iNeedSell.com: Free online ads. Post your Ad here.

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

Apr 12, 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 1-15

NURSING PRACTICE IV SET B

NURSING PRACTICE V - NURSING CARE OF CLIENT WITH PHYSIOLOGICAL AND PSYCHOSOCIAL ALTERATIONS (Part C)

Situation - Felisa has a ritualistic pattern of constantly washing her hands with soap and water followed by rubbing alcohol.

1. This behavior is categorized as:

A. delusional

B. normal

C. neurotic

D. psychotic

2. A therapeutic intervention in this situation is:

A. avoid limits on her behavior to release her anxiety

B. call attention to her ritualistic pattern

C. provide alternative behaviors to deal with increased anxiety

D. ignore her behavior totally

3. The anxiety of Felisa is disabling and interferes with her job performance, interpersonal relationships and other activities of daily living. To minimize such problems, she is likely to be given:

A. diazepam ( Valium )

B. haloperidol ( Haldol )

C. imipramine Hcl ( Tofranil )

D. chlorpromazine ( Thorazine )

4. Felisa understands the effects of her medicine when expresses:

A. “I should watch out for signs of sore lips or sore throat”

B. “I might have constipation”

C. “I might feel changes in my body temperature”

D. “ I should not drive or operate machines”

5. The level of anxiety that Felisa is experiencing is:

A. Panic

B. Severe

C. Mild

D. Moderate

Situation - The nurse recognizes the need to learn to cope with stress and change. She becomes interested to practice natural ways to enhance well being.

6. Lifestyle modification begins with:

A. minimizing eating in fast food restaurants

B. having an exercise regimen to follow regularly

C. recognizing the impact of unhealthy habits

D. avoiding pollutants in the environment

7. All of these are the behavior intervention to stress management. EXCEPT:

A. guided imagery

B. pharmacotherapy

C. meditation

D. progressive muscle relaxation

8. Basic to progressive muscle relaxation is:

A. focusing on an image to relax

B relaxing muscles from tension

C. use of industrial equipment

D. stopping disturbing thoughts

9. Dietary practices are very important to the health of the Filipino family. The nurse needs to assess this lifestyle because:

A. the nurse wants to change the eating patterns of the Filipino family

B. the nurse knows that being overweight is a major health hazard

C. the nurse wants to stop all the mainstream weight-loss diets

D. the nurse has to find out what people are eating

10. A young overweight adult smokes 5-10 sticks of cigarettes/day, ambitious, looks at life as challenging and perfect and never considers change in his lifestyle, initially needs:

A. commitment

B. information

C. skills to attempt change

D. motivation

Situation - Bernie and John in their late 40’s have been married for 20 years and at the peak of their careers. Suddenly, Bernie discovered that her husband was falling in love with another woman. Shaken by this situation, she started to have problems sleeping and could not function well at work and at the risk of losing her job. John asked forgiveness and regret very much the hurt his wife was going through and suffered guilt feelings:

11. Bernie and John are going through a:

A. situational crisis

B. developmental crisis

C. anticipated crisis

D. both developmental and situational crisis

12. All of these are characteristics of crisis EXCEPT:

A. a hazardous or threatening event occurs

B. it has a growth promoting potential

C. usual problem solving methods and coping mechanisms produce a

solution

D. anxiety or depression continue to increase

13. The nurse employs this approach in crisis intervention:

A. problem-solving

B. behavior modification

C. role-playing

D. nurse-patient relationship

14. Assessment data of the nurse include all the following EXCEPT:

A. coping mechanisms

B. situational support

C. perception of the event

D. repressed problems

15. The duration of crisis usually lasts several days and usually:

A. 2 – 4 weeks

B. 1 – 2 weeks

C. 1 – 2 months

D. 4 – 6 weeks

Apr 8, 2010

NURSING BOARD EXAM PRACTICE IV – 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 NP4 Nursing Board Exam Answer Key
Nursing Board Exams Questions 91 - 100


Situation – 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.

91. 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

92. 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

93. 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

94. 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

95. 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

B. Yellowish drainage

C. Greenish drainage

D. Bloody drainage

Situation – As a nurse you are expected to be competent in utilizing the nursing process in the care of your clients.

96. Getty is receiving chemotherapy for cancer. You review Getty’s laboratory report and note that he has anemia. To which nursing diagnosis should you give the highest priority?

A. Activity intolerance

B. Impaired oral mucous membrane

C. Impaired tissue perfusion, cerebral, cardiovascular, gastrointestinal

D. Impaired tissue integrity

97. An immediate objective for nursing care of an overweight mildly hypertensive client with ureteral colic and hematuria is to decrease:

A. Hypertension

B. Pain

C. Hematuria

D. Weight

98. A difficult problem to deal with when caring for a patient with a partial thickness burns sustained 3 days ago is:

A. Alteration in body image

B. Maintenance of sterility

C. Frequent dressing change

D. Severe pain

99. Which outcome criterion would be appropriate for a client with a nursing diagnosis of effective airway clearance?

A. Continued use of oxygen when necessary

B. Breath sound clear on auscultation

C. Respiratory rate of 24/min

D. Presence of congestion

100. Which assessment would be most supportive of the nursing diagnosis, impaired skin integrity related to purulent drainage?

A. Heart rate of 88 beats/min

B. Dry and intact wound dressing

C. Oral temperature

D. Wound healing by first intention

Apr 5, 2010

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

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


June 2008 Nursing Licensure Examination (NLE)
June 2008 NP4 Nursing Board Exam Answer Key
Nursing Board Exams Questions 86-90

Situation – Ensuring safety before, during, and after a diagnostic procedure is an important responsibility of the nurse

86. To help Fernan better tolerate the bronchoscopy, you should instruct him to practice which of the following prior to the procedure?

A. Clenching his fist every 2 minutes

B. Breathing in and out through the nose with his mouth open

C. Tensing the shoulder muscles while lying on his back

D. Holding his breath periodically for 30 seconds

87. Following bronchoscopy, which of the following complains to Fernan should be noted as possible complication:

A. Nausea and vomiting

B. Shortness of breath and laryngeal stridor

C. Blood tinged sputum and coughing

D. Sore throat and hoarseness

88. Immediately after bronchoscopy, you instructed Fernan to:

A. Exercise the neck muscles

B. Breathe deeply

C. Retrain from coughing and talking

D. Clear his throat

89. Thoracentesis may be performed for cytologic study of pleural fluid. As a nurse your most important function during procedure is to:

A. Keep the sterile equipment from contamination

B. Assist the physician

C. open and close the three-way stopcock

D. Observe the patient’s vital signs

90. Right after thoracentesis, which of the following is most appropriate intervention?

A. Instruct the patient not to cough or deep breathe for two hours

B. Observe for symptoms of tightness of chest or bleeding

C. Place an ice pack to the puncture site

D. Remove the dressing to check for bleeding

Apr 1, 2010

Seminar on Tuberculosis Nursing

Global Learning Innovation invites you to a seminar entitled:
"TUBERCULOSIS NURSING"

Topics Include:
-Tuberculosis:A Global Perspective
-Treatment, Management Updates
-Nursing in TB Control

Speaker: WINSTON A. PALASI, MD,MPH,RN, -Dir., Field Operations Division-Philippine TB Society, Inc., Operations Manager, PTSI-TB LINC(USAID Project)

on April 18, 2010 (Sunday) 8:00 am til 12:00 noon
at SM Cinema 4-The Block, SM North Edsa

Fee: 600 pesos (Pre-registration needs half of the payment before the said date. Meet up with Michelle or payments can be made thru LBC or bank)

-with 3 certificates, break time refreshments, cd-rom handouts

For reservation contact: Ms. Michelle dela Cruz 09278359861

GLOBAL LEARNING INNOVATION IS AN ACCREDITED CPE PROVIDER BY THE PRC-CPE COUNCIL OF NURSING. ACCREDITATION NO. 2009-026