2. What should Nurse Thelma anticipate to administer which of the following medication to Olive who is diagnosed to be suffering from hypothyroidism?

3. Your appropriate nursing diagnosis for Olive who is suffering from hypothyroidism would probably include which of the following?

4. What characteristic is seen in Myxedema coma, a life threatening complication of long standing and untreated hypothyroidism

5. A pregnant patient is receiving treatment for hyperthyroidism. Which of the following medications would Nurse Daniel expect to see?

Situation - Mrs. Polly is admitted to Room 12 the Pay ward. The physician ordered "Prepare for thoracentesis this pm to remove excess air from the pleural cavity"

6. Which of the following nursing responsibilities is essential in Mrs. Polly who will undergo thoracentesis?

7. To which position will Mrs. Polly be placed knowing that she is for thoracentesis?

8. During thoracentesis, which of the following nursing intervention will be most crucial?

9. To prevent leakage of fluid in the thoracic cavity, how will you position the client after thoracentesis?

10. Chest x-ray was ordered after thoracentesis. When Mrs. Polly asks what is the reason for another x-ray, you will explain:

Situation: Patients with chest tubes can be very challenging to new nurses.

12. The chest tube drainage of Tirso has continuous bubbling in the water seal drainage. After an hour you noticed that the bubbling stops. Which of the following condition is the possible cause of the malfunctioning sealed drainage?

12. While you were making your endorsement, you found out the chest tube of a client was disconnected. What would be your appropriate action?

13. Dr. Reyes asked you to assist him with the removal; of Tirso’s chest tube. You would instruct the client to:

14. Chest tube diameter is measured or expressed in:

15. When transporting clients with chest tube, the system should be:

Situation: Parkinson’s disease

16. The client had been diagnosed to have Parkinson's disease. He is receiving levodopa. Which of the following health teachings should be included by the nurse?

17. The nurse identifies the nursing diagnosis of impaired physical mobility related to bradykinesia for a patient with Parkinson’s disease. To assist the patient to ambulate safely, the nurse should:

18. For which side effects in the client with Parkinson’s disease who has been taking a combination carbidopa-levodopa drug (Sinemet) for 3 years will the nurse monitor?

19. Which teaching intervention is most appropriate for the client with Parkinson’s disease?

20. Which statement indicates that the family has a good understanding of the changes in motor movement associated with Parkinson’s disease?

Situation - 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.

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

22. JCAHO's, universal protocol for surgical and invasive procedures to prevent wrong sites, wrong person and wrong procedure/surgery, includes the following EXCEPT:

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

24. As a nurse, you know you can improve on accuracy of patients identification by 2 patient identifiers, EXCEPT:

25. The Nurse notices the surgical consent form of a pre-operative client, Mang Lito who is scheduled for surgery this morning is unsigned. What is the nurse’s best action?

SITUATION: Rachel is assigned to conduct health instruction for clients who have airway problems. Majority of who are suffering asthma attacks.

27. A client with asthma and coughing out secretions was advised to increase his fluid intake. The client asks the reason for this instruction. The CORRECT response of the nurse is:

28. Rachel continued to give instruction to client by demonstrating different positions that the client can assume to reduce to work of breathing and increase lung expansion especially in basilar areas. These position includes:

1. High fowler’s 3. Sitting upright

2. Orthopneic 4. Slide lying

29 Some of the clients using metered dose-inhaler (MDI). The nurse reinforced instructions to the right use of the device. The nurse will commend the client who uses the MDI in which manner?

30. One client raised the question why she coughs after using MDI. The nurse gave which CORRECT way to prevent coughing after the use of MDI?

31. The nurse underscored the observance of 1 and 2 minutes before repeating the procedure for the second puff. The MOST important reason for this is to:

I

Situation - A specimen is a piece of tissue of body fluid taken from the disease body organ or tissue to aid health care team in diagnosis and effective treatment.

32. Julia is for frozen section in OR room 8. She is suspected to have breast CA. How will you prepare the specimen for laboratory?

33. What information was essential in the label? How will you label this specimen?

34. You are the circulating nurse in OR 2. You have 4 cholecystectomy cases for the day. How do you prevent switching of specimens?

35. The functionality and integrity of instruments and medical devices used in surgical procedure, is the responsibility of the:

36. Negligence in the practice of nursing can be a ground for:

SITUATION: Endocrine disorders and diseases usually manifest according to which endocrine hormone is being overproduced and secreted or underproduced and secreted. The key to discovering the nature of the symptoms lies in your understanding of the functions of the endocrine hormones.

37. The client just diagnosed with acromegaly is scheduled for a hypophysectomy. Which statement made by the client indicates a need for clarification regarding this treatment?

38. Which statement made by Mr. Delima who is going home after a trans-sphenoidal hypophysectomy indicates an adequate understanding of actions to prevent complications from this treatment?

1. While assessing airway and breathing, Mrs. Perlita presenting with increased ICP would most likely exhibit which of the following vital signs?

40. In the client with increased intracranial pressure (ICP), the most appropriate intravenous fluid is:

Marie established a goal to maintain intracranial pressure (ICP) within the normal range. What should Nurse Marie do? Select all that apply

1. Encourage the client to cough and take deep breaths 4. Monitor neurologic status using the Glasgow Coma Scale

2. Elevate the head of the bed 15 to 30 degrees 5. Stimulate the client with active range-of-motion exercises

3.Contact the health care provider if ICP is greater than 20 mmHg

4.Monitor the Neurological status using the Glasgow Coma Scale.

5. Stimulate the client with active range of motion exercises.

SITUATION 11: Beth Ray, age 62, is admitted to the medical-surgical unit for treatment of heart failure. She called her physician when she started getting short of breath walking up her stairs and noticed that her ankles seemed swollen. She has been relatively healthy with no heart problems up to 2 years ago when she was diagnosed with hypertension.

41. The nurse on a cardiac unit is caring for Beth Ray. The nurse concludes that she is developing pulmonary edema after observing which change in the client?

43. Beth Ray is being treated with a sodium-controlled diet, digoxin (Lanoxin) and furosemide (Lasix). The ECG monitor shows a new U wave. Based on this new finding the nurse determines that it is important to check which of the following laboratory test results?

44. Which of the following would be the best menu choices for this client?

45. After Beth Ray stabilized, she was being prepared for discharge. The nurse is developing a plan for her. The nurse is teaching the client to monitor fluid status. The best instruction is to teach the client to do which of the following?

46. During follow up check up, Beth Ray denies any changes in the way she feels. The nurse notes that the client has gained 5 pounds in the last week, and the client is concerned about the weight gain. Which of the following is the best statement for the nurse to make at this time?

SITUATION 15: Mrs.A. Dizon, has undergone right modified mastectomy. You are the nurse assigned for her care.

47. Mrs.A. Dizon has just been returned to her surgery. Which of the following actions would the nurse take first?

SITUATION 15: Mrs.A. Dizon, has undergone right modified mastectomy. You are the nurse assigned for her care.

48. Which arm position will best facilitate venous return on the operative side of Mrs.A. Dizon to reduce the occurrence of lymphedema?

49. What will you the nurse encourages Mrs. A. Dizon, to do which is appropriate as initial therapy 24 hours after surgery?

50. 1. On turning Mrs. A. Dizon to her left side, the nurse notes a moderately large amount of serosanguineous drainage on the bedsheets. The nurse should:

51. Which nursing action would be contraindicated for the care of Mrs. A. Dizon?

SITUATION 8: Mrs. Florencia Cruz, a retired 50-year-old female client is being evaluated for osteoporosis as part of a yearly physical. The client tells the nurse that she is a smoker, watches television for most of the day, and has been hospitalized with three different fractures within the last year.

52. The physician determined that Mrs. Cruz has osteoporosis. What foods other than milk can the nurse suggest to this client to increase her calcium intake?

53. What risk factors identified by the nurse would put a client at risk for developing osteoporosis?

54. Alendronate (Fosamax) is ordered for Mrs. Cruz. Which information should the nurse include in teaching the client about this drug?

.

The nurse encourages Mrs. Cruz to discuss estrogen replacement therapy with the physician after explaining that estrogen has which of the following benefits?

56. Mrs. Cruz condition required a total hip replacement. After the procedure, Mrs. Cruz is concerned about dislocation of the prosthesis. What can the nurse say to reassure this client?

Situation: The nurse is caring for a client who was admitted for a 54-year-old male to the medical ward with chest pain radiating to the jaw and left arm. He is diagnosed of myocardial infarction (MI).

57. An appropriate nursing diagnosis would be “Risk for alteration in cardiac output” related to which of the following?

58.Which enzyme would be most specific in the diagnosis of a myocardial infarction?

59. The nurse is monitoring a client’s EKG strip and notes coupled premature ventricular contractions greater than 10 per minute. The nurse should expect to administer which of the following?

60. Which of the following nursing interventions is not be included in the prevention of vasovagal stimulation in this patient who has MI?

61. The nurse is performing a cardiac assessment on a client. In order to auscultate the client’s apical pulse, the nurse places the bell or diaphragm of the stethoscope at the

SITUATION 19: The following requires nursing care management for patients with hematologic aberrations.

62. A client is diagnosed with thrombocytopenia due to acute lymphocytic leukemia. He is admitted to the hospital for treatment. Where should the nurse assign the client?

63. A child who has acute lymphocytic leukemia is receiving chemotherapeutic drugs and has an order for allopurinol (Aloprim). The nurse should recognize that the purpose of Aloprim for the child is to:

64. In the treatment of a client with leukemia, what is the main goal of chemotherapy?

65. Which of the following dietary choices should be avoided by the client with a recent bone marrow depression?

66. Edward, 9yrs old was diagnosed with Acute Lymphocytic Leukemia, What is the route of administration of Bone Marrow Transplant for a child suffering from Leukemia?

Situation: Many hospitals form bioethical review committees to ensure quality of life of patients. You are invited by the nursing service departments to participate in their bioethical review committee. You are expected to know the purpose and apply bioethical principles

67. Which of the following is the purpose of ethical review committee?

68. Lina who is admitted to the hospital with autoimmune thrombocytopenia and a platelet count of 21,000 develops epistaxis and melena. Treatment with corticosteroids and immunoglobulin has not been successful. Md suggested splenectomy. Lina states: "I don’t need surgery. This will go away on its own"

69. Sherlyn is terminally ill and is experiencing severe pain. She has bone and liver metastasis. She had been on morphine for several months now. Sherlyn is aware that they are having financial problems. She decides to sign a DNR form. What ethical principle did Sherlyn and her family utilize as basis for their decision to sign a DNR?

70. Catherine, a staff nurse working in a cancer unit is considered a role model not only by her colleagues but also by her patients. She goes out of her way to help others. She is very active in their professional organization and she practices what she teaches. What ethical principles is she practicing?

71. You are communiting to work riding the MRT. An older person collapsed and nobody seems to notice her. The security guard tried to make her sit down but she remained unconscious. With your help, you brought the patient to the nearest hospital. You learned that the woman is diabetic. Before reaching the clinic to measure her blood sugar, she developed hypoglycemia. You were able to save her life. What principle was applied?

Situation:Mang Rolando was long diagnosed with Chronic Renal Failure. You are the nrse and the following questions will assess your knowledge on the different fluid and electrolyte imbalances associated with chronic renal failure.

72. Mang Rolando’s CRF was caused by injury due to stabbed wound, his condition started as acute renal failure. Which later progressed to chronic Renal Failure. The nurse is correct in determining that the cause of the client’s renal failure before was:

73. Mang Rolando is scheduled for hemo-dialysis the main indicator for the need for hemodialysis is:

73. Mang Rolando misses two sessions of hemodialysis. Blood was drawn and is sent for analysis. Which electrolyte disturbance is expected in a client with CRF?

74. In mang Rolando’s ECG tracing, you would expect to find:

76. As mang Rolando’s condition conitinues to worsen, the client complains of weakness and fatigued secondary to anemia, nausea and vomiting and mild itching. The physician stated that mang Rolando’s condition isn’t responding to dialysis. The patient undergoes renal transplant. Mang Rolando started to take prescribed medication for his condition to prevent graft rejection. The physician prescribed Cyclosporine, Imuran, which of the following is a major complication of this drug regimen?

Situation: Antonio, Age 52, was admitted to the hospital with acute adrenal insufficiency. He has a history of Addison’s disease for

Which he has been taking hydrocortisone over the past week, he has flu like symptoms accompanied by nausea and vomiting, extremely weak.

The nurse would assess for which of the following signs and symptoms for a client suffering from addisonian crisis?

78. Antonio blood pressure is 90/58mmHg his heart rate is 116bpm and is temperature is 101F. The nurse should expect to start and IV infusion of:

79. Which is an appropriate measure for a patient with addisonian crisis?

80. During the initial 24hours after admission which nursing diagnosis is a priority?

81. Which of the following nursing implications is most important in a client being medicated for Addison's disease?

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

82. Nurse Yirma is to educate Wilma about skin care around the stoma. Which of the following is not indicated as a skin care barriers?

82. Wilma asks Nurse Yirma why she passes wastes materials from her stoma irregularly. Nurse Yirma states that it will eventually become regular. What health instruction will enhance regulation of a colostomy [defecation] of clients?

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

85. The nurse is teaching the client how to care for a new ileostomy. Which client statement indicates that additional teaching is needed?

86. What sensation is used as a gauge so that patients will ileostomy can determine how often their pouch should be drain.

Situation: Nurse Eunice and her colleagues are providing health teachings regarding various medications used by clients with problems in oxygenation as part of their client education program.

86. Nurse Eunice is teaching a client with chronic obstructive pulmonary disease (COPD) how to administer multiple medications by inhalation. Which statement by the client indicates an understanding of the instruction?

88. The client asks Nurse Eunice why the physician ordered beclomethasone (Beclovent) for his chronic obstructive pulmonary disease (COPD). Which statement by Nurse Eunice is most appropriate?

Nurse Eunice is teaching a client about cromolyn (Intanchoconstriction with an exposure to allergen.”

89l). Which of the following statements should she make about the mechanism of action of this medication?

90. Nurse Eunice is teaching the client proper technique for administration of nasal sprays. Which explanations should she use in order to provide accurate information?

90. A client with asthma has started to take a beta-adrenergic agent. The client also takes a monoamine oxidase inhibitor (MAOI).]Nurse Eunice should inform the client for which of the following complications?

Situation: Nurse Adrian is assigned in caring for Junjun, a 35-year-old client who is admitted recently for a possible diagnosis of aplastic anemia. He constantly reports of muscle weakness and fatigue.

92. Which of the following data is most important to elicit during the interview once with this kind of diagnosis of to “rule out aplastic anemia”?

92. During assessment, Nurse Adrian noted a systolic murmur on Junjun. He interprets that this finding correlates with which of the following?

94. When admitting Junjun who has a diagnosis of aplastic anemia, which of the following is the best room for Nurse Adrian to assign for this client?

95. Nurse Adrian is assisting a physician with a bone marrow aspiration on Junjun. After the procedure, the nurse should take which of the following actions?

95. Mr. de Guzman receives a blood transfusion and develops flank pain, chills, fever, and hematuria. The nurse recognizes that this is a sign of what kind of transfusion reaction:

Situation: Loyd, the public health nurse is going to conduct a research regarding family planning in the Municipality of Malaybalay. He decided to get his sample population in every 4^th family representing the total population of the said community.

97. What is the type of sampling method utilized in the said research?

98. There is no difference between nursing and non-nursing students in the source of satisfaction and stress in their individual areas of experience. This illustrates:

99. It is a research design that used manipulation of independent variables and experimentation using only particular samples chosen in the population.

100. A variable that undergone a research manipulation in attempt to ascertain relationship to the observed phenomenon is:

101. Which of the following is not a type of non-probability sampling?