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Sep 5, 2008

June 2007 NP4 Nursing Board ExamAnswer Key

NURSING PRACTICE IV – SET B


NURSING PRACTICE IV – Care of Clients with Physiologic and Psychosocial Alterations (Part B)

GENERAL INSTRUCTIONS

1. This test booklet contains 100 test questions

2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheet.

3. Shade only one (1) box for each question on your answer sheets. Two or more

boxes shaded will invalidate your answer.

4. AVOID ERASURES.


INSTRUCTIONS

1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet

Set.

2. Write the subject title “Nursing Practice IV” on the box provided.

3. 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.


1. 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. log roll on the grass/ground

B. slap the flames with his hands

C. remove the burning clothes

D. pour cold liquid over the flames


2. Once the flames are extinguished, it is most important to:

A. cover Sergio with a warm blanket

B. give him sips of water

C. calculate the extent of his burns

D. assess the Sergio’s breathing


3. 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. Structures beneath the skin are damage

B. Dermis is partially damaged

C. Epidermis and dermis are both damaged

D. Epidermis is damaged


4. During the first 24 hours after the thermal injury, you should asses Sergio for:

A. hypokalemia and hypernatremia

B. hypokalemia and hyponatremia

C. hyperkalemia and hyponatremia

D. hyperkalemia and hypernatremia


5. 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 C. metabolic acidosis

B. Hypervolemia 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.


6. 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?

A. Make an incident report

B. Call security to report the incident

C. Wait for 2 hours before reporting

D. 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?

A. Write an incident report and refer the matter to the nursing director

B. Keep your findings to yourself

C. Report the matter to your supervisor

D. 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.

A. Start basic life support measures

B. Call for the Code

C. Bring the crush cart to the room

D. 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?

A. Take note of it and plan to endorse this to next shift

B. Keep this matter to yourself

C. Write an incident report

D. 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.

A. Barium enema

B. Carcinoembryonic antigen

C. Annual digital rectal examination

D. Proctosigmoidoscopy

12. To confirm his impression of colorectal cancer, Larry will require which diagnostic

study?

A. Carcinoembryonic antigen

B. Proctosigmoidoscopy

C. Stool hematologic test

D. Abdominal computed tomography (CT) test

13. The following are risk factors for colorectal cancer, EXCEPT:

A. Inflammatory bowels

B. High fat, high fiber diet

C. Smoking

D. Genetic factors-familial adenomatous polyposis

14. Symptoms associated with cancer of the colon include:

A. constipation, ascites and mucus in the stool

B. diarrhea, heart burn and eructation

C. blood in the stools, anemia, and “pencil shaped” stools

D. anorexia, hematemesis, and increased peristalasis

15. Several days prior to bowel surgery, Larry may be given sulfasuxidine and

neomycin primarily to:

A. promote rest of the bowel by minimizing peristalsis

B. reduce the bacterial content of the colon

C. empty the bowel of solid waste

D. 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:

A. The perineal wound heals And Fermin can sit comfortably on the commode

B. Fermin can lie on the side comfortably, about the 3rd postoperative day

C. The abdominal incision is closed and contamination is no longer a danger

D. 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:

A. When Fermin would have normal bowel movement

B. At least 2 hours before visiting hours

C. Prior to breakfast and morning care

D. 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:

A. Lubricates the tip of the catheter prior to inserting into the stoma

B. Hangs the irrigating bag on the bathroom door cloth hook during fluid

insertion

C. Discontinues the insertion of fluid after only 500 ml of fluid has been instilled

D. 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:

A. If I have any difficulty inserting the irrigating tub into the stoma.”

B. If I noticed a loss of sensation to touch in the stoma tissue.”

C. The expulsion of flatus while the irrigating fluid is running out.”

D. 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:

A. Soft food that are easily digested and absorbed by my large intestines.”

B. Bland food so that my intestines do not become irritated.”

C. Food low in fiber so that there is less stool.”

D. 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:

A. empty the drainage system at the end of the shift

B. clamp the chest tube when suctioning

C. palpate the surrounding areas for crepitus

D. 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:

A. a tender, painful area on the leg

B. a pitting edema of the ankle

C. a reddened area at the ankle

D. 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?

A. Recognize that prompt closure of the tracheal opening may occur

B. Keep calm because there is no immediate emergency

C. Reinsert another tubing immediately

D. Notify the physician at once

25. When caring for Larry after an exploratory chest surgery and pneumonectomy,

your priority would be to maintain:

A. supplementary oxygen

B. ventilation exchange

C. chest tube drainage

D. 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:

A. “Don’t worry your husband’s type of hepatitis is no longer communicable”

B. “Gamma globulin provides passive immunity for hepatitis B”

C. “You should contact your physician immediately about getting

gammaglobulin.”

D. “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:

A. “You acquired the infection after you have been admitted to the

hospital.”

B. “This is a highly contagious infection requiring complete isolation.”

C. “The infection you had prior to hospitalization flared up.”

D. “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:

A. stomatitis

B. hepatitis

C. dysrhythmia

D. infection

29. A solution used to treat Pseudomonas wound infection is:

A. Dakin’s solution

B. Half-strength hydrogen peroxide

C. Acetic acid

D. Betadine

30. Which of the following is the most reliable in diagnosing a wound infection?

A. Culture and sensitivity

B. Purulent drainage from a wound

C. WBC count of 20,000/μL

D. 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?

A. Prevent skin breakdown

B. Preserve muscle function

C. Promote urinary elimination

D. 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?

A. Tell her family that probably she can’t hear them

B. Talk loudly so that Wendy can hear you

C. Tell her family who are in the room not to talk

D. 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?

A. Place June on an upright lateral position

B. Perform range of motion exercises

C. Apply antiembolic stockings

D. 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?

A. honoring her request for a television

B. placing her bed near the window

C. dimming the light in her room

D. 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:

A. probably has meningitis

B. is going to be blind because of trauma

C. is permanently paralyzed

D. 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.

A. Ineffective airway clearance

B. Decreased alveolar surfaced area

C. Decreased anterior-posterior chest diameter

D. Hyperventilation

37. The older patient is at higher risk for incontinence because of:

A. dilated urethra

B. increased glomerular filtration rate

C. diuretic use

D. decreased bladder capacity

38. Merle, age 86, is complaining of dizziness when she stands up. This may

indicate:

A. dementia

B. a visual problem

C. functional decline

D. drug toxicity

39. Cardiac ischemia in an older patient usually produces:

A. ST-T wave changes

B. Very high creatinine kinase level

C. Chest pain radiating to the left arm

D. Acute confusion

40. The most dependable sign of infection in the older patient is:

A. change in mental status

B. fever

C. pain

D. 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.”?

A. Recovery

B. Mitigation

C. Response

D. 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:

A. Tertiary prevention

B. Primary prevention

C. Aggregate care prevention

D. Secondary prevention

43. During the disaster you see a victim with a green tag, you know that the

person:

A. has injuries that are significant and require medical care but can wait hours with

threat to life or limb

B. has injuries that are life threatening but survival is good with minimal

intervention

C. indicates injuries that are extensive and chances of survival are unlikely even

with definitive care

D. 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:

A. Immediate

B. Emergent

C. Non-acute

D. 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?

A. Clinical incident stress management

B. Follow-up

C. Debfriefing

D. 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:

A. Acetone

B. Alcohol

C. Ammonia

D. 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?

A. Establish policies for surveillance and monitoring

B. Do data gathering about the possible sources of infection (observation,

chart review, interview).

C. Assign point persons who can implement policies.

D. 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?

A. Bring your diabetes teaching kit and start your session taking into consideration

their distance from your office

B. Contact the nurse in-charge and find out from her the reason for the referral

C. Determine their learning needs then prioritize

D. 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?

A. Find out if there is a budget for this activity

B. Clarify objectives of the activity with the task force before contacting the

support groups

C. Determine the VIPs and Celebrities who will be invited

D. 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?

A. Conduct health education on healthy life style

B. Be a triage nurse

C. Take the initial history and document findings

D. 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?

A. Tell the physician who in turn could tell the family

B. Obtain Irma’s permission to share the information in the family

C. Tell Irma that she has to tell her family what she told you

D. 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?

A. Arrange for visitors who might cheer him

B. Sit down and talk with him for a while

C. Encourage him to look at the brighter side of things

D. Sit silently with him

54. Which of the following statements would best indicate that Ruffy, who is

dying, has accepted his impending death?

A. “I’m ready to go.”

B. “I have resigned myself to dying.”

C. “What’s the use?”

D. “I’m giving up”

55. Marla, 90 years old has planned ahead for her death-philosophically, socially,

financially and emotionally. This is recognized as:

A. Acceptance that death is inevitable

B. Avoidance of the true situation

C. Denial with planning for continued life

D. 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?

A. Administer bowel softener

B. Position Conrad with his head turned toward the side of the tumor

C. Provide sensory stimulation

D. Encourage coughing and deep breathing

57. Keeping Conrad’s head and neck alignment results in:

A. increased inthrathoracic pressure

B. increased venous outflow

C. decreased venous outflow

D. increased intrabdominal pressure

58. Which of the following activities may increase intracranial pressure (ICP)?

A. Raising the head of the bed

B. Manual hyperventilation

C. Use of osmotic diuretics

D. Valsalva’s maneuver

59. After you asses Conrad, you suspected increased ICP. Your most

appropriate respiratory goal is to:

A. maintain partial pressure of arterial O2 (PaO2) above 80 mmHg

B. lower arterial pH

C. prevent respiratory alkalosis

D. 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 drainage

B. Yellowish drainage D. Bloody 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 C. Cure

B. Care D. Coordination

62. You are assigned to care for four (4) patients. Which of the following patients

should you give first priority?

A. Grace, who is terminally ill with breast cancer.

B. Emy, who was previously lucid but is now unarousable.

C. Aris, who is newly admitted and is scheduled for an executive check-up.

D. 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?

A. Brenda should be informed when she goes back on duty

B. Although Brenda is not on duty, the nursing supervisor on duty decides to call her

if time permits

C. The nursing supervisor on duty will notify Brenda at home

D. Brenda is not duty therefore it is not necessary to inform her.

64. Which barrier should you avoid, to manage time wisely?

A. Practical planning

B. Procrastination

C. Setting limits

D. 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?

A. Move his bed to a room far from nurse’s station to reduce

B. Assign the same nurse to him when possible

C. Allow Vincent uninterrupted period of time

D. 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?

A. Offer tranquilizers and antiemetics

B. Instruct the patient of the possibility of radiation burn

C. Emphasis on the therapeutic value of the treatment

D. Map out the precise course of treatment

67. What side effects are most apt to occur the patient during radiation therapy

to the pelvis?

A. Urinary retention

B. Abnormal vaginal or perineal discharge

C. Paresthesia of the lower extremities

D. Nausea and vomiting and diarrhea

68. Which of the following can be used on the irradiated skin during a course of

radiation therapy?

A. Adhesive tape

B. Mineral oil

C. Talcum powder

D. Zinc oxide ointment

69. Earliest sign of skin reaction to radiation therapy is:

A. desquamation

B. erythema

C. atrophy

D. pigmentation

70. What is the purpose of wearing a film badge while caring for the patient who

is radioactive?

A. Identify the nurse who is assigned to care for such a patient

B. Prevent radiation-induced sterility

C. Protect the nurse from radiation effects

D. 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 pre-assigned 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 C. Morgue management

B. Triage group 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:

A. any disaster plan should have resources available to triage at each facility and at

the disaster site if possible

B. make the most efficient use of available resources

C. training on the disaster is not important to the response in the event of a

real disaster because each disaster is unique in itself

D. 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?

A. Intracranial pressure and mental status

B. Lower gastrointestinal problems

C. Respiratory infections

D. Trauma

74. A guideline that is utilized in determining priorities is to asses the status of

the following, EXCEPT:

A. perfusion C. respiration

B. locomotion D. mentation

75. The most important component of neurologic assessment is:

A. pupil reactivity

B. vital sign assessment

C. cranial nerve assessment

D. 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:

A. immunosuppressive therapy

B. sex at an early age, multiple partners, exposure to socially transmitted disease,

male partner’s sexual habits

C. viral agents like the Human Papilloma Virus

D. smoking

77. Late signs and symptoms of cervical cancer include the following EXCEPT:

A. urinary/bowel changes

B. pain in pelvis, leg or flank

C. uterine bleeding

D. lymph edema of lower extremities

78. When a panhysterectomy is performed due to cancer of the cervix, which of

the following organs are removed?

A. the uterus, cervix, and one ovary

B. the uterus, cervix, and two-thirds of the vagina

C. the uterus, cervix, tubes and ovaries

D. the uterus and cervix

79. The primary modalities of treatment for Stage 1 and IIA cervical cancer

include the following:

A. surgery, radiation therapy and hormone therapy

B. surgery

C. radiation therapy

D. surgery and radiation therapy

80. A common complication of hysterectomy is

A. thrombophelbitis of the pelvic and thigh vessels

B. diarrhea due to over stimulation

C. atelectasis

D. 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:

A. Perform range and motion exercise on the head and neck

B. Apply gentle pressure against the incision when swallowing

C. Cough and deep breath every 2 hours

D. 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:

A. An airway and rebreathing tube

B. A tracheostomy set and oxygen

C. A crush cart with bed board

D. Two ampules of sodium bicarbonate

83. Which of the following nursing interventions is appropriate after a total

thyroidectomy?

A. Place pillows under your patient’s shoulders.

B. Raise the knee-gatch to 30 degrees

C. Keep you patient in a high-fowler’s position.

D. 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 failure

B. Dyspnea D. Tetany

85. After surgery Leda develops peripheral numbness, tingling and muscle

twitching and spasm. What would you anticipate to administer?

A. Magnesium sulfate C. Potassium iodide

B. Calcium gluconate D. Potassium chloride

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:

A. to immediately apply a chemical decontamination foam to the area of

contamination

B. a through soap and water wash and rinse of the patient

C. to immediately apply personal protective equipment

D. 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 C. saline

B. colloidal (oatmeal D. sodium bicarbonate

88. Induction of vomiting is indicated for the accidental poisoning patient who has

ingested.

A. rust remover C. toilet bowl cleaner

B. gasoline 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?

A. Secondary blood stream infections

B. Nosocomial infection

C. Emerging infectious disease

D. Primary blood stream infection

90. Which of the following guidelines is not appropriate to helping family

members cope with sudden death?

A. Obtain orders for sedation of family members

B. Provide details of the factors attendant to the sudden death

C. Show acceptance of the body by touching it and giving the family

permission to touch

D. 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 C. Independent

B. Correlational D. Demographic

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?

A. 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.

B. The Effect Of The Type Of Support System of Patients With Chronic

Illness And Those With Acute Illness.

C. A Comparative Analysis Of The Support System Of Patients

With Chronic Illness And Those With Acute Illness.

D. 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?

A. Correlational

B. Descriptive

C. Experimental

D. 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?

A. Are the techniques to complete and score the scale provided?

B. Are the reliability and validity information on the scale described?

C. If the Likert scale is to be used for a study, was the

development process described?

D. 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:

A. Consent to incomplete disclosure

B. Descriptions of benefits, risks and discomforts

C. Explanation of procedure

D. 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 C. Surgical

B. Mechanical D. Chemical

97. Which topical antimicrobial is most frequently used in burn wound care?

A. Neosporin

B. Silver nitrate

C. Silver sulfadiazine

D. Sulfamylon

98. Hypertrophic burn scars are caused by:

A. exaggerated contraction

B. random layering of collagen

C. wound ischemia

D. delayed epithelialization

99. The major disadvantage of whirlpool cleansing of burn wound is:

A. patient hypothermia

B. cross contamination of wound

C. patient discomfort

D. excessive manpower requirement

100. Oral analgesics are most frequently used to control burn injury pain:

A. upon patient request

B. during the emergent phase

C. after hospital discharge

D. during the acute phase

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