Feb 28, 2009

Psychiatry Nursing ( 21 - 40 )

21. The nurse teaches the parents of a mentally retarded child regarding her care. The following guidelines may be taught except:
A. overprotection of the child
B. patience, routine and repetition
C. assisting the parents set realistic goals
D. giving reasonable compliments

Answer: (A) overprotection of the child
The child with mental retardation should not be overprotected but need protection from injury and the teasing of other children. B,C, and D Children with mental retardation have learning difficulty. They should be taught with patience and repetition, start from simple to complex, use visuals and compliment them for motivation. Realistic expectations should be set and optimize their capability.
22. The parents express apprehensions on their ability to care for their maladaptive child. The nurse identifies what nursing diagnosis:
A. hopelessness
B. altered parenting role
C. altered family process
D. ineffective coping

Answer: (B) altered parenting role
Altered parenting role refers to the inability to create an environment that promotes optimum growth and development of the child. This is reflected in the parent’s inability to care for the child. A. This refers to lack of choices or inability to mobilize one’s resources. C. Refers to change in family relationship and function. D. Ineffective coping is the inability to form valid appraisal of the stressor or inability to use available resources
23. A 5 year old boy is diagnosed to have autistic disorder.
Which of the following manifestations may be noted in a client with autistic disorder?

A. argumentativeness, disobedience, angry outburst
B. intolerance to change, disturbed relatedness, stereotypes
C. distractibility, impulsiveness and overactivity
D. aggression, truancy, stealing, lying

Answer: (B) intolerance to change, disturbed relatedness, stereotypes
These are manifestations of autistic disorder. A. These manifestations are noted in Oppositional Defiant Disorder, a disruptive disorder among children. C. These are manifestations of Attention Deficit Disorder D. These are the manifestations of Conduct Disorder
24. The therapeutic approach in the care of an autistic child include the following EXCEPT:
A. Engage in diversionary activities when acting -out
B. Provide an atmosphere of acceptance
C. Provide safety measures
D. Rearrange the environment to activate the child

Answer: (D) Rearrange the environment to activate the child
The child with autistic disorder does not want change. Maintaining a consistent environment is therapeutic. A. Angry outburst can be rechannelled through safe activities. B. Acceptance enhances a trusting relationship. C. Ensure safety from self-destructive behaviors like head banging and hair pulling.
25. According to Piaget a 5 year old is in what stage of development:
A. Sensory motor stage
B. Concrete operations
C. Pre-operational
D. Formal operation

Answer: (C) Pre-operational
Pre-operational stage (2-7 years) is the stage when the use of language, the use of symbols and the concept of time occur. A. Sensory-motor stage (0-2 years) is the stage when the child uses the senses in learning about the self and the environment through exploration. B. Concrete operations (7-12 years) when inductive reasoning develops. D. Formal operations (2 till adulthood) is when abstract thinking and deductive reasoning develop.
26. Situation : The nurse assigned in the detoxification unit attends to various patients with substance-related disorders.

A 45 years old male revealed that he experienced a marked increase in his intake of alcohol to achieve the desired effect This indicates:
A. withdrawal
B. tolerance
C. intoxication
D. psychological dependence

Answer: (B) tolerance
tolerance refers to the increase in the amount of the substance to achieve the same effects. A. Withdrawal refers to the physical signs and symptoms that occur when the addictive substance is reduced or withheld. B. Intoxication refers to the behavioral changes that occur upon recent ingestion of a substance. D. Psychological dependence refers to the intake of the substance to prevent the onset of withdrawal symptoms.
27. The client admitted for alcohol detoxification develops increased tremors, irritability, hypertension and fever. The nurse should be alert for impending:
A. delirium tremens
B. Korsakoff’s syndrome
C. esophageal varices
D. Wernicke’s syndrome

Answer: (A) delirium tremens
Delirium Tremens is the most extreme central nervous system irritability due to withdrawal from alcohol B. This refers to an amnestic syndrome associated with chronic alcoholism due to a deficiency in Vit. B C. This is a complication of liver cirrhosis which may be secondary to alcoholism . D. This is a complication of alcoholism characterized by irregularities of eye movements and lack of coordination.
28. The care for the client places priority to which of the following:
A. Monitoring his vital signs every hour
B. Providing a quiet, dim room
C. Encouraging adequate fluids and nutritious foods
D. Administering Librium as ordered

Answer: (A) Monitoring his vital signs every hour
Pulse and blood pressure are usually elevated during withdrawal, Elevation may indicate impending delirium tremens B. Client needs quiet, well lighted, consistent and secure environment. Excessive stimulation can aggravate anxiety and cause illusions and hallucinations. C. Adequate nutrition with sulpplement of Vit. B should be ensured. D. Sedatives are used to relieve anxiety.
29. Another client is brought to the emergency room by friends who state that he took something an hour ago. He is actively hallucinating, agitated, with irritated nasal septum.
A. Heroin
B. cocaine
D. marijuana

Answer: (B) cocaine
The manifestations indicate intoxication with cocaine, a CNS stimulant. A. Intoxication with heroine is manifested by euphoria then impairment in judgment, attention and the presence of papillary constriction. C. Intoxication with hallucinogen like LSD is manifested by grandiosity, hallucinations, synesthesia and increase in vital signs D. Intoxication with Marijuana, a cannabinoid is manifested by sensation of slowed time, conjunctival redness, social withdrawal, impaired judgment and hallucinations.
30. A client is admitted with needle tracts on his arm, stuporous and with pin point pupil will likely be managed with:
A. Naltrexone (Revia)
B. Narcan (Naloxone)
C. Disulfiram (Antabuse)
D. Methadone (Dolophine)

Answer: (B) Narcan (Naloxone)
Narcan is a narcotic antagonist used to manage the CNS depression due to overdose with heroin. A. This is an opiate receptor blocker used to relieve the craving for heroine C. Disulfiram is used as a deterrent in the use of alcohol. D. Methadone is used as a substitute in the withdrawal from heroine
31. Situation: An old woman was brought for evaluation due to the hospital for evaluation due to increasing forgetfulness and limitations in daily function.

The daughter revealed that the client used her toothbrush to comb her hair. She is manifesting:
A. apraxia
B. aphasia
C. agnosia
D. amnesia

Answer: (C) agnosia
This is the inability to recognize objects. A. Apraxia is the inability to execute motor activities despite intact comprehension. B. Aphasia is the loss of ability to use or understand words. D. Amnesia is loss of memory.
32. She tearfully tells the nurse “I can’t take it when she accuses me of stealing her things.” Which response by the nurse will be most therapeutic?
A. ”Don’t take it personally. Your mother does not mean it.”
B. “Have you tried discussing this with your mother?”
C. “This must be difficult for you and your mother.”
D. “Next time ask your mother where her things were last seen.”

Answer: (C) “This must be difficult for you and your mother.”
This reflecting the feeling of the daughter that shows empathy. A and D. Giving advise does not encourage verbalization. B. This response does not encourage verbalization of feelings.
33. The primary nursing intervention in working with a client with moderate stage dementia is ensuring that the client:
A. receives adequate nutrition and hydration
B. will reminisce to decrease isolation
C. remains in a safe and secure environment
D. independently performs self care

Answer: (C) remains in a safe and secure environment
Safety is a priority consideration as the client’s cognitive ability deteriorates.. A is appropriate interventions because the client’s cognitive impairment can affect the client’s ability to attend to his nutritional needs, but it is not the priority B. Patient is allowed to reminisce but it is not the priority. D. The client in the moderate stage of Alzheimer’s disease will have difficulty in performing activities independently
34. She says to the nurse who offers her breakfast, “Oh no, I will wait for my husband. We will eat together” The therapeutic response by the nurse is:
A. “Your husband is dead. Let me serve you your breakfast.”
B. “I’ve told you several times that he is dead. It’s time to eat.”
C. “You’re going to have to wait a long time.”
D. “What made you say that your husband is alive?

Answer: (A) “Your husband is dead. Let me serve you your breakfast.”
The client should be reoriented to reality and be focused on the here and now.. B. This is not a helpful approach because of the short term memory of the client. C. This indicates a pompous response. D. The cognitive limitation of the client makes the client incapable of giving explanation.
35. Dementia unlike delirium is characterized by:
A. slurred speech
B. insidious onset
C. clouding of consciousness
D. sensory perceptual change

Answer: (B) insidious onset
Dementia has a gradual onset and progressive deterioration. It causes pronounced memory and cognitive disturbances. A,C and D are all characteristics of delirium.
36. Situation: A 17 year old gymnast is admitted to the hospital due to weight loss and dehydration secondary to starvation.

Which of the following nursing diagnoses will be given priority for the client?
A. altered self-image
B. fluid volume deficit
C. altered nutrition less than body requirements
D. altered family process

Answer: (B) fluid volume deficit
Fluid volume deficit is the priority over altered nutrition (A) since the situation indicates that the client is dehydrated. A and D are psychosocial needs of a client with anorexia nervosa but they are not the priority.
37. What is the best intervention to teach the client when she feels the need to starve?
A. Allow her to starve to relieve her anxiety
B. Do a short term exercise until the urge passes
C. Approach the nurse and talk out her feelings
D. Call her mother on the phone and tell her how she feels

Answer: (C) Approach the nurse and talk out her feelings
The client with anorexia nervosa uses starvation as a way of managing anxiety. Talking out feelings with the nurse is an adaptive coping. A. Starvation should not be encouraged. Physical safety is a priority. Without adequate nutrition, a life threatening situation exists. B. The client with anorexia nervosa is preoccupied with losing weight due to disturbed body image. Limits should be set on attempts to lose more weight. D. The client may have a domineering mother which causes the client to feel ambivalent. The client will not discuss her feelings with her mother.
38. The client with anorexia nervosa is improving if:
A. She eats meals in the dining room.
B. Weight gain
C. She attends ward activities.
D. She has a more realistic self concept.

Answer: (B) Weight gain
Weight gain is the best indication of the client’s improvement. The goal is for the client to gain 1-2 pounds per week. (A)The client may purge after eating. (C) Attending an activity does not indicate improvement in nutritional state. (D) Body image is a factor in anorexia nervosa but it is not an indicator for improvement.
39. The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is that bulimic individuals
A. have episodic binge eating and purging
B. have repeated attempts to stabilize their weight
C. have peculiar food handling patterns
D. have threatened self-esteem

Answer: (A) have episodic binge eating and purging
Bulimia is characterized by binge eating which is characterized by taking in a large amount of food over a short period of time. B and C are characteristics of a client with anorexia nervosa D. Low esteem is noted in both eating disorders
40. A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating habits. The goal for this problem is:
A. Patient will learn problem solving skills
B. Patient will have decreased symptoms of anxiety.
C. Patient will perform self care activities daily.
D. Patient will verbalize how to set limits on others.

Answer: (A) Patient will learn problem solving skills
if the client learns problem solving skills she will gain a sense of control over her life. (B) Anxiety is caused by powerlessness. (C) Performing self care activities will not decrease ones powerlessness (D) Setting limits to control imposed by others is a necessary skill but problem solving skill is the priority.

Feb 23, 2009

Performance of RP Nursing Schools Nov 2008 NLE

Nov 2008 Nursing-Schools

Top Performing Students - November 2008 Board Exam

Top Performing Students

1) Jovie Ann Alawas Decoyna of Baguio Central University, 89 percent

2) John Patrick Morales Dimarucot , Central Luzon Doctor's Hospital Educational Institute, 88.40%

3) Gian Karlo Timog Cusi, Baguio Central University 88%; Erycar Del Mundo Manaois-Pamantasan ng Lungsod ng Maynila, 88%

4) Florina Conde Corpuz, Saint Dominic Savio College 87.60%; Angelica Aubrey Pantig Morla, Far Eastern University Manila 87.60%; and Jamie Anne Tolentino Tinio, Angeles University Foundation 87.60%

5) Roberto Madrona Asuncion, Arellano University, Pasay City, 87.40; Irisa Kriya Turaja Biag, San Pedro College, Davao City, 87.40; Miguela Macuto Gabisan, Cebu Normal University, 87.40%; Edita Te Lim-Arriesgado College Foundation, Inc, 87.40%; Rosario Lei Mosqueda Pasimio, Xavier University, 87.40%; and Elaine Grace Esperancilla Praile
Saint Paul University, Iloilo 87.4%; Catherine Duran Reyes, Our Lady of Fatima College QC, 87.4%

6) Geronimo Carillo Burce Jr., Mabini College, 87.20%; Joanna Mae Francisco Evangelista, San Beda College, 87.20%; Christopher Alvarez Irorita, San Pedro College, Davao City, 87.20%, Paul Delfin Reyes Jamero, Father Saturnino Urios University (Urios College), 87.20%; Hazel Joy Amarillo Jimenez, University of Batangas, 87.20%; Ma. Concepcion Ashley Delizo Mapagu, Saint Louis University, 87.20%; Maria Cecilia Castillo Navata, Canossa College, 87.20%; Francis Ian Sabanal Pascual, Universidad de Zamboanga (ZAEC), 87.20%; and George Garcia Vega Jr., University of Saint Louis, Tuguegarao, 87.20%

7)Katrina Andrea Pagdanganan Arceo, Nueva Ecija College, 87.00%; Rose Jean Dumaboc Capidlac, Silliman University, 87.00; Carla Mae Tenorio Cuisia, Silliman University, 87.00; Mary Ann Alvarez Garing, Lyceum of Batangas, 87.00; Ma. Joya Jimenea Genzola, Colegio de San Agustin, Bacolod City, 87.00%; and Rose Anne Miranda Mungcal, Angeles University Foundation, 87.00%; Pretzel Estremos Vicencio, (Butuan Doctors College (Butuan Dr. HSP. Sch. of Nursing), 87.00%; and Faye Stephanie Yao Yu, Remedios T. Romualdez Medical Foundation, 87.00%

8) Lylani Mutya Balote, University of Makati, 86.80; Jamaicca Rabulan Banting, Davao Doctors College, Inc., 86.80%; Garey Jay Avelino Delfin, Iloilo Doctors’ College, 86.80%; Josephine Celoso Elvas, 86.80%; Vanito Diocson Ilanga Jr., Sultan Kudarat Educational Institution, 86.80%; Maria Edna Charise Godoy Java, Misamis University, Ozamiz City, 86.80%; Hannah Lee Alde Padilla, University of San Agustin, 86.80%; Bryan Morella Peralta, Univesity of Makati, 86.80%; and Robinson Uy Kaw Sing, Iloilo Doctors’ College, 86.80%

9) Maria Jurem Quilar Alcarde, Central Philippine University, 86.60%; Ruel Bobadilla Arzadon, Saint Louis University, 86.60%; Karina Genciane Banayat, Our Lady of Fatima College, Quezon City, 86.60%; Ryan Daniel Rivera Dablo, University of San Carlos, 86.60%; Matthew Wayne Real Chang, Silliman University, 86.60%; Fritzie Quiatzon Dela Raga, Fellowhip Baptist College, 86.60%; Hiromi Balaguer Fernandez, Saint Paul University, Iloilo, 86.60%; Josephine Franz Pagulayan Gammad, Saint Paul University, Tuguegarao, 86.60%; Paul Fabian Robosa Gumabao, Arellano University, Manila, 86.60%; Maila Carl Majam Morantte, Colegio De Sta. Lourdes of Leyte Foundation Inc., 86.60%; Michael Dorothy Frances Gaer Montojo, Ateneo de Davao University, 86.60%; Cindy Mae Alvarez Nañoz, Ateneo de Zamboanga, 86.60%; Glenda Mae Macapal Omaña, Riverside College, 86.60%; Rhea Jhoy Padinay Pantaleon, Saint Louis University, 86.60%; Rolly Mendoza Policarpio, Angeles University Foundation, 86.60%; Arlette Castillo Quinan, University of St. Louis, Tuguegarao, 86.60%; Crystal Mae Abejuela Sabela, Xavier University, 86.60%; Katrina Isabel Hugo Santos, Philippine Women’s University, Quezon City, 86.60%; and Shiella Marie Gamboa Simplina, Saint Louis University, 86.60%

10) James Altura Baguio, Saint Mary’s University, 86.40%; Miljoyce Daligdig Cabat, Lyceum Northwestern, 86.40%; Sarah Mae Clemente Capulong, Angeles University Foundation, 86.40%; Johcy Angeleme Fausto De La Fuente, Central Philippine University, 86.40; Renante Lazarte Dig-Aoan, Baguio Central University, 86.40%; Jake Desor Diputado, Silliman University, 86.40%; Marjory Boquia Emperio, Misamis University , Ozamiz City, 86.40%, Marissa Raposas Ferrer, Lyceum Northwestern, 86.40%; Erika Bautista Galang, Central Luzon Doctor’s Hospital Educational Institute, 86.40%; Francis Gerwin Uy Jalipa, San Pedro College, Davao City, 86.40%; Angela Gilda Baltazar Mencias, Unciano Colleges & General Hospital, Manila, 86.40%; Carina Yabut Pacete, Our Lady of Fatima University, Valenzuela, 86.40%; Joy Jenelynn Chua Tan, University of Sto. Tomas, 86.40%; Francis Dollente Villanueva, Saint Paul University, Tuguegarao, 86.40%

Feb 20, 2009


Nursing board exam result november 2008


At least 39,455 or 44.51% out of 88,649 examinees that took the November 2008 Nursing Board have passed, the Professional Regulatory Commission has announced.

Jovie Ann Alawas Decoyna of Baguio Central University topped the board, with 89 percent, the PRC said.

Xavier university ranked number one among the schools whose students took the board exams, the results of which were released by the PRC Friday.

The Nursing Regulatory Board (NRB) is headed by Carmencita Abaquin. Members of the NRB include Yolanda Arugay, Betty Merritt, Leonila Faire, Perla Po, Marco Antonio Sto.Tomas, and Amelia Rosales.

Feb 11, 2009


NOVEMBER 2008 RESULTS BULLETIN : Result will be released within the next 10 Days.

The Board of Nursing started its quarantine today, February 08 2009. Deliberations about the passing rate, top performing schools and the topnotchers are already finished by the BON and the PRC rating and statistics division.

The Quarantine is performed when the results is to be release as to prevent the BON from influencing any aspect of the results.

Results will be release anytime within the next 10 days. Passing rate is at a usual percentage of 40s but can still change.

Results will be release here 1 day before the national release.


Feb 5, 2009

November 2008 Nursing Board Exam Results

November 2008 Exam Results BULLETIN

Do not believe the circulating rumors that results are already posted. The BON is not yet on their quarantine period. Expect that the result will be release at the 3rd to 4th week of february. This date can be later depending on the outcome of the deliberation.




DATE: JANUARY 30, 2008

It has come to the attention of the PRC Board of Nursing that some Nursing Colleges have reduced the required number of “intra-partal, intra-operative, and immediate care of the newborn” (D.R. / O.R. / Cord Care) from five (5) to three(3) cases causing confusion especially among nursing students.

The BOARD wishes to reiterate to all concerned that in accordance with its quasi-legislative function (Article III, Section 9 (c), (d) and (h), it is still in the process of HEARING the outputs from the Association of Deans of Philippine Colleges of Nursing (ADPCN) based on commitments duly made during the last ADPCN Convention of October 2008 and therefore has not announced any changes in the prevailing requirement of cases for the intra-partal, intraoperative and immediate care of the newborn.

This BOARD wishes to FURTHER EMPHASIZE, that it adheres to a NO RETROACTIVE APPLICATION OF ANY NEW POLICY, therefore if and when new promulgations are finally issued this will never be applied to “graduating students”.

And that FINALLY, this BOARD envisions that all related policy-changes that will be announced shall be in effect for those who will enrol for their intra-partal, intra-operative, and immediate care of the newborn clinical experiences in June of 2009.

In view hereof, all Deans and faculty-members of Colleges of Nursing, and all concerned professional nurses ARE HEREBY DIRECTED to follow the PREVAILING PRESCRIPTIONS of five cases each with regards to O.R., D.R., and Cord Care requirements for the filing of applications to the 2009-2010 Nurse Licensure Examinations (NLE). Nursing graduates of 2011 and 2012, meaning those enrolling in their 2nd and 3rd Academic Year shall be those who shall be affected by the new policy promulgations.



Feb 2, 2009

Medical Surgical Nursing (151 - 175)

151. An unconscious client is admitted to the ICU, IV fluids are started and a Foley catheter is inserted. With an indwelling catheter, urinary infection is a potential danger. The nurse can best plan to avoid this problem by:

A. Emptying the drainage bag frequently
B. Collecting a weekly urine specimen
C. Maintaining the ordered hydration
D. Assessing urine specific gravity

Answer: (C) Maintaining the ordered hydration
Promoting hydration, maintains urine production at a higher rate, which flushes the bladder and prevents urinary stasis and possible infection

152. The nurse performs full range of motion on a bedridden client’s extremities. When putting his ankle through range of motion, the nurse must perform:

A. Flexion, extension and left and right rotation
B. Abduction, flexion, adduction and extension
C. Pronation, supination, rotation, and extension
D. Dorsiflexion, plantar flexion, eversion and inversion

Answer: (D) Dorsiflexion, plantar flexion, eversion and inversion
These movements include all possible range of motion for the ankle joint

153. A client has been in a coma for 2 months. The nurse understands that to prevent the effects of shearing force on the skin, the head of the bed should be at an angle of:

A. 30 degrees
B. 45 degrees
C. 60 degrees
D. 90 degrees

Answer: (A) 30 degrees
Shearing force occurs when 2 surfaces move against each other; when the bed is at an angle greater than 30 degrees, the torso tends to slide and causes this phenomenon. Shearing forces are good contributory factors of pressure sores.

154. Rene, age 62, is scheduled for a TURP after being diagnosed with a Benign Prostatic Hyperplasia (BPH). As part of the preoperative teaching, the nurse should tell the client that after surgery:

A. Urinary control may be permanently lost to some degree
B. Urinary drainage will be dependent on a urethral catheter for 24 hours
C. Frequency and burning on urination will last while the cystotomy tube is in place
D. His ability to perform sexually will be permanently impaired

Answer: (B) Urinary drainage will be dependent on a urethral catheter for 24 hours
An indwelling urethral catheter is used, because surgical trauma can cause urinary retention leading to further complications such as bleeding.

155. The transurethral resection of the prostate is performed on a client with BPH. Following surgery, nursing care should include:

A. Changing the abdominal dressing
B. Maintaining patency of the cystotomy tube
C. Maintaining patency of a three-way Foley catheter for cystoclysis
D. Observing for hemorrhage and wound infection

Answer: (C) Maintaining patency of a three-way Foley catheter for cystoclysis
Patency of the catheter promotes bladder decompression, which prevents distention and bleeding. Continuous flow of fluid through the bladder limits clot formation and promotes hemostasis

156. In the early postoperative period following a transurethral surgery, the most common complication the nurse should observe for is:

A. Sepsis
B. Hemorrhage
C. Leakage around the catheter
D. Urinary retention with overflow

Answer: (B) Hemorrhage
After transurethral surgery, hemorrhage is common because of venous oozing and bleeding from many small arteries in the prostatic bed.

157. Following prostate surgery, the retention catheter is secured to the client’s leg causing slight traction of the inflatable balloon against the prostatic fossa. This is done to:

A. Limit discomfort
B. Provide hemostasis
C. Reduce bladder spasms
D. Promote urinary drainage

Answer: (B) Provide hemostasis
The pressure of the balloon against the small blood vessels of the prostate creates a tampon-like effect that causes them to constrict thereby preventing bleeding.

158. Twenty-four hours after TURP surgery, the client tells the nurse he has lower abdominal discomfort. The nurse notes that the catheter drainage has stopped. The nurse’s initial action should be to:

A. Irrigate the catheter with saline
B. Milk the catheter tubing
C. Remove the catheter
D. Notify the physician

Answer: (B) Milk the catheter tubing
Milking the tubing will usually dislodge the plug and will not harm the client. A physician’s order is not necessary for a nurse to check catheter patency.

159. The nurse would know that a post-TURP client understood his discharge teaching when he says “I should:”

A. Get out of bed into a chair for several hours daily
B. Call the physician if my urinary stream decreases
C. Attempt to void every 3 hours when I’m awake
D. Avoid vigorous exercise for 6 months after surgery

Answer: (B) Call the physician if my urinary stream decreases
Urethral mucosa in the prostatic area is destroyed during surgery and strictures my form with healing that causes partial or even complete ueinary obstruction.

160. Lucy is admitted to the surgical unit for a subtotal thyroidectomy. She is diagnosed with Grave’s Disease. When assessing Lucy, the nurse would expect to find:

A. Lethargy, weight gain, and forgetfulness
B. Weight loss, protruding eyeballs, and lethargy
C. Weight loss, exopthalmos and restlessness
D. Constipation, dry skin, and weight gain

Answer: (C) Weight loss, exopthalmos and restlessness
Classic signs associated with hyperthyroidism are weight loss and restlessness because of increased basal metabolic rate. Exopthalmos is due to peribulbar edema.

161. Lucy undergoes Subtotal Thyroidectomy for Grave’s Disease. In planning for the client’s return from the OR, the nurse would consider that in a subtotal thyroidectomy:
A. The entire thyroid gland is removed
B. A small part of the gland is left intact
C. One parathyroid gland is also removed
D. A portion of the thyroid and four parathyroids are removed

Answer: (B) A small part of the gland is left intact
Remaining thyroid tissue may provide enough hormone for normal function. Total thyroidectomy is generally done in clients with Thyroid Ca.

162. Before a post- thyroidectomy client returns to her room from the OR, the nurse plans to set up emergency equipment, which should include:

A. A crash cart with bed board
B. A tracheostomy set and oxygen
C. An airway and rebreathing mask
D. Two ampules of sodium bicarbonate

Answer: (B) A tracheostomy set and oxygen
Acute respiratory obstruction in the post-operative period can result from edema, subcutaneous bleeding that presses on the trachea, nerve damage, or tetany.

163. When a post-thyroidectomy client returns from surgery the nurse assesses her for unilateral injury of the laryngeal nerve every 30 to 60 minutes by:

A. Observing for signs of tetany
B. Checking her throat for swelling
C. Asking her to state her name out loud
D. Palpating the side of her neck for blood seepage

Answer: (C) Asking her to state her name out loud
If the recurrent laryngeal nerve is damaged during surgery, the client will be hoarse and have difficult speaking.

164. On a post-thyroidectomy client’s discharge, the nurse teaches her to observe for signs of surgically induced hypothyroidism. The nurse would know that the client understands the teaching when she states she should notify the physician if she develops:

A. Intolerance to heat
B. Dry skin and fatigue
C. Progressive weight loss
D. Insomnia and excitability

Answer: (B) Dry skin and fatigue
Dry skin is most likely caused by decreased glandular function and fatigue caused by decreased metabolic rate. Body functions and metabolism are decreased in hypothyroidism.

165. A client’s exopthalmos continues inspite of thyroidectomy for Grave’s Disease. The nurse teaches her how to reduce discomfort and prevent corneal ulceration. The nurse recognizes that the client understands the teaching when she says: “I should:

A. Elevate the head of my bed at night
B. Avoid moving my extra-ocular muscles
C. Avoid using a sleeping mask at night
D. Avoid excessive blinking

Answer: (C) Avoid using a sleeping mask at night
The mask may irritate or scratch the eye if the client turns and lies on it during the night.

166. Clara is a 37-year old cook. She is admitted for treatment of partial and full-thickness burns of her entire right lower extremity and the anterior portion of her right upper extremity. Her respiratory status is compromised, and she is in pain and anxious.

Performing an immediate appraisal, using the rule of nines, the nurse estimates the percent of Clara’s body surface that is burned is:

A. 4.5%
B. 9%
C. 18 %
D. 22.5%

Answer: (D) 22.5%
The entire right lower extremity is 18% the anterior portion of the right upper extremity is 4.5% giving a total of 22.5%

167. The nurse applies mafenide acetate (Sulfamylon cream) to Clara, who has second and third degree burns on the right upper and lower extremities, as ordered by the physician. This medication will:

A. Inhibit bacterial growth
B. Relieve pain from the burn
C. Prevent scar tissue formation
D. Provide chemical debridement

Answer: (A) Inhibit bacterial growth
Sulfamylon is effective against a wide variety of gram positive and gram negative organisms including anaerobes

168. Forty-eight hours after a burn injury, the physician orders for the client 2 liters of IV fluid to be administered q12 h. The drop factor of the tubing is 10 gtt/ml. The nurse should set the flow to provide:

A. 18 gtt/min
B. 28 gtt/min
C. 32 gtt/min
D. 36 gtt/min

Answer: (B) 28 gtt/min
This is the correct flow rate; multiply the amount to be infused (2000 ml) by the drop factor (10) and divide the result by the amount of time in minutes (12 hours x 60 minutes)

169. Clara, a burn client, receives a temporary heterograft (pig skin) on some of her burns. These grafts will:
A. Debride necrotic epithelium
B. Be sutured in place for better adherence
C. Relieve pain and promote rapid epithelialization
D. Frequently be used concurrently with topical antimicrobials.

Answer: (C) Relieve pain and promote rapid epithelialization
The graft covers nerve endings, which reduces pain and provides a framework for granulation that promotes effective healing.

170. A client with burns on the chest has periodic episodes of dyspnea. The position that would provide for the greatest respiratory capacity would be the:

A. Semi-fowler’s position
B. Sims’ position
C. Orthopneic position
D. Supine position

Answer: (C) Orthopneic position
The orthopneic position lowers the diaphragm and provides for maximal thoracic expansion

171. Jane, a 20- year old college student is admiited to the hospital with a tentative diagnosis of myasthenia gravis. She is scheduled to have a series of diagnostic studies for myasthenia gravis, including a Tensilon test. In preparing her for this procedure, the nurse explains that her response to the medication will confirm the diagnosis if Tensilon produces:

A. Brief exaggeration of symptoms
B. Prolonged symptomatic improvement
C. Rapid but brief symptomatic improvement
D. Symptomatic improvement of just the ptosis

Answer: (C) Rapid but brief symptomatic improvement
Tensilon acts systemically to increase muscle strength; with a peak effect in 30 seconds, It lasts several minutes.

172. The initial nursing goal for a client with myasthenia gravis during the diagnostic phase of her hospitalization would be to:

A. Develop a teaching plan
B. Facilitate psychologic adjustment
C. Maintain the present muscle strength
D. Prepare for the appearance of myasthenic crisis

Answer: (C) Maintain the present muscle strength
Until diagnosis is confirmed, primary goal should be to maintain adequate activity and prevent muscle atrophy

173. The most significant initial nursing observations that need to be made about a client with myasthenia include:
A. Ability to chew and speak distinctly
B. Degree of anxiety about her diagnosis
C. Ability to smile an to close her eyelids
D. Respiratory exchange and ability to swallow

Answer: (D) Respiratory exchange and ability to swallow
Muscle weakness can lead to respiratory failure that will require emergency intervention and inability to swallow may lead to aspiration

174. Helen is diagnosed with myasthenia gravis and pyridostigmine bromide (Mestinon) therapy is started. The Mestinon dosage is frequently changed during the first week. While the dosage is being adjusted, the nurse’s priority intervention is to:

A. Administer the medication exactly on time
B. Administer the medication with food or mild
C. Evaluate the client’s muscle strength hourly after medication
D. Evaluate the client’s emotional side effects between doses

Answer: (C) Evaluate the client’s muscle strength hourly after medication
Peak response occurs 1 hour after administration and lasts up to 8 hours; the response will influence dosage levels.

175. Helen, a client with myasthenia gravis, begins to experience increased difficulty in swallowing. To prevent aspiration of food, the nursing action that would be most effective would be to:

A. Change her diet order from soft foods to clear liquids
B. Place an emergency tracheostomy set in her room
C. Assess her respiratory status before and after meals
D. Coordinate her meal schedule with the peak effect of her medication, Mestinon

Answer: (D) Coordinate her meal schedule with the peak effect of her medication, Mestinon
Dysphagia should be minimized during peak effect of Mestinon, thereby decreasing the probability of aspiration. Mestinon can increase her muscle strength including her ability to swallow.

Feb 1, 2009


The PROFESSIONAL REGULATION COMMISSION announces that the schedules and deadlines in filing applications for the Nurses Licensure Examinations for year 2009 are as follows:

June 7, 2009 Sunday
June 8, 2009 Monday
April 17, 2009

November 28, 2009 Saturday
November 29, 2009 Sunday
October 16, 2009

The PRC enjoins early filing of applications to avoid over-crowding at the PRC filing centers.

The Professional Regulation Commission announces that application for admission to the June 2009 Nurse Licensure Examination is now being accepted until April 17, 2009 only. Applications may be filed at the Central Office at P. Paredes Street near Morayta (also at its satellite accepting center at the 2nd Floor of Ever Gotesco Mall - Recto Branch) in Manila or at any regional offices located in the cities of Baguio, Cagayan de Oro, Cebu, Davao, Iloilo, Legazpi, Lucena, Tacloban, Tuguegarao, and Zamboanga.

Visit this link: "GUIDELINES IN FILING" to know more about documentary requirements.