ASTIGNURSE VLOGS NURSING TUTORIAL REVIEW PREBOARDS

NURSING PRACTICE IV – CARE OF CLIENTS (PART B) SET A

INSTRUCTION: Select the correct answer for each of the following questions. Mark only one answer for
each item by shading the box corresponding to the letter of your choice on the answer sheet
provided. STRICTLY NO ERASURE ALLOWED.

SITUATIONAL

Situation - Patient Narding is diagnosed with stroke and suffers from a number of deficits as a
result of injury to his brain. His rehabilitation may be long, depending on the extent of brain
injury.

1. Narding has been urinating on and off in bed which is possibly related concerned because he
is showing signs and symptoms of pressure sores due to a flaccid bladder and difficulty in
communicating. The nurse becomes to his immobility and the frequently wet beddings. The nurse
decides to refer the patient to the
A. Resident on duty C. Infectious doctor specialist
B. Attending physician D. Supervisor- in- charge

2. Narding becomes unduly silent and keeps to himself after his stroke left. him with left-sided
weakness. The nurse observes that the patient seems really sad and shares the information to
the physician, who refers the patient to a _____.
A. psychiatrist C. psychologist
B. neurologist D. physiotherapist

3. The patient shared his concern about being able to father a child after the stroke,
especially that he has only one child, a girl. He would like to have two boys but he doubts
his present sexual capacity. Who can BEST help him along this area?
A. Primary consultant C. Supervisor in charge
B. Nurse D. Urologist

4. The patient should be assisted back to normal mobility after his stroke partially
incapacitated him. The referral that will be done by the attending physician must be to which
professional?
A. Occupational Therapist C. Physical therapist
B. Resident physician D. Primary consultant

5. Narding seems forgetful, inattentive, and not answering appropriately to some questions
posed. The nurse anticipates that the consultant will need to ask the professional help of
the ______ for cognitive improvement
A. psychologist C. family doctor
B. psychiatrist D. Neurologist

Situation - The nurse conducts health education on common types of allergy with the parents of
allergic children and adults with hypersensitivity issues.

6. During the conduct of the health education class, which communication skill involves active
listening that Is being used by nurse to gain an understanding of the patient's message?
A.Clarifying C. Attending
B. Responding D. Confronting

7. The nurse must be alert about BARRIERS to communication during the health education class so
that she
A. use them when communicating
B. communicate much better
C. use them to enhance interactions
D. rationalize wrong styles of communication

8. The mother of the atopic dermatitis patient is very concerned about scarring that will result
from the child's frequent scratching. How will the nurse BEST communicate her reassurance?
A. Asking the mother what she prefers: for the child to have scars or he be unable to sleep?
B. Telling the mother matter of fact that scars will lighten as the child grows older anyway.
C. Tapping the hand of the mother while explaining that scarring occurs only when lesions get
infected.
D. Reminding the mother that beauty is only secondary to comfort derived from scratching.

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 9. Because of the presence of skin lesions, atopic dermatitis affects the patient's self-esteem
and his willingness to interact with others. The nurse communicates her nursing intervention
by ______.
A. instructing the patient to go back to the primary physician
B. giving instructions and counseling on preventive measures and treatments
C. referring the patient to the dermatologist
D. referring the patient to the psychologist

10. The adult patient who was receiving diphenhydramine (Benadryl) verbalized he was always
sleepy and fears ne would sleep on the job and will get fired. The nurse will best calm the
patient by assuring him that his physician can readily change his medicine to
A. chlorpheniramine (Actifed)
B. brompheniramine (Dimetapp)
C. loratadine (Allerta)
D. dimenhydrinate (Dramamine) (how to effect a good communication)

Situation - Nilda, 53 years of age, was brought to the ER because of numbness on her left face and
arms and a confused mental state. The ER doctor made an initial impression of ischemic stroke.

11. Nilda wonders how she developed the manifestation of ischemic stroke. The nurse explains that
there is ______.
A. extravasation of blood into the brain.
B. possible presence of a cerebral aneurysm.
C. vascular occlusion to the brain
D. an increase in cerebral blood flow

12. The nurse knows that visual-perceptual disturbances can occur in stroke. when patient Nilda
manifests hemianopsia, she has
A. inability to perform everyday movements and gestures
B. blindness in half of the visual field
C. difficulty speaking
D. inability to understand spoken language

13. The nurse knows that initial diagnostic test that is ordered for stroke _____.
A. Carotid ultrasound C. Magnetic Resonance Imaging (MRI)
B. 12-lead ECG D. CT scan

14. The ER nurse anticipates that a thrombolytic agent would be ordered to treat ischemic
attacks. Knowing the action of thrombolytics, the nurse must particularly be alert for which
adverse reaction?
A. Formation of blood clots C. Early onset of infection
B. Bleeding D. Allergies

15. Patient Nilda complains of shoulder pain. The nurse is aware that she is prone to have
adduction of the shoulder. A nursing intervention for this is to _____.
A. position distal joint higher than proximal joint
B. place a pillow under the arm to keep the arm close to the chest
C. position the fingers so that they are barely flexed
D. place one pillow in the axilla to keep the arm away from the chest

Situation - Health education on HIV-AIDS has been massive in the years prior, yet patients and their
relatives still have a number of queries and misconceptions about it. Lerma, a young mother of 34,
has been recently diagnosed of the disease.

16. Lerma is aware that there is mother-to-child transmission of HIV-1. She becomes concerned and
asks the nurse when it specifically happens. The nurse answers that it can occur in the
following circumstances, EXCEPT _____.
A. during breastfeeding C. at the time of delivery
B. during casual contact D. in utero

17. Lerma would like to know how she could limit further exposure to more HIV virus by using
preventive measures. The nurse informs her that the use of a highly effective male condom
that can decrease the transmission of HIV is;_____
A. Non-latex C. Polyurethane
B. Latex D. lambskin

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 18. Patient Lerma has a CD4 lymphocyte count which is below 200 cells/mm³. She then asks what it
means the nurse answers that _____.
A. the result still falls within normal limits
B. she is in Stage 3 HIV-AIDS
C. it is slightly below normal but there is nothing to worry
D. it is a worrisome result but immediate attending in not necessary

19. The nurse counsels Lerma that the prevention of HIV infection that is usually NOT REALISTIC
is which one of the following?
A. HIV testing
B. Behavioral interventions to reduce risks
C. Total abstinence
D. Linkage to a treatment center

20. Nurses are at risk for HIV exposure. Post exposure prophylaxis (PEP)DOES NOT include one of
the following?
A. Tale 2-3 anti- retroviral drugs, as prescribed.
B. Drugs must be taken for 28 days
C. Drugs must be taken for at least a week.
D. Take the medicines within 72 hours of exposure.

Situation- Patient Reno, 53 years of age, is pale and complains of easy fatigability. He has
undergone complete Blood Count (CBC) where abnormal cells were found. He was diagnosed with acute
lynphocytic leukemia (ALL).

21. The nurse ensures that the isolation procedure APPROPRIATE for Reno is _____.
A. standard C. strict
B. airborne precaution D. protective

22. Which of the following diagnostic procedures will definitely establish the diagnosis for
patient Reno?
A. White Blood Cell count C. Bone marrow biopsy
B. Complete Blood Count D. Hemoglobin and hematocrit counts

23. When the thrombocyte count falls below 20,000/cu mm, the nurse will expect that the physician
will order
A. complete bed rest C. platelet transfusion
B. strict aseptic technique D. "limit visitors"

24. On the basis of his leukocyte count, the nurse instructs the patient NOT to do, which one of
the following?
A. Limit number of staff entering the room.
B. Be in a private room with the door closed always.
C. Receive immunization with a live attenuated virus.
D. Use antimicrobial soap when bathing.

25. During the period of exacerbation, the patient's hemoglobin is markedly decreased. What
instruction by the nurse is APPROPRIATE?
A. Allow exercise as long as tolerated
B. Let patient be dependent on
C. Perform only activities of daily living.
D. Serve pork and liver barbeque.

Situation- The nurse is assigned to care to teenagers with a diagnosis of allergic rhinitis.

26. Which of the following clinical manifestations would the nurse expect to find in the client
with rhinitis?
A. Nasal congestion, rhinorrhea and sneezing
B. Nasal congestion, pyrexic and rhinorrhea
C. Headache, sore throat and sneezing
D. Nasal congestion, headache and sore throat

27. The physician prescribes decongestant intranasal spray. The nurse instructs the client on the
proper use of the spray. Which of the following procedures is the CORRECT method?
A. Finish instillation of spray into one nostril before spraying into the other nostril
B. Inhale quickly to prevent irritation off the mucous membranes
C. Blow the nose after spraying to prevent medications from entering the throat
D. Tilt the head slightly forward and angle the bottle toward the side of the nostril
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 28. The client asks the nurse about using decongestant nasal sprays. Which of the following
statements by the nurse is CORRECT regarding its use?
A. "Nasal sprays should be use sparingly because they can exacerbate a cough"
B. "It would take several days of using nasal sprays before any effect on congestion is
noted"
C. "Nasal sprays should not be used formore than three days because it can worsen
congestion"
D. "They should be used along with corticosteroid nasal sprays for maximum benefit"

29. The nurse would determine that her teaching goal one the use of a decongestant nasal spray
has been met when the client says ______..
A. "The spray should be used round-the-clock at equally spaced intervals"
B. "Nasal sprays must be combined with an oral antihistamine to achieve relief"
C. “Overuse can result in nosebleeds and mucosal ulceration”
D. “Rebound rhinitis (rhinitis medicamentosa) is common with continued use"

30. The physician orders cromolyn sodium (nasal crom) for the client. The nurse instructs the
client that the most effective administration schedule is ________.
A. When manifestations peak only, with two or three doses per day
B. At the start of the allergy season, with a dose of once-a-day
C. One week before the allergy season begins, with four to six doses per day
D. Just after manifestations begin, with a dose of twice-a-day

Situation – Nurses should not only abide the laws, but be guided by the Code of Ethics for Nurses as
well.

31. The Code of Ethics for Nurses have articles relating to the relationship of nurses
on_______ (Select all that apply.)
I. people
II. practice and the profession
III. CO-workers
IV. Society and environment

A. I, III, and IV C. II III, and IV

B. I, II, III, and IV D. I, II, and III

32. The Code of Ethics adopted all the principles under the ___________.
A. Code of Good Governance
B. Patient 's Bill of Rights
C. ICN Code of Ethics
D. American Nurses Association (ANA) Code of Ethics

33. According to the Code of Ethics WHO determines the coverage and scope of the examination for
the practice of nursing in the Philippines?
A. Professional Regulation Commission
B. Association of Deans of Philippine colleges of Nursing
C.Professional Regulatory Board of Nursing (PRBON)
D. Professional Association of Philippine Regulatory Boards (PAPRBB)

34. What are the three important legal principles in nursing professional ethics?
I. Autonomy
II. Informed consent
II. Confidentiality
IV. Truth-telling
A. I, II, and IV C. I, III, and IV
B. II, III, and IV D. I, II, and III

35. The "end- justifies- the- means" ethic is described as _______.

A. having no correct or wrong Conclusion
B. basically without any ethical issue
C. conclusively unethical
D. unavoidable during these modern times

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Situation-In order for the medical team to work best, there must be smooth collaboration and
teamwork among its members.

36. John, the patient with Urinary Tract Infection (UTI) is on his 3rd day of antibiotic but is
still having high fever. There is a need for the nurse to refer her observation to which of
the following?
A. Intern C. Attending Physician
B. Resident-on-duty D. Head nurse

37. Urine for culture and sensitivity (C &S) was ordered and the nurse was told by the secretary
from the Laboratory that the result will be due in 5-7 days. The nurse knows from her
readings that bacterial Culture and Sensitivity may be reported in three days' time. Thus,
she plans to follow up the result from which of the health allied professionals?
A. Head nurse C. Medical technologist
B. Intern D. Physician

38. The patient developed worsening cough and was given an anti-cough elixir. After 30 minutes he
developed itchiness with hives. The nurse is hesitant to call anyone since it is already
midnight, and there was no one else since it is a holiday. Who will she refer the patient
to?
A. Head Nurse C. Consultant- in- Charge
B. Nurse Supervisor D. Head intern

39. The patient suddenly developed chest pain. The result of the stat Troph I revealed high-
result. What steps are CORRECT and according to protocol in this situation?
I. The medical technologist immediately calls up the physician to update him of the result.
II. The nurse waits for the doctor to call to confirm the result.
III. The nurse calls up the physician to inform him of the just-in lab result.
IV. The doctor waits for the update of the result from the hospital
A. I, II, and III C. I, II, and IV
B. I, III, and IV D. II, III, and IV

40. The patient was prescribed a number of stat medications to prevent any untoward
complications. The nurse closely coordinates with which professional
to facilitate the immediate release of the necessary medicines and supplies?
A. Attending Physician C. Pharmacist
B. Nurse Supervisor D. Head Nurse

Situation -Proper recording is a vita1 task that the nurse is trained to do properly in nursing
school and expected to practice as a professional

41. Nurses are taught as students that the ideal and PROPER time for recording vital signs and
notes on the patient is __________.
A. to wait for lunch break to do the recording
B. after al11 the tasks are done, in order to conserve time
C. as Soon as they obtain the signs or observations on the patient
D. to wait for lunch break to do the recordi1ng

42. Right after endorsement and during the rounds, the incoming nurse observes that the IV fluid
is at 800 cc level and not 400cc, as endorsed. What is the CORRECT information that she
will chart?
A. Anything goes, nobody reads the charting anyway.
B. Record the 400 cc.
C. Chart that she received 800
D. Refer to the Head Nurse on what to do.

43. Which is the APPROPRIATE way to correct an error in the Nurses Notes?
A. Take the whole page out and replace with a fresh one
B. Draw a single 1ine across the error and initial it
C. Use the sticky side of the plastic tape to erase the error
D. Use a rubber eraser to erase an error.

44. It a medicine is unavailable and therefore not given to the patient, how is it charted?
A. Leave it blank.
B. Sign and make an explanation in the Nurses Notes.
C. With an asterisk or mark, as per hospital protocol.
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 D. Write the letter.

45. If the patient is referred to another consultant and the latter has made an
order already, what can the nurse CORRECTLY chart?
A. The attending physician has not yet read the order
B. Only one order has been left to be Carried out.
C. She has carried out the orders of the consultant
D. That the consultant has seen the patient with new orders.

Situation - The nurse when practicing the profession must adhere to ethical principles.

46. When the nurse treats the patients in the air-conditioned rooms favorably compared to those
in the charity wing, she violates which of the following ethical principles?
A. Veracity C. Fidelity
B. Justice D. Distributive justice

47. The nurse has an obligation to tell the truth. when she admits mistakes promptly, she
manifests
A. Fidelity C. Respect
B. Veracity D. Autonomy

48. The cancer patient has been frequently complaining of pain and demands that the pain
reliever administered even before the due time. The nurse prepares to inject NSS as a
placebo. Which principle will she transgress?
A. Respect C. Justice
B. Veracity D. Fidelity

49. The nurse know that ethical dilemmas may be referred to the Hospital Ethics Committee that
has the PRIMARY role to _________.
A. Prevent the physician from making the wrong decision
B. Decide what must be done under the circumstances
C. Prevent ethical dilemmas from occurring
D. Provide guidance for healthcare teams and family of patients

50. Nurses were overheard talking about the patient and his prognosis. What ethical principle was
violated?
A. Autonomy C. Non-maleficence
B. Confidentiality D. Beneficence

Situation - You are a nurse manager of a female and male medical unit. You realize that being
manager entails a great responsibility. One of your major responsibilities is to implement quality
improvement initiatives in your unit.

51. You collaborate with the maintenance personnel to prepare a safety program. The program
includes, periodic inspection of electrical equipment, conduct of fire drills and proper
disposal of hazardous waste materials. These activities illustrate a component of which
quality program?
A. Total quality management C. Risk management
B. Quality assurance D. Quality improvement

52. You call for a staff meeting. You remind the nurses to improve the quality of care to
patients. Which of the following activities is MOST important to safeguard nursing practice?
A. Know own strengths and limitation
B. Provide nursing care competently and efficiently
C. Document care accurately
D. Understand professional, legal, ethical obligations and responsibilities

53. You take time to review reports from your staff. One report records the incidence of patients
falling off from their beds and other falls. Which of the following approaches is MOST
appropriate to manage the situation?
A. Implement quality assurance measures
B. Apply risk management principles
C. Apply total quality management principles in the unit
D. Implement a systems approach to the situation

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 54. A staff nurse in your unit administers a drug incorrectly to a diabetic patient who needs
more than one type of insulin. The staff nurse`s action causes serious negative effects on
the patient. What would be the MOST appropriate action that you as the manager should take?
A. Refer the staff nurse to quality assurance committee
B. Refer the staff nurse to the risk management committee
C. Refer the patient to the attending physician immediately
D. Ask the staff nurse to write a detailed incident report

55. A patient in the unit had episodes of seizures. Sometime during the night, the patient fell
off from the bed. The nurse on duty finds the patient on the floor. As a nurse manager, you
ask the nurse involved in the incident to write an incident report. Which of the following
statements is NOT true about incident reports? The reports _____.
A. Is a part of the patient`s medical record
B. Can be used in a court of law
C. Identifies the people involved, the date, time and location of the incident
D. Serves as a record of facts surrounding the incident

Situation - The nurse manager of the Oncology Unit invites an oncology nurse specialist to conduct
an educational session to the nursing staff on the topic Hodgkin`s disease.

56. The nurse specialist explains the characteristics of Hodgkin`s disease. Which of the
following is NOT a characteristics of Hodgkin`s disease?
A. There is presence of Reed-Sternberg cells
B. The disease occurs the most often in the older adult
C. The lymph nodes, spleen, and liver are involved
D. The prognosis depends on the stage of the disease

57. The nurse specialist describe the stages of Hodgkin`s disease. Which of the following
symptoms is MOST commonly an early indicator of Stage I?
A. Chest and Back pains C. Unexplained fever, night sweats
B. Subnormal body temperature D. Swelling of extremities

58. The nurse specialist emphasizes the importance of preventing complications. Which of the
following conditions are complications of Hodgkin`s disease?
1. Nausea
2. Myocardial infarction
3. Anemia
4. Infection
5. Hypotension

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

59. The nurse specialist cites a situation. If a patient experiences episodes of severe nausea
and vomiting with more than 1,000 ml. of vomitus with in a period of four hours, which of the
following is the nurses MOST appropriate action?
A. Withhold fluids for four hours
B. Notify the physician
C. Observe the patient for another four hours
D. Place the patient on a liquid diet

60. The nurse specialist explains that chemotherapy is extremely toxic to the bone marrow and the
patient may develop thrombocytopenia. What is the priority goal of the nurse? To take
precautions to control _______.
A. Bleeding C. Infection
B. Hypotension D. diarrhea

Situation - The nurse admits a male patient with complaints of epigastric pain, fatigue, anorexia,
weight loss and pain in the right upper quadrant. The probable diagnosis is primary liver cancer.

61. The nurse prepares the patient for the tests ordered by the physician. Which of the following
procedures would confirm the diagnosis of liver cancer?
A. Computed tomography (CT) scan C. Abdominal flat plate x-ray
B. Abdominal ultrasound D. Cholangiogram
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 62. The physician performs a liver biopsy on the patient. Which of the following complications
should the nurse monitor immediately after the procedure?
A. Nausea and vomiting C. Hemorrhage
B. Abdominal cramping D. Potential infection

63. The physician prescribes Adriamycin for the patient. Which of the following considerations
has the HIGHEST priority when preparing to administer the medication to patient with liver
cancer? _______ of the medication.
A. Metabolism C. Purpose
B. Necessity D. Frequency

64. Based on the information gathered, the nurse writes a nursing diagnosis. Which of the
following is the priority nursing diagnosis for the patient?
A. Acute pain related to abdominal pressure
B. Risk for infection related to complications of liver biopsy
C. Knowledge deficit related to self-care and cancer risk prevention
D. Fear and anxiety related to actual or potential lifestyle

65. The nurse understands the two basic types of liver cancer which are primary and secondary.
Which of the following statements is true regarding primary liver cancer?
A. Women experience more primary liver cancer than men
B. It is more common in developed countries
C. It is more common in the presence of chronic renal disease
D. Prognosis is poor: there is 20 percent survival rate

Situation - A 61 year old male seeks consultation in the OPD. He complains of blood in the urine,
pain on urination and frequents urination. Medical diagnosis is bladder cancer.

66. The male client is admitted to the oncology unit. A cystostomy is performed, a tumor is
visualized and biopsies. The nurse recognizes that the activity most often associated with
bladder tumor is _________.
A. Drinking three cans of carbonated beverages everyday
B. Smoking two packs of cigarettes a day
C. Jogging 6 km a day
D. Working with a heavy equipment everyday

67. The client receives a radiation implant for the treatment of bladder cancer. Which of the
following intervention is appropriate?
A. Place client in isolation
B. Encourage fluid intake
C. Monitor client for signs and symptoms of cystitis
D. Restrict fluid intake

68. The physician plans to do a cystectomy and ileal conduit on the male client. The nurse
prepares the client for the procedure. Which of he following is an appropriate action of the
nurse
A. Perform cleaning enema and give laxatives as ordered
B. Teach the client muscle tightening exercises
C. Demonstrate to the client the procedure for irrigating the stoma
D. Limit fluid intake for 24 hours

69. The client undergoes a radical cystectomy and has an ileal conduit. Which of the following
postoperative assessment findings should the nurse observe and report to the physician
immediately?
A. Slight bleeding from the stoma when changing the appliance
B. A urine output of more than 30 mL per hour
C. A red moist stoma
D. A dusky, colored stoma

70. Which of the following instructions should the nurse give to the client with an ideal conduit
skin care at the stoma site?
A. Clean the skin around the stoma with mild soap and water and dry the are thoroughly
B. Leave the stoma open to air while changing the appliance
C. Cut the faceplate or wafer of the appliance no more than 4mm layer than stoma
D. Change the appliance before going to sleep

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Situation - Nurse Lorelie is assigned in the oncology unit of the Provincial hospital. She assists
in the care of a Janna, 40 year old female with bone cancer.

71. Patient Janna complains of pain. Nurse Lorelie assesses the patient. Which of the following
statements is a MOST important information nurse Lorelie gather during the initial
assessment? The ________.
A. Patient’s self-reporting of her pain experience
B. Results of assessment of the physical examination
C. Amount of pain medication the patient is taking
D. Response of the family toward the illness of the patient

72. The patient informs nurse Lory that she is taking medications to control the pain. Which of
the following statements verbalized by the patient indicates that the patient needs further
teachings about medications to control pain?
A. "It is okay to take my pain medication even if I am not having any pain"
B. "I should take my pain medication periodically so I don't get addicted to the drug"
C. "I should contact the nurse if the pain is not effectively controlled by my
medication"
D. "I should take my medications around the clock to control the pain"

73. The patient receives chemotherapy. Nurse Lory writes a nursing diagnosis for the patient.
Which of the following nursing diagnosis is MOST appropriate?
A. Altered body image C. Impaired physical mobility
B. Pain related to treatment D. Risk for infection

74. Nurse Lory is aware that patent receiving chemotherapy is at risk for bone marrow depression.
She instructs the patient on how to prevent infection at home when she discharged. Which of
the following should nurseLory communicate to the patient?
A. "Wash your hands frequently and maintain good hygiene"
B. "Avoid physical contact with other people while receiving chemotherapy"
C. "Do not share the bathroom with young children or with any pregnant member of the
family"
D. " Visit the laboratory everyweek for WBC analysis"

75. Nurse Lory observes that the patient gets irritable and angry with the medical/nursing staff
whenever a procedure of treatment is done on her. Which of the following approaches would be
BEST to diffuse the anger of the patient?
A. Let the patient and family members have time for each other
B. Direct the discussion and allow the patient to express her feelings
C. Arrange a meeting between the patient and another person with bone cancer
D. Request the social worker of the psychiatrist in the hospital to talk to the patient

Situation – Nurse Edna, a charge nurse of an oncology unit attends a semi on evidence-based nursing
practice.

76. The conference speaker explained the difference between evidence-based practice and evidence-
based nursing practice. Which of the following is NOT TRUE regarding evidence-based nursing
practice? Evidence-based nursing practice______.
A. Has a medical focus
B. Uses a theory-derived and research-based information in making decisions about nursing care
delivery
C. Considers the patient’s need and preferences based on nursing theory and research
D. Is a strategy use to improve patient care outcomes.

77. The speaker encourage the nurses to participate in the use of evidence-based nursing
practice. The speaker said that nurses must _________.
1. Participate in the development use, or evaluation of practice guidelines.
2. Read and analyze outcomes of research studies.
3. Involve themselves in everyday patient care and nursing practice
4. Know why they are doing what they are doing.

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

B. 1 & 2 D. 1,3 & 4
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 78. Nurse Edna is aware of the importance of patient outcomes as a measure of quality care. Which
of the following statements is TRUE regarding patient-focused outcome indicators? To
________.
1. achieve safe, quality, cost-effective care for patient in daily practice
2. realize that individual nursing practice styles directly affect the rates at which
patients recover.
3. prevent development of unnecessary complication and injury.
4. determine satisfaction rate from patients or family care receiver from nursing staff.

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

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

79. A model for using evidence-based practice was presented. The model has the following elements
: plan, do, study and act (PDSA). If nurse Edna want to utilize this model to prove ward
management, what questions will she ask?
1. What are we trying to accomplish
2. How well do we know that a change is an improvement?
3. Will the patient be satisfied with the improvement?
4. what change/changes can we make that will result in an improvement?

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

80. Nurse Edna is aware that patient care improvement must be based on which of the following?
A. Total cost of health care
B. Building and applying knowledge
C. Hospital policy on how to staff a nursing unit.
D. Accreditation standards

Situation – The nurse cares for a client with cancer who had lung surgery. The nurse educates the
client on breathing exercises and ambulation.

81. The nurse teaches the client how to deep breath effectively after a lobectomy. The nurse
instructs the client to:
A. Contract the abdominal muscles, take a deep breath through the mouth, and exhale slowly as
one trying to blow out a candle
B. Relax the abdominal muscles, take a slow deep breath through the nose, and hold it for 3
to 5 seconds
C. Relax the abdominal muscles, take a slow deep breath through the mouth and exhale slowly
for 15 seconds
D. Contract the abdominal muscles, take a slow deep breath through the nose, and hold it for
3 to 5 seconds.

82. The client ask the nurse how much of is lungs are remove. The nurse responds based on
information that in lobectomy, a lobe is removed. In a wedge resection, which of the
following is removed?
A. A small, localized area near the surface of the lung
B. Segment of the lung, Including a bronchiole and its alveoli
C. Two lobes of the lung
D. One entire lung

83. The client ask the nurse, what will fill the space where the lobe was? The correct response
would be: the _____.
A. Lung space will be filled up with serous fluid.
B. Remaining lobe or lobes over expand to fill the space
C. Space stays empty
D. Surgeon filled the space gel.

84. On the second post operative day, the nurse auscultates the lung and determines scattered
crackles bilaterally. Which of the following interventions would be most appropriate for the
nurse to perform?
A. Encourage deep breathing and ambulation as soon as the client is able.
B. Encourage coughing and check the water seal system
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 C. Reduce the frequency of the pain medications and increased the suction in the water seal
bottle
D. Perform endotracheal suctioning every shift

85. The nurse teaches the client to perform which of the following exercises to prevent shoulder
ankylosis?
A. Raise and lower the head
B. Turn from side to side
C. Raised the arm on the affected side over the head
D. Flex and extend the elbow on the affected side.

Situation– A 51-year old man male is admitted for complaints of rectal bleeding, abdominal pain,
weight lost and change in bowel habits. Nurse Lawrence is aware that these are manifestation of
colon cancer. The physician prescribes radiation therapy and chemotherapy.

86. Nurse Lawrence knows that radiation therapy is used to treat colon cancer before surgery,
which of the following is the effect of radiation therapy is______
A. Helps heal the bowel after surgery C. Cures the cancer
B. Eliminates malignant cells D. Reduces the size of tumor

87. The patient undergoes radiation therapy. Therapy nurse Lawrence noted that the patient’s
white blood cell (WBC) count is severely depressed. The PRIORITY nursing intervention would
be to ______.
A. Place the patient in a private room and maintain strict aseptic technique for all
procedures.
B. Instruct the patient to avoid shaving with a sharp razor
C. Encourage visitors to visit the patient regularly to reduce the feelings of isolation the
patient may feel.
D. Encourage the patient to include fresh fruits and green leaf vegetables in his diet.

88. Nurse Lawrence is aware that chemotherapy should only be administering chemotherapy and who
are highly skilled. Before the nurse gives the prescribed dose of a chemotherapy agent, the
nurse should do which of the following:
A. Verify the dose, drug, and schedule with another trained nurse.
B. Collect an extra syringe and needle in case of contamination
C. Explain the expected side effects of the drug to the patient
D. Cover the patient with a water-resistant shield.

89. Nurse Lawrence assesses the patient receiving chemotherapy. Select the signs and symptoms
that would require further evaluation
A. Patient complains of fatigue
B. Hair loss on scalp
C. Large areas of ecchymosis in various sites on the body
D. Dry mucous membrane

90. Nurse Lawrence writes a care plan for the patient receiving chemotherapy. Select what should
be included in the care plan
1. Nursing diagnosis 4. Interventions
2. Medical diagnosis 5. Patient education
3. Outcomes 6. Evaluation

A. 1,2,3,4,5, C. 1,3,4,5,6,
B. 1,2,3,4,6 D. 2,3,4,5,6

Situation – Ms. Dong-a, 35 years old, and a mother of two sought consultation at the OPD. She claims
that she felt a lump on her breast while doing a self-breast examination. On further examination,
Nurse Atilde confirmed that the lump was felt in the upper outer quadrant of the right breast.

91. The nurse evaluates Ms. Dong-a for breast cancer. Which of the following is a risk factor for
developing breast cancer?
A. Using foam contraceptives
B. Early menarche before the age of 12
C. Having an early menopause before the age of 45
D. Giving birth to a first child before the age of 20

92. The nurse recalls that there are other known risk factors for breast cancer such as family
history, environmental and dietary factors. Which of the following is a BEST establish
dietary risk factor for breast cancer?
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 A. Fat-rich foods C. Carbonated drink consumption
B. Alcohol intake D. Caffeine consumption

93. The nurse is aware that for breast cancer patients, the single and MOST important predictor
of outcome is the _______:
A. Presence of mastitis and an infection process upon diagnosis
B. Presence of nipple discharge at the time of diagnosis
C. Histological status of the axillary nodes
D. Age of the patient

94. Ms. Dong -a appears to be worried and anxious. she asks the nurse what the doctor meant when
told that she has stage II cancer. The nurse explained that staging is based on the size of
the primary tumor. In stage II. The tumor is_______.
A. 3 cm in diameter and confined to the breast
B. Larger than 5 cm with involvement of the internal mammary lymph nodes
C. 2 cm or less in diameter and confined to the breast
D. Up to 5 cm, or early metastasis to axillary lymph nodes

95. Based on further assessment, biopsy results, Ms. Dong-a have to undergo mastectomy is the
treatment of choice when which of the following conditions apply?
1. Tumor involves the nipple-areola complex
2. Tumor is larger than 7 cm
3. Tumor exhibits extensive intraductal disease involving multiple quadrants of the breast
4. Patient cannot comply with daily radiation therapy

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

Situation– Nurse Dianne participates in a study the purpose of which is to determine the extent to
which gender, age, weight, and height predict selected physiologic outcomes, namely: forced
expiratory volume in one second, hemoglobin concentration, food intake serum glucose concentration,
total serum cholesterol concentration, and cancer-related weight change.

96. The independent variables of this study are the following, EXCEPT:
A. Height and weight C. Gender
B. Age D. Educational attainment

97. The dependent variables of this study are which of the following:
A. Cancer C. Amount of serum concentration
B. Physical characteristic D. Physiologic outcomes

98. Nurse Dianne formulates the problem statements for the study. she understands that a good
problem has which of the following characteristics: the problem________.
1. Clearly and unambiguously identifies the variables under consideration.
2. Clearly expresses the relationship of the variables to one another
3. Specifies the nature of the population being studied.
4. Implies the possibility of empirical testing.

A. 1, 3 and 4 C. All of the options

B. 1 and 3 D. 2 and 4

99. Nurse Dianne determines the participants in the study. The sample of the study will be every
5th person in the oncology unit. A table of random numbers will be used to select the
beginning of the sampling with in the first sampling interval. This is an example of which
sampling method?
A. Simple random sampling C. Stratified random sampling
B. Quota sampling D. Systematic sampling

100. Nurse Dianne plans to use method of data collection that uses technical instruments to
collect data about the client’s physical, chemical, microbiological and anatomical status.
Which of the following is a method appropriate for the study?
A. Psychological C. Instrumentation
B. Physiological D. Pharmacological

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