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pace. You can also copy this exam and make a print out.
Situation 1 Concerted work efforts among members of the surgical team is essential to the
success of the surgical procedure.
1. The sterile nurse or sterile personnel touch only sterile supplies and instruments.
When there is a need for sterile supply which is not in the sterile field, who hands out
these items by opening its outer cover?
a. Circulating nurse
b. Anesthesiologist
c. Surgeon
d. Nursing aide
2. The OR team performs distinct roles for one surgical procedure to be accomplished
within a prescribed time frame and deliver a standard patient outcome. While the
surgeon performs the surgical procedure, who monitors the status of the client like
urine output, blood loss?
a. Scrub nurse
b. Surgeon
c. Anesthesiologist
d. Circulating nurse
3. Surgery schedules are communicated to the OR usually a day prior to the procedure
by the nurse of the floor or ward where the patient is confined. For orthopedic cases,
what department is usually informed to be present in the OR?
a. Rehabilitation department
b. Laboratory department
c. Maintenance department
d. Radiology department
4. Minimally invasive surgery is very much into technology. Aside from the usual
surgical team who else to be present when a client undergoes laparoscopic surgery?
a. Information technician
b. Biomedical technician
c. Electrician
d. Laboratory technician
5. In massive blood loss, prompt replacement of compatible blood is crucial. What
department needs to be alerted to coordinate closely with the patients family for
immediate blood component therapy?
a. Security Division
b. Chaplaincy
11. The patients medical record can work as a double-edged swords. When can the
medical record become the doctors/nurse worst enemy?
a. When the record is voluminous
b. When a medical record is subpoenaed in court
c. When it is missing
d. When the medical record is inaccurate, incomplete, and inadequate
12. Disposal of medical records in government hospitals/institutions must be done in
close coordination with what agency?
a. Department of Interior and Local Government (DILG)
b. Metro Manila Development Authority (MMDA)
c. Records Management Archives Office (RMAO)
d. Depart of Health (DOH)
13. In the hospital, when you need-the medical record of a discharged patient for
research, you will request permission through:
a. Doctor in charge
b. The hospital director
c. The nursing Service
d. Medical records section
14. You readmitted a client who was in another department a month ago. Since you will
need the previous chart, from whom do you request the old chart?
a. Central supply section
b. Previous doctors clinic
c. Department where the patient was previously admitted
d. Medical records section
15. Records Management and Archives Offices of the DOH is responsible for
implementing its policies on record, disposal. You know that your institution is covered
by this policy it;
a. Your hospital is considered tertiary
b. Your hospital is in Metro Manila
c. It obtained permit to operate from DOH
d. Your hospital is Philhealth accredited
Situation 4 In the OR, there are safety protocols that should be followed. The OR nurse
should be well versed with all these to safeguard the safety and quality to patient delivery
outcome.
16. Which of the following should be given highest priority when receiving patient in the
OR?
a. Assess level of consciousness
b. Verify patient identification and informed consent
a. Put side rails up and ask client not to get out of bed
b. Send the client to ORD with the family
c. Allow client to get up to go to the comfort room
d. Obtain consent form
23. It is the responsibility of the pre-op, nurse to do skin prep for patients undergoing
surgery. If hair at the operative site is not shaved, what should be done to make
suturing easy and lessen chance of incision infection?
a. Draped
b. Pulled
c. Clipped
d. Shampooed
24. It is also the nurses function to determine when infection is developing in the
surgical incision. The perioperative nurse should observe for what signs of impending
infection?
a. Localized heat and redness
b. Serosanguinous exudates and skin blanching
c. Separation of the incision
d. Blood clots and scar tissue are visible
25. Which of the following nursing intervention is done when examining the incision
wound and changing the dressing?
a. Observe the dressing and type and odor of drainage if any
b. Get patients consent
c. Wash hands
d. Request the client to expose the incision wound
Situation 6 Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min
and he appears to be in acute respiratory distress.
26. Which of the following nursing actions should be initiated first?
a. Promote emotional support
b. Administer oxygen at 6L/min
c. Suction the client every 30 min
d. Administer bronchodilator by nebulizer
27. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse,
what its indication the nurse will say is:
a. Relax smooth muscles of the bronchial airway
b. Promote expectoration
c. Prevent thickening of secretions
d. Suppress cough
28. You will give health instructions to Carlo, a case of bronchial asthma. The health
instruction will include the following EXCEPT:
a. Avoid emotional stress and extreme temperature
b. Avoid pollution like smoking
c. Avoid pollens, dust seafood
d. Practice respiratory isolation
29. The asthmatic client asked you what breathing technique he can best practice when
asthmatic attack starts. What will be the best position?
a. Sit in high-Fowlers position with extended legs
b. Sit-up with shoulders back
c. Push on abdomen during exhalation
d. Lean forward 30-40 degrees with each exhalation
30. As a nurse you are always alerted to monitor status asthmaticus who will likely and
initially manifest symptoms of:
a. metabolic alkalosis
b. respiratory acidosis
c. respiratory alkalosis
d. metabolic acidosis
Situation 7 Joint Commission on Accreditation of Hospital Organization (JCAHO) patient
safety goals and requirements include the care and efficient use of technology in the OR arid
elsewhere in the healthcare facility.
31. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm
systems?
a. limit suppliers to a few so that quality is maintained
b. implement a regular inventory of supplies and equipment
c. Adherence to manufacturers recommendation
d. Implement a regular maintenance and testing of alarm systems
32. Over dosage of medication or anesthetic can happen even with the aid of technology
like infusion pump, sphygmomanometer, and similar devices/machines. As a staff, how
can you improve the safety of using infusion pumps?
a. Check the functionality of the pump before use
b. Select your brand of infusion pump like you do with your cellphone
C. Allow the technician to set the; infusion pump before use
d. Verify the flow rate against your computation
33. JCAHOs universal protocol for surgical and invasive procedures to prevent wrong
site, wrong person, and wrong procedures/surgery includes the following EXCEPT:
a. Mark the operative site if possible
b. Conduct pre-procedure verification process
a. Orderly/clerk
b. Nurse supervisor
c. Circulating nurse
d. Anaesthesiologist
40. The breakdown in teamwork is often times a failure in:
a. Electricity
b. Inadequate supply
c. Leg work
d. Communication
Situation 9 Colostomy is a surgically created anus- It can be temporary or permanent,
depending on the disease condition.
41. Skin care around the stoma is critical. Which of the following is not indicated as a
skin care barriers?
a. Apply liberal amount of mineral oil to the area
b. Use karaya paste and rings around the stoma
c. Clean the area daily with soap and water before applying bag
d. Apply talcum powder twice a day
42. What health instruction will enhance regulation of a colostomy (defecation) of
clients?
a. Irrigate after lunch everyday
b. Eat fruits and vegetables in all three meals
c. Eat balanced meals at regular intervals
d. Restrict exercise to walking only
43. After ileostomy, which of the following condition is NOT expected?
a. increased weight
b. Irritation of skin around the stoma
c. Liquid stool
d. Establishment of regular bowel movement
44. The following are appropriate nursing interventions during colostomy irrigation
EXCEPT:
a. Increase the irrigating solution flow rate when abdominal cramps is felt
b. Insert 2-4 inches of an adequately lubricated catheter to the stoma
c. Position client in semi-Fowler
d. Hand the solution 18 inches above the stoma
45. What sensation is used as a gauge so that patients with ileostomy can determine how
often their pouch should be drained?
a. Sensation of taste
b. Sensation of pressure
c. Sensation of smell
d. Urge to defecate
Situation 10 As a beginner in research, you are aware that sampling is an essential element
of the research process.
46. What does a sample group represent?
a. Control group
b. Study subjects
c. General population
d. Universe
47. What is the most important characteristics of a sample?
a. Randomization
b. Appropriate location
c. Appropriate number
d. Representativeness
48. Random sampling ensures that each subject has:
a. Been selected systematically
b. An equal chance of selection
c. Been selected based on set criteria
d. Characteristics that match other samples
49. Which of the following sampling methods allows the use of any group of research
subject?
a. Purposive
b. Convenience
c. Snow-bail
d. Quota
50. You decided to include 5 barangays in your municipality and chose a sampling
method that would get representative samples from each barangay. What should be the
appropriate method for you to use in this care?
a. Cluster sampling
b. Random sampling
c. Stratifies sampling
d. Systematic sampling
Situation 11 -After an abdominal surgery, the circulating and scrub nurses have critical
responsibility about sponge and Instrument count.
51. When is the first sponge/instrument count reported?
63. The client complained of abdominal and pain. Your nursing intervention that can
alleviate pain is:
a. Instruct client to go to sleep and relax
b. Advise the client to close the lips and avoid deep breathing and talking
c. Offer hot and clear soup
d. Turn to sides frequently and avoid too much talking
64. Surgical pain might be minimized by which nursing action in the OR:
a. Skill of surgical team and lesser manipulation
b. Appropriate preparation For the scheduled procedure
c. Use of modem technology in closing the wound
d. Proper positioning and draping of clients
65. One very common cause of postoperative pain is:
a. Forceful traction during surgery
b. Prolonged surgery
c. Break in aseptic technique
d. Inadequate anesthetic
Situation 14 You were on duty at the medical ward when Zeny came in for admission for
tiredness, cold intolerance, constipation, and weight gain. Upon examination, the doctors
diagnosis was hypothyroidism.
66. Your independent nursing care for hypothyroidism includes:
a. administer sedative round the clock
b. administer thyroid hormone replacement
c. providing a cool, quiet, and comfortable environment
d. encourage to drink 6-8 glasses of water
67. As the nurse, you should anticipate to administer which of the following medications
to Zeny who is diagnosed to be suffering from hypothyroidism?
a. Levothyroxine
b. Lidocaine
c. Lipitor
d. Levophed
68. Your appropriate nursing diagnosis for Zeny who is suffering from hypothyroidism
would probably include which of the following?
a. Activity intolerance related to tiredness associated with disorder
b. Risk to injury related to incomplete eyelid closure
c. Imbalance nutrition related to hypermetabolism
d. Deficient fluid volume related to diarrhea
69. Myxedema coma is a life threatening complication of long standing and untreated
hypothyroidism with one of the following characteristics.
a. Hyperglycemia
b. hypothermia
c. hyperthermia
d. hypoglycemia
70. As a nurse, you know that the most common type of goiter is related to a deficiency
a. thyroxine
b. thyrotropin
c. iron
d. iodine
Situation 15 Mrs. Pichay is admitted to your ward. The MD ordered Prepared for
thoracentesis this pm to remove excess air from the pleural cavity.
71. Which of the following nursing responsibility is essential in Mrs. Pichay who will
undergo thoracentesis?
a. Support, and reassure client during the procedure
b. Ensure that informed consent has been signed
c. Determine if client has allergic reaction to local anesthesia
d. Ascertain if chest x-rays and other tests have been prescribed and completed
72. Mrs. Pichay, who is for thoracentesis, is assisted by the nurse to any of the following
positions, EXCEPT:
a. straddling a chair with arms and head resting on the back of the chair
b. lying on the unaffected side with the bed elevated 30-40 degrees
c. lying prone with the head of the bed lowered 15-30 degrees
d. sitting on the edge of the bed with her feet supported and arms and head on a padded
overhead table
73. During thoracentesis, which of the following nursing intervention will be most
crucial?
a. Place patient in a quiet and cool room
b. Maintain strict aseptic technique
c. Advise patient to sit perfectly still during needle insertion until it has been withdrawn from
the chest
d. Apply pressure over the puncture site as soon as the needle is withdrawn
74. To prevent leakage of fluid in the thoracic cavity, how wilt you position the client
after thoracentesis?
a. Place flat in bed
b. Turn on the unaffected side
86. Which of the following action would be of highest priority with regards to the
external shunt?
a. Avoid taking BP or blood sample from the arm with shunt
b. Instruct the client not to exercise the arm with the shunt
c. Heparinize the shunt daily
d. Change dressing of the shunt daily
87. Diet therapy for Rudy, who has acute renal failure, is tow-protein, low potassium
and sodium. The nutrition instruction should include:
a. Recommend protein of high biologic value like eggs, poultry and lean meat
b. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
c. Allowing the client cheese, canned foods, and other processed food
d. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet
88. Rudy undergoes hemodialysis for the first time and was scared of disequilibrium
syndrome. He asked you how this can be prevented. Your response is:
a. maintain a conducive comfortable and cool environment
b. maintain fluid and electrolyte balance
c. initial hemodialysis shall be done for 30 minutes only so as not to rapidly remove the waste
from the blood than from the brain
d. maintain aseptic technique throughout the hemodialysis
89. You are assisted by a nursing aide with the care of the client with renal failure.
Which delegated function to the aide would you particularly check?
a. Monitoring and recording I and O
b. Checking bowel movement
c. Obtaining vital signs
d. Monitoring diet
90. A renal failure patient was ordered for creatinine clearance. As the nurse you will
collect
a. 48 hour urine specimen
b. first morning urine
c. 24 hour urine specimen
d. random urine specimen
Situation 19 Fe is experiencing left sharp pain and occasional hematuria. She was advised
to undergo IVP by her physician.
91. Fe was so anxious about the procedure and particularly expressed her low pain
threshold. Nursing health instruction will include:
a. assure the client that the pain is associated with the warm sensation during the
administration of the Hypaque by IV
b. assure the client that the procedure painless
Answers
Here are the answers for the exam. Unfortunately, rationales are not given. If you need
clarifications or disputes, please direct them to the comments section and well be glad to
give you an explanation.
1. A. Circulating Nurse
2. C. Anesthesiologist
3. D. Radiology department
4. B. Biomedical technician
5. C. Social Service Section
6. B. Left foot is cold to touch and pedal pulse is absent
7. C. At 11 pm
8. C. The client can distract himself during pain episodes