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NURSING PRACTICE IV – SET B NURSING PRACTICE IV – Care of Clients with Physiologic and Psychosocial Alterations (Part B) GENERAL INSTRUCTIONS D. This test booklet contains 100 test questions E. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheet. F. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer. G. AVOID ERASURES.

INSTRUCTIONS H. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. I. Write the subject title “Nursing Practice IV” on the box provided. J. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box “B” if your test booklet is Set B. MULTIPLE CHOICE Situation 1 – Because of the serious consequences of severe burns, management requires a multidisciplinary approach. You have important responsibilities as a nurse. K. While Sergio was lighting a barbecue grill with a lighter fluid, his shirt burns into flames. The most effective way to extinguish the flames with as little further damage as possible is to: A. B. C. D.

log roll on the grass/ground slap the flames with his hands remove the burning clothes pour cold liquid over the flames

L. Once the flames are extinguished, it is most important to: A. B. C. D.

cover Sergio with a warm blanket give him sips of water calculate the extent of his burns assess the Sergio’s breathing

M. Sergio is brought to Emergency Room after the barbecue grill accident. Based on the assessment of the physician, Sergio sustained superficial partial thickness burns on his trunk, right upper extremities and right lower extremities. His wife asks what that means? Your most accurate response would be: A. B. C. D.

Structures beneath the skin are damage Dermis is partially damaged Epidermis and dermis are both damaged Epidermis is damaged

N. During the first 24 hours after the thermal injury, you should asses Sergio for: A. B. C. D.

hypokalemia and hypernatremia hypokalemia and hyponatremia hyperkalemia and hyponatremia hyperkalemia and hypernatremia

O. Teddy, who sustained deep partial thickness and full thickness burns of the face, whole anterior chest and both upper extremities two days ago begins to exhibit extreme restlessness. You recognize that this most likely indicates that Teddy is developing: A. Cerebral hypoxia B. Hypervolemia

C. metabolic acidosis D. Renal failure

Situation 2 – You are now working as a staff nurse in a general hospital. You have to be prepared to handle situations with ethico-legal and moral implifications. P. You are in night duty in surgical ward. One of your patients Martin is a prisoner who sustained an abdominal gunshot wound. He is being guarded by policeman from the local police unit. During your rounds you heard a commotion. You saw the policeman trying to hit Martin. You asked why he was trying to hit Martin. He denied the matter. Which among the following activities will you do first? A. Write an accident report B. Call security officer and report the incident

C. Call your nurse supervisor and report the incident D. Call the physician on duty

7. You are on morning duty in the medical ward. You have 10 patients assigned to you. During your endorsement rounds, you found out that one of your patients was not in bed. The patient next to him informed you that he went home without notifying the nurses. Which among the following will you do first? Q. R. S. T.

Make an incident report Call security to report the incident Wait for 2 hours before reporting Report the incident to your supervisor

8. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. Which among the following will you do first? U. V. W. X.

Write an incident report and refer the matter to the nursing director Keep your findings to yourself Report the matter to your supervisor Find out from the endorsement any patient who might have been given narcotics

9. You are on duty in the medical ward. The mother of your patient who is also a nurse, came running to the nurses station and informed you that Fiolo went into cardiopulmonary arrest. Y. Start basic life support measures Z. Call for the Code AA.Bring the crush cart to the room BB.Go to see Fiolo and assess for airway patency and breathing problems 10. You are admitting Jorge to the ward and you found out that he is positive for HIV. Which among the following will you do first? CC.Take note of it and plan to endorse this to next shift DD.Keep this matter to yourself EE.Write an incident report FF. Report the matter to your head nurse

Situation 3 - Colorectal cancer can affect old and younger people. Surgical procedures and other modes of treatment are done to ensure quality of life. You are assigned in the cancer institute to care of patients with this type of cancer. 11. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the CI. After taking the history and vital signs the physician does which test as a screening test for colorectal cancer. GG.Barium enema HH.Carcinoembryonic antigen II. Annual digital rectal examination JJ. Proctosigmoidoscopy 12. To confirm his impression of colorectal cancer, Larry will require which diagnostic study? KK.Carcinoembryonic antigen LL. Proctosigmoidoscopy MM.Stool hematologic test NN.Abdominal computed tomography (CT) test 13. The following are risk factors for colorectal cancer, EXCEPT: OO.Inflammatory bowels PP.High fat, high fiber diet QQ.Smoking RR.Genetic factors-familial adenomatous polyposis 14. Symptoms associated with cancer of the colon include: SS.constipation, ascites and mucus in the stool TT. diarrhea, heart burn and eructation UU.blood in the stools, anemia, and “pencil shaped” stools VV.anorexia, hematemesis, and increased peristalasis 15. Several days prior to bowel surgery, Larry may be given sulfasuxidine and neomycin primarily to:

WW.promote rest of the bowel by minimizing peristalsis XX.reduce the bacterial content of the colon YY.empty the bowel of solid waste ZZ.soften the stool by retaining water in the colon Situation 4 – ENTEROSTOMAL THERAPY is now considered a specialty in nursing. You are participating in the OSTOMY CARE CLASS. 16. You plan to teach Fermin how to irrigate the colostomy when: AAA.The perineal wound heals And Fermin can sit comfortably on the commode BBB.Fermin can lie on the side comfortably, about the 3rd postoperative day CCC.The abdominal incision is closed and contamination is no longer a danger DDD.The stools starts to become formed, around the 7th postoperative day 17. When preparing to teach Fermin how to irrigate colostomy, you should plan to do the procedure: EEE.When Fermin would have normal bowel movement FFF.At least 2 hours before visiting hours GGG.Prior to breakfast and morning care HHH.After Fermin accepts alteration in body image 18. When observing a return demonstration of a colostomy irrigation, you know that more teaching is required if Fermin: III. Lubricates the tip of the catheter prior to inserting into the stoma JJJ.Hangs the irrigating bag on the bathroom door cloth hook during fluid insertion KKK.Discontinues the insertion of fluid after only 500 ml of fluid has been instilled LLL.Clamps of the flow of fluid when felling uncomfortable 19. You are aware that teaching about colostomy care is understood when Fermin states, “I will contact my physician and report: MMM.If I have any difficulty inserting the irrigating tub into the stoma.”

NNN.If I noticed a loss of sensation to touch in the stoma tissue.” OOO.The expulsion of flatus while the irrigating fluid is running out.” PPP.When mucus is passed from the stoma between the irrigations.” 20. You would know after teaching Fermin that dietary instruction for him is effective when he states, “It is important that I eat: QQQ.Soft food that are easily digested and absorbed by my large intestines.” RRR. Bland food so that my intestines do not become irritated.” SSS.Food low in fiber so that there is less stool.” TTT.Everything that I ate before the operation, while avoiding foods that cause gas.” Situation 5 – Ensuring safety is one of your most important responsibilities. You will need to provide instructions and information to your clients to prevent complications. 21. Randy has chest tubes attached to a pleural drainage system. When caring for him you should: UUU.empty the drainage system at the end of the shift VVV.clamp the chest tube when suctioning WWW.palpate the surrounding areas for crepitus XXX.change the dressing daily using aseptic techniques 22. Fanny, came in from PACU after pelvic surgery. As Fanny’s nurse you know that the sign that would be indicative of a developing thrombophlebitis would be: YYY.a tender, painful area on the leg ZZZ.a pitting edema of the ankle AAAA.a reddened area at the ankle BBBB.pruritus on the calf and ankle 23. To prevent recurrent attacks on Terry who has acute glumerulonephritis, you should instruct her to: A. seek early treatment for respiratory infections B. take showers instead of tub bath C. continue to take the same restrictions on fluid intake D. avoid situations that involve physical activity 24. Herbert had a laryngectomy and he is now for discharge. He verbalized his concern regarding his laryngectomy tube being

dislodged. What should you teach him first? CCCC.Recognize that prompt closure of the tracheal opening may occur DDDD.Keep calm because there is no immediate emergency EEEE.Reinsert another tubing immediately FFFF.Notify the physician at once 25. When caring for Larry after an exploratory chest surgery and pneumonectomy, your priority would be to maintain: GGGG.supplementary oxygen HHHH.ventilation exchange IIII. chest tube drainage JJJJ.blood replacement Situation 6 – Infection can cause debilitating consequences when host resistance is compromised and virulence of microorganisms and environmental factors are favorable. Infection control is one important responsibility of the nurse to ensure quality of care. 26. Honrad, who has been complaining of anorexia and feeling tired, develops jaundice, after a workup he is diagnosed of having Hepatitis A. his wife asks you about gamma globulin for herself and her household help. Your most appropriate response would be: KKKK.“Don’t worry your husband’s type of hepatitis is no longer communicable” LLLL.“Gamma globulin provides passive immunity for hepatitis B” MMMM.“You should contact your physician immediately about getting gammaglobulin.” NNNN.“A vaccine has been developed for this type of hepatitis” 27. Voltaire develops a nosocomial respiratory tract infection. He ask you what that means? Your best response would be: OOOO.“You acquired the infection after you have been admitted to the hospital.” PPPP.“This is a highly contagious infection requiring complete isolation.” QQQQ.“The infection you had prior to hospitalization flared up.” RRRR.“As a result of medical treatment, you have acquired a secondary infection.’

28. As a nurse you know that one of the complications that you have to watch out for when caring for Omar who is receiving total parenteral nutrition is: SSSS.stomatitis TTTT.hepatitis UUUU.dysrhythmia VVVV.infection 29. A solution used to treat Pseudomonas wound infection is: WWWW.Dakin’s solution XXXX.Half-strength hydrogen peroxide YYYY.Acetic acid ZZZZ.Betadine 30. Which of the following is the most reliable in diagnosing a wound infection? AAAAA.Culture and sensitivity BBBBB.Purulent drainage from a wound CCCCC.WBC count of 20,000/μL DDDDD.Gram stain testing Situation 7 – As a nurse you need to anticipate the occurrence of complications of stroke so that life threatening situations can be prevented. 31. Wendy is admitted to the hospital with signs and symptoms of stroke. Her Glasgow Coma Scale is 6 on admission. A central venous catheter was inserted an I.V. infusion was started. As a nurse assigned to Wendy what will be your priority goal? EEEEE.Prevent skin breakdown FFFFF.Preserve muscle function GGGGG.Promote urinary elimination HHHHH.Maintain a patent airway 32. Knowing that for a comatose patient hearing is the last sense to be lost, as Judy’s nurse, what should you do? IIIII.Tell her family that probably she can’t hear them JJJJJ.Talk loudly so that Wendy can hear you KKKKK.Tell her family who are in the room not to talk

LLLLL.Speak softly then hold her hands gently 33. Which among the following interventions should you consider as the highest priority when caring for June who has hemiparesis secondary to stroke? MMMMM.Place June on an upright lateral position NNNNN.Perform range of motion exercises OOOOO.Apply antiembolic stockings PPPPP.Use hand rolls or pillows for support 34. Ivy, age 40, was admitted to the hospital with a severe headache, stiff neck and photophobia. She was diagnosed with a subarachnoid hemorrhage secondary to ruptured aneurysm. While waiting for surgery, you can provide a therapeutic environment by doing which of the following? QQQQQ.honoring her request for a television RRRRR.placing her bed near the window SSSSS.dimming the light in her room TTTTT.allowing the family unrestricted visiting privileges 35. When performing a neurologic assessment on Walter, you find that his pupils are fixed and dilated. This indicated that he: UUUUU.probably has meningitis VVVVV.is going to be blind because of trauma WWWWW.is permanently paralyzed XXXXX.has received a significant brain injury Situation 8 – With the improvement in life expectancies and the emphasis in the quality of life it is important to provide quality care to our older patients. There are frequently encountered situations and issues relevant to the older patients. 36. Hypoxia may occur in the older patients because of which of the following physiologic changes associated with aging. YYYYY.Ineffective airway clearance ZZZZZ.Decreased alveolar surfaced area AAAAAA.Decreased anterior-posterior chest diameter BBBBBB.Hyperventilation

37. The older patient is at higher risk for incontinence because of: CCCCCC.dilated urethra DDDDDD.increased glomerular filtration rate EEEEEE.diuretic use FFFFFF.decreased bladder capacity 38. Merle, age 86, is complaining of dizziness when she stands up. This may indicate: GGGGGG.dementia HHHHHH.a visual problem IIIIII.functional decline JJJJJJ.drug toxicity 39. Cardiac ischemia in an older patient usually produces: KKKKKK.ST-T wave changes LLLLLL.Very high creatinine kinase level MMMMMM.Chest pain radiating to the left arm NNNNNN.Acute confusion

40. The most dependable sign of infection in the older patient is: OOOOOO.change in mental status PPPPPP.fever QQQQQQ.pain RRRRRR.decreased breath sounds with crackles Situation 9 – A “disaster” is a large-scale emergency—even a small emergency left unmanaged may turn into a disaster. Disaster preparedness is crucial and is everybody’s business. There are agencies that are in charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated approach to the management of emergency programs and activities for all four emergency phases (mitigation, preparedness, response, and recovery), for all types of emergencies and disasters (natural, man-made, and attack) and for all levels of government and the private sector. 41. Which of the four phases of emergency management is defined as “sustained action that reduces or eliminates long-term risk to

people and property from natural hazards and their effects.”? SSSSSS.Recovery TTTTTT.Mitigation UUUUUU.Response VVVVVV.Preparedness 42. You are a community health nurse collaborating with the Red Cross and working with disaster relief following a typhoon which flooded and devastated the whole province. Finding safe housing for survivors, organizing support for the family, organizing counseling debriefing sessions and securing physical care are the services you are involved with. To which type of prevention are these activities included: WWWWWW.Tertiary prevention XXXXXX.Primary prevention YYYYYY.Aggregate care prevention ZZZZZZ.Secondary prevention 43. During the disaster you see a victim with a green tag, you know that the person: AAAAAAA.has injuries that are significant and require medical care but can wait hours with threat to life or limb BBBBBBB.has injuries that are life threatening but survival is good with minimal intervention CCCCCCC.indicates injuries that are extensive and chances of survival are unlikely even with definitive care DDDDDDD.has injuries that are minor and treatment can be delayed from hours to days 44. The term given to a category of triage that refers to life threatening or potentially life threatening injury or illness requiring immediate treatment: EEEEEEE.Immediate FFFFFFF.Emergent GGGGGGG.Non-acute HHHHHHH.Urgent 45. Which of the following terms refer to a process by which the individual receives education about recognition of stress reaction and management strategies for handling stress which may be instituted after a disaster?

IIIIIII.Clinical incident stress management JJJJJJJ.Follow-up KKKKKKK.Defriefing LLLLLLL.Defusion Situation 10 – As a member of the health and nursing team you have a crucial role to play in ensuring that all the members participate actively is the various tasks agreed upon. 46. While eating his meal, Matthew accidentally dislodges his IV lines and bleeds. Blood oozes on the surface of the over-bed table. It is most appropriate that you instruct the housekeeper to clean the table with: MMMMMMM.Acetone NNNNNNN.Alcohol OOOOOOO.Ammonia PPPPPPP.Bleach 47. You are a member of the infection control team of the hospital. Based on a feedback during the meeting of the committee there is an increased incidence of pseudomonas infection in the Burn Unit (3 out of 10 patients had positive blood and wound culture). What is your priority activity? QQQQQQQ.Establish policies for surveillance and monitoring RRRRRRR.Do data gathering about the possible sources of infection (observation, chart review, interview). SSSSSSS.Assign point persons who can implement policies. TTTTTTT.Meet with the nursing group working in the burn unit and discuss problem with them. 48. Part of your responsibility as a member of the diabetes core group is to get referrals from the various wards regarding diabetic patients needing diabetes education. Prior to discharge today, 4 patients are referred to you. How would you start prioritizing your activities? UUUUUUU.Bring your diabetes teaching kit and start your session taking into consideration their distance from your office VVVVVVV.Contact the nurse in-charge and find out from her the reason for the referral WWWWWWW.Determine their learning needs then prioritize XXXXXXX.Involve the whole family in the teaching class

49. You have been designated as a member of the task force to plan activities for the Cancer Consciousness Week. Your committee has 4 months to plan and implement the plan. You are assigned to contact the various cancer support groups in your hospital. What will be your priority activity? YYYYYYY.Find out if there is a budget for this activity ZZZZZZZ.Clarify objectives of the activity with the task force before contacting the support groups AAAAAAAA.Determine the VIPs and Celebrities who will be invited BBBBBBBB.Find out how many support groups there are in the hospital and get the contact number of their president 50. You are invited to participate in the medical mission activity of your alumni association. In the planning stage everybody is expected to identify what they can do during the medical mission and what resources are needed. You thought it is also your chance to share what you can do for others. What will be your most important role where you can demonstrate the impact of nursing in health? CCCCCCCC.Conduct health education on healthy life style DDDDDDDD.Be a triage nurse EEEEEEEE.Take the initial history and document findings FFFFFFFF.Act as a coordinator

Situation 11 – One of the realities that we are confronted with is our mortality. It is important for us nurses to be aware of how we view suffering, pain, illness, and even our death as well as its meaning. That way we can help our patients cope with death and dying. 51. Irma is terminally ill, she speaks to you in confidence. You now feel that Irma’s family could be helpful if they knew what Irma has told to you. What should you do first?

GGGGGGGG.Tell the physician who in turn could tell the family HHHHHHHH.Obtain Irma’s permission to share the information in the family IIIIIIII.Tell Irma that she has to tell her family what she told you JJJJJJJJ.Make an appointment to discuss the situation with the family 52. Ruby who has been told she has terminal cancer, turns away and refuses to respond to you. You can best help her by: A. Coming back periodically and indicating your availability if she would like you to sit with her B. Insisting that Ruby should talk with you because it is not good to keep everything inside C. Leaving her alone because she is uncooperative and unpleasant to be with D. Encouraging her to be physically active as possible 53. Leo, who is terminally ill and recognizes that he is in the process of losing everything and everybody he loves, is depressed. Which of the following would best help him during his depression? KKKKKKKK.Arrange for visitors who might cheer him LLLLLLLL.Sit down and talk with him for a while MMMMMMMM.Encourage him to look at the brighter side of things NNNNNNNN.Sit silently with him 54. Which of the following statements would best indicate that Ruffy, who is dying, has accepted his impending death? OOOOOOOO.“I’m ready to go.” PPPPPPPP.“I have resigned myself to dying.” QQQQQQQQ.“What’s the use?” RRRRRRRR.“I’m giving up”

55. Marla, 90 years old has planned ahead for her death-philosophically, socially, financially and emotionally. This is recognized as: SSSSSSSS.Acceptance that death is inevitable TTTTTTTT.Avoidance of the true situation

UUUUUUUU.Denial with planning for continued life VVVVVVVV.Awareness that death will soon occur Situation 12 – Brain tumor, whether malignant or benign, has serious management implications. As a nurse, you should be able to understand the consequences of the disease and the treatment. 56. You are caring for Conrad who has a brained tumor and increased Intracranial Pressure (ICP). Which intervention should you include in your plan to reduce ICP? WWWWWWWW.Administer bowel softener XXXXXXXX.Position Conrad with his head turned toward the side of the tumor YYYYYYYY.Provide sensory stimulation ZZZZZZZZ.Encourage coughing and deep breathing 57. Keeping Conrad’s head and neck alignment results in: AAAAAAAAA.increased inthrathoracic pressure BBBBBBBBB.increased venous outflow CCCCCCCCC.decreased venous outflow DDDDDDDDD.increased intrabdominal pressure 58. Which of the following activities may increase intracranial pressure (ICP)? EEEEEEEEE.Raising the head of the bed FFFFFFFFF.Manual hyperventilation GGGGGGGGG.Use of osmotic diuretics HHHHHHHHH.Valsalva’s maneuver 59. After you asses Conrad, you suspected increased ICP. Your most appropriate respiratory goal is to: IIIIIIIII.maintain partial pressure of arterial O2 (PaO2) above 80 mmHg JJJJJJJJJ.lower arterial pH KKKKKKKKK.prevent respiratory alkalosis LLLLLLLLL.promote CO2 elimination

60. Conrad underwent craniotomy. As his nurse, you know that

drainage on a craniotomy dressing must be measured and marked. Which findings should you report immediately to the surgeon? A. Foul-smelling drainage

C. Greenish

B. Yellowish drainage

D. Bloody drainage

drainage

Situation 13 – As a Nurse, you have specific responsibilities as professional. You have to demonstrate specific competencies. 61. The essential components of professional nursing practice are all the following EXCEPT: A. Culture B. Care

C. Cure D. Coordination

62. You are assigned to care for four (4) patients. Which of the following patients should you give first priority? MMMMMMMMM.Grace, who is terminally ill with breast cancer. NNNNNNNNN.Emy, who was previously lucid but is now unarousable. OOOOOOOOO.Aris, who is newly admitted and is scheduled for an executive check-up. PPPPPPPPP.Claire, who has cholelithiasis and is for operation on call. 63. Brenda, the Nursing Supervisor of the intensive care unit (ICU) is not on duty when a staff nurse committed a serious medication error. Which statement accurately reflects the accountability of the nursing supervisor? QQQQQQQQQ.Brenda should be informed when she goes back on duty RRRRRRRRR.Although Brenda is not on duty, the nursing supervisor on duty decides to call her if time permits SSSSSSSSS.The nursing supervisor on duty will nitify Brenda at home TTTTTTTTT.Brenda is not duty therefore it is not necessary to inform her. 64. Which barrier should you avoid, to manage time wisely? UUUUUUUUU.Practical planning

VVVVVVVVV.Procrastination WWWWWWWWW.Setting limits XXXXXXXXX.Realistic personal expectation

65. You are caring for Vincent who has just been transferred to the private room. He is anxious because he fears he won’t be monitored as closely as he was in the Coronary Care Unit. How can you allay his fear? YYYYYYYYY.Move his bed to a room far from nurse’s station to reduce ZZZZZZZZZ.Assign the same nurse to him when possible AAAAAAAAAA.Allow Vincent uninterrupted period of time BBBBBBBBBB.Limit Vincent’s visitors to coincide with CCU policies Situation 14 – As a nurse in the Oncology Unit, you have to be prepared to provide safe, efficient and effective care to your patients. 66. Which one of the following nursing interventions would be most helpful in preparing the patient for radiation therapy? CCCCCCCCCC.Offer tranquilizers and antiemetics DDDDDDDDDD.Instruct the patient of the possibility of radiation burn EEEEEEEEEE.Emphasis on the therapeutic value of the treatment FFFFFFFFFF.Map out the precise course of treatment 67. What side effects are most apt to occur the patient during radiation therapy to the pelvis? GGGGGGGGGG.Urinary retention HHHHHHHHHH.Abnormal vaginal or perineal discharge IIIIIIIIII.Paresthesia of the lower extremities JJJJJJJJJJ.Nausea and vomiting and diarrhea 68. Which of the following can be used on the irradiated skin during a course of radiation therapy? KKKKKKKKKK.Adhesive tape

LLLLLLLLLL.Mineral oil MMMMMMMMMM.Talcum powder NNNNNNNNNN.Zinc oxide ointment 69. Earliest sign of skin reaction to radiation therapy is: OOOOOOOOOO.desquamation PPPPPPPPPP.erythema QQQQQQQQQQ.atrophy RRRRRRRRRR.pigmentation

70. What is the purpose of wearing a film badge while caring for the patient who is radioactive? SSSSSSSSSS.Identify the nurse who is assigned to care for such a patient TTTTTTTTTT.Prevent radiation-induced sterility UUUUUUUUUU.Protect the nurse from radiation effects VVVVVVVVVV.Measure the amount of exposure to radiation Situation 15 – In a disaster there must be a chain of command in place that defined the roles of each member of the response team. Within the health care group there are preassigned roles based on education, experience and training on disaster. 71. As a nurse to which of the following groups are you best prepared to join? A. Treatment group management B. Triage group

C. Morgue D. Transport group

72. There are important principles that should guide the triage team in disaster management that you have to know if you were to volunteer as part of the triage team. The following principles should be observed in disaster triage, EXCEPT: WWWWWWWWWW.any disaster plan should have resources available to triage at each facility and at the disaster site if possible XXXXXXXXXX.make the most efficient use of available resources

YYYYYYYYYY.training on the disaster is not important to the response in the event of a real disaster because each disaster is unique in itself ZZZZZZZZZZ.do the greatest good for the greatest number of casualties 73. Which of the following categories of conditions should be considered first priority in a disaster? AAAAAAAAAAA.Intracranial pressure and mental status BBBBBBBBBBB.Lower gastrointestinal problems CCCCCCCCCCC.Respiratory infections DDDDDDDDDDD.Trauma 74. A guideline that is utilized in determining priorities is to asses the status of the following, EXCEPT: A. perfusion B. locomotion

C. respiration D. mentation

75. The most important component of neurologic assessment is: EEEEEEEEEEE.pupil reactivity FFFFFFFFFFF.vital sign assessment GGGGGGGGGGG.cranial nerve assessment HHHHHHHHHHH.level of consciousness/responsiveness Situation 16 – You are going to participate in a Cancer Consciousness Week. You are assigned to take charge of the women to make them aware of cervical cancer. You reviewed its manifestations and management, 76. The following are risk factors for cervical cancer EXCEPT: IIIIIIIIIII.immunosuppressive therapy JJJJJJJJJJJ.sex at an early age, multiple partners, exposure to socially transmitted disease, male partner’s sexual habits KKKKKKKKKKK.viral agents like the Human Papilloma Virus LLLLLLLLLLL.smoking 77. Late signs and symptoms of cervical cancer include the following EXCEPT:

MMMMMMMMMMM.urinary/bowel changes NNNNNNNNNNN.pain in pelvis, leg or flank OOOOOOOOOOO.uterine bleeding PPPPPPPPPPP.lymph edema of lower extremities 78. When a panhysterectomy is performed due to cancer of the cervix, which of the following organs are removed? QQQQQQQQQQQ.the uterus, cervix, and one ovary RRRRRRRRRRR.the uterus, cervix, and two-thirds of the vagina SSSSSSSSSSS.the uterus, cervix, tubes and ovaries TTTTTTTTTTT.the uterus and cervix 79. The primary modalities of treatment for Stage 1 and IIA cervical cancer include the following: UUUUUUUUUUU.surgery, radiation therapy and hormone therapy VVVVVVVVVVV.surgery WWWWWWWWWWW.radiation therapy XXXXXXXXXXX.surgery and radiation therapy

80. A common complication of hysterectomy is YYYYYYYYYYY.thrombophelbitis of the pelvic and thigh vessels ZZZZZZZZZZZ.diarrhea due to over stimulation AAAAAAAAAAAA.atelectasis BBBBBBBBBBBB.wound dehiscence Situation 17 – The body has regulatory mechanism to maintain the needed electrolytes. However there are conditions/surgical interventions that could compromise life. You have to understand how management of these conditions are done. 81. You are caring for Leda who is scheduled to undergo total thyroidectomy because of a diagnosis of thyroid cancer. Prior to total thyroidectomy, you should instruct Leda to: CCCCCCCCCCCC.Perform range and motion exercise on the

head and neck DDDDDDDDDDDD.Apply gentle pressure against the incision when swallowing EEEEEEEEEEEE.Cough and deep breath every 2 hours FFFFFFFFFFFF.Support head with the hands when changing position 82. As Leda’s nurse, you plan to set up an emergency equipment at her beside following thyroidectomy. You should include: GGGGGGGGGGGG.An airway and rebreathing tube HHHHHHHHHHHH.A tracheostomy set and oxygen IIIIIIIIIIII.A crush cart with bed board JJJJJJJJJJJJ.Two ampules of sodium bicarbonate 83. Which of the following nursing interventions is appropriate after a total thyroidectomy? KKKKKKKKKKKK.Place pillows under your patient’s shoulders. LLLLLLLLLLLL.Raise the knee-gatch to 30 degrees MMMMMMMMMMMM.Keep you patient in a high-fowler’s position. NNNNNNNNNNNN.Support the patient’s head and neck with pillows and sandbags. 84. If there is an accidental injury to the parathyroid gland during a thyroidectomy which of the following might Leda develop postoperatively? A. Cardiac arrest

C. Respiratory

B. Dyspnea

D. Tetany

failure

85. After surgery Leda develops peripheral numbness, tingling and muscle twitching and spasm. What would you anticipate to administer? A. Magnesium sulfate B. Calcium gluconate chloride

C. Potassium iodide D. Potassium

Situation 18 – NURSES are involved in maintaining a safe and healthy environment. This is part of quality care management. 86. The first step in decontamination is: OOOOOOOOOOOO.to immediately apply a chemical decontamination foam to the area of contamination PPPPPPPPPPPP.a through soap and water wash and rinse of the patient QQQQQQQQQQQQ.to immediately apply personal protective equipment RRRRRRRRRRRR.removal of the patients clothing and jewelry and then rinsing the patient with water 87. For a patient experiencing pruritus, you recommend which type of bath. A. water B. colloidal (oatmeal)

C. saline D. sodium bicarbonate

88. Induction of vomiting is indicated for the accidental poisoning patient who has ingested. A. rust remover B. gasoline

C. toilet bowl cleaner D. aspirin

89. Which of the following term most precisely refer to an infection acquired in the hospital that was not present or incubating at the same time of hospital admission? SSSSSSSSSSSS.Secondary blood stream infections TTTTTTTTTTTT.Nosocomial infection UUUUUUUUUUUU.Emerging infectious disease VVVVVVVVVVVV.Primary blood stream infection 90. Which of the following guidelines is not appropriate to helping family members cope with sudden death? WWWWWWWWWWWW.Obtain orders for sedation of family members XXXXXXXXXXXX.Provide details of the factors attendant to the sudden death YYYYYYYYYYYY.Show acceptance of the body by touching it and giving the family permission to touch ZZZZZZZZZZZZ.Inform the family that the patient has passed on

Situation 19 – As a nurse you are expected to participate in initiating or participating in the conduct of research studies to improve nursing practice. You have to be updated on the latest trends and issues affecting profession and the best practices arrived at by the profession. 91. You are interested to study the effects of meditation and relaxation on the pain experienced by cancer patients. What type of variable is pain? A. Dependent Independent B. Correlational Demographic

C. D.

92. You would like to compare the support system of patients with chronic illness to those with acute illness. How will you best state your problem? AAAAAAAAAAAAA.A Descriptive Study To Compare The Support System Of Patients With Chronic Illness And Those With Acute Illness In Terms Of Demographic Data And Knowledge About Interventions. BBBBBBBBBBBBB.The Effect Of The Type Of Support System of Patients With Chronic Illness And Those With Acute Illness. CCCCCCCCCCCCC.A Comparative Analysis Of The Support System Of Patients With Chronic Illness And Those With Acute Illness. DDDDDDDDDDDDD.A Study To Compare The Support System Of Patients With Chronic Illness And Those With Acute Illness. 93. You would like to compare the support system of patients with chronic illness to those with acute illness. What type of research it this? EEEEEEEEEEEEE.Correlational FFFFFFFFFFFFF.Descriptive GGGGGGGGGGGGG.Experimental HHHHHHHHHHHHH.Quasi-experimental 94. You are shown a Likert Scale that will be used in evaluating your performance in the clinical area. Which of the following questions will you not use in critiquing the Likert Scale?

IIIIIIIIIIIII.Are the techniques to complete and score the scale provided? JJJJJJJJJJJJJ.Are the reliability and validity information on the scale described? KKKKKKKKKKKKK.If the Likert scale is to be used for a study, was the development process described? LLLLLLLLLLLLL.Is the instrument clearly described?

95. In any research study where individual persons are involved, it is important that an informed consent for the study is obtained. The following are essential information about the consent that you should disclose to the prospective subjects EXCEPT: MMMMMMMMMMMMM.Consent to incomplete disclosure NNNNNNNNNNNNN.Descriptions of benefits, risks and discomforts OOOOOOOOOOOOO.Explanation of procedure PPPPPPPPPPPPP.Assurance of anonymity and confidentiality Situation 20 – Because severe burn can affect the person’s totality it is important that-you apply interventions focusing on the various dimensions of man. You also have to understand the rationale of the treatment. 96. What type of debridement involves proteolytic enzymes? A. Interventional B. Mechanical

C. Surgical D. Chemical

97. Which topical antimicrobial is most frequently used in burn wound care? QQQQQQQQQQQQQ.Neosporin RRRRRRRRRRRRR.Silver nitrate SSSSSSSSSSSSS.Silver sulfadiazine TTTTTTTTTTTTT.Sulfamylon 98. Hypertrophic burn scars are caused by: UUUUUUUUUUUUU.exaggerated contraction VVVVVVVVVVVVV.random layering of collagen

WWWWWWWWWWWWW.wound ischemia XXXXXXXXXXXXX.delayed epithelialization 99. The major disadvantage of whirlpool cleansing of burn wound is: YYYYYYYYYYYYY.patient hypothermia ZZZZZZZZZZZZZ.cross contamination of wound AAAAAAAAAAAAAA.patient discomfort BBBBBBBBBBBBBB.excessive manpower requirement

100. Oral analgesics are most frequently used to control burn injury pain: CCCCCCCCCCCCCC.upon patient request DDDDDDDDDDDDDD.during the emergent phase EEEEEEEEEEEEEE.after hospital discharge FFFFFFFFFFFFFF.during the acute phase *** END *** SUBMIT THIS TEST BOOKLET TOGETHER WITH THE ANSWER SHEET TO YOUR WATCHERS. BRINGING THE TEST BOOKLET OUT OF THE ROOM WILL BE A GROUND FOR CANCELLATION OF YOUR EXAMINATION.