward the end of pregnancy?

A. Aspirin can lead to deep vein thrombosis following birth
B. Newborns develop a red rash from salicylate toxicity
C. Newbors develop withdrawal headaches from salicylates
D. Salicylates can lead to increased maternal bleeding at childbirth

45. Bernadette received a laceration on her leg from her automobile accident. Why are lacerations of lower extremities potentially more serious in pregnant women than others?

A. Lacerations can provoke allergic responses because of gonadothropic hormone
B. Increased bleeding can occur from uterine pressure on leg veins
C. A woman is less able to keep the laceration clean because of her fatigue
D. Healing is limited during pregnancy, so these will not heal until after birth.

Situation 10 – Still in your self-managed Child Health Nursing Clinic, you encounter these cases pertaining to the CARE OF CHILDREN WITH PULMONARY AFFECTIONS.

46. Josie brought her 3 months old child to your clinic because of cough and colds. Which of the following is your primary action?

A. Give cotrimoxazole tablet or syrup
B. Assess the patient using the chart on management of children with cough
C. Refer to the doctor
D. Teach the mother how to count her child’s breathing

47. In responding to the care concerns of children with sever disease, referral to the hospital is of the essence especially if the child manifests which of the following?

A. Wheezing
B. Stop feeding well
C. Fast breathing
D. Difficulty to awaken

48. Which of the following is the most important responsibility of a nurse in the prevention of unnecessary deaths from pneumonia and other severe diseases?

A. Giving antibiotics
B. Taking of the temperature of the sick child
C. Provision of Careful Assessment
D. Weighing of the sick child

49. You were able to identify factors that lead to respiratory problems in the community where your health facility serve. Your primary role therefore in order to reduce morbidity due to pneumonia is to:

A. Teach mothers how to recognize early signs and symptoms of pneumonia
B. Make home visits to sick children
C. Refer cases to hospitals
D. Seek assistance and mobilize the BHWs to have a meeting with mothers

50. Which of the following is the principal focus of the CARI program of the Department of Health?

A. Enhancement of health team capabilities
B. Teach mothers how to detect signs and where to refer
C. Mortality reduction through early detection
D. Teach other community health workers how to assess patients.

answer key np

note: guys, i'll post the rationales later this month na lang ha, super hectic lang talaga my sched (^^,)


NURSING PRACTICE II – Community Health Nursing and Care of the Mother and Child

SITUATIONAL

Situation 1 – Nurse Minette is an Independent Nurse Practitioner following-up referred clients in their respective homes. Here she handles a case of POSTPARTIAL MOTHER AND FAMILY focusing on HOME CARE.

1. Nurse Minette needs to schedule a first home visit to OB client Leah. When is a first home-care visit typically made?

Within 24 hours after discharge

2. Leah is developing constipation from being on bed rest. What measures would you suggest she take to help prevent this?

Drink eight full glasses of fluid such as water daily

3. If you were Minette, which of the following actions would alert you that a new mother is entering a postpartal taking-hold phase?

She urges the baby to stay awake so that she can breast-feed him or her

4. At 6-week postpartum visit what should this postpartal mother’s fundic height be?

No longer palpable on her abdomen

5. This postpartal mother wants to loose the weight she gained in pregnancy, so she is reluctant to increase her caloric intake for breast-feeding. By how much should a lactating mother increase her caloric intake during the first 6 months after birth?

500 kcal/day

Situation 2 – As the CPE is applicable for all professional nurse, the professional growth and development of Nurses with specialties shall be addressed by a Specialty Certification Council. The following questions apply to these special groups of nurses.

6. Which of the following serves as the legal basis and statute authority for the Board of Nursing to promulgate measures to effect the creation of a Specialty Certification Council and promulgate professional development programs for this group of nurse-professionals?

R.A. 7164
7. By force of law, therefore, the PRC-Board of Nursing released Resolution No. 14 Series of 1999 entitled: “Adoption of a Nursing Specialty Certification Program and Creation of Nursing Specialty Certification Council.” This rule-making power is called:

Quasi-Legislative Power

8. Under the PRC-Board of Nursing Resolution promulgating the adoption of a Nursing Specialty Certification Program and Council, which two (2) of the following serves as the strongest for its enforcement?

(a) Advances made in Science and Technology have provided the climate for specialization in almost all aspects of human endeavor; and
(b) As necessary consequence, there has emerged a new concept known as globalization which seeks to remove barriers in trade, industry and services imposed by the national laws of countries all over the world; and
(c) Awareness of this development should impel the nursing sector to prepare our people in the services sector to meet the above challenge; and
(d) Current trends of specialization in nursing practice recognized by the International Council of Nurses (ICN) of which the Philippines is a member for the benefit of the Filipino in terms of deepening and refining nursing practice and enhancing the quality of nursing care.

a & b are strong justifications

9. Which of the following IS NOT a correct statement as regards Specialty Certification?

The Board of Nursing intended to create the Nursing Specialty Certification Program as a means of perpetuating the creation of an elite force of Filipino Nurse Professionals.

10. The NSCC was created for the purpose of implementing the Nursing Specialty policy under the direct supervision and stewardship of the Board of Nursing. Who shall comprise the NSCC?

A. A Chairperson who is the current President of the APO; a member from the Academe; and the last member coming from the Regulatory Board
B. The chairperson and members of the Regulatory Board ipso facto acts as the CPE Council
C. A Chairperson, chosen from among the Regulatory Board members; a Vice Chairperson appointed by the BON at-large; two other members also chosen at-large; and one representing the consumer group;
D. A Chairperson who is the President of the Association from the Academe; a member from the Regulatory Board; and the last member coming from the APO

No answer..maybe a bonus question…

Situation 3 –Nurse Anna is a new BSN graduate and has just passed her Licensure Examination for Nurses in the Philippines. She has likewise been hired as a new Community Health Nurse in one of the Rural Health Units in their City, which of the following conditions may be acceptable TRUTHS applied to Community Health Nursing Practice.

11. Which of the following is the primary focus of community health nursing practice?

Promotion of health

12. In community health nursing, which of the following is our unit of service as nurses?

The Family

13. A very important part of the Community Health Nursing Assessment Process includes:

the application of professional judgment in estimating importance of facts to family and community

14. In community health nursing it is important to take into account the family health data coupled with an equally important need to perform ocular inspection of the area as activities which are powerful elements of:

assessment

15. The initial step in PLANNING process in order to engage in any nursing project or activities at the community level involves

goal-setting

Situation 4 – Please continue responding as a professional nurse in these other health situations through the following questions.

16. Transmission of HIV from an infected individual to another person occurs:

Most commonly as a result of sexual contact

17. The medical record of a client reveals a condition in which the fetus cannot pass through the maternal pelvis. The nurse interprets this as:

A. Fetopelvic disproportion

18. The nurse would anticipate a cesarean birth for a client who has which infection present at the onset of labor?

Herpes-simplex virus

19. After a vaginal examination, the nurse determines that the client’s fetus is in an occiput posterior position. The nurse would anticipate that the client will have:

Intense back pain

20. The rationales for using a prostaglandin gel for a client prior to the induction of labor is to:

Soften and efface the cervix

Situation 5 – Nurse Lorena is a Family Planning and Infertility Nurse Specialist and currently attends to FAMILY PLANNING CLIENTS AND INFERTILE COUPLES. The following conditions pertain to meeting the nursing needs of this particular population group.

21. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer?

Sperm can no longer reach the ova, because the fallopian tubes are blocked

22. The Dators are a couple undergoing testing for infertility. Infertility is said to exist when:

a couple has been trying to conceive for 1 year

23. Another client named Lilia is diagnosed as having endometriosis. This condition interferes with fertility because:

endometrial implants can block the fallopian tubes

24. Lilia is scheduled to have a hysterosalphingogram. Which of the following instructions would you give her regarding this procedure?

She may feel some cramping when the dye is inserted

25. Lilia’s cousin on the other hand, knowing nurse Lorena’s specialization asks what artificial insemination by donor entails. Which would be your best answer if you were Nurse Lorena?

Donor sperm are introduced vaginally into the uterus or cervix

Situation 6 – There are other important basic knowledge in the performance of our task as Community Health Nurse in relation to IMMUNIZATION, these include:

26. The correct temperature to store vaccines in a refrigerator is:

between 2 deg C and +8 deg C

27. Which of the following vaccines is not done by intramuscular (IM) injection?

Measles vaccine

28. This vaccine content is derived from RNA recombinants.

Hepatitis B vaccines

29. This is the vaccine needed before a child reaches one (1) year in order for him/her to qualify as a :fully immunized child”.

Measles

30. Which of the following dose of tetanus toxoid is given to the mother to protect her infant from neonatal tetanus and likewise provide 10 years protection for the mother?

Tetanus toxoid 4

Situation 7 – Records contain those comprehensive descriptions of patient’s health conditions and needs and at the same serve as evidences of every nurse’s accountability in the care giving process. Nursing records normally differ from institution to institution nonetheless they follow similar patterns of meeting needs for specific types of information. The following pertains to documentation/records management.

31. This special form is used when the patient is admitted to the unit. The nurse completes the information in this record particularly his/her basic personal data, current illness, previous health history, health history of the family, emotional profile, environmental history as well as physical assessment together with nursing diagnosis on admission. What do you call this record?

Nursing Health History and Assessment Worksheet

32. These are sheets/forms which provide an efficient and time saving way to record information that must be obtained repeatedly at regular and/or short intervals of time. This does not replace the progress notes; instead this record of information on vital signs, intake and output, treatment, postoperative care, post partum care, and diabetic regimen, etc. This is used whenever specific measurements or observations are needed to be documented repeatedly. What is this?

Graphic Flow Sheets

33. These records show all medications and treatment provided on a repeated basis. What do you call this record?

Medicine and Treatment Record

34. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2-parts: the activity and treatment section and a nursing care plan section. This carries information about basic demographic data, primary medical diagnosis, current orders of the physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in patient care and factors related to daily living activities. This record is used in the charge-of-shift reports or during the bedside rounds or walking rounds. What record is this?

Nursing Kardex

35. Most nurses regard this conventional recording of the date, time, and mode by which the patient leaves a healthcare unit but this record includes importantly, directs of planning for discharge that starts soon after the person is admitted to a healthcare institution. It is accepted that collaboration or multidisciplinary involvement (of all members of the health team) in discharge results in comprehensive care. What do you call this?

Discharge Summary

Situation 8 – As Filipino Professional Nurses we must be knowledgeable about the Code of Ethics for Filipino Nurse and practice these by heart. The next questions pertain to this Code of Ethics.

36. Which of the following is TRUE about the Code of Ethics of Filipino Nurses?

The present code utilized the Code of Good Governance for the Professions in the Philippines

37. Based on the Code of Ethics for Filipino Nurses, what is regarded as the hallmark of nursing responsibility and accountability?

Accurate documentation of actions and outcomes

38. Which of the following nurses behavior is regarded as a violation of the Code of Ethics of Filipino Nurses?

Nurse Reviewers and/or nurse review center managers who pays a considerable amount of cash for reviewees who would memorize items from the licensure exams and submit these to them after the examination.

39. A nurse should be cognizant that professional programs for specialty certification by the Board of Nursing accredited through the:

Nursing Specialty Certification Council

40. Mr. Santos, R.N. works in a nursing home, and he knows that one of his duties is to be an advocate for his patients. Mr. Santos knows a primary duty of an advocate is to;

maintain the patient’s right to privacy

Situation 9 – Nurse Joanna works as an OB-Gyne Nurse and attends to several HIGH-RISK PREGNANCIES: Particular women with preexisting or Newly Acquired illness. The following conditions apply

41. Bernadette is a 22-year old woman. Which condition would make her more prone than others to developing a Candida infection during pregnancy?

She has developed gestational diabetes

42. Bernadette develops a deep vein thrombosis following an auto accident and is prescribed heparin sub-Q. What should Joanna educate her about in regard to this?

Heparin does not cross placenta and so does not affect a fetus

43. The cousin of Bernadette with sickle-cell anemia alerted Joanna that she may need further instruction on prenatal care. What statement signifies this fact?

I take an iron pill every day to help grow new red blood cells

44. Bernadette routinely takes acetylsalicylic acid (aspirin) for arthritis. Why should she limit or discontinue this toward the end of pregnancy?

Salicylates can lead to increased maternal bleeding at childbirth

45. Bernadette received a laceration on her leg from her automobile accident. Why are lacerations of lower extremities potentially more serious in pregnant women than others?

Increased bleeding can occur from uterine pressure on leg veins

Situation 10 – Still in your self-managed Child Health Nursing Clinic, you encounter these cases pertaining to the CARE OF CHILDREN WITH PULMONARY AFFECTIONS.

46. Josie brought her 3 months old child to your clinic because of cough and colds. Which of the following is your primary action?

Assess the patient using the chart on management of children with cough
A. Refer to the doctor
B. Teach the mother how to count her child’s breathing

47. In responding to the care concerns of children with sever disease, referral to the hospital is of the essence especially if the child manifests which of the following?

Difficulty to awaken

48. Which of the following is the most important responsibility of a nurse in the prevention of unnecessary deaths from pneumonia and other severe diseases?

Provision of Careful Assessment

49. You were able to identify factors that lead to respiratory problems in the community where your health facility serve. Your primary role therefore in order to reduce morbidity due to pneumonia is to:

Teach mothers how to recognize early signs and symptoms of pneumonia

50. Which of the following is the principal focus of the CARI program of the Department of Health?

Mortality reduction through early detection

StuffedNurse: NP3 practice exam

NURSING PRACTICE III – Care of Clients with Physiologic and Psychosocial Alterations (Part A)

SITUATIONAL

Situation 1 – Concerted work efforts among members of the surgical team is essential to the success of the surgical procedure.

1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a need for sterile supply which is not in the sterile field, who hands out these items by opening its outer cover?

A. Circulating Nurse
B. Anaesthesiologist
C. Surgeon
D. Nursing Aide

2. The OR team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame and deliver a standard patient outcome. While the surgeon performs the surgical procedure, who monitors the status of the client like urine output, blood loss?

A. Scrub Nurse
B. Surgeon
C. Anaesthesiologist
D. Circulating Nurse

3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed to be present in the OR?

A. Rehabilitation department
B. Laboratory department
C. Maintenance department
D. Radiology department

4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team, who else has to be present when a client undergoes laparoscopic surgery?

A. Information technician
B. Biomedical technician
C. Electrician
D. Laboratory technician

5. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to be alerted to coordinate closely with the patient’s family for immediate blood component therapy?

A. Security Division
B. Chaiplaincy
C. Social Service Section
D. Pathology department

Situation 2 – You are assigned in the Orthopedic Ward where clients are complaining of pain in varying degrees upon movement of body parts.

6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain. Which of the following observation would prompt you to call the doctor?

A. Dressing is intact but partially soiled
B. Left foot is cold to touch and pedal pulse is absent
C. Left leg in limited functional anatomic position
D. BP 114/78, pulse of 82 beats/minute

7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at 5 pm. The next dose of Demerol 50 mg I.M. is given:

A. When the client asks for the next dose
B. When the patient is in severe pain
C. At 11 pm
D. At 12 pm

8. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors indicate appropriate adaptation?

A. The client reports pain reduction and decreased activity
B. The client denies existence of pain
C. The client can distract himself during pain episodes
D. The client reports independence from watchers

9. Pain in ortho cases may not be mainly due to the surgery. There might be other factors such as cultural or psychological that influence pain. How can you alter these factors as the nurse?

A. Explain all the possible interventions that may cause the client to worry
B. Establish trusting relationship by giving his medication on time
C. Stay with the client during pain episodes
D. Promote client’s sense of control and participation in control by listening to his concerns

10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?

A. Instruct client to observe strict bed rest
B. Check for epidural catheter drainage
C. Administer analgesia through epidural catheter as prescribed
D. Assess respiratory rate carefully

Situation 3 – Records are vital tools in any institution and should be properly maintained for specific use and time.

11. The patient’s medical record can work as a double edged sword. When can the medical record become the doctor’s/nurse’s worst enemy?

A. When the record is voluminous
B. When a medical record is subpoenaed in court
C. When it is missing
D. When the medical record is inaccurate, incomplete, and inadequate

12. Disposal of medical records in government hospitals/institutions must be done in close coordination with what agency?

A. Department of Interior and Local Government (DILG)
B. Metro Manila Development Authority (MMDA)
C. Records Management Archives Office (RMAO)
D. Department of Health (DOH)

13. In the hospital, when you need the medical record of a discharged patient for research you will request permission through:

A. Doctor in charge
B. The hospital director
C. The nursing service
D. Medical records section

14. You readmitted a client who was in another department a month ago. Since you will need the previous chart, from whom do you request the old chart?

A. Central supply section
B. Previous doctor’s clinic
C. Department where the patient was previously admitted
D. Medical records section

15. Records Management and Archives Office of the DOH is responsible for implementing its policies on record disposal. You know that your institution is covered by this policy if:

A. Your hospital is considered tertiary
B. Your hospital is in Metro Manila
C. It obtained permit to operate from DOH
D. Your hospital is PhilHealth accredited

Situation 4 – In the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all these to safeguard the safety and quality of patient delivery outcome.

16. Which of the following should be given highest priority when receiving patient in the OR?

A. Assess level of consciousness
B. Verify patient identification and informed consent
C. Assess vital signs
D. Check for jewelry, gown, manicure, and dentures

17. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but considered ‘dirty cases’. When are these procedures best scheduled?

A. Last case
B. In between cases
C. According to availability of anaesthesiologist
D. According to the surgeon’s preference

18. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing care during the intraoperative phase. As the circulating nurse, you make certain that throughout the procedure…

A. the surgeon greets his client before induction of anesthesia
B. the surgeon and anesthesiologist are in tandem
C. strap made of strong non-abrasive materials are fastened securely around the joints of the knees and ankles and around the 2 hands around an arm board.
D. Client is monitored throughout the surgery by the assistant anesthesiologist

19. Another nursing check that should not be missed before the induction of general anesthesia is:

A. check for presence underwear
B. check for presence dentures
C. check patient’s ID
D. check baseline vital signs

20. Some lifetime habits and hobbies affect postoperative respiratory function. If your client smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate increased risk for:

A. perioperative anxiety and stress
B. delayed coagulation time
C. delayed wound healing
D. postoperative respiratory function

Situation 5 – Nurses hold a variety of roles when providing care to a perioperative patient.

21. Which of the following role would be the responsibility of the scrub nurse?

A. Assess the readiness of the client prior to surgery
B. Ensure that the airway is adequate
C. Account for the number of sponges, needles, supplies, used during the surgical procedure.
D. Evaluate the type of anesthesia appropriate for the surgical client

22. As a perioperative nurse, how can you best meet the safety need of the client after administering preoperative narcotic?

A. Put side rails up and ask the client not to get out of bed
B. Send the client to OR with the family
C. Allow client to get up to go to the comfort room
D. Obtain consent form

23. It is the responsibility of the pre-op nurse to do skin prep for patients undergoing surgery. If hair at the operative site is not shaved, what should be done to make suturing easy and lessen chance of incision infection?

A. Draped
B. Pulled
C. Clipped
D. Shampooed

24. It is also the nurse’s function to determine when infection is developing in the surgical incision. The perioperative nurse should observe for what signs of impending infection?

A. Localized heat and redness
B. Serosanguinous exudates and skin blanching
C. Separation of the incision
D. Blood clots and scar tissue are visible

25. Which of the following nursing interventions is done when examining the incision wound and changing the dressing?

A. Observe the dressing and type and odor of drainage if any
B. Get patient’s consent
C. Wash hands
D. Request the client to expose the incision wound

Situation 6 – Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min and he appears to be in acute respiratory distress.

26. Which of the following nursing actions should be initiated first?

A. Promote emotional support
B. Administer oxygen at 6L/min
C. Suction the client every 30 min
D. Administer bronchodilator by nebulizer

27. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse, what is its indication, the nurse will say:

A. Relax smooth muscles of the bronchial airway
B. Promote expectoration
C. Prevent thickening of secretions
D. Suppress cough

28. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction will include the following, EXCEPT:

A. Avoid emotional stress and extreme temperature
B. Avoid pollution like smoking
C. Avoid pollens, dust, seafood
D. Practice respiratory isolation

29. The asthmatic client asked you what breathing techniques he can best practice when asthmatic attack starts. What will be the best position?

A. Sit in high-Fowler’s position with extended legs
B. Sit-up with shoulders back
C. Push on abdomen during exhalation
D. Lean forward 30-40 degrees with each exhalation

30. As a nurse, you are always alerted to monitor status asthmaticus who will likely and initially manifest symptoms of:

A. metabolic alkalosis
B. respiratory acidosis
C. respiratory alkalosis
D. metabolic acidosis

Situation 7 – Joint Commission on Accreditation of Hospital Organization (JCAHO) patient safety goals and requirements include the care and efficient use of technology in the OR and elsewhere in the healthcare facility.

31. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm systems?

A. Limit suppliers to a few so that quality is maintained
B. Implement a regular inventory of supplies and equipment
C. Adherence to manufacturer’s recommendation
D. Implement a regular maintenance and testing of alarm systems

32. Overdosage of medication or anesthetic can happen even with the aid of technology like infusion pumps, sphygmomanometer and similar devices/machines. As a staff, how can you improve the safety of using infusion pumps?

A. Check the functionality of the pump before use
B. Select your brand of infusion pump like you do with your cellphone
C. Allow the technician to set the infusion pump before use
D. Verify the flow rate against your computation

33. JCAHOs universal protocol for surgical and invasive procedures to prevent wrong site, wrong person, and wrong procedure/surgery includes the following, EXCEPT:

A. Mark the operative site if possible
B. Conduct pre-procedure verification process
C. Take a video of the entire intra-operative procedure
D. Conduct ‘time out’ immediately before starting the procedure

34. You identified a potential risk of pre-and postoperative clients. To reduce the risk of patient harm resulting from fall, you can implement the following, EXCEPT:

A. Assess potential risk of fall associated with the patient’s medication regimen
B. Take action to address any identified risks through Incident Report (IR)
C. Allow client to walk with relative to the OR
D. Assess and periodically reassess individual client’s risk for falling

35. As a nurse, you know you can improve on accuracy of patient’s identification by 2 patient identifiers, EXCEPT:

A. identify the client by his/her wrist tag and verify with family members
B. identify client by his/her wrist tag and call his/her by name
C. call the client by his/her case and bed number
D. call the patient by his/her name and bed number

Situation 8 – Team efforts is best demonstrated in the OR.

36. If you are the nurse in charge for scheduling surgical cases, what important information do you need to ask the surgeon?

A. Who is your internist
B. Who is your assistant and anesthesiologist, and what is your preferred time and type of surgery?
C. Who are your anesthesiologist, internist, and assistant
D. Who is your anesthesiologist

37. In the OR, the nursing tandem for every surgery is:

A. Instrument technician and circulating nurse
B. Nurse anesthetist, nurse assistant, and instrument technician
C. Scrub nurse and nurse anesthetist
D. Scrub and circulating nurses

38. While team effort is needed in the OR for efficient and quality patient care delivery, we should limit the number of people in the room for infection control. Who comprise this team?

A. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly
B. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
C. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
D. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

39. When surgery is on-going, who coordinates the activities outside, including the family?

A. Orderly/clerk
B. Nurse Supervisor
C. Circulating Nurse
D. Anesthesiologist

40. The breakdown in teamwork is often times a failure in:

A. Electricity
B. Inadequate supply
C. Leg work
D. Communication

Situation 9 – Colostomy is a surgically created anus. It can be temporary or permanent, depending on the disease condition.

41. Skin care around the stoma is critical. Which of the following is not indicated as a skin care barriers?

A. Apply liberal amount of mineral oil to the area
B. Use karaya paste and rings around the stoma
C. Clean the area daily with soap and water before applying bag
D. Apply talcum powder twice a day

42. What health instruction will enhance regulation of a colostomy (defecation) of clients?

A. Irrigate after lunch everyday
B. Eat fruits and vegetables in all three meals
C. Eat balanced meals at regular intervals
D. Restrict exercise to walking only

43. After ileostomy, which of the following condition is NOT expected?

A. Increased weight
B. Irritation of skin around the stoma
C. Liquid stool
D. Establishment of regular bowel movement

44. The following are appropriate nursing interventions during colostomy irrigation, EXCEPT:

A. Increase the irrigating solution flow rate when abdominal cramps is felt
B. Insert 2-4 inches of an adequately lubricated catheter to the stoma
C. Position client in semi-Fowler
D. Hang the solution 18 inches above the stoma

45. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained?

A. Sensation of taste
B. Sensation of pressure
C. Sensation of smell
D. Urge to defecate

Situation 10 – As a beginner in research, you are aware that sampling is an essential elements of the research process.

46. What does a sample group represent?

A. Control group
B. Study subjects
C. General population
D. Universe

47. What is the most important characteristic of a sample?

A. Randomization
B. Appropriate location
C. Appropriate number
D. Representativeness

48. Random sampling ensures that each subject has:

A. Been selected systematically
B. An equal chance of selection
C. Been selected based on set criteria
D. Characteristics that match other samples

49. Which of the following methods allows the use of any group of research subject?

A. Purposive
B. Convenience
C. Snow-ball
D. Quota

50. You decided to include 5 barangays in your municipality and chose a sampling method that would get representative samples from each barangay. What should be the appropriate method ofor you to use in this care?

A. Cluster sampling
B. Random sampling
C. Startified ampling
D. Systematic sampling


answer key np3

note: later na po ung rationales! (^^,)

NURSING PRACTICE III – Care of Clients with Physiologic and Psychosocial Alterations (Part A)

SITUATIONAL

Situation 1 – Concerted work efforts among members of the surgical team is essential to the success of the surgical procedure.

1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a need for sterile supply which is not in the sterile field, who hands out these items by opening its outer cover?

Circulating Nurse

2. The OR team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame and deliver a standard patient outcome. While the surgeon performs the surgical procedure, who monitors the status of the client like urine output, blood loss?

Anaesthesiologist

3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed to be present in the OR?

Radiology department

4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team, who else has to be present when a client undergoes laparoscopic surgery?

Biomedical technician

5. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to be alerted to coordinate closely with the patient’s family for immediate blood component therapy?

Social Service Section

Situation 2 – You are assigned in the Orthopedic Ward where clients are complaining of pain in varying degrees upon movement of body parts.

6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain. Which of the following observation would prompt you to call the doctor?

Left foot is cold to touch and pedal pulse is absent


7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at 5 pm. The next dose of Demerol 50 mg I.M. is given:

At 11 pm

8. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors indicate appropriate adaptation?

The client can distract himself during pain episodes

9. Pain in ortho cases may not be mainly due to the surgery. There might be other factors such as cultural or psychological that influence pain. How can you alter these factors as the nurse?

Promote client’s sense of control and participation in control by listening to his concerns

10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?

Assess respiratory rate carefully

Situation 3 – Records are vital tools in any institution and should be properly maintained for specific use and time.

11. The patient’s medical record can work as a double edged sword. When can the medical record become the doctor’s/nurse’s worst enemy?

When the medical record is inaccurate, incomplete, and inadequate

12. Disposal of medical records in government hospitals/institutions must be done in close coordination with what agency?

Department of Health (DOH)

13. In the hospital, when you need the medical record of a discharged patient for research you will request permission through:

Medical records section

14. You readmitted a client who was in another department a month ago. Since you will need the previous chart, from whom do you request the old chart?

Medical records section

15. Records Management and Archives Office of the DOH is responsible for implementing its policies on record disposal. You know that your institution is covered by this policy if:

It obtained permit to operate from DOH

Situation 4 – In the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all these to safeguard the safety and quality of patient delivery outcome.

16. Which of the following should be given highest priority when receiving patient in the OR?

Verify patient identification and informed consent

17. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but considered ‘dirty cases’. When are these procedures best scheduled?

Last case

18. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing care during the intraoperative phase. As the circulating nurse, you make certain that throughout the procedure…

strap made of strong non-abrasive materials are fastened securely around the joints of the knees and ankles and around the 2 hands around an arm board.

19. Another nursing check that should not be missed before the induction of general anesthesia is:

check baseline vital signs

20. Some lifetime habits and hobbies affect postoperative respiratory function. If your client smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate increased risk for:

delayed wound healing

Situation 5 – Nurses hold a variety of roles when providing care to a perioperative patient.

21. Which of the following role would be the responsibility of the scrub nurse?

Account for the number of sponges, needles, supplies, used during the surgical procedure.

22. As a perioperative nurse, how can you best meet the safety need of the client after administering preoperative narcotic?

Put side rails up and ask the client not to get out of bed


23. It is the responsibility of the pre-op nurse to do skin prep for patients undergoing surgery. If hair at the operative site is not shaved, what should be done to make suturing easy and lessen chance of incision infection?

Clipped

24. It is also the nurse’s function to determine when infection is developing in the surgical incision. The perioperative nurse should observe for what signs of impending infection?

Localized heat and redness

25. Which of the following nursing interventions is done when examining the incision wound and changing the dressing?

Observe the dressing and type and odor of drainage if any

Situation 6 – Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min and he appears to be in acute respiratory distress.

26. Which of the following nursing actions should be initiated first?

Administer bronchodilator by nebulizer

27. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse, what is its indication, the nurse will say:

Relax smooth muscles of the bronchial airway

28. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction will include the following, EXCEPT:

Practice respiratory isolation

29. The asthmatic client asked you what breathing techniques he can best practice when asthmatic attack starts. What will be the best position?

Lean forward 30-40 degrees with each exhalation

30. As a nurse, you are always alerted to monitor status asthmaticus who will likely and initially manifest symptoms of:

respiratory acidosis

Situation 7 – Joint Commission on Accreditation of Hospital Organization (JCAHO) patient safety goals and requirements include the care and efficient use of technology in the OR and elsewhere in the healthcare facility.

31. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm systems?

Implement a regular maintenance and testing of alarm systems

32. Overdosage of medication or anesthetic can happen even with the aid of technology like infusion pumps, sphygmomanometer and similar devices/machines. As a staff, how can you improve the safety of using infusion pumps?

Check the functionality of the pump before use

33. JCAHOs universal protocol for surgical and invasive procedures to prevent wrong site, wrong person, and wrong procedure/surgery includes the following, EXCEPT:

Take a video of the entire intra-operative procedure

34. You identified a potential risk of pre-and postoperative clients. To reduce the risk of patient harm resulting from fall, you can implement the following, EXCEPT:

Allow client to walk with relative to the OR

35. As a nurse, you know you can improve on accuracy of patient’s identification by 2 patient identifiers, EXCEPT:

call the client by his/her case and bed number

Situation 8 – Team efforts is best demonstrated in the OR.

36. If you are the nurse in charge for scheduling surgical cases, what important information do you need to ask the surgeon?

Who is your assistant and anesthesiologist, and what is your preferred time and type of surgery?

37. In the OR, the nursing tandem for every surgery is:

Scrub and circulating nurses

38. While team effort is needed in the OR for efficient and quality patient care delivery, we should limit the number of people in the room for infection control. Who comprise this team?


Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist

39. When surgery is on-going, who coordinates the activities outside, including the family?

Circulating Nurse

40. The breakdown in teamwork is often times a failure in:

Communication

Situation 9 – Colostomy is a surgically created anus. It can be temporary or permanent, depending on the disease condition.

41. Skin care around the stoma is critical. Which of the following is not indicated as a skin care barriers?

Apply liberal amount of mineral oil to the area

42. What health instruction will enhance regulation of a colostomy (defecation) of clients?

Eat balanced meals at regular intervals

43. After ileostomy, which of the following condition is NOT expected?

Increased weight

44. The following are appropriate nursing interventions during colostomy irrigation, EXCEPT:

Increase the irrigating solution flow rate when abdominal cramps is felt

45. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained?

Sensation of pressure

Situation 10 – As a beginner in research, you are aware that sampling is an essential elements of the research process.

46. What does a sample group represent?

General population

47. What is the most important characteristic of a sample?

Representativeness

48. Random sampling ensures that each subject has:

An equal chance of selection

49. Which of the following methods allows the use of any group of research subject?

Convenience

50. You decided to include 5 barangays in your municipality and chose a sampling method that would get representative samples from each barangay. What should be the appropriate method ofor you to use in this care?

Cluster sampling

Labels

2010 (19) advertorial (1) answer key (12) application (2) board exam (36) board exam results december 2007 (17) board exam results june 2009 (26) board exam results november 2008 (29) board exam tips (4) board of nursing (8) bon (2) calculations (1) california (1) cancer (1) CAT (2) computations (1) dec 2007 nle (27) dialysis (5) dianne maydee mandal (4) diannemaydee (152) EB (3) events (1) exam results (113) exclusive materials (20) filing (1) FINAL COACHING (10) FREE REVIEW (2) fundamentals of nursing review (1) health articles (3) health news (2) HOSPITALS (1) IDIOT'S GUIDE (1) ivt (9) JOBS (1) July (4) July 2011 (28) june 2007 nle (12) june 2008 (25) june 2009 (28) june 2009 nle (27) june08 (7) june2008 (9) lectures and notes (31) LIST OF PASSERS NOVEMBER 2008 (28) medical surgical nursing (2) medsurg (2) muskuloskeletal (1) nclex (19) news (2) nle (125) nle review (5) NOTES AND HANDOUTS (5) nov 2009 nle (5) november 2008 nle (30) nurse (98) nurse oath taking (9) NURSES (38) nursing (139) oncology (1) our lady of fatima university (33) party (8) philippine nurse licensure exam (29) PHILIPPINES (29) pinoybsn (3) pna (13) pnle (40) PRC (77) process (4) questionnaires and rationales (32) RACHELL ALLEN (3) registration schedule (9) reproductive health (1) REQUIREMENTS (5) resource speaker (1) retakers (2) review (8) reviewees (10) reviewer (20) reviewers (33) scope (1) seminars (5) slides (1) StuffedNurse (247) StuffedNurse Club (82) StuffedNurse Elite (50) stuffednurse.com (176) test plan (3) top performing schools (2) top ten (2) topnotchers (13) trainings (11) work (15)