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Apr 30, 2010

What I've LeaRNed of Being a Nurse (Video)

This is an inspiring video to watch for. The joy and tears of being a devoted nure. The simple yet caring things the nurses do that bring big impacts to their patients.

And this video emphasizes the importance of HAND WASHING. Remember Nurses... Hand washing!... Very basic but very Important in Nursing Care. A caring nurse washes hands!

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

June 2008 Nursing Licensure Examination (NLE)
June 2008 NP5 Nursing Board Exam Answer Key
Nursing Board Exams Questions 76 - 85

Situation - A group of adult chronic schizophrenic patients were recommended to undergo social skills training.

76. The following are the objectives of a social skills training program EXCEPT:

A. explore deep seated intrapsychic conflicts

B. practice skills in relating with people

C. help build self esteem and self confidence

D. develop and practice general coping skills

77. Social skills training is NOT primarily indicated for psychiatric patients who are:

A. in acute stage of illness

B. having difficulties starting and maintaining interpersonal relationships

C. having chronic episodes of stress and anxiety while interacting with others

D. experiencing recurrence of symptoms in front of particular people or among

people in general

78. The focus of the group interaction is “here and now”. An appropriate topic would be:

A. ways to celebrate Valentine’s Day in February

B. how to spend the summer vacation

C. an unforgettable experience as a child

D. how to tell a joke

79. An appropriate technique for the participants to practice how to communicate effectively is through/a:

A. lecture

B. seminar

C. role play

D. psychodrama

80. Considering that it is BEST to learn by example, it is MOST practical to:

A. model good social skills throughout the session

B. relate successful past experiences

C. invite a resource person

D. watch a movie

Situation - Andy, 30 years old, was admitted to the Psychiatric Ward because of religious preoccupation, deterioration in self-care and disturbed thoughts. He believes that he has committed a lot of sins. He is threatened by people reaching out to him. His fasting for several days was not sufficient for him to feel forgiven.

81. Andy is demonstrating:

A. religious delusion

B. delusion of grandeur

C. somatic delusion

D. delusion of being controlled

82. A delusion is:

A. psychomotor disturbance

B. mood disturbance

C. disturbance of thought

D. disturbance of perception

83. The nursing goal for Andy is to:

A. have him see a priest for confession

B. encourage him to pray to atone for his sins

C. help him develop a positive self image

D. socialize him with a group to keep him in touch with reality

84. As Andy talks about his sins that he believes make people look down upon him. It is BEST to:

A. agree with him and sympathize how sinful he has really been

B. explore the nature of his sins

C. explain that he is depreciating himself too much

D. acknowledge how he feels and focus on reality oriented topics

85. Which of the following drugs will most likely to decrease Andy’s hallucination?

A. Chlorpromazine (Thorazine)

B. Chlomipramine (Anafranil)

C. Fluoxetine (Prozac)

D. Carbamazepine (Tegretol)

Apr 27, 2010

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

June 2008 Nursing Licensure Examination (NLE)
June 2008 NP5 Nursing Board Exam Answer Key
Nursing Board Exams Questions 66 - 75

Situation -
As a program manager, the mental health psychiatric nurse is tasked to provide general patient management.

66. The nurse is aware that identifying the aspects of general patient management and identifying interventions for meeting these basic needs are distinctions of:

A. psychotherapy

B. therapeutic milieu

C. pharmacotherapy

D. behavior therapy

67. In order to get active participation of the clients to carry out the objective of the program, it is BEST for the nurse to conduct a/an:

A. community meeting

B. survey

C. observation

D. selective interview of patients

68. Through the nurse’s role modeling of effective communication, the clients learned new ways of dealing with authority figures. This gives the clients a venue to:

A. communicate

B. socialize

C. identify their problems

D. test new patterns of behavior

69. This element of communication facilitates evaluation of the program:

A. receiver

B. message

C. sender

D. feedback

70. The nurse’s style of leadership in milieu therapy is:

A. autocratic

B. laissez-faire

C. democratic

D. benevolent

Situation - Loretta is a 28 years old, unemployed patient, admitted to the psychiatric unit with a diagnosis of chronic undifferentiated schizophrenia. She described herself as the “Virgin Mary” and her mission is to propagate peace. She was observed laughing and talking to herself. Her thought processes were profoundly disorganized. She was also fearful and suspicious of others.

71. Loretta’s claim of being the “Virgin Mary” is a/an:

A. imagination

B. delusion

C. hallucination

D. obsession

72. Her mission to propagate peace is:

A. a serious call for a need of transformation

B. an attempt to overcome low self-esteem

C. realistic and laudable

D. an advocacy that she can participate in

73. Which of this intervention would NOT be therapeutic in decreasing Loretta’s anxiety?

A. joke about her thought to help her feel at ease

B. listen to her thoughts and feelings

C. simply accept

D. do not convince her that her perception is unreal

74. The nurse evaluates that Loretta’s ready for a rehabilitation program when she:

A. approaches the nurse at frequent intervals

B. ceases to talk about “Virgin Mary”

C. goes to the coffee shop alone more often

D. carries a book “The Purpose Driven Life”

75. The nurse is leading a group meeting of patients to prepare them to be discharged. An appropriate goal for the group members is to develop:

A. attitudes of society towards the mentally ill

B. skills for maintaining daily living

C. awareness of interpersonal patterns of interactions

D. insight into personal problems

Apr 24, 2010

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations


June 2008 Nursing Licensure Examination (NLE)
June 2008 NP5 Nursing Board Exam Answer Key
Nursing Board Exams Questions 56 - 65



56. The following concept are true EXCEPT:

A. Hostility is destructive

B. Frustration develops in response to unmet needs, wants and desire

C. Anger is incompatible with love

D. Aggression can be expressed in a constructive as well as a destructive

Manner

57. Carlo is acting out hostile and aggressive feeling by kicking the chairs in the room, the MOST effective way to deal with Carlo’s behavior is initially to:

A. Set limits on the behavior by verbal command

B. Administer PRN tranquilizer

C. Remove the chairs from the room

D. Restrain the patient and place him in the “Isolation Room”

58. Mrs. Dizon was visiting her son at the Psychiatry Ward. Which of the following items will the nurse NOT allow to brought inside the ward?

A. String rosary bracelet

B. Box of cake

C. Bottle of coke

D. Rubber shoes

59. Which of the following will probably be most therapeutic for a patient on a behavioral modification ward?

A. If the client is agitated, discuss the feelings especially anger

B. Insist to stop obscene language by verbal reprimand

C. Give client support and positive feedback for controlling use of

obscene language.

D. Provide a punching bag as an alternative to express upset emotions.

60. Which of the following must be considered while planning activities for the depressed client?

A. Activities which require exertion of energy

B. Challenging activities to get him out of his depression

C. Structured activities that the client can participate

D. Variety of unstructured activities

Situation - The nurse works with Mina to help her work through termination of the nurse-patient relationship.

61. Preparation for termination of the nurse-patient relationship begins during the:

A. termination phase

B. working phase

C. pre-orientation phase

D. orientation phase

62. Mina’s past reactions to ending relationships is withdrawal. The nurse assists her to practice better ways of coping termination by providing opportunities to:

A. test new patterns of behavior

B. plan for alternatives

C. conceptualize her problem

D. value and find meaning in experience

63. During the early part of the interaction, the nurse asked after a period of silence. “Perhaps we would talk about my leaving”. The nurse utilized which communication technique:

A. encouraging

B. suggesting

C. focusing on client

D. understanding

64. The longest and the most productive phase of the NPR is:

A. Termination phase

B. Working phase

C. Pre-orientation phase

D. Orientation phase

65. The objection of the nurse-patient relationship is to provide an opportunity of the patient to:

A. clarify problems

B. develop insights

C. have a corrective emotional experience

D. develop interpersonal relationship

Apr 21, 2010

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

June 2008 Nursing Licensure Examination (NLE)
June 2008 NP5 Nursing Board Exam Answer Key
Nursing Board Exams Questions 41 - 55

Situation – Annie has a morbid fear of heights. She asks the nurse what desensitization therapy is:

41. The accurate information of the nurse the goal of desensitization is:

A. To help the clients relax and progressively work up a list of anxiety provoking situations through imagery

B. To provide corrective emotional experiences through a one-to-one intensive relationship

C. To help clients in a group therapy setting to take on specific roles and reenact in front of an audience, situations in which interpersonal conflict is involved.

D. To help clients cope with their problems by learning behaviors that we are more functional and be better equipped to face reality and make decisions.

42. It is essential in desensitization for the patient to:

A. Have a rapport with therapist

B. Use deep breathing or another relaxation technique

C. Assess one’s self for the need of anxiolytic drug

D. Work through unresolved unconsciousness conflicts

43. In this level of anxiety, cognitive capacity diminishes. Focus becomes limited and client experiences turned vision. Physical signs of anxiety become more pronounced.

A. Severe anxiety

B. Panic

C. Mild anxiety

D. Moderate anxiety

44. Anti-anxiety medication should be used with extreme caution because long term use can lead to.

A. Parkinsonian like syndrome

B. Hypertensive crisis

C. Hepatic failure

D. Risk of addiction

45. The nursing management of anxiety related with post traumatic stress disorder includes all of the following EXCEPT:

A. Encourage participation in recreation or sport activities

B. Reassurance client’s safety while touching client

C. Speak in calm soothing voice

D. Remain with the client while fear level is high

Situation – The nurse is often met with the following situations when clients become angry and aggressive individual, the nurse should:

46. To maintain a therapeutic eye contact and body posture while interacting with angry and aggressive individual, the nurse should:

A. keep an eye contact while staring at the client

B. keep his/her hands behind his/her back or in one’s pockets

C. fold his/her arms across his/her chest

D. keep an “open” posture, e.g. Hands by sides but palms turned outwards

47. During the pre-interaction phase of the N-P relationship, the nurse recognizes thisnormal INITIAL reaction to an assaultive or potentially assaultive person.

A. To remain and cope with the incident

B. Display empathy towards the patient

C. To call for help from other members of the team

D. To stay and fight or run away

48. Which of the following is an accurate way of reporting and recording an incident?

A. “When asked about his relationship with his father, client became anxious.”

B. “When asked about his relationship with his father, client clenched his jaw/teeth, made a fist and turned away from the nurse.”

C. “When asked about his relationship with his father, client was resistant to

respond”

D. “When asked about his relationship with his father, his anger was suppressed”

49. To encourage thought, which of the following approaches is NOT therapeutic?

A. “Why do you feel angry?”

B. “When do you usually feel angry?”

C. “How do you usually express anger?”

D. What situations provoke you to be angry?”

50. A patient grabs and about to throw it. The nurse best responds saying.

A. “Stop! Put that chair down.”

B. “Don’t be silly.”

C. “Stop! The security will be here in a minute.”

D. “Calm down.”

Situation – A vehicle hit some pedestrian while waiting for a bus ride. Some of the victims suffered injuries in different part of the body. The victims were brought to the nearby hospital. One of the victims, Josephine was confirmed to have a fractured left arm. While waiting for plaster cast to be applied, Josephine appears to be anxious.

51. To reduce anxiety, the nurse teaches the procedure to the client, which of the following topics should NOT be included in the teaching plan?

A. Leave the cast uncovered to promote drying

B. Bear weight on the plaster for one hour. A stockinet will be placed

over the left arm to be placed in the cast.

C. Handle hardening cast with palm of hands.

D. Trim and reshape finish cast with knife or cutter.

52. Cast was applied on Josephine’s left arm. In assessing the neurovascular status of the client, which of the following assessment findings should be reported to the physician?

A. Pain on the left arm

B. Swelling of the fingers

C. Skin abrasion on the edges of the plaster cast

D. Nail bed capillary refill time of 10 seconds

53. One of the victims a sixty year old woman sustained hip fracture. Prior to surgery, a Buck’s extension traction is to be applied. The rationale of traction is primarily based the understanding that Buck’s extension traction:

A. Reduces muscle spasms and helps to immobilize the fracture

B. Allows reduction of the fracture site for bone healing.

C. Secures the fracture site to prevent damage to the muscle tissues

D. Secures the fracture site for rigid immobilization

54. Philip was placed in skeletal leg traction with an overbed frame. He is not allowed to move from side to side. Which of the following nursing interventions is useful in maintaining.

A. Assist the client by holding the trapeze and raising hips of the bed.

B. Check the apparatus that weights hang free and knots in the rope

are tied securely.

C. Suspend a trapeze within easy reach of the client

D. Support the affected extremity while the weights are removed.

55. To prevent complication when a child is in Buck’s traction, the nurse should:

A. Clean the extremity and keep the skin dry

B. Assess any skin and circulatory disturbances

C. Clean the pin sites as necessary

D. Provide high fiber small meals.

Apr 18, 2010

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

June 2008 Nursing Licensure Examination (NLE)
June 2008 NP5 Nursing Board Exam Answer Key
Nursing Board Exams Questions 31-40



Situation – The supervising nurse received report that a staff nurse is displaying frequent irritation, anger, and even indifference toward clients and co-workers.

31. The initial action of the supervisor would be to:

A. Post guidelines on proper decorum of nurse in the bulletin board.

B. Write a memo of warning to the house

C. Request anecdotal report from the nurse’s co-workers

D. Call the nurse for a one on one conference

32. The nurse expressed increasing feelings of dissatisfaction. The supervising nurse intervenes therapeutically by taking the role of:

A. Administrator by relieving her of responsibilities

B. Therapist by delving into the nurse’s internal conflict

C. Counselor by actively listening

D. Educator by reorienting her of role as a nurse.

33. Coupled with poor work performance, mental and physical fatigue and actual withdrawal from client contact and nursing duties. The nurse can be said to be suffering from:

A. Psychotic anxiety

B. Staff burn-out

C. Personality maladjustment

D. Neurotic depression

34. A priority in the nurse’s personal development would be to:

A. Address her physical well-being

B. Boost her self-confidence

C. Provide social support

D. Help her find value and meaning in her work

35. The most relevant professional program for her would be:

A. Assertiveness training

B. Stress management

C. Group dynamics and team building

D. Behavior modification

Situation – A nurse assigned in the neurologic unit is taking of clients with varying degrees of generative disorders.

36. Mr. A with Myasthenia Gravis is having difficulty speaking. What communication strategies should the nurse avoid when interacting with Mr. A?

A. Repeating what the client says for better understanding

B. Using paper and pencil in communicating with the client

C. Encouraging the client to speak slowly

D. Encouraging the client to speak quickly

37. When planning for nursing care for Mr. B who has Parkinson’s disease. Which of the following goals would be most appropriate?

A. To improve muscle tone

B. To start rehabilitation as much as possible

C. TO treat the disease

D. TO maintain optimal body function

38. For the past 10 years, Alma, 42 years old has had multiple sclerosis. Client with multiple sclerosis experience many different symptoms. As part of the rehabilitation planned for Alma, the nurse suggested therapy and hobbies to help her.

A. Strengthen muscle coordination

B. Establish routine

C. Develop perseverance and motivation

D. Establish good health habits

39. On his second day of hospitalization, Mr. Santos was unable to stand and is having difficulty swallowing and talking. Which of the following is the priority of the nurse in assisting Mr. Santos?

A. To prevent bladder distention

B. To prevent decubitus ulcer

C. To prevent contracture

D. To prevent aspiration pneumonia

40. The wife of a seventy two year old man with a diagnosis of Alzheimer’s disease begins to cry and tells the nurse, “I could not understand my husband anymore. He has changed drastically.” “Which of the following responses of the nurse is MOST appropriate?

A. The physician and the staff will make sure that your husband will be comfortable and safe here.

B. This has been a difficult time for you. Let us walk and find a quiet place where we can talk.

C. He will soon recover in his condition.

D. You need not worry, we are doing the best we could.

Apr 15, 2010

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

June 2008 Nursing Licensure Examination (NLE)
June 2008 NP5 Nursing Board Exam Answer Key
Nursing Board Exams Questions 16-30


Situation - The community health nurse encounters special children in the community.

16. An individual with antisocial personality disorder lacks remorse, shame and guilt in going against the norms of society. Psychodynamically, this defect in the personality reflects a disturbance of the:

A. ego

B. super ego

C. ego ideal

D. id

17. The nurse teaches parents about children’s beginning concepts of right and wrong by emphasizing child rearing attitude and practices during the:

A. school age

B. toddler age

C. infancy period

D. latency period

18. It is BEST for parents to teach healthy interpersonal relationships to their children by:

A. modeling to their children

B. encouraging their children to attend secondary school

C. encouraging their children at home to behave properly

D. teaching their children good manners and right conduct

19. An important principle for the nurse to follow in interacting with retarded children is:

A. seen that if the child appears contented, his needs are being met

B. provide an environment appropriate to their development task as scheduled

C. treat the child according to his chronological age

D. treat the child according to his developmental level

20. Mental retardation is:

A. a delay in normal growth and development caused by an inadequate environment

B. a lack of development of sensory abilities

C. a condition of subaverage intellectual functioning that originates during the developmental period and is associated with impairment in adaptive behavior

D. a severe lag in neuromuscular development and motor abilities

Situation - As a professional, it is imperative that the nurse is accountable to oneself hence the importance of personal and professional development.

21. Nurse: “ I feel personally involved with my client’s problems” demonstrates:

A. counter transference

B. empathy

C. transference

D. sympathy

22. The nurse has achieved self-awareness in which of the following verbalizations?

A. every time people around me yell, I feel upset and withdrawn

B. when the patient yelled at me I became speechless

C. with the patients tone of voice and stare, I got reminded of how my father would be so angry and this made me anxious

D. I thought it was rude for the patient to yell hence I kept quiet

23. An accepting attitude requires being:

A. aware of ones biases

B. tolerant of the faults of others

C. non judgmental

D. in control of tendency to blame

24. Self-awareness, knowledge and understanding of human behavior and communication skills define what is essential in caring for every nurse to be able to demonstrate:

A. positive self-projection

B. assertiveness

C. therapeutic use of self

D. self-mastery

25. Considering that man is by nature social, it is BEST for the nurse to gain self-awareness by:

A. participating in intensive group experiences

B. individual psychotherapy

C. hypnotherapy

D. writing an autobiography for self introspection

Situation – Ninety year old Purita is confined at the medical unit for respiratory ailment for which a breathing apparatus is prescribed for her to use while she sleeps. She refuses to wear continuously though she full understands the medical indication for it:

26. Which of these ethical principles can guide the nurse in her action?

A. Beneficence

B. Fidelity

C. Autonomy

D. Nonmaleficence

27. Purita has six children who already adults. They differ in their opinion whether or not to allow their mother to decide for her. The nurse would encourage family conference for:

A. The eldest child’s opinion to be given priority.

B. Majority of the children to decide

C. Allowing the medical staff to decide in their behalf

D. Consensus building

28. Breathing treatments are to be given to Purita. In anticipation that Purita might refuse. Dinio, one of the children requests that he be the one to sign the consent in behalf of their mother. The nurse explains that Purita is rational in her thinking and which of this client’s right must be regarding?

A. Right to refuse treatment

B. Right to privacy

C. Right to informed consent

D. Right of habeas consent

29. Which of these would be the nurse’s priority following the treatment principle of least restrictive alternative?

A. One on one staffing

B. Use of on site guard/watcher

C. Physical restraint

D. Seclusion

30. Purita talks about her joy in having responsible and accomplished children and recalls challenging career as a lawyer. She is demonstrating a sense of:

A. Ego integrity

B. Industry

C. Generativity

D. Autonomy