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To all June 2009 examinees, the following tips and hints may help you in the upcoming Nurse Licensure Examination.

Familiarize yourselves with the below topics, it may be of help.

In NP 1

• Virginia Henderson’s 14 basic needs, Faye Glenn Abdellah’s Concept of Twenty One Nursing Problems, Lydia Hall’s Key Concepts of Three Interlocking Circles Theory, Dorothea Orem’s Self-Care Theory, Martha Roger’s Concept of Science of Unitary Human Beings and Principles of Homeodynamics, Pattern of nursing care, Levels of Prevention, Care of clients with tracheostomy and suctioning, Professional Adjustment/Negligence

In NP 2

• COPAR , Kawasaki disease , Immunity, Contraceptives, Lawrence Kohlberg’s Development of Moral Reasoning, Epidemiology , Measles, Reproductive Health, Influenza A (H1N1), IMCI

In NP3 and 4

• Colostomy, Tuberculosis , Tracheostomy, Hodgkin’s disease, Asthma, Cholecystitis, Dumping Syndrome, Spinal Cord Injury, Typhoid Fever, Pain, Burns, Breast surgery

In NP 5

• Communication, Defense Mechanism, Anxiety, Leadership and Management, Electroconvulsive therapy, Therapeutic Community, Alcoholism, Crisis.

God bless from your NursesPub family.

Courtesy of NursingCrib.

Instructions: Get a pen/pencil and a piece of paper for your answers.

FOUNDATION OF PROFESSIONAL NURSING PRACTICE

Situation 1: Mr. Martin, 71 years old was suddenly rushed to the hospital because of severe chest pain. On admission, he was diagnosed to have acute myocardial infarction and was placed in the ICU.

1. While in the ICU, he executes the document tat list the medical treatment he chooses to refuse in case his condition becomes severe to a point that he will be unable to make decisions for himself. This document is:

A. living will
B. informed consent
C. last will and testament
D. power of attorney

2. After one day, the patient’s condition worsened and feeling hopeless. He requested the nurse to remove the oxygen. The nurse should:

A. follow the patient because it is his right to die gracefully
B. follow the patient as it is his right to determine the medical regimen he needs
C. refuse the patient and encourage him to verbalize hid feelings
D. refuse the patient since euthanasia is not accepted in the Philippines

3. Euthanasia is an ethical dilemma which confronts nurses in the ICU because:

A. the choices involved do not appear to be clearly right or wrong
B. a clients legal right co-exist with the nurse’s professional obligation
C. decisions has to be made based on societal norms.
D. decisions has to be mad quickly, often under stressful conditions

4. A nurse who supports a patient and family’s need to make decisions that is right for them is practicing which of the following ethical principles?

A. Autonomy
B. confidentiality
C. privacy
D. truthfulness

5. Mr. Martin felt better after 5 days but recognizing the severity of his illness, he executes a document authorizing the wife to transact any form of business in his behalf in addition to all decisions relative to his confinement his document is referred to as:

A. power of attorney
B. living will
C. informed consent
D. medical records

Situation 2: Miss Castro was recently appointed chief nurse of a 50-bed government hospital in Valenzuela. On her first day of duty, she tried to remember the elements of administration she learned from her basic nursing education.

6. One of the first things Ms. Castro did was to engage her until in objective writing, formulating goals and philosophy of nursing service. Which activities are MOST appropriately described to which elements of administration?

A. planning
B. controlling
C. directing
d. organizing

7. In recognizing the Department of Nursing, she comes up with the organizational structure defining the role and function of the different nursing positions and line-up the position with qualified people. This is included in which element of administration:

A. monitoring
B. evaluation
C. organizing
D. planning

8. After one month, she and her management committee assess the regulatory measures taken and correct whatever discrepancies are found. This is part of which element of administration:

A. monitoring
B. organizing
C. evaluation
D. planning

9. Revaluation and administrative process is BEST described as:

A. a continuing process of seeing that performance meets goals and targets
B. obtaining commitment of members to do better
C. informing personnel how well and how much improvement has been made
D. follow-up of activities that have been studied

10. In all of the various administrative functions, which of the following management skill is demanded efficiently and effectively of Ms. Castro?

1. Decision making skills
2. Forecasting skills
3. Auditing skills
4. Communications skills

A. 2 & 3
B. 1 & 4
C. 1 & 2
D. 2 & 4

Situation 3: Meldy. 40 years old. is waiting for her doctor’s appointment at the clinic where you work.

11. You are to interview her as an initial nursing action so that you can.

A. Document important data in her client records for health team to read.
B. Gather data about her lifestyle, health needs, lifestyle, health needs and problems to develop
plan of care
C. provide solutions to her immediate health concern
D. identify the most appropriate nurse diagnosis for her heath problem

12. During the interview, Meldy experiences a sharp abdominal pain on the right side of her abdomen. She further tells you that an hour ago, she ate fatty food and this had happened many times before. You will record this as:

A. Client complains of intermittent abdominal pain an hour alter eating fatty foods
B. After eating fatty food the client experienced severe abdominal pain
C. Client claims to have sharp abdominal pains after eating fatty food unrelieved by pain medication
D. Client reported sharp abdominal pain on the right upper quadrant of abdomen an hour after
ingestion of fatty foods.

13. Meldy tells you that she has been on a high protein / high fat / low carbohydrate diet order to lose weight and that she has successfully lost 8 lbs during the past two weeks. In planning a healthy balanced diet for her, you will:

A. Encourage her to eat well-balanced diet with a variety of food from the major food groups and
take plenty of fluids.
B. Ask her to shift to a macrobiotic diet rich in complex carbohydrates.
C. Encourage her to cleanse her body toxins by changing a vegetarian diet with regular exercise.
D. Encourage her to eat a high carbohydrate, low protein diet and low fat diet.

14. You learn that Meldy drinks 5-8 cups o coffee a day plus cola drinks. Because she is in her pre-menopausal years, the nurse instructs her to decrease consumption of coffee and cola preparation because:

A. these products increase calcium loss from the bones
B. These products have stimulant effect n the body
C. these products encourage increase in sugar consumption
D. these products are addicting

15. Health education plan for Meldy stresses prevention of NCD or Non-communicable diseases that are influenced by lifestyle. These include the following EXCEPT:

A. Cancer
B. DM
C. Osteoporosis
D. Cardiovascular diseases

Situation 4: Changes in technology, the nation’s economy and the increasing number of population have brought about changes in the Health Care System.

16. At present, government hospitals are expected to offer comprehensive health services to include illness prevention
and health promotion. In which of the following unit of services are these services integrated?

A. Wellness center
B. Intensive Care unit
C. Rehabilitation Center
D. newborn screening unit

17. Which of the following is the MOST recent government initiative to help subsidize the cost of health services for both the employed and the unemployed?

A. National Health Insurance Act
B. Worker’s Compensation Act
C. Medicare Act
D. Magna Carta for Public Health Workers

18. The top ten morbidity cases in the Phil. Include TB, diarrhea among children to name a few. Many of these conditions are preventable and have implications are preventable and have implications in the development of which nursing competencies?

A. Execution of nsg. procedure and technique
B. Therapeutic use of self
C. Administration of treatment and medication
D. Health education

19. The cost of hospitalization is getting more expensive and unaffordable to many of our people. These facts will MOST LIKELY bring about development in which of the following?

A. acute services
B. managed care services
C. home care services
D. advance practice nursing

20. Which of the following latest trend has expanded health services based on prepaid fees with emphasis on health promotion and illness prevention?

A. Government Insurance Plan
B. Preferred Provider Organization
C. Health Maintenance Organization
D. Private Insurance Plan

Situation 5: It is Safety Awareness Week in the Community and the nurse checks on the presence of hazards at home. The nurse plan is to have the residents themselves identify the physical hazards in their own homes.

21. Which of the following is NOT a physical hazard in the home?

A. unstable and slippery stairway
B. large windows that allow good ventilation
C. obstacle people cam trip over like door mats, rugs, electric cords
D. inadequate lighting in and out of the house

22. Risk factors exist for each of the different developmental levels. From infancy to preschool age, the most common cause of death is injury rather than disease. To protect children from harm, that parents should be aware that MOST injuries for this age group are due to:

A. Accidents at home caused by the swallowed poisonous materials, small objects, exploring
electrical sockets
B. Accidents from self inflicted wounds
C. accidents from sports related activities at school or the neighborhood
D. accidents in the Playground Park, school and presence of strangers who may abduct of molest the child.

23. To promote safety at home, the nurse identifies ways and means of “child proofing” the house. Which of the following is NOT safe?

A. apply child proof caps and medicine bottles and chemicals
B. covering electrical outlets, tying up long and loose electrical and telephone cords, securing cabinets or doors within reach o the child
C. giving colorful grocery bags to play with or to store toys and materials
D. removing objects that the child could easily dismantle and swallow like small parts of a mechanical toy, buttons, materials inside, stuffed animals, liquid chemicals.

24. The nurse knows that a person’s hygienic practices are influenced family customs and traditions. Which of the following is NOT part of Basic Hygienic Practices?

A. bathing practices, frequency and time, care of eyes, ear and nose
B. oral hygiene practices such as brushing and flossing teeth, gum care
C. care of skin with lesions, cuts with infection
D. hair and skin such as washing hair and face, feet, hand and nail care

25. Falls are the common home accident among elderly and these are due to physical limitations imposed by aging and some hazards in the home setting. The nurse reduces the risk of falling through the following EXCEPT:

A. rearranging furniture frequently
B. having the bed or mattress close to the floor
C. providing a nonskid and well fitted shoes or slippers
D. having a call bell within the persons reach and answering call bells immediately

Situation 6: Eileen, 45 years old is admitted to the hospital with a diagnosis of renal calculi. She is experiencing severe flank pain, nauseated and with a temperature of 39 0C.

26. Given the above assessment data, the most immediate goal of the nurse would be which of the following?

A. Prevent urinary complication
B. maintains fluid and electrolytes
C. Alleviate pain
D. Alleviating nausea

27. After IVP a renal stone was confirmed, a left nephrectomy was done. Her post operative order includes “daily urine specimen to be sent to the laboratory” . Eileen has a foley catheter attached to a urinary drainage system. How will you collect the urine specimen?

A. remove urine from drainage tube with sterile needle and syringe and empty urine from the
syringe into the specimen container
B. empty a sample urine from the collecting bag into the specimen container
C. disconnect the drainage tube from the indwelling catheter and allow urine to flow from catheter into the specimen container.
D. disconnect the drainage the from the collecting bag and allow the urine to flow from the catheter into the specimen container.

28. Where would the nurse tape Eileen’s indwelling catheter in order to reduce urethral irritation?

A. to the patient’s inner thigh
B. to the patient’s lower thigh
C. to the patient’
D. to the patient lower abdomen

29. Which of the following menu is appropriate for one with low sodium diet?

A. instant noodles, fresh fruits and ice tea
B. ham and cheese sandwich, fresh fruits and vegetables
C. white chicken sandwich, vegetable salad and tea
D. canned soup, potato salad, and diet soda

30. Howe will you prevent ascending infection to Eileen who has an indwelling catheter?

A. see to it that the drainage tubing touches the level of the urine
B. change he catheter every eight hours
C. see to it that the drainage tubing does not touch the level of the urine
D. clean catheter may be used since urethral meatus is not a sterile area

Situation 7: Miss Tingson is assigned to Mang Carlos, a 60 year old newly diagnosed diabetic patient. She is beginning to write objectives of her teaching plan.

31. Which of the following objectives is written in behavioral terms?

A. Mang Carlos will know about diabetes related to foot care and the techniques and equipments necessary to carry it out
B. Mang Carlos daughter should learn about DM within the week
C. Mang Carlos wife needs to understand the side effects of insulin
D. Mang Carlos sister will be able to determine in two days his insulin requirement based on blood glucose levels obtained from glucometer

32. Which of the following is the BEST rationale for written objectives?
A. ensure communication among staff members
B. facilitate evaluation of the nurse’s performance
C. ensure learning on the part of the nurse
D. document the quality of care

33. Which of the following behavior BEST contribute to the learning of Mang Carlos regarding his disease condition?
A. frequent use of technical terms for familiarization
B. drawing him into discussion about diabetes
C. detailed lengthy explanation about his condition
D. loosely structured teaching session

34. Miss Tingson should encourage exercise in the management of diabetes, because it:

A. decrease total triglyceride levels
B. improves insulin utilization
C. lowers blood glucose
D. accomplishes all of the above

35. The chief life-threatening hazard for surgical patient with uncontrolled diabetes is:

A. dehydration
B. hypertension
C. hypoglycemia
D. glucosuria

Situation 8: Caring for the perioperative patient.

36. An appendectomy during a hysterectomy would be classified as:

A. Major, emergency, diagnosis
B. major, urgent, palliative
C. Minor, elective, ablative
D. minor, urgent, reconstructive

37. An informed consent is required for:

A. closed reduction of a fracture
B. insertion of intravenous catheter
C. irrigation of the external ear canal
D. urethral catheterization

38. The circulating nurse’s responsibilities, in contrast to the scrub nurse’s responsibilities, include:

A. assisting the surgeon
B. monitoring aseptic practices
C. setting up the sterile tables
D. all of the above functions

39. The primary nursing goal in the immediate postoperative period is maintenance of pulmonary function and prevention of:

A. Laryngospasm
B. hyperventilation
C. hypoxemia and hypercapnea
D. pulmonary edema ad embolism

40. Unless contraindicated, any unconscious patient should be positioned:

A. flat on his of her back, without elevation of the head, to facilitate frequent turning and minimize pulmonary complications
B. in semi-fowlers position, to promote respiratory function and reduce the incidence of orthostatic hypotension when the patient can eventually stand.
C. in fowler’s position, which most closely stimulates a sitting position, thus facilitating reparatory as well as gastrointestinal functioning.
D. on his or her side without a pillow at the patient’s back and his or her chin extended to minimize
the danger of aspirations

Situation 9: To prevent further injury to patients with problems of immobility / mobility, the nurse should observe certain principles of body mechanics for herself and her patients.

41. Which of the following are appropriate goals for client with positioning and mobility needs?

A. developing of contractures
B. proper body alignment
C. sensory alterations
D. decrease in activity tolerance

42. Which for the following would MOST likely cause injury to the nurse when moving the patient from bed to the wheelchair?

A. bending at the knees
B. standing with feet together
C. using body weight to assist with the movement
D. standing with feet apart

43. Which of the following is the CORRECT guideline when positioning patients?

A. put pillows above a joint to immobilize it
B. position of the joint should be slightly extended
C. joints of patient to be supported with pillow
D. patient’s position should be changed at least three or four times a day

44. Which of the following can be used by clients with problem of immobility to enable them raise their body from bed to wheelchair or perform some bed exercises?

A. sandbag
B. side-rail
C. trochanter roll
D. trapeze bar

45. The importance of forcing fluids with an immobilized patient is to:

A. prevent pneumonia
B. prevent urinary stasis
C. prevent skin breakdown
D. maintain peristalsis

46. Which of the following is the least nursing activity in performing assessment of the patient?

A. laboratory test
B. physical examination
C. Health history
D. systemic review

47. One of the responsibilities of Mr. Lata, RN, an industrial nurse, is to conduct physical head-to-toe assessment of a newly hired factory worker. As part of the assessment, he took the vital signs. Which of the four assessment techniques did he utilize?

1. auscultation
2. percussion
3. palpation
4. inspection

A. 1,2 & 3
B. 3 &4
C. 1 & 2
D. 1,3 & 4

48. Which of the following are the purpose of performing a physical assessment?

1. gather baseline data about the client’s health
2. confirm and identify nursing diagnosis
3. evaluate physiological outcome of care
4. make clinical judgment of patients’ diagnosis

A. 1,2 & 4
B. 2, 3 & 4
C. 1, 3 & 4
D. 1,2 & 3

49. Which of the following should be given the HIGHEST PRIORITY before physical examination is done to a patient?

A. preparation of the equipment
B. psychological preparation of the client
C. preparation of the environment
D. physical preparation of the client

50. During the assessment phase of the nursing process, the nurse is concerned with:

A. interpreting data
B. designing nursing strategies
C. establishing a data base
D. comparing client responses with the anticipated outcome

Situation 11: The nurse is responsible to accurately records and reports patient’s progress. She is able to communicate to the other member of the team by documenting the nursing care plan and the appropriate nursing intervention.

51. A main function of the patient’s records is to:

A. prepare the nurse for the shift worked
B. serve as a record of financial charges
C. serve as a vehicle for communication
D. ensure that the message is received

52. When the nurse writes in the chart and discovers an error has been made, which is the BEST approach?

A. erase the erroneous material
B. carefully ink out the erroneous material
C. place as asterisk next to the statement, then footnote it
D. draw a straight line through the error and initial it.

53. Which of the following persons cannot have the access to the patient record?

A. physical therapist
B. lawyer of the family
C. the patient
D. speech therapist

54. POMR charting is different from traditional method because of which of the following practices?

1. SOAP charting
2. use of flow sheet
3. narrative charting
4. use of checklist

A. 3 & 4
B. 1 & 2
C. 1 & 3
D. 2 & 3

55. Which of the following qualities are relevant in documenting patients care?

1. Accuracy and consciousness
2. thoroughness and currentness
3. systematic and orderly
4. legibly, properly dated and signed
5. use of locally accepted abbreviation

A. 1,3,4 & 5
B. 2,3,4 & 5
C. 1,2,3 & 5
D. 1,2,3 & 4

Situation 12: The practice of primary nurse in primary nursing is preferred by many nurses because it supports professional autonomy and accountability of the nurses.

56. What is the function of the primary nurse in primary nursing?

A. acts as patient advocate and coordinate the health care team for specific group of patients
B. act as the charge nurse, organizing staff assignments and help in solving problem in the unit
C. plans and coordinate the patient care assigned to her from admission to discharge
D. coordinates the care given to a group of patients by support staff

57. Primary nursing is MOST advantageous and satisfying to the patient and nurse because of which of the following
principles?

A. autonomy and authority for planning care are best delegated to a nurse
B. accountability is clearest since our nurse is responsible for the overall plan and implementation of care
C. the holistic approach provides fro a therapeutic relationship continuity of care and efficient
nursing care
D. continuity of patients care promotes efficient nursing care.

58. Which is the role of the associate nurse in primary nursing?

A. over-all manager of the unit
B. responsible for the over-all care of the patient during off days of primary nurse
C. patient advocate in the health care team
D. coordinator of comprehensive, holistic patient care

59. In primary nursing, the nurse is responsible for which of the following group of patient?

A. the whole ward
B. small group of patient like 3-5 patients
C. big group of patients like 10-15 patients
D. the whole unit

60. In primary nursing who among the following is needed to her leadership and quality control in the ward?

A. the chief nurse
B. the head nurse
C. the nurse supervisor
D. the service director

Situation 13: Your nursing unit plans to conduct a study on the use of structured preoperative preparation in lessening the demand for post-operative pain medications.

61. Which of the following research activities should you initially do?

A. find out from interview how many patients are willing to participate
B. get the permission from the hospital director
C. review literature on the topic
D. prepare the tool for collecting data

62. Which of the following statements do NOT contribute to the researchabilty of your proposed problem?

A. potential use of findings
B. readability of findings
C. well-defined problem statement
D. measurability of variables

63. A study /research table should NOT contain which of the following ?

A. categories of data collected
B. relevant rows and columns
C. specific title of table
D. names and sample of the selected

64. Which of the following actions will facilitate analysis of research data?

A. consult a physician
B. consult an adviser
C. consult a complete expert
D. categorize data collected

65. The research methodology that is appropriate for the above problem would be:

A. descriptive
B. normative
C. experimental
D. quasi experimental

Situation 14: The nurse meets a new client, Mr. Principe, 50 years old. During the initial interview, the nurse begins to feel irritated towards the client. Shortly after, he becomes uncomfortable and politely leaves the room. The nurse realizes the behavior and mannerism of Mr. Principe reminds him of his strict disciplinarian father who abused him physically.

66. The recognize that his feeling for the client is known as:

A. denial
B. counter transference
C. revenge
D. transference

67. Seeing that his negative feelings for Mr. Principe could affect his nursing care, the nurse applies the concept of therapeutic use of self when:

A. the nurse talks about his personal feelings towards the client
B. the nurse suppresses his feelings and continue to take care of the client
C. the nurse uses his awareness and asks to be reassigned to another client
D. the nurse uses self-awareness to manage his feelings and thoughts towards the client

68. Mr. Principe is terminally ill and his family is coping with his impending death. The nurse has to deal with his own thoughts and personal feelings about death and grieving in order to:

A. avoid sharing personal thought about their impending loss and feeling of grief since this is very subjective
B. get self out of the way while he assists the client and his family express their feelings of impending loss
C. prevent self from being affected by the family’s grief and remain objective
D. help the family plan for the funeral arrangement and burial services

69. One morning when the nurse enters the client’s room. Mr. Principe asks the nurse to “leave me alone and stop bothering me and I don’t want your pity”. The following response by the nurse would be MOST appropriate?

A. “You seem upset this morning” and remains with the client
B. “You are probably upset because you don’t feel well”
C. “Why you are angry with me? What did I do anything to upset you?
D. “I understand and will leave you for a while”

70. The nurse understands that the nurse-client relationship is a therapeutic alliance when:

A. the nurse is a role model for a client
B. this is an essential part of the nursing process
C. the nurse has to be therapeutic at all times
D. how the nurse thinks and feels affects her actions and behavior towards her client and her work

Situation 15: Mr. Ong is for admission to the medical unit and you are his nurse.

71. The MOST important initial nursing approach when admitting client is to:

A. introduce the client to the ward staff
B. orient the client to the physical set up of the unit
C. identify the most immediate needs of the client and implement the necessary intervention
D. take V/S fro baseline assessment

72. When gathering baseline data, the BEST way for you to check if the client has pedal edema is to:

A. talk to the relatives
B. interview the client
C. do auscultation
D. do a physical assessment

73. You want to know the sleeping pattern of Mr. Ong You will:

A. interview the clients and relatives
B. take his BP before sleeping and upon waking up
C. observe his sleeping pattern over a period of time
D. perform physical assessment

74. Mr. Ong has severe pedal edema. Which accessory device would be appropriate for his condition?

A. footboard
B. cradle
C. bed board
D. rolled pillows

75. A student nurse is observed putting a standard size cuff on an obese client. The action would probably result in BP reading that is:

A. false high
B. false low
C. normal
D. undetectable

Situation 16: Health is wealth specifically in this time of the century. The nurse is trained to promote well being of the people.

76. How does a nurse promote one’s well being?

A. periodic travels for rest and recreation
B. faithful and observance of healthy simple lifestyle
C. run away from polluted, stressful areas
D. avoid sleepless, over fatigue nights

77. The nurse can be involved with health promotion as a significant person in helping the family:

A. become a better family
B. prevent disease
C. control their symptoms
D. modify health promotive behaviors

78. The nurse should NOT leave medication at the bedside because:

a. the bedside table is not sterile
b. it is convenient for the nurse
c. the nurse will not be able to accurately document that the patient actually took the
medication
d. the patient may forget to take it.

79. Non-pharmacologic pain management includes all the following EXCEPT:

a. relaxation techniques
b. massage
c. use of herbal medicines
d. body movement

80. When assessing a client’s blood pressure, the nurse finds it necessary to recheck the reading. How many seconds after deflating the cuff should the nurse wait before rechecking the pressure?

a. 10
b. 30
c. 45
d. 60

Situation 17: Safe nursing practice involves an understanding of the law.

81. In the Philippines, this law is :

a. The Philippine Nursing Act of 2002 or R.A. 9173
b. the Philippine Nursing Act of 1991 or R.A. 7164
c. IRR or Resolution 425 of 2003
d. Republic Act No. 8981

82. The Philippine Nursing Act delineates the scope of nursing. It specifies that independent practicing nurse is responsible for:

a. health promotion and prevention of illness
b. administration of written prescription for treatment and therapies
c. rehabilitative aspect of care
d. Collaborating with other healthcare providers for health restoration and alleviation of suffering

83. Standards of care provide the legal basis for evaluation of nursing practice or malpractice. Its functions include all EXCEPT:

a. used by nurse experts to define what appropriate nursing practice is in a given situation
b. used to measure or evaluate nursing conduct to determine if the nurse acted reasonably as any prudent nurse would under similar circumstances
c. used to delineate the scope, function and role of the nurse
d. use to measure or evaluate the conduct of nurse specialists who are certified in their own
specialty fields

84. As a standard in ethics, this represents an understanding and agreement to respect another person’s right to decide a course his or her own destiny:

a. Autonomy
b. justice
c. Beneficence
d. nonmalifecence

85. The Code of Ethics refers to standards of behavior or ideals of conduct. The ability to answer for and stand by one’s action refers to:

a. accountability
b. veracity
c. advocacy
d. responsibility

Situation 18: An understanding of the factors influencing the health care delivery system will enable nurses to adjust to change, create better ways of providing nursing care and develop new nursing roles.

86. Wellness clinics and health education activities have been integrated in government hospitals to render appropriate services. Which of the following purposes LEAST helps clients in cases of these health promotion activities?

A. maintain maximum functions
B. reduce the costs of health care
C. promote health habits
D. identify disease symptoms

87. With regards to illness prevention activities as part of nursing care, which of the following will help clients MOST?

A. maintain maximum function
B. reduce risk factor
C. promote habits related to health care
D. manage stress

88. By experience, which of the following nursing goals are MOST often overlooked by nurses and other members of the hospital team in the care of their clients in the hospital?

A. illness prevention
B. health promotion
C. diagnosis and treatment
D. rehabilitation of patients

89. Which of the following health care agencies is usually family-centered, relatively recent in popularity and oftentimes focuses on maintenance of comfort and satisfactory lifestyle of clients in the terminal phase of illness?

A. non-government organization
B. hospice
C. community health center
D. support group

90. Which of the following is NOT a legally binding document but nonetheless very important in the care of all patients in any setting?

A. Bill of rights as provided in the Philippine Constitution
B. Scope of nursing practice as defined in R.A. 9173
C. Patient’s Bill of Rights ( as adopted by American Nurses Association )
D. Board of Nursing resolution adopting the Code of Ethics

Situation 19: One of the professional competencies that nurse must always demonstrate is in the area of communication:

91. Which communication technique would be MOST effective in eliciting detailed information from the client?

A. open-ended questioning
B. verbalizing observations
C. active listening
D. summarizing clients views

92. Which of the following terms refer to the sender’s attitude towards the self, the message and the listener?

A. verbal communication
B. double-bind communication
C. non-verbal communication
D. meta communication

93. In interacting with patients, the nurses should remember that a client’s personal space is:

A. that which revolves around the client
B. highly mobile depending upon certain situation
C. clearly visible to others
D. the same as that of the nurse

94. In interpersonal communication is LEAST threatening during what type of relationship?

A. social
B. intimate
C. personal
D. professional

95. In demonstrating the method for deep breathing exercises, the nurse places the hands on the client’s abdomen to explain diaphragmatic movement. This technique involves the use of which element of communication?

A. appropriateness
B. feedback
C. channel
D. message

Situation 20: Roy, an adolescent, was diagnosed to have pneumonia. He constantly complains of chest pain and has a standing order of Morphine SO4.

96. Which of the following MOST appropriately describe pain sensation that has periods of remission and exacerbation?

A. chronic
B. intractable
C. acute
D. Psychosomatic

97. Roy is constantly asking to be relieved from pain. Since morphine is an addicting drug, which of the following is BEST for the patient?

A. administer morphine SO4 PRN
B. administer morphine on a routine schedule as ordered
C. give instructions on relaxation technique to reduce frequency of pain sensation
D. divert the attention by not limiting visitors

98. To get accurate information about the quality of pain the patient is experiencing, which of the following statements would be MOST APPROPRIATE?

A. “What cause you the pain?”
B. “ Tell me what your pain feels like”
C. “Have you taken something to relieve the pain?”
D. “Is it stubbing or radiating pain?”

99. As the nurse assigned to Ray, which of the following can decrease his chest pain?

A. supporting his rib cage when he coughs
B. advising him
C. teaching him
D. encouraging him to breathe deeply

100. Which of the following is the nurse’s primary goal in caring for clients with chronic pain?

A. change the clients perception of pain
B. reduce the clients perception of pain
C. change the clients reaction to pain
D. enumerate the source of pain

1. What’s the answer ( ANSWER FIRST)
2. What’s the question (REPHRASING)

· Numbers ( age, lab values, percentage)

· Signs & Symptoms

· Acute or Chronic

3. ELIMINATION

· True or False

· Clustering (GROUPING)

o A. hypertension (BP)

o B. tachycardia (HR)

o C. hypotension (BP)

o D. bradycardia (HR)

· Odd Man Out/In (TOO OBVIOUS)

· Comma-Comma-And, “Rule”

o ___, ___, & ___ (ELIMINATE VERTICALLY)

4. ALL OF THE ABOVE

· Eliminate AOTA if there is an: OPPOSITE TERM

o A. tachycardia, bradycardia & tachypnea

o B. hypertension, hypotension & pyrexia

5. KEYWORDS

· Eliminate choices with the ff words:

o Always,

o Never,

o Necessarily,

o Any,

o Only,

o Must,

o Completely,

o Totally

6. TRAPS

· Be aware of the ff words that are often missed:

o Inappropriate

o Not applicable

o Ineffective

o Further teaching

CRITICAL THINKING

· Validate & Organize data

· Look for patterns & relationship

· Transfer knowledge

· Evaluate

1. Identify the topic of the question

o NO: Read the choices and restate the problem

o YES: Proceed to 2

2. The Nursing Process

o Assessment & Implementation = Read the stem carefully

o All Assessment & Implementation = Proceed to 3

3. Does Maslow fit?

o YES: Physical vs. Psychosocial

ü PHYSICAL FIRST!

ü If all Physical, ABC!

o NO: Focus on the TOPIC/ PROBLEM

PSYCHIATRIC QUESTIONS

WRONG

· False assurance

· Personal opinion/ advice

· Should not insist

· Blocking

· Why?

CORRECT

· Listening to client’s concern

· Assessing & acknowledging client’s response

· Encourage to talk more about the client’s feelings

· Focus on the concern of the client

· Use open ended questions

IMPORTANT TERMS

· Laenec’s disease- liver cirrhosis 2^nd to alcoholism

· Homman’s sign- distention in the calf that is used to determine Deep Vein Thrombosis

· Hegar’s sign- softening of the Uterus

· Goodel’s sign- softening of the Cervix

· Chadwick’s sign- bluish discoloration of the Vagina

· Korsakoff- complication of Chronic Alcoholism manifested by Confabulation

· Confabulation- making up stories

· Illusion- with stimulus ( Desert- water)

· Hallucination- without stimulus ( Auditory)

· Delusion- false belief

SIGNS & SYMPTOMS

· Tachycardia (Cardiac Rate) = Mild Dehydration

· Hyperthermia (Temperature) = Moderate to Severe Dehydration

· ↓ K+ = Severe Vomiting

· ↑ Glucose = Diarrhea

· ↓ Cal+ = Trosseau’s Sign

· Hyperventilation = DM Ketoacidosis

· N pH = 7. 35 – 7. 45

· N pCO₂ = 35 – 45 / partial pressure of Carbon Dioxide

· N pO₂ = 95 – 100 / partial pressure of Oxygen

· N HCO₃ = 22 – 26 / Bicarbonate

· Metabolic (HCO₃)

o Acidosis (↓pH, ↓ HCO₃)

o Alkalosis (↑ pH, ↑ HCO₃)

· Respiratory (pCO₂)

o Acidosis (↑ pH, ↓ pCO₂)

o Alkalosis (↓ pH, ↑ pCO₂)

I cannot pray…

I cannot pray “Our”, if my faith has no room for others and their need.

I cannot pray “Father,” or “Creator,” If I do not demonstrate this relationship to God in my daily living.

I cannot pray “Who art in Heaven,” if all my interests and pursuits are in earthly or material things.

I cannot pray “Hallowed be Thy Name,” if I am not striving for God’s help to be holy.

I cannot pray “Thy Kingdom come,” if I am unwilling to accept God’s rule in my life.

I cannot pray “On earth as it is in Heaven,” unless I am ready to give myself to God’s service here and now.

I cannot pray “Give us this day, our daily bread,” without expending honest effort for it or if I withhold from my neighbor the bread I receive.

I cannot pray “Forgive us our trespasses as we forgive those who trespass against us,” if I continue to harbor grudge against anyone.

I cannot pray “Lead us not into temptation,” if I deliberately choose to remain in a situation where I am likely to be tempted.

I cannot pray “deliver us from the Evil One,” if I am not prepared to fight with my life and my prayer.

I cannot pray “Thine is the kingdom,’ if I am unwilling to obey the King.

I cannot pray “Thine is the power and the glory,” if I am seeking power for myself and my own glory first.

I cannot pray “forever and ever” if I am too anxious about each day’s affairs.

I cannot pray “Amen,’ unless I honestly say “Not MY will, but THY will be done”, so let it be.

“But when ye pray, use not vain repetitions, as the heathen do: for they think that they shall be heard fr their much speaking. Be not ye therefore like unto them: for your heavenly father/Creator knoweth what things ye have need of before ye ask HIM.” (Matthew 6: 7-8).