TOPRANK REVIEW CENTER

Professor: Atty. Arlene Capili

November 2024

OUTLINE

I. Scientific Method
II. Research
a. Nursing Research
b. Research in Nursing
c. Evidence Based Practice
d. Importance of Research in Nursing
e. Ultimate Goal of Nursing Research
III. 5 Major Steps of the Research Process
a. Phase I: The Conceptual Phase
b. Phase 2: The Design and Planning
c. Phase 3: Empirical Phase
d. Phase 4:The Analytic Phase
e. Phase 5:The Disseminating Phase

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SITUATION
a. Staffing
A professional nurse is assumed to update herself b. Directing
about the profession to maintain competence in c. Planning
practice. The nursing management process is a topic for d. Controlling
both staff and head nurses.
5. The purpose of organizational structure is to:

FUNCTIONS OF MANAGEMENT
PURPOSE OF ORGANIZATIONAL STRUCTURE
Planning
• Knowing where you are and where you want to be; allow • Purpose of organization structure is in the Organizing
what you want to happen; assess situation Phase
• This is the time where you conduct your SWOT analysis, • Purpose of organization structure; For work distribution
tools in planning (hierarchy of planning: mission, vision, • Management - focus is Goal Accomplishment
philosophy, objectives, etc.)
• Where you set your budget
Organizing a. Have a written plan of organizational structure of her
• You establish a formal structure of the organization and governing bodies - ORGANIZATIONAL STRUCTURE IS
create the job qualification and job description; NOT A PLAN
• Includes staffing b. Explain to each member the line of authority - scalar chain
• Where you create the structure (ilang department, unit) c. Inform all her staff members of the philosophy and goals
• Alam mo kung kanino mo bibigay yung trabaho of the institution - PLANNING
• Utilize different nursing care system (case method, functional d. Provide mechanism through which tasks are
method, team nursing, etc.) distributed among members for goal realization
Directing
• The issuance of orders, assignments, and instructions;
naguutos kana, giving instructions, delegations Jun is the new supervisor of the medical-surgical unit with 40
• Includes Delegation, Problem solving and Decision bed capacity.
making SITUATION
Controlling
• Seeing to it that what is planned is done; Kung ano yung 6. A critical component of the supervisory process is
plinano mo, yun yung mangyayari delegation. Which of the following is the most
• Evaluation; other term: reviewing, checking, determining and empowering to the staff?
comparing

NOTES: DELEGATION
1. This major function of the management process
establishes formal authority. It defines qualifications • Immediate superior - pwede lang ang mag-utos sayo
and also includes staffing: • Delegation and Evaluation complement each other
a. Planning
b. Organizing a. Delegation starts at top management
c. Directing b. Delegation frees the manager to do other task
d. Controlling c. Effective delegation requires the nurse manager to
determine the abilities of the staff – EVALUATION (strength
2. On the other hand, this major function of the lang, walang weakness) formal authority staffing
management process actuates efforts towards the d. Delegation enables the staff to improve competence
accomplishment of goals. It includes updating policies and confidence
and procedures:
7. Which task can be delegated to the nursing aid when
• You are already implementing the plan the patient is stable? - SKIP THE WARD SINCE
UNLICENSED, SIMPLE TASK, STABLE PATIENT
a. Planning
b. Organizing
4 POINTERS OF DELEGATION
c. Directing
d. Controlling Position of the Staff

3. She noticed that policies and standard operating • Licensed - isa-isahin mo yung mga ward na pinaggalingan
procedures (SOP’s) are strictly implemented in the niya kasi yun lang ang kaya niyang gawin or alagaan tsaka
hospital. What management function is this? mo i- compare sa ward na pupuntahan niya
• Unlicensed - SIMPLE TASKS (DO NOT CONSIDER OR
a. Planning SKIP THE WARD)
b. Organizing Ward
c. Controlling
d. Directing • Kung saan galing at saan pupunta
• There will be times the nurse will float to another unit
4. The management function that involves determining Capabilities of the Staff
the objectives of an organization and tasks needed to
complete objectives is • Capabilities will depend on the position in the ward
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Condition of the Patient 4. Defining the framework and develop conceptual

definitions
• Stable or Unstable
5 MAJOR STEPS OF THE RESEARCH PROCESS
5. Formulating the hypothesis

PHASE 1: THE CONCEPTUAL PHASE

FRAMEWORK OF THE STUDY
• Graphical representation of concepts and relationship
• more formal, intensive, and comprehensive method for the between concepts
discovering of new knowledge ◦ Concepts came from the RRL
• can finish in months or years ◦ No findings on framework
• Focus
Nursing Research ◦ Conceptual framework - topic (relate concept to topic)
• deals with clinical problems encountered in the clinical ◦ Theoretical framework - theory
duty
DEFINITION OF TERMS
Research in Nursing • We define the variables
• broader study of nursing and the profession, focuses more • We utilize
on issues that can affect the nursing profession • Operational
PHASE 3: EMPIRICAL PHASE Definition
◦ Define the variable on how they were used in the study
• Conceptual Definition
Evidenced Based Practice
◦ Utilized for highly technical terms
• the use of current best evidence
◦ Definition found in the book, resource material
• “latest findings”
PHASE 4: THE ANALYTIC PHASE • Q: Which phase in research the researcher spend most
of the time?
• A: Phase 2: The Design and Planning
IMPORTANCE OF RESEARCH IN NURSING
• Professionalism - enhance the profession
PHASE 5: THE DISSEMINATING PHASE
• Accountability - increase accountability (how far it can go)
6. Selecting a research design
• Social Relevance - contribute to society
7. Developing protocols for the intervention
• Research and Decision Making - new discovery for best
◦ Optional, used experimental (with manipulation)
decisions
◦ Protocol - susundin ng lahat ng researcher before, during
and after giving the intervention to all the subjects to prevent
THE PROBLEM bias
8. Identifying the population to be studied
*ULTIMATE GOAL OF NURSING RESEARCH 9. Designing the sampling plan
• to improve the practice of; nursing (the profession) • Probability and Non-Probability sampling
◦ client care 10. Specifying the methods to measure the research
◦ patient care variables
◦ healthcare • Methods - tools and instruments on data collection
◦ nursing care 11. Developing methods for safeguarding human/animal
rights
1. Formulating and delimiting the problem 12. Finalizing and reviewing the research plan
2. Reviewing the related literature (RL) - synthesis • Phase of research - the researchers spends most of
of previous studies related to the problem of interest his/her time
• Purpose: to get an idea and background of the study
• How to create the RRL? 13. Collecting data
◦ Have a topic 14. Preparing the data for analysis
◦ Identify the variables - focus of research • Longest phase of research
◦ Conduct a computer search/ library search
◦ Remove irrelevant resources 15. Analyzing the data
◦ Print it out for easy retrieval 16. Interpreting the results
◦ Organize - most important to least important
◦ Retrieving 17. Communicating the findings
◦ Copy the article 18. Utilizing the findings in practice
◦ Conduct a preliminary reading
◦ Critically read the sources PHASE 1: THE CONCEPTUAL PHASE
◦ Summarize the resources
◦ Recognized the author - to prevent plagiarism • Sources of research problems: "NITESS"
◦ Copyright infringement - intellectual property ◦ Nursing literature
◦ Plagiarism - stealing an idea on an author. Even ◦ Ideas from external sources
if translated to another language ◦ Theory
3. Undertaking a clinical fieldwork ◦ Experience and clinical fieldwork*
• Same purpose on RRL - one that is rich in information
• RL and clinical fieldwork complement each ither ◦ Social issues - found in the society
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PHASE 2: THE DESIGN AND PLANNING ◦ example: Return demonstration

• Environmental characteristics
◦ Scientific research ◦ example: PAGASA
- previous researches • Verbal communication
- least that is being used because of the criteria of novelty ◦ Manner on how a person answer a question
- ginagawa lang siya if may need for modification and • Non - verbal communication
innovation 4. Biophysiologic measures - use of equipments or
gadgets
CRITERIA OF GOOD RESEARCH PROBLEMS (SALT LIN) 1. In Vivo - measurement is performed directly on the
sublect
HYPOTHESIS
• Habang nakakablt sa kanya yung equipment or gadgets
• S ignificance of the study you do the measurement
◦ To people (sila ang target) • Research done on a living organism
◦ To society - at large (not target but can influence) • Bp taking, 02 pulse oximeter
◦ To profession - improve the practice of nursing 2. In Vitro - measurement is performed outside
• A vailability of the subject ◦ Kuha muna ng specimen tapos dadalhin sa lab so gagawin
• L imitations of the subjects sa laboratory
• T ime allotment and Research ability • done in a laboratory dish or test tube.
• L imitations of tools ◦ Urinalysis, fecalysis, ABG analysis
• I nterest or the researcher
• N ovelty / newness / freshness of data/idea CRITERIA USED TO KNOWN EFFECTIVITY
• Validity - measure what is supposed to be measured
Major Types of Data Collection Method ◦ Kung ano mang ang gagamitin mo, or yung tool is
1. Use of existing data - it is already available
◦ example: during case presentation we used the PHENOMENA AMENABLE TO OBSERVATIONS
patient's chart for research purposes masasagot or iaaddress yung research problem mo
◦ Any form of reports, documents and records ◦ refers to whether a measure accurately measures what it
2. Self reports - Interview, questionnaire intends to measure.
◦ Most widely used form of data collection • Reliability - consistency or the repeatability of the tool
◦ Researcher mismo kumukuha - DIRECT ◦ Kahit llang beses binigay yung tool, same results / same
◦ Flexible response pa rin dapat = Reliable
◦ we usually gather OPINIONS ◦ refers to the consistency of a measure in producing the
◦ Gather data that cannot gather in other methods same results over time
◦ We cannot gather opinion using gadgets and equipments • Sensitivity - able to detect small variations or find
Crucial disadvantages: Validity & Accuracy differences
3. Observation
◦ Participant - you are going to give an intervention • Tentative prediction or explanation of the relation between
and you are going to observe two or more variables
◦ Non-participant - wala kang gagawin but just to
observe PARTS OF HYPOTHESIS (ICD EFFECT)
◦ Phenomena - amenable to observation
- characteristics and condition of the subjects • Independent Variables - CAUSE
- activities and behavior ◦ Fixed = set (by the researcher)
- skill attainment and performance • Dependent Variables - EFFECT
- environmental characteristics ◦ vary - kung ano ang nagvavary sa population, pwede
- verbal communication mabago
- non-verbal communication
• Characteristics and condition of the individual • Population - the research population, also known as the
◦ example: target population, refers to the entire group or set of
◦ Problem sa RH incompatibility -› presence of individuals, objects, or events that possess specific
rhogam nagpoproduce ng antibody characteristics and are of interest to the researcher. It
◦ Problem sa ABO incompatibility - Jaundice represents the larger population from which a sample is
(you can observe the characteristics of the skin) drawn.
◦ Condition: Comatose - you can observe and use
GCS RELATIONSHIP
• Activities and behavior
◦ BEHAVIOR EXAMPLE: POPULATION TO WHICH IT APPLIES
◦ Autism - temper tantrums (ignore but give ◦ Most neglected part
ensure and give safety helmet - you can observe the ◦ First thing is to IDENTIFY in the population
behavior tantrums
◦ ACTIVITIES EXAMPLE: 1. All of the CHARACTERISTICS
◦ DAT (Dementia of the Alzheimer's Type) ◦ *box or encircle the population including all its
- Remember A - Alzheimer’s - walang characteristics
Acetylcholine - Amnesia - Aphasia and so on 2. SETS
- Apraxia - hindi na alam gamitin yung mga bagay na alam a. If you have 2 or more sets of the population
LIMITATIONS OF TOOLS you concentrate on their characteristics that
differentiate them ano man ang characteristics nila
niya before, unable to perform that is automatically the INDEPENDENT VARIABLE
- First initial sign of Alzheimer's - Forgetfulness
• Skill attainment and performance
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b. If vou have 1 set of population ang characteristic ay wala 2. The effect of Toprank Nursing Review to the passing
na silbi, It will form part of the population, hindi na gagamitin rate of nursing students at the licensure exam.
and characteristics = ELIMINATE IT ◦ population - nursing students

Example: for 2 or more Sets of Population

1. Older patient are more risk for fall than younger

patients
◦ population - older and young patient
◦ characteristics that differentiates the population - age -
independent variable
◦ nagbabago - bago; risk for fall - dependent variable

2. Girls are less sexually active than boys

◦ population - girls and boys
◦ characteristics that differentiates the population -
gender - independent variable
◦ nagbabago - bago; sexually active - dependent variable

3. Full term infants who are breastfeeding weight more

than preterm infants who are mixed fed
◦ population - full term infants breast fed/ preterm infants
mixed bred
◦ characteristics that differentiates the population - term
and type of feeding - independent variable
◦ nagbabago - bago; weight - dependent variable
4. Depressed patients who are living with significant
others have lesser chances of committing suicide than SITUATION
those depressed patients who are living alone.
◦ population - Depressed patients who are living with A professional nurse is assumed to update herself
significant others and Depressed patients who are living about the profession to maintain competence in
alone practice. The nursing management process is a topic for
◦ characteristics that differentiates the population - living both staff and head nurses.
condition - independent variable
◦ nagbabago - bago; chance of committing suicide -
dependent variable NOTES: FUNCTIONS OF MANAGEMENT

Example: for 1 Set of Population PLANNING

• Knowing where you are and where you want to be; allow
1. Education attainment is not related to the compliance what you want to happen; assess situation
of PTB patients
◦ population - PTB patients - wala na kwenta so better • This is the time where you conduct your SWOT analysis,
eliminate it in the options because it is just a part of tools in planning (hierarchy of planning: mission, vision,
population philosophy, objectives, etc.)
• Where you set your budget
Go back to hypothesis then ask:
◦ what is being studied kay population and then used fixed ORGANIZING
and vary • You establish a formal structure of the organization and
◦ educational attainment - which is fixed - independent create the job qualification and job description;
variable
◦ compliance - which is vary - dependent variable • Includes staffing
• Where you create the structure (ilang department, unit)
EXPERIMENTAL • Alam mo kung kanino mo bibigay yung trabaho
• there is always a manipulation - anything that is given • Utilize different nursing care system (case method,
◦ ang ibibigay sa subject - fixed/set functional method, team nursing, etc.)
• all manipulation is automatically independent variable
DIRECTING
Example: • The issuance of orders, assignments, and instructions;
naguutos kana, giving instructions, delegations
1. Music therapy decreases the levels of anxiety among • Includes Delegation, Problem solving and decision
Cancer patients making
◦ population - cancer patients
◦ 1 set only so eliminate population and go back to what is CONTROLLING
being studied • Seeing to it that what is planned is done; Kung ano yung
◦ music therapy - given to the patient - independent variable; plinano mo, yun yung mangyayari
fixed/set by the researcher • Evaluation
◦ nagbabago - bago; vary; levels of anxiety - dependent
variable Reviewing, checking, determine, comparing,

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1. This major function of the management process Alamin Kung saan galing at saan pupunta
establishes formal authority. It defines qualifications
and also includes staffing: W • There will be times the nurse will float to another unit

A. Planning --
B. Organizing
C. Directing CAPABILITIES OF THE STAFF
D. Controlling
• Capabilities will depend on the position in the ward
2. actuates efforts; C. Directing C
--
[Link] implemented; C. Controlling C
4. determine objectives ; C. Planning C CONDITION OF THE PATIENT

5. The purpose of organizational structure is to: D. C Stable or unstable

NOTES: PURPOSE OF ORGANIZATIONAL STRUCTURE a. Administering tap water enema – LABATIBA; simple
task
Purpose of organization structure is in the ORGANIZING b. Incorporating potassium chloride intravenously –
PHASE medication; performed by licensed only
c. Teaching patient to administer insulin – health teaching;
Purpose of organization structure : For work distribution one of the scope of nursing practice (under RA 9173);
Registered Nurse; licensed only
Management – focus is GOAL ACCOMPLISHMENT d. Taking CVP / Central Venous Patient – a complicated
procedure

NOTES: UNLICENSED DELEGATION TIP

SITUATION
Unlicensed - we give dirty task to them;
Jun is the new supervisor of the medical-surgical unit with 40
bed capacity. 8. A nurse manager assigned a registered nurse from
telemetry unit to the pediatrics unit. There were three
6. A critical component of the supervisory process is patients assigned to the RN. Which of the following
delegation. Which of the following is the most patients should not be assigned to the floated nurse?
empowering to the staff? C
- LICENSED; TELEMETRY TO PEDIA WARD; TELEMETRY
NOTES: DELEGATION NURSE - read cardiac monitors, easily read ECGs (TELE:
• Immediate superior – pwede lang ang mag-utos sayo MONITOR; METRY: MEASURE)
• Delegation and Evaluation complement each other
a. A 9-year-old child diagnosed with rheumatic fever -
a. Delegation starts at top management possible complication is rheumatic heart disease
b. Delegation frees the manager to do other task b. A young infant after pyloromyotomy - opening of the
c. Effective delegation requires the nurse manager to pylorus; done with infants with pyloric stenosis (GI
determine the abilities of the staff – EVALUATION (strength disorder)
lang, walang weakness); should be both strength and c. A 4-year-old with VSD following cardiac catheterization -
weakness cardiac problem
d. Delegation enables the staff to improve competence d. A 5-month-old with Kawasaki disease - autoimmune
and confidence; disease; inflammation of the blood vessels/vasculitis

7. Which task can be delegated to the nursing aid when 9. The registered nurse is planning to delegate tasks to
the patient is stable? – SKIP THE WARD SINCE unlicensed assistive personnel (UAP). Which of the
UNLICENSED, SIMPLE TASK, STABLE PATIENT C following task could the registered nurse safely
assigned to a UAP? UNLICENSED; SIMPLE TASK;
STABLE PATIENT
NOTES: 4 POINTERS OF DELEGATION
a. Monitor the I&O of a comatose toddler client with
Consider the POSITION OF THE STAFF; if licensed or salicylate poisoning - COMPLICATED TASK
unlicensed b. Perform a complete bed bath on a 2-year-old with multiple
injuries from a serious fall - DIRTY TASK BUT
Licensed – isa-isahin mo yung mga ward na pinaggalingan COMPLICATED
niya kasi yun lang ang kaya niyang gawin or alagaan tsaka c. Check the IV of a preschooler with Kawasaki disease -
mo i-compare sa ward na pupuntahan niya COMPLICATED TASK
d. Give an oatmeal bath to an infant with eczema - skin
• Unlicensed – SIMPLE TASKS (DO NOT CONSIDER OR disorder and simple task (hindi nakakahawa); oatmeal
SKIP THE WARD) has the properties that relieves itching; simple; it is a
skin disease
--
10. A nurse in charge in the pediatric unit is absent. The
Second to consider; WARD nurse manager decided to assign the nurse in the
obstetrics unit to the pediatrics unit. Which of the
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following patients could the nurse manager safely 2. Interpersonal - includes attitudes, behaviors, and styles
assign to the float nurse? of direction giving

- LICENSED; OB UNIT TO PEDIA UNIT; PREGNANT, BASTA ATTITUDE AND BEHAVIOR AND PROBLEM:
POSTPARTUM, AND GYNE PATIENTS (ABDOMINAL ETO ANG SAGOT
SURGERY PATIENTS D/T CS); UNSTABLE PATIENTS • Verbalization of the feelings - know the cause of the
problem
a. A child who had multiple injuries from a serious vehicle • Talk with them
accident - ORTHO CASE
b. A child diagnosed with Kawasaki disease and with cardiac
complications - CARDIAC CASE
c. A child who has had a nephrectomy for Wilms’ tumor
- REMOVAL OF THE KIDNEYS; ABDOMINAL SURGERY; BASTA STYLES OF DIRECTION GIVING: ETO ANG
from OB nurse so she knows abdominal surgery that’s SAGOT
why eto
d. A child receiving an IV chelating therapy for lead • Assertiveness - sending direct messages, standing up for
poisoning your own rights without stepping the rights of others;
THERAPEUTIC
11. As the supervisor, you plan to implement change in • X Aggressiveness - not concerned with the feelings of
the nursing unit from team nursing to primary nursing. others
You anticipate that there will be resistance to change. In
order to avoid such, which of the following should be a. Determine the need for change - there is already the
done? problem
b. Confront the staff individually - GROUP
Change Management: Any alteration in the status quo; c. Develop the change one step at a time
status quo is the present situation d. Use coercion to implement change; force, violence - error

KAPANGYARIHAN: STEPS IN CHANGE PROCESS 12. The supervisor has implemented to change. A nurse
aide seems to be resistant to the change. Which of the
PERCEIVE THE NEED TO CHANGE following should be done? - interpersonal problem
Identify the problem, determine the issue, accept the fact to (attitude and behavior)
change
a. Ignore the resistance - automatically wrong
INITIATE A GROUP INTERACTION*** b. Utilize coercion
• Bring the group together, meeting with the group (we c. Give reward to the nursing assistant
usually do is planning, try to find the best solution here) d. Talk to the nurse assistant and encourage
• This step is the key to problem solving verbalization of feelings
• Best thing that you are going to do? A: initiate a group
interaction 13. As a medication nurse, you are tasked to give
• Who is the key? A: THE GROUP digoxin to a patient with arrhythmia. You noticed that
• If the problem concerns the group - consult the WHOLE the heart rate is 40 beats per minute and the potassium
GROUP level is below normal. The physician orders digoxin
• Except if the problem is just one staff - consult the STAT. An assertive response of the nurse should be:
individual PRIVATELY and CONFIDENTIALY, never
confront in the front of others (this is violation of code of NOTES: THERAPEUTIC COMMUNICATION EXAM TIP
ethics) • BASAHIN MO WITH FEELINGS PARA ALAM MO YUNG
DATING SAYO
IMPLEMENT THE PLAN
• One step at a time a. “I think we have first to monitor the patient’s cardiac
• Implement the change gradually to prevent resistance; rate before giving the drug.”
• Status quo - present situation; nakasanayan; hindi madali b. “I don’t want to carry out your order”
bitawan kasi nakasanayan c. “Don’t you know the precaution for giving this drug?”
d. “Yes doctor. I will give it right now.”
--
14. Determining the standard of the institution is one of
EVALUATE THE OVERALL RESULTS the concerns in controlling. When the institution has
reached the minimum level of excellence, it should:
2 aspects of delegation:
NOTES: CONTROLLING (OTHER TERMS)
1. Technical aspect - includes tasks, procedures, materials,
and equipment • Evaluating
• Reviewing
NOTE: the PROBLEM will fall in the technical aspect • Checking
BASTA TECHINICAL ANG PROBLEMA: ETO ANG SAGOT • Determining
• Show • Comparing
• Teach
• Demonstrate TOTAL QUALITY MANAGEMENT:
• Supervise
• Do or perform it with the nurse KAPANGYARIHAN: 4 BASIC STEPS OF CONTROLLING

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1. DEVELOP STANDARDS AND CRITERIA • Both WRONG

• Standard - pre-determined level of care 15. When conducting nursing audit, the following must
• Criteria - characteristics used to meet the level of care be considered EXCEPT:
a. Outcome
NOTE: the basis of evaluation - is standards and criteria b. Quality
EXAMPLE: OR Scrubbing c. Process
d. Structure
3 TYPES OF STANDARDS (SPO)
16. The most effective way in conducting the
• Structure - includes facilities, equipments, materials, and nursing audit is to:
management system; si MANAGER ang gumagawa a. Evaluate the records of the patient
• Process - includes plans and procedures; si NURSE ang
b. Determine the job description of the staff – staff
gumagawa
• Outcome - pertains to results; FIRST THING TO LOOK focused
INTO c. Evaluate staffing patterns – staff focused
d. Determine job performance – staff focused
2. DETERMINE COMPLIANCE

• Determine compliance = you evaluate SITUATION

2 TYPES OF EVALUATION As a nurse in charge, you noted that a lot of confusion

occurs in your unit due to some disorganization. You
THE Nursing Audit - patient focused
decided to improve work performance.
2 Types of Nursing Audit:
17. When resistance threatens needed change,
- Concurrent - present; you evaluate as the care what important measure would you use to
is given (ex. patient has fever, you provide TSB overcome the resistance?
and you check the temperature of the patient)
- Retrospective - past; discharged patient - tapos na ang a. Send a memorandum of change – memorandum is
ginawa sa kaniya (ex. bumalik siya sa hospital, iccheck yung a letter that circulates within the organization; this is
patient chart niya)
ABRUPT CHANGE not gradual
SOURCE OF EVALUATION IN RETROSPECTIVE : b. Use a problem-solving strategy – general answer
PATIENT CHART c. Gain early support from staff
d. Conduct staff re-education – will not solve
Performance Appraisal – staff focused resistance to change
- Informal appraisal – incidental; walang balak
mag-evaluate; pag may accident 18. This is a factor influencing acceptance of staff
- Formal appraisal – systematically done; for change:
scheduled for the evaluation (ex. Evaluation of CIs) it will
end in review session
a. Externally imposed
Review session - irereveal yung result ng b. Share its benefits – not all about the benefit
evaluation c. Staff participants
d. Planned ahead - initiate a group interaction - meet
3. IDENTIFY STRENGTH AND WEAKNESSES with the group - plan with them
• You concentrate on both; strength and weakness,
not only on one 19. These are important qualities of a change
agent except:
4. ACT TO REINFORCE THE STRENGTHS AND a. Leadership skills
TAKE CORRECTIVE ACTIONS TO WEAKNESS b. Sociability
• Support the strengths c. Credibility
• Go back to your 2 aspects in correcting your d. Management skills
weaknesses; technical and interpersonal
-Quality Improvement 20. Having to deal with a lot of people, the nurse
manager’s most important communication skill is
Quality assurance which of the following?
a. Questioning
a. Be contented on the result of the evaluation b. Assertiveness – a style; if you are able to talk with
b. Do something to improve the standard your staff
c. Help maintain the standard of the institution c. Affirmation
d. Publish the result to the publication d. Listening

NOTES: IF THE CHOICES HAVE THE SAME MEANING NOTES: BUDGET - systematic way of meeting
EXAM TIP expenses; involves past, present, future expenses

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24. An operational budget is a financial tool that

• Focus is revenues and expenses outlines anticipated revenue and expenses over a
• Income and cost specified period. Which of the following are
incorrect regarding budget?
4 COMMON TYPES OF BUDGET
NOTES: IF YOU SEE THE ALL OF THE ABOVE
[Link] BUDGET CHOICE IN THE EXAM (EXAM TIP)
• Expensive
• For long-term use; regardless of price as long as it is a.80% correct answer
for long term use b.20% incorrect

2. OPERATIONAL BUDGET a. The budget translates operational plans into

• Day-to-day expense financial and statistical terms so that income can be
• Part-time employees salary projected with associated costs
• Salary of both part time and full time employees
b. Budget serve as standards to plan, monitor,
3. PERSONNEL BUDGET and evaluate the performance of a health care
system - money is not the standard
• Salary for full-time employees c. Budget account for the relationship of income to the
• Full-time employee – working 8 hours a day, 5 days expenses needed to deliver the services
a week d. All of the above
• Prepared ahead of time, will be prepared in the time
of salary 25. Which among the following is the purpose of
monitoring a budget? – BOTH INCOME AND
4. CASH BUDGET EXPENSE DAPAT ANG NASA CHOICE PARA
MAGING TAMA
• Available all the time for emergency purpose
• Cash on hand, petty cash, emergency funds a. Keep expenses above budget
b. Maintain revenue above the previous year’s budget
21. An old ventilator often malfunctions and has c. Ensure revenue is generated monthly
inefficiencies resulting from the speed of the d. Generate revenue and control expenses within
equipment or downtime (amount of time it is out a projected framework
of service for repairs). The organization decided
to purchase new technology because the old one 26. Mr. Cabrido gives strong orders, makes
is too expensive to maintain. What type of budget decisions and thinks less of his subordinates. He
is allotted for the equipment? is a leader who is:

a. Operational budget a. Autocratic; best in emergency

b. Capital Budget – long term b. Laissez-faire – member focused; when the
c. Construction budget – also taken from the capital members are matured enough
budget c. Democratic – compliance; leader by the book
d. Any of the above d. Bureaucratic

22. Nurse Laila is the project head for a feeding 27. When the situation calls for compliance of the
program; she requested extra funds in followers to ensure the success of the activity, the
anticipation for fluctuations in resource needs or best leadership style that Nurse Beng will use is:
meet contingency expenses. This type of budget
is called: a. Laissez-faire
b. Autocratic
a. Operational budget c. Democratic
b. Capital expenditure budget d. Authoritative
c. Cash budget
d. Flexible budget – general type 28. A leader who defers decision making to his or
her followers is called what type of leader?
23. Which of the following is NOT included in the
Operational budget? a. Laissez-faire
a. Repairs and maintenance - operational b. Democratic
b. Medical/surgical supplies - operational c. Autocratic
c. Purchase of a major equipment - capital d. Employee-centered
d. Purchase of consumable materials – operational
29. What kind of communication style should a
nurse manager should possess?
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b. Talk with nursing aide to explore the reasons

a. Passive for the behavior and review expectations
b. Assertive c. Arrange a meeting with the nurse so they can
c. Aggressive
confront the nursing aide as a group
d. Sarcastic
d. Document the nursing aide’s behavior and place it
30. The morning supervisor was visiting the ward in the aide’s personnel file
when the doctor of a patient complained to her
about the staff nurse who failed to give the “stat” SITUATION
medication. Applying the principle of “line of As a supervisor you are confronted with several
authority”, you expected the supervisor to first: problems arising from various causes or reasons.
COMPLAINT
It ranks from Administration – clinical –
personnel, which later resulted to conflict. You
tried to find means to resolve it.
NOTES: SCALAR CHAIN 33. When conflicts arise in the unit, the best thing
• Follow the chain of command; hierarchical order that the unit manager should do is:

REPORTING a. Discuss the situation with the group and make

a move to resolve it.
• Only to immediate superior; don’t bypass the
superior b. Ignore the situation
• Nurse -> Head Nurse -> Supervisor -> Chief Nurse c. Give warning to staff
d. Recommend shifting of the staff
COMPLAINT
• Address the complaint to the immediate superior of 34. Desirable goals for a nurse manager include
the person you are complaining
all of the following EXCEPT:
a. Reassure the patient that next time the nurse will
not miss the medication – lose the trust of the patient a. Select a style of leadership that works best for
to the nurse the individual and to practice it exclusively
b. Report the incident to the chief nurse b. Use a style of leadership that promotes high – level
c. Ask the staff nurse to explain the incident work performance - CONTIGENCY
d. Talk to you as the head nurse about the c. Use a style of leadership that creates the least
doctor’s complaint
amount of disruption - CONTINGENCY
d. Adopt a leadership style that best suits the task to
31. You delegate to the nursing assistant the task
be accomplished – CONTINGENCY
of taking the client’s vital signs every 2 hours and
recording the vital signs in the patient’s chart.
35. Katherine tells one of the staff, “I don’t have
Later you check the client’s chart and discover
time to discuss the matter with you now. See me
that the vital signs have not been recorded. What
in my office later” when the latter asks if they can
is your BEST action?
talk about an issue. Which of the following
conflict resolution strategies did she use?
a. Take the vital signs because it is not the nursing
assistant’s scope of practice
a. Smoothing - unacceptable appears to be
b. Speak to the nursing assistant privately to
acceptable
determine why the vital signs were not recorded
b. Compromise - meeting halfway
c. Notify the head nurse
c. Avoidance
d. Call the nursing assistant to the nurses’ station to
d. Restriction - power; kung sino may kapangyarihan
reprimand
sya ang gumagawa paraan
32. Several nurses complain to the nurse manager
Complaints – immediate report of the person who are
that one of the nursing aides constantly takes
complaining
extensive lunch breaks. The nurse manager
Dominance – Ako masusunod wala ka magagawa
should: - INTERPERSONAL PROBLEM
Majority Rule: let us divide the house
Collaboration- working hand in hand in solving the
a. Convene a group meeting of all nursing aides to
problem
review their responsibilities related to time
management.
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Brainstorming - give suggestions; #1 rule all ideas are

welcome

36. She notes that there is an increasing unrest of

the staff due to fatigue brought about by shortage
of staff. Which action is a priority? – PROBLEM
SOLVING

a. Evaluate the overall result of the unrest 40. She knows that performance appraisal
b. Initiate a group interaction consists of all the following activities EXCEPT:
c. Develop a plan and implement it
d. Identify external and internal forces. a. Setting specific standards and activities for
individual performance.
37. Kathleen knows that one of her staff is b. Using agency standards as a guide.
experiencing burnout. Which of the following is c. Determine areas of strength and weaknesses
the best thing for her to do? – INTERPERSONAL d. Focusing activity on the correction of identified
PROBLEM EXCEPT behavior. – WEAKNESS LANG

a. Advise her staff to go on vacation. 41. Which of the following statements is NOT true
b. Ignore her observations; it will be resolved even about performance appraisal? - STAFF FOCUSED
without intervention
c. Remind her to show loyalty to the institution. a. Informing the staff about the specific impressions of
d. Let the staff ventilate her feelings and ask how their work help improve their performance.
she can b. A verbal appraisal is an acceptable substitute for a
written report.
38. St. Raphael Medical Center just opened its c. Patients are the best source of information
new Performance Improvement Department. Ms. regarding personnel appraisal. – PATIENTS ARE
Valencia is appointed as the Quality Control ALSO A SOURCE OF PERSONNEL APPRAISAL,
Officer. She commits herself to her new role and BUT NOT THE
plans her strategies to realize the goals and d. Let the staff ventilate her feelings and ask how she
objectives of the department. Which of the can BEST SOURCE (BEST SOURCE is Observation)
following is a primary task that they should
perform to have an effective control system? – 42. There are times when Katherine evaluates her
CONTROLLING staff as she makes her daily rounds. Which of the
following is NOT a benefit of conducting an
a. Make an interpretation about strengths and informal appraisal?
weaknesses a. The staff member is observed in natural setting.
b. Identify the values of the department b. Incidental confrontation and collaboration are
c. Identify structure, process, outcome standards allowed.
& criteria c. The evaluation is focused on objective data
d. Measure actual performances systematically.

39. Ms. Valencia develops the standards to be d. The evaluation may provide valid information for
followed. Among the following standards, which compilation of a formal report.
is considered as a structure standard?
43. When she presents the nursing procedures to
a. The patients verbalized satisfaction of the nursing be followed, she refers to what type of standards?
care received – OUTCOME
b. Rotation of duty will be done every four weeks a. Process
for all b. Outcome
c. All patients shall have their weights taken recorded c. Structure
- PROCESS d. Criteria
d. Patients shall answer the evaluation form before
discharge – OUTCOME
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44. Ms. Valencia prepares the process standards.

Which of the following is NOT a process
standard?

a. Initial assessment shall be done to all patients

within twenty-
four hours upon admission. – DONE BY THE NURSE 47. When responsibilities have to be delegated to
b. Informed consent shall be secured prior to any the member, the manager must:
invasive procedure – DONE BY THE DOCTOR,
SECURED BY THE NURSE
c. Patients’ reports 95% satisfaction rate prior to NOTE: KAPAG NAGDODOBLE ISIP SA
discharge from the hospital. - OUTCOME DALAWANG CHOICES, BALIKAN MO YUNG
TANONG (EXAM TIP)
d. Patient education about their illness and treatment
shall be provided for all patients and their families. – a. Ensure that the member is capable of doing the
DONE BY THE NURSE task
b. Supervise the new members all the time – absolute
45. Nurse Mary is the head nurse and tells Nurse words = WRONG
Fatima her staff nurse what to do. What kind of c. Perform the task based on the acceptable standard
d. Let the member write an accident report in case of
communication is this?
mistakes

NOTES: KINDS OF COMMUNICATION 48. He was asked how the staff will be evaluated.
• Exist within the organization He probably will show them the following
EXCEPT:
VERTICAL COMMUNICATION a. Performances Evaluation sheet
• Patay]],ll b. Performance Checklist
c. Ranking Device
• UPWARD – from the subordinate to the superior
d. Nursing Audit – PATIENT FOCUSED
(SCALAR CHAIN)
• DOWNWARD – from the superior to the subordinate SITUATION
(DELEGATION) Jun just received his appointment paper as
permanent employee. He was told by the head nurse
HORIZONTAL / LATERAL COMMUNICATION - ----- that it was his loyalty, commitment, competence, and
• Diretso caring attitude that contributed to his present
appointment.
• Exist within the same position, same department
a• Example: Maternal Care Department 49. Which response describes Jun as an assertive
person?
DIAGONAL COMMUNICATION
• Communication Exist within different departments a. “I am used to this. I am born a winner.” -
MAYABANG
b. “I don’t know why I became permanent. Probably
a. Upward communication
they like
b. Downward communication me.” – MAYABANG
c. Lateral communication c. “Thank you. I hope I will be able to contribute to
d. Diagonal communication the goals of the department.”
d. “I expected this to happen. I know I did my best.” -
46. Nurse Jane is coordinating with the OR MAYABANG
department for a scheduled surgery of one of her
50. The nurse revised the system for the delivery
patients. This kind of communication is?
of nursing care which is referred to as:

a. Upward Communication NOTES: NURSING CARE SYSTEM

b. Grapevine; Chismis • A system that is used to delivery nursing care
c. Diagonal Communication • Another terms: Modalities of nursing care,
d. Lateral Communication Patterns of nursing care

CASE NURSING / CASE METHOD

• Oldest system

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• Total care nursing – ikaw ang bahala sa lahat- 51.-58 paper

lahat sa pasyente
• 1 nurse: 1 patient
• Used by private duty nurse
• Used in ICU

FUNCTIONAL NURSING

• Tasks are delegated among the staff – kaniya-

kaniya ng trabaho ang ginagawa

TEAM NURSING
• Group of nurses assigned to a group of patients
wherein there is a team leader
• Example: RLE duty (group of students nurses
assigned to a group of patients, the team leader is
the clinical instructor)
• Usually used in the Pedia ward

PRIMARY NURSING***
• 24-hour continuous, coordinated,
comprehensive nursing service of 5 to 6 patients
from admission to discharge
• 1:5/6 nurse-patient ratio
• Maximum of 5-6 patients, pwede 3 or 4 patients •
How is the primary nursing being done? Proto gene – e.g Kirsten rat sarcoma (KRAS) gene
1. Primary nurse – responsible to create the NCP;
kung kanino in-endorse ang case
2. Associate primary nurse – reliever associates;
uses the NCP that the primary nurse made; except
there is the change in the patient’s condition
provided he will report into the primary
• Ideal used in the ward
ILAN ANG NURSE PER SHIFT? – 1 ILAN ANG
NURSE DITO? – Marami ILAN ANG PATIENTS? –
5-6

MODULAR NURSING
• Combination of Team and Primary
• There is geographical assignment of patients
• Take care of patient with the same disease
condition (ex.
COVID)
• Magpadala ng nurses to take care of patients
• Do case finding
• Best to use during national emergencies,
disaster or
Calamities

CASE MANAGEMENT
• Utilizing the health care delivery system wherein
the goals are to delivery quality care, to promote
the quality of life, to decrease fragmentation, and
to contain cost
• EXAMPLE: Nursing homes, Hospice, Psychiatric
facilities - Music and Art therapy, Occupational
therapy
• Focuses on long-term treatment • Case Manager
– nurse

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RESEARCH

PAR, RN 2024