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SET A
c. c, d, e
d. all of the above
SITUATION: Please continue answering the following questions with your knowledge on alteration ins
endocrine and metabolism.
6. A client with type 1 diabetes is advised to undergo pancreas and islet cell transplantation.
Which of the following is the goal of this transplantation?
a. Cholesterol reduction
b. Muscle tone improvement
c. Blood circulation improvement
d. Administer insulin through IV route
7. Which of the following nursing actions helps the nurse to detect evidence of albuminuria when
caring for a client with diabetic neuropathy?
a. Check the urine with a test strip
b. Monitor blood glucose and haemoglobin A1c results
c. Check the postprandial glucose test results
d. Check the fasting blood glucose test results
8. A nurse is caring for a client whose blood glucose is 49 mg/dL. The client is lethargic but
arousable. Which of the following is the priority nursing action?
a. Re-check blood glucose in 15 min.
b. Give 7 g of protein.
c. Give 15 to 20 g of carbohydrates.
d. Report findings to the clients health care provider.
9. A clients blood glucose level is 257 mg/dL at 0800, and the health care providers prescription
for sliding scale insulin for this blood glucose result is 6 units of Regular insulin (Humulin R)
subcutaneously. This client also receives 12 units of insulin glargine (Lantus) subcutaneously
every morning. Which of the following methods should the nurse use to draw up and
administer the insulin?
a. In one insulin syringe, draw up 6 units of Regular insulin. In a separate insulin
syringe, draw up 12 units of insulin glargine and give two separate injections.
b. Draw up the Regular insulin first, and then draw up the insulin glargine in the same
syringe. Administer one injection that contains both insulins.
c. Draw up the insulin glargine first, and then draw up the Regular insulin in the same
syringe. Administer one injection that contains both insulins.
d. Give only the 6 units of Regular insulin as indicated on the sliding scale prescription.
10. When assessing the laboratory values of a client with type 2 diabetes, the nurse should
expect the results to reveal:
a. Ketones in the blood but not the urine
b. Glucose in the urine but not in the blood
c. Urine negative for ketones and glucose in the blood
d. Urine and blood positive for both glucose and ketones
SITUATION: The human body needs nourishment. Once it is obstructed, alteration in the bodys
normal function will crash and cause disability. The following questions will test your knowledge
related to alteration in nutrition and metabolic function.
11. What instruction should be given to a client scheduled for a gallbladder series test?
a. To remain on a low residue diet 1 to 2 days before the test
b. To take a laxative the evening before the test
c. Not to eat or drink until the test is complete
d. To take cleansing enemas the morning of the test
12. Which of the following diagnostic tests can be given to a client who cannot retain dye tablets
given to test his gallbladder?
a. Oral cholecystography
b. Cholangiography
c. Barium enema
d. Barium swallow
13. The nurse needs to promote easy passage of food to the stomach in an obese elderly client
with hiatal hernia. Which of the following nursing actions in the care plan would help the
client?
a. Encouraging frequent, small, well-balanced meals
22. Postoperatively, a client asks, Could i have a pillow under my knees? My legs feel stretched.
The nurse can best reinforce the preoperative teaching by responding:
a. Ill get pillows for you. I want you to be as rested as possible.
b. Its not a good idea, but you do look uncomfortable. Ill get one.
c. We dont allow pillows under the legs because you will get too warm.
d. A pillow under the knees can result in clot formation because it slows blood
flow.
23. The nurse teaches a client with exophthalmos how to reduce discomfort and prevent corneal
laceration. The nurse recognizes that the teaching is understood when the client states, I
should:
a. Eliminate excessive blinking.
b. Not move my extraocular muscles.
c. Elevate the head of my bed at night.
d. Avoid using a sleeping mask at night.
24. When teaching a client how to prevent constipation, the nurse identifies that the dietary
teaching is understood when the client states that the preferred breakfast cereal is:
a. Froot loops
b. Corn flakes
c. Capn crunch
d. Shredded wheat
25. A client has decided to become a vegan (total vegetarian) and wishes to plan a diet to ensure
adequate protein quality. To provide guidance, the nurse should instruct this client to:
a. Add milk to grains to provide complete proteins
b. Use eggs and plant foods o provide essential amino acids
c. Plan a careful mixture of plant proteins to provide a balance of amino acids
d. Add cheese to grains and beans to increase the quality of the protein consumed
SITUATION:Nurse Martha is aware of her ethical and legal responsibilities as a professional nurse.
She sees to it that she complies with the ethical principles in the care of her patients.
26. Which of the following principles apply to the action of the Martha to refrain from discussing
the disease condition of the patient with those who are not involved in his care?
a. Beneficence
b. Non-maleficencE
c. Justice
d. Autonomy
27. Mr. Garcia is diagnosed to have acute myocardial infarction and is recommended for
admission. He refuses to be admitted and asks to be transferred to a tertiary hospital instead.
Which of thE following principles should Martha use as guide for her action?
a. Autonomy
b. Justice
c. Non-maleficence
d. Beneficence
28. The present Code of Ethics Nurses in the Philippines was approved by the Board of Nursing
through:
a. BON Resolution No. 1955
b. BON Resolution No. 633
c. Bon Resolution No. 110
d. BON Resolution No. 220
29. When conflict arises regarding management of patient care, which of the following should be
upheld?
a. Physicians orders
b. Preference of the family
c. Patients rights
d. Institutional policy
30. Mr. Gibson, a British national, who is terminally ill, instructed the Martha to refrain from giving
him resuscitation in the event that he goes into cardiac arrest. Which of the following actions
of Martha is NOT within legal norms?
a. Prepare the form for advanced directives and ask Mr. Gibson to sign
b. Ask two other persons who are qualified to be witnesses of the signed directive
45. Julius orients his staff on the patterns of reporting relationship throughout the organization.
Which of the following principles refer to this?
a. Span of control
b. Hierarchy
c. Esprit d corps
d. Unity of direction
SITUATION: Documentation and reporting are just as important as providing patient care, As such,
the nurse must be factual and accurate to ensure quality documentation and reporting.
46. Health care reports have different purposes. The availability of patients record to all health
team members demonstrates which of the following purposes:
a. Legal documentation
b. Research
c. Education
d. Vehicle for communication
47. When a nurse commits medication error, she should accurately document clients response
and her corresponding action. This is very important for which of the following purposes:
a. Research
b. Legal documentation
c. Nursing Audit
d. Vehicle for communication
48. POMR has been widely used in many teaching hospitals. One of its unique features is
SOAPIE charting. The P in SOAPIE charting should include:
a. Prescription of the doctor to the patients illness
b. Plan of care for patient
c. Patients perception of ones illness
d. Nursing problem and Nursing diagnosis
49. The medical records that are organized into separate section from doctors or nurses has more
disadvantages than advantages. This is classified as what type of recording?
a. POMR
b. Modified POMR
c. SOAPIE
d. SOMR
50. Which of the following is the advantage of SOMR or Traditional recording?
a. Increases efficiency in data gathering
b. Reinforces the use of the nursing process
c. The caregiver can easily locate proper section for making charting entries
d. Enhances effective communication among health care team members
SITUATION Survey and Statistics are important part of research that is necessary to explain the
characteristics of the population.
51. According to the WHO statistics on the Homeless population around the world, which of the
following groups of people in the world disproportionately represents the homeless
population?
a. Hispanics
b. Asians
c. African Americans
d. Caucasians
52. Which of the following is not true about a Pure Experimental research?
a. There is a control group
b. There is an experimental group
c. Selection of subjects in the control group is randomized
d. There is a careful selection of subjects in the experimental group
53. The researcher implemented a medication regimen using a new type of combination drugs to
manic patients while another group of manic patient receives the routine drugs. The
researcher however handpicked the experimental group for they are the clients with multiple
episodes of bipolar disorder. The researcher utilized which research design?
a. Quasi-experimental
b. Phenomenological
c. Pure experimental
d. Longitudinal
54. You would like to compare the support system of patient with chronic illness to those with
acute illness. How will you best state your problem?
a. A descriptive study to compare the support system of patients with chronic illness and
those with acute illness in terms of demographic data and knowledge about
intervention.
b. The effects of the types of support system of patients with chronic illness and those
with acute illness.
c. A comparative analysis of the support system of patients with chronic illness and
those with acute illness.
d. What are the differences of the support system being received by patient with
chronic illness and patients with acute illness?
55. In the Hypothesis: The utilization of technology in teaching improves the retention and
attention of the nursing students. Which is the dependent variable?
a. Utilization of technology
b. Improvement in the retention and attention
c. Nursing students
d. Teaching
SITUATION: Joint Commission on Accreditation of Hospital Organization (JCAHP) patient safety
goals and requirements include the care and efficient use of technology in the OR arid elsewhere in
the healthcare facility.
56. 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 manufacturer's recommendation
d. Implement a regular maintenance and testing of alarm systems
57. Over dosage of medication or anesthetic can happen even with the aid of technology like
infusion pump, sphymomanometer, 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
58. 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
c. Take a video of the entire intra-operative procedure
d. Conduct time out immediately before starting the procedure
59. You identified a potential risk of pre and post operative clients. To reduce the risk of patient
harm resulting from fall, you can implement the following EXCEPT:
a. Assess potential risk of fail associated with the patient's medication regimen
b. Take action to address any identified risks through Incident Report (IR)
c. Allow client to walk with relative to the OR
d. Assess and periodically reassess individual client's risk for falling
60. As a nurse you know you can improve on accuracy of patient's identification by 2 patient
identifiers, EXCEPT:
a. identify the client by his/her wrist tag and verify with family members
b. identify client by his/her wrist tag and call his/her by name
c. call the client by his/her case and bed number
d. call the patient by his/her name and bed number
SITUATION: Communication is vital to provide knowledge to the patient and relay information to other
health care team.
1. 61.A client is on a ventilator. One of the nurses asks what should be done when condensation
resulting from humidity collects in the ventilator tubing. The best response to this question
would be:
a. Notify the respiratory therapist.
b. Empty the fluid from the tubing.
c. Decrease the amount of humidity.
d. Record the amount of fluid removed from the tubing.
2. 62.The nurse performs preoperative teaching related to subtotal thyroidectomy. The nurse
identifies that the client understands the teaching about the local effects of the administration
of a general anesthetic when the client states. Immediately after surgery I may experience:
a. Transient headaches.
b. Feelings of chilliness.
c. Paroxysmal hiccoughs.
d. Discomfort swallowing.
3. 63.During a health symposium, a nurse teaches the group how to prevent food poisoning. The
nurse evaluates that the teaching has been understood when one of the participants states:
a. Meats and cream based food need to be refrigerated.
b. Once most food is cooked it does not need to be refrigerated.
c. Poultry should be stuffed and then refrigerated before cooking.
d. Cooked food should be cooled before being put into the refrigerator.
4. 64.A client, who had hiatal hernia, is 5 feet 3 inches tall and weighs 140 pounds, asks the nurse
how to prevent esophageal reflux. The nurses best response would be:
a. Increase your intake of fat with each meal.
b. Lie down after eating to help your digestion.
c. Reduce your caloric intake to foster weight reduction.
d. Drink several glasses of fluid during each of your meals.
5. 65.A client with type 2 diabetes travels frequently and asks how to plan meals during trips. The
nurses most appropriate response would be to:
a. You can order diabetic foods on most airlines and in restaurants.
b. You should plan your food ahead and carry it with you from home.
c. Make regular food choices, wherever you are, following your food plan.
d. You can monitor your blood glucose level frequently and can eat accordingly.
SITUATION: Alexa Mika Lisa is taking care of clients with gastrointestinal, hepatobiliary and
endocrine problems..
1. 66.Ray was admitted to the ER 3 hours of vomiting after having been suspected of liver
cirrhosis . His respiratory rate is 4 and the ABG result shows the following: pH = 7.16; PCO2 =
70; HCO3= 22. You know that his ABG interpretation would be:
a. Fully compensatory metabolic acidosis
b. Uncompensated respiratory acidosis
c. Partially compensatory metabolic acidosis
d. Fully compensated respiratory acidosis
2. 67.Another patient was admitted to the hospital diarrhea due to ulcerative colitis with the
following ABG reading: pH = 7.35; PaO2 = 88; PaCO2 = 33 and HCO3 = 18. The ABG result
would be interpreted as:
a. Fully compensated Metabolic acidosis
b. Fully compensated Respiratory acidosis
c. Partially compensated Metabolic acidosis
d. Partially compensated Respiratory acidosis
3. 68.The nurse Lisa is aware that total parenteral nutrition is a more desirable therapy than
just intravenous fluids for clients with gastrointestinal problems. She understands that the
clients receiving only IV fluids lose weight because:
a. Lack of bulk in the diet
b. Deficient carbohydrate intake
c. Insufficient intake of water soluble vitamins
SITUATION: Alyssa, a newly graduate nurse is taking care of patients at the Oncology department.
Her knowledge on principles and care of patients with cancer is vital in this scenario.
1. 71.A male client with pancreatic cancer is aware of the terminal nature of the illness.
Behaviors that would indicate that he is accepting the fact of his impending death are:
a. Alternately crying and talking openly about death
b. Getting second, third, and fourth medical opinions
c. Making out his will and planning a visit to a good friend
d. Refusing to follow treatments and stating, Im going to die anyway.
2. 72.An older adult develops severe bone marrow depression from chemotherapy for cancer of
the colon. The nurse should:
a. Monitor for signs of alopecia
b. Increase daily intake of fluids
c. Monitor intake and output of fluids
d. Use a soft toothbrush for oral hygiene
3. 73.The laboratory results of a client following chemotherapy for cancer of the colon indicate
bone marrow depression. The nurse should encourage the client to:
a. Use an electric razor when shaving
b. Drink citrus juices frequently for nourishment
c. Increase activity levels and ambulate frequently
d. Sleep with the head of the bed slightly elevated
4. 74.A client has an abdomino-perineal resection to remove a cancerous lesion. After this
surgery the nurse should expect the client to have:
a. Temporary colostomy
b. Ileostomy
c. Permanent colostomy with rectal packing
d. Permanent colostomy only
5. 75.After a surgical procedure for Whipples procedure that included the removal of the
stomach, the head of the pancreas, the distal end of the duodenum, and the spleen, the
postoperative manifestation by the client that requires immediate attention by the nurse
should be:
a. Jaundice
b. Indigestion
c. Weight loss
d. Hyperglycemia
b. all except 4
d.
2 and 5 only
95. The first line of therapy for juvenile onset diabetes mellitus will be?
a. Insulin
b. OHA
c. Diet
d. All of the
above
c. 1, 2, 3, 4, 6
d. 1,2,3,5,6
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EXAMINATIONS-------------------------------------------X