PNLE Exam 1

1. A 10 year old who has sustained a head injury is brought to the emergency department by his mother.
A diagnosis of a mild concussion is made. At the time of discharge, Nurse Ron should instruct the mother
to:
A. Withhold food and fluids for 24 hours.
B. Allow him to play outdoors with his friends.
C. Arrange for a follow up visit with the child’s primary care provider in one week.
D. Check for any change in responsiveness every two hours until the follow-up visit.

2. A male client has suffered a motor accident and is now suffering from hypovolemic shock. Nurse
Helen should frequency assess the client’s vital signs during the compensatory stage of shock, because:
A. Arteriolar constriction occurs
B. The cardiac workload decreases
C. Decreased contractility of the heart occurs
D. The parasympathetic nervous system is triggered

3. A paranoid male client with schizophrenia is losing weight, reluctant to eat, and voicing concerns about
being poisoned. The best intervention by nurse Dina would be to:
A. Allow the client to open canned or pre-packaged food
B. Restrict the client to his room until 2 lbs are gained
C. Have a staff member personally taste all of the client’s food
D. Tell the client the food has been x-rayed by the staff and is safe

4. One day the mother of a young adult confides to nurse Frida that she is very troubled by he child’s
emotional illness. The nurse’s most therapeutic initial response would be:
A. “You may be able to lessen your feelings of guilt by seeking counseling”
B. “It would be helpful if you become involved in volunteer work at this time”
C. “I recognize it’s hard to deal with this, but try to remember that this too shall pass”
D. “Joining a support group of parents who are coping with this problem can be quite helpful.

5. To check for wound hemorrhage after a client has had a surgery for the removal of a tumor in the neck,
nurse grace should:
A. Loosen an edge of the dressing and lift it to see the wound
B. Observe the dressing at the back of the neck for the presence of blood
C. Outline the blood as it appears on the dressing to observe any progression
D. Press gently around the incision to express accumulated blood from the wound

6. A 16-year-old primigravida arrives at the labor and birthing unit in her 38th week of gestation and
states that she is labor. To verify that the client is in true labor nurse Trina should:
A. Obtain sides for a fern test
B. Time any uterine contractions
C. Prepare her for a pelvic examination
D. Apply nitrazine paper to moist vaginal tissue

7. As part of the diagnostic workup for pulmonic stenosis, a child has cardiac catheterization. Nurse Julius
is aware that children with pulmonic stenosis have increased pressure:
A. In the pulmonary vein
B. In the pulmonary artery
C. On the left side of the heart
D. On the right side of the heart
8. An obese client asks Nurse Julius how to lose weight. Before answering, the nurse should remember
that long-term weight loss occurs best when:
A. Eating patterns are altered
B. Fats are limited in the diet
C. Carbohydrates are regulated
D. Exercise is a major component

9. As a very anxious female client is talking to the nurse May, she starts crying. She appears to be upset
that she cannot control her crying. The most appropriate response by the nurse would be:
A. “Is talking about your problem upsetting you?”
B. “It is Ok to cry; I’ll just stay with you for now”
C. “You look upset; let’s talk about why you are crying.”
D. “Sometimes it helps to get it out of your system.”

10. A patient has partial-thickness burns to both legs and portions of his trunk. Which of the following
I.V. fluids is given first?
A. Albumin
B. D5W
C. Lactated Ringer’s solution
D. 0.9% sodium chloride solution with 2 mEq of potassium per 100 ml

11. During the first 48 hours after a severe burn of 40% of the clients body surface, the nurse’s
assessment should include observations for water intoxication. Associated adaptations include:
A. Sooty-colored sputum
B. Frothy pink-tinged sputum
C. Twitching and disorientation
D. Urine output below 30ml per hour

12. After a muscle biopsy, nurse Willy should teach the client to:
A. Change the dressing as needed
B. Resume the usual diet as soon as desired
C. Bathe or shower according to preference
D. Expect a rise in body temperature for 48 hours

13. Before a client whose left hand has been amputated can be fitted for a prosthesis, nurse Joy is aware
that:
A. Arm and shoulder muscles must be developed
B. Shrinkage of the residual limb must be completed
C. Dexterity in the other extremity must be achieved
D. Full adjustment to the altered body image must have occurred

14. Nurse Cathy applies a fetal monitor to the abdomen of a client in active labor. When the client has
contractions, the nurse notes a 15 beat per minute deceleration of the fetal heart rate below the baseline
lasting 15 seconds. Nurse Cathy should:
A. Change the maternal position
B. Prepare for an immediate birth
C. Call the physician immediately
D. Obtain the client’s blood pressure
15. A male client receiving prolonged steroid therapy complains of always being thirsty and urinating
frequently. The best initial action by the nurse would be to:
A. Perform a finger stick to test the client’s blood glucose level
B. Have the physician assess the client for an enlarged prostate
C. Obtain a urine specimen from the client for screening purposes
D. Assess the client’s lower extremities for the presence of pitting edema

16. Nurse Bea recognizes that a pacemaker is indicated when a client is experiencing:
A. Angina
B. Chest pain
C. Heart block
D. Tachycardia

17. When administering pancrelipase (Pancreases capsules) to child with cystic fibrosis, nurse Faith
knows they should be given:
A. With meals and snacks
B. Every three hours while awake
C. On awakening, following meals, and at bedtime
D. After each bowel movement and after postural draianage

18. A preterm neonate is receiving oxygen by an overhead hood. During the time the infant is under the
hood, it would be appropriate for nurse Gian to:
A. Hydrate the infant q15 min
B. Put a hat on the infant’s head
C. Keep the oxygen concentration consistent
D. Remove the infant q15 min for stimulation

19. A client’s sputum smears for acid fast bacilli (AFB) are positive, and transmission-based airborne
precautions are ordered. Nurse Kyle should instruct visitors to:
A. Limit contact with non-exposed family members
B. Avoid contact with any objects present in the client’s room
C. Wear an Ultra-Filter mask when they are in the client’s room
D. Put on a gown and gloves before going into the client’s room

20. A client with a head injury has a fixed, dilated right pupil; responds only to painful stimuli; and
exhibits decorticate posturing. Nurse Kate should recognize that these are signs of:
A. Meningeal irritation
B. Subdural hemorrhage
C. Medullary compression
D. Cerebral cortex compression

21. After a lateral crushing chest injury, obvious right-sided paradoxic motion of the client’s chest
demonstrates multiple rib fraactures, resulting in a flail chest. The complication the nurse should carefully
observe for would be:
A. Mediastinal shift
B. Tracheal laceration
C. Open pneumothorax
D. Pericardial tamponade
22. When planning care for a client at 30-weeks gestation, admitted to the hospital after vaginal bleeding
secondary to placenta previa, the nurse’s primary objective would be:
A. Provide a calm, quiet environment
B. Prepare the client for an immediate cesarean birth
C. Prevent situations that may stimulate the cervix or uterus
D. Ensure that the client has regular cervical examinations assess for labor

23. When planning discharge teaching for a young female client who has had a pneumothorax, it is
important that the nurse include the signs and symptoms of a pneumothorax and teach the client to seek
medical assistance if she experiences:
A. Substernal chest pain
B. Episodes of palpitation
C. Severe shortness of breath
D. Dizziness when standing up

24. After a laryngectomy, the most important equipment to place at the client’s bedside would be:
A. Suction equipment
B. Humidified oxygen
C. A nonelectric call bell
D. A cold-stream vaporizer

25. Nurse Oliver interviews a young female client with anorexia nervosa to obtain information for the
nursing history. The client’s history is likely to reveal a:
A. Strong desire to improve her body image
B. Close, supportive mother-daughter relationship
C. Satisfaction with and desire to maintain her present weight
D. Low level of achievement in school, with little concerns for grades

26. Nurse Bea should plan to assist a client with an obsessive-compulsive disorder to control the use of
ritualistic behavior by:
A. Providing repetitive activities that require little thought
B. Attempting to reduce or limit situations that increase anxiety
C. Getting the client involved with activities that will provide distraction
D. Suggesting that the client perform menial tasks to expiate feelings of guilt

27. A 2 ½ year old child undergoes a ventriculoperitoneal shunt revision. Before discharge, nurse John,
knowing the expected developmental behaviors for this age group, should tell the parents to call the
physician if the child:
A. Tries to copy all the father’s mannerisms
B. Talks incessantly regardless of the presence of others
C. Becomes fussy when frustrated and displays a shortened attention span
D. Frequently starts arguments with playmates by claiming all toys are “mine”

28. A urinary tract infection is a potential danger with an indwelling catheter. Nurse Gina can best plan to
avoid this complication by:
A. Assessing urine specific gravity
B. Maintaining the ordered hydration
C. Collecting a weekly urine specimen
D. Emptying the drainage bag frequently
29. A client has sustained a fractured right femur in a fall on stairs. Nurse Troy with the emergency
response team assess for signs of circulatory impairment by:
A. Turning the client to side lying position
B. Asking the client to cough and deep breathe
C. Taking the client’s pedal pulse in the affected limb
D. Instructing the client to wiggle the toes of the right foot

30. To assess orientation to place in a client suspected of having dementia of the alzheimers type, nurse
Chris should ask:
A. “Where are you?”
B. “Who brought you here?”
C. “Do you know where you are?”
D. “How long have you been there?”

31. Nurse Mary assesses a postpartum client who had an abruption placentae and suspects that
disseminated intravascular coagulation (DIC) is occurring when assessments demonstrate:
A. A boggy uterus
B. Multiple vaginal clots
C. Hypotension and tachycardia
D. Bleeding from the venipuncture site

32. When a client on labor experiences the urge to push a 9cm dilation, the breathing pattern that nurse
Rhea should instruct the client to use is the:
A. Expulsion pattern
B. Slow paced pattern
C. Shallow chest pattern
D. blowing pattern

33. Nurse Ronald should explain that the most beneficial between-meal snack for a client who is
recovering from the full-thickness burns would be a:
A. Cheeseburger and a malted
B. Piece of blueberry pie and milk
C. Bacon and tomato sandwich and tea
D. Chicken salad sandwich and soft drink

34. Nurse Wilma recognizes that failure of a newborn to make the appropriate adaptation to extrauterine
life would be indicated by:
A. flexed extremities
B. Cyanotic lips and face
C. A heart rate of 130 beats per minute
D. A respiratory rate of 40 breath per minute

35. The laboratory calls to state that a client’s lithium level is 1.9 mEq/L after 10 days of lithium therapy.
Nurse Reese should:
A. Notify the physician of the findings because the level is dangerously high
B. Monitor the client closely because the level of lithium in the blood is slightly elevated
C. Continue to administer the medication as ordered because the level is within the therapeutic range
D. Report the findings to the physician so the dosage can be increased because the level is below
therapeutic range
36. A client has a regular 30-day menstrual cycles. When teaching about the rhythm method, Wwhich the
client and her husband have chosen to use for family planning, Nurse Dianne should emphasize that the
client’s most fertile days are:
A. Days 9 to 11
B. Days 12 to 14
C. Days 15 to 17
D. Days 18 to 20

37. Before an amniocentesis, Nurse Alexandra should:

A. Initiate the intravenous therapy as ordered by the physiscian
B. Inform the client that the procedure could precipitate an infection
C. Assure that informed consent has been obtained from the client
D. Perform a vaginal examination on the client to assess cervical dilation

38. While a client is on intravenous magnesium sulfate therapy for preeclampsia, it is essential for nurse
Amy to monitor the client’s deep tendon reflexes to:
A. Determine her level of consciousness
B. Evaluate the mobility of the extremities
C. Determine her response to painful stimuli
D. Prevent development of respiratory distress

39. A preschooler is admitted to the hospital with a diagnosis of acute glomerulonephritis. The child’s
history reveals a 5-pound weight gain in one week and peritoneal edema. For the most accurate
information on the status of the child’s edema, nursing intervention should include:
A. Obtaining the child’s daily weight
B. Doing a visual inspection of the child
C. Measuring the child’s intake and output
D. Monitoring the child’s electrolyte values

40. Nurse Mickey is administering dexamethasome (Decadron) for the early management of a client’s
cerebral edema. This treatment is effective because:
A. Acts as hyperosmotic diuretic
B. Increases tissue resistance to infection
C. Reduces the inflammatory response of tissues
D. Decreases the information of cerebrospinal fluid

41. During newborn nursing assessment, a positive Ortolani’s sign would be indicated by:
A. A unilateral droop of hip
B. A broadening of the perineum
C. An apparent shortening of one leg
D. An audible click on hip manipulation

42. When caring for a dying client who is in the denial stage of grief, the best nursing approach would be
to:
A. Agree and encourage the client’s denial
B. Allow the denial but be available to discuss death
C. Reassure the client that everything will be OK
D. Leave the client alone to confront the feelings of impending loss
43. To decrease the symptoms of gastroesophageal reflux disease (GERD), the physician orders dietary
and medication management. Nurse Helen should teach the client that the meal alteration that would be
most appropriate would be:
A. Ingest foods while they are hot
B. Divide food into four to six meals a day
C. Eat the last of three meals daily by 8pm
D. Suck a peppermint candy after each meal

44. After a mastectomy or hysterectomy, clients may feel incomplete as women. The statement that
should alert Nurse Gina to this feeling would be:
A. “I can’t wait to see all my friends again”
B. “I feel washed out; there isn’t much left”
C. “I can’t wait to get home to see my grandchild”
D. “My husband plans for me to recuperate at our daughter’s home”

45. A client with obstruction of the common bile duct may show a prolonged bleeding and clotting time
because:
A. Vitamin K is not absorbed
B. The ionized calcium levels falls
C. The extrinsic factor is not absorbed
D. Bilirubin accumulates in the plasma

46. Realizing that the hypokalemia is a side effect of steroid therapy, nurse Monette should monitor a
client taking steroid medication for:
A. Hyperactive reflexes
B. An increased pulse rate
C. Nausea, vomiting, and diarrhea
D. Leg weakness with muscle cramps

47. When assessing a newborn suspected of having Down syndrome, nurse Rey would expect to observe:
A. long thin fingers
B. Large, protruding ears
C. Hypertonic neck muscles
D. Simian lines on the hands

48. A 10 year old girl is admitted to the pediatric unit for recurrent pain and swelling of her joints,
particularly her knees and ankles. Her diagnosis is juvenile rheumatoid arthritis. Nurse Janah recognizes
that besides joint inflammation, a unique manifestation of the rheumatoid process involves the:
A. Ears
B. Eyes
C. Liver
D. Brain

49. A disturbed client is scheduled to begin group therapy. The client refuses to attend. Nurse Lolit
should:
A. Accept the client’s decision without discussion
B. Have another client to ask the client to consider
C. Tell the client that attendance at the meeting is required
D. Insist that the client join the group to help the socialization process
50. Because a severely depressed client has not responded to any of the antidepressant medications, the
psychiatrist decides to try electroconvulsive therapy (ECT). Before the treatment the nurse should:
A. Have the client speak with other clients receiving ECT
B. Give the client a detailed explanation of the entire procedure
C. Limit the client’s intake to a light breakfast on the days of the treatment
D. Provide a simple explanation of the procedure and continue to reassure the client

51. Nurse Vicky is aware that teaching about colostomy care is understood when the client states, “I will
contact my physician and report ____”:
A. If I notice a loss of sensation to touch in the stoma tissue”
B. When mucus is passed from the stoma between irrigations”
C. The expulsion of flatus while the irrigating fluid is running out”
D. If I have difficulty in inserting the irrigating tube into the stoma”

52. The client’s history that alerts Nurse Henry to assess closely for signs of postpartum infection would
be:
A. Three spontaneous abortions
B. negative maternal blood type
C. Blood loss of 850 ml after a vaginal birth
D. Maternal temperature of 99.9° F 12 hours after delivery

53. A client is experiencing stomatitis as a result of chemotherapy. An appropriate nursing intervention

related to this condition would be to:
A. Provide frequent saline mouthwashes
B. Use karaya powder to decrease irritation
C. Increase fluid intake to compensate for the diarrhea
D. Provide meticulous skin care of the abdomen with Betadine

54. During a group therapy session, one of the clients ask a male client with the diagnosis of antisocial
personality disorder why he is in the hospital. Considering this client’s type of personality disorder, the
nurse might expect him to respond:
A. “I need a lot of help with my troubles”
B. “Society makes people react in old ways”
C. “I decided that it’s time I own up to my problems”
D. “My life needs straightening out and this might help”

55. A child visits the clinic for a 6-week checkup after a tonsillectomy and adenoidectomy. In addition to
assessing hearing, the nurse should include an assessment of the child’s:
A. Taste and smell
B. Taste and speech
C. Swallowing and smell
D. Swallowing and speech

56. A client is diagnosed with cancer of the jaw. A course of radiation therapy is to be followed by
surgery. The client is concerned about the side effects related to the radiation treaments. Nurse Ria should
explain that the major side effects that will experienced is:
A. Fatigue
B. Alopecia
C. Vomiting
D. Leucopenia
57. Nurse Katrina prepares an older-adult client for sleep, actions are taken to help reduce the likelihood
of a fall during the night. Targeting the most frequent cause of falls, the nurse should:
A. Offer the client assistance to the bathroom
B. Move the bedside table closer to the client’s bed
C. Encourage the client to take an available sedative
D. Assist the client to telephone the spouse to say “goodnight”

58. When evaluating a growth and development of a 6 month old infant, nurse Patty would expect the
infant to be able to:
A. Sit alone, display pincer grasp, wave bye bye
B. Pull self to a standing position, release a toy by choice, play peek-a-boo
C. Crawl, transfer toy from one hand to the other, display of fear of strangers
D. Turn completely over, sit momentarily without support, reach to be picked up

59. A breastfeeding mother asks the nurse what she can do to ease the discomfort caused by a cracked
nipple. Nurse Tina should instruct the client to:
A. Manually express milk and feed it to the baby in a bottle
B. Stop breastfeeding for two days to allow the nipple to heal
C. Use a breast shield to keep the baby from direct contact with the nipple
D. Feed the baby on the unaffected breast first until the affected breast heals

60. Nurse Sandy observes that there is blood coming from the client’s ear after head injury. Nurse Sandy
should:
A. Turn the client to the unaffected side
B. Cleanse the client’s ear with sterile gauze
C. Test the drainage from the client’s ear with Dextrostix
D. Place sterile cotton loosely in the external ear of the client

61. Nurse Gio plans a long term care for parents of children with sickle-cell anemia, which includes
periodic group conferences. Some of the discussions should be directed towards:
A. Finding special school facilities for the child
B. Making plans for moving to a more therapeutic climate
C. Choosing a means of birth control to avoid future pregnancies
D. Airing their feelings regarding the transmission of the disease to the child

62. The central problem the nurse might face with a disturbed schizophrenic client is the client’s:
A. Suspicious feelings
B. Continuous pacing
C. Relationship with the family
D. Concern about working with others

63. When planning care with a client during the postoperative recovery period following an abdominal
hysterectomy and bilateral salpingo-oophorectomy, nurse Frida should include the explanation that:
A. Surgical menopause will occur
B. Urinary retention is a common problem
C. Weight gain is expected, and dietary plan are needed
D. Depression is normal and should be expected
64. An adolescent client with anorexia nervosa refuses to eat, stating, “I’ll get too fat.” Nurse Andrea can
best respond to this behavior initially by:
A. Not talking about the fact that the client is not eating
B. Stopping all of the client’s priviledges until food is eaten
C. Telling the client that tube feeding will eventually be necessary
D. Pointing out to the client that death can occur with malnutrition.

65. A pain scale is used to assess the degree of pain. The client rates the pain as an 8 on a scale of 10
before medication and a 7 on a scale of 10 after being medicated. Nurse Glenda determines that the:
A. Client has a low pain tolerance
B. Medication is not adequately effective
C. Medication has sufficiently decreased the pain level
D. Client needs more education about the use of the pain scale

66. To enhance a neonate’s behavioral development, therapeutic nursing measures should include:
A. Keeping the baby awake for longer periods of time before each feeding
B. Assisting the parents to stimulate their baby through touch, sound, and sight.
C. Encouraging parental contact for at least one 15-minute period every four hours.
D. Touching and talking to the baby at least hourly, beginning within two to four hours after birth

67. Before formulating a plan of care for a 6 year old boy with attention deficit hyperactivity disorder
(ADHD), nurse Kyla is aware that the initial aim of therapy is to help the client to:
A. Develop language skills
B. Avoid his own regressive behavior
C. Mainstream into a regular class in school
D. Recognize himself as an independent person of worth

68. Nurse Wally knows that the most important aspect of the preoperative care for a child with Wilms’
tumor would be:
A. Checking the size of the child’s liver
B. Monitoring the child’s blood pressure
C. Maintaining the child in a prone position
D. Collecting the child’s urine for culture and sensitivity

69. At 11:00 pm the count of hydrocodone (Vicodin) is incorrect. After several minutes of searching the
medication cart and medication administration records, no explanation can be found. The primary nurse
should notify the:
A. Nursing unit manager
B. Hospital administrator
C. Quality control manager
D. Physician ordering the medication

70. When caring for a client with a pneumothorax, who has a chest tube in place, Nurse Kate should plan
to:
A. Administer cough suppressants at appropriate intervals as ordered
B. Empty and measure the drainage in the collection chamber each shift
C. Apply clamps below the insertion site when ever getting the client out of bed
D. Encourage coughing, deep breathing, and range of motion to the arm on the affected side
71. According to C.E.Winslow, which of the following is the goal of Public Health?
A. For people to attain their birthrights of health and longevity
B. For promotion of health and prevention of disease
C. For people to have access to basic health services
D. For people to be organized in their health efforts

72. What other statistic may be used to determine attainment of longevity?

A. Age-specific mortality rate
B. Proportionate mortality rate
C. Swaroop’s index
D. Case fatality rate

73. Which of the following is the most prominent feature of public health nursing?
A. It involves providing home care to sick people who are not confined in the hospital
B. Services are provided free of charge to people within the catchment area.
C. The public health nurse functions as part of a team providing a public health nursing services.
D. Public health nursing focuses on preventive, not curative, services.

74. Which of the following is the mission of the Department of Health?

A. Health for all Filipinos
B. Ensure the accessibility and quality of health care
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020

75. Nurse Pauline determines whether resources were maximized in implementing Ligtas Tigdas, she is
evaluating:
A. Effectiveness
B. Efficiency
C. Adequacy
D. Appropriateness

76. Lissa is a B.S.N. graduate. She want to become a Public Health Nurse. Where will she apply?
A. Department of Health
B. Provincial Health Office
C. Regional Health Office
D. Rural Health Unit

77. As an epidemiologist, Nurse Celeste is responsible for reporting cases of notifiable diseases. What law
mandates reporting of cases of notifiable diseases?
A. Act 3573
B. R.A. 3753
C. R.A. 1054
D. R.A. 1082

78. Nurse Fay is aware that isolation of a child with measles belongs to what level of prevention?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
79. Nurse Gina is aware that the following is an advantage of a home visit?
A. It allows the nurse to provide nursing care to a greater number of people.
B. It provides an opportunity to do first hand appraisal of the home situation.
C. It allows sharing of experiences among people with similar health problems.
D. It develops the family’s initiative in providing for health needs of its members.

80. The PHN bag is an important tool in providing nursing care during a home visit. The most important
principle of bag technique states that it:
A. Should save time and effort.
B. Should minimize if not totally prevent the spread of infection.
C. Should not overshadow concern for the patient and his family.
D. May be done in a variety of ways depending on the home situation, etc.

81. Nurse Willy reads about Path Goal theory. Which of the following behaviors is manifested by the
leader who uses this theory?
A. Recognizes staff for going beyond expectations by giving them citations
B. Challenges the staff to take individual accountability for their own practice
C. Admonishes staff for being laggards
D. Reminds staff about the sanctions for non-performance

82. Nurse Cathy learns that some leaders are transactional leaders. Which of the following does NOT
characterize a transactional leader?
A. Focuses on management tasks
B. Is a caretaker
C. Uses trade-offs to meet goals
D. Inspires others with vision

83. Functional nursing has some advantages, which one is an EXCEPTION?

A. Psychological and sociological needs are emphasized.
B. Great control of work activities.
C. Most economical way of delivering nursing services.
D. Workers feel secure in dependent role

84. Which of the following is the best guarantee that the patient’s priority needs are met?
A. Checking with the relative of the patient
B. Preparing a nursing care plan in collaboration with the patient
C. Consulting with the physician
D. Coordinating with other members of the team

85. Nurse Tony stresses the need for all the employees to follow orders and instructions from him and not
from anyone else. Which of the following principles does he refer to?
A. Scalar chain
B. Discipline
C. Unity of command
D. Order

86. Nurse Joey discusses the goal of the department. Which of the following statements is a goal?
A. Increase the patient satisfaction rate
B. Eliminate the incidence of delayed administration of medications
C. Establish rapport with patients
D. Reduce response time to two minutes
87. Nurse Lou considers shifting to transformational leadership. Which of the following statements best
describes this type of leadership?
A. Uses visioning as the essence of leadership
B. Serves the followers rather than being served
C. Maintains full trust and confidence in the subordinates
D. Possesses innate charisma that makes others feel good in his presence.

88. Nurse Mae tells one of the staff, “I don’t have time to discuss the matter with you now. See me in my
office later” when the latter asks if they can talk about an issue. Which of the following conflict resolution
strategies did she use?
A. Smoothing
B. Compromise
C. Avoidance
D. Restriction

89. Nurse Bea plans of assigning competent people to fill the roles designed in the hierarchy. Which
process refers to this?
A. Staffing
B. Scheduling
C. Recruitment
D. Induction

90. Nurse Linda tries to design an organizational structure that allows communication to flow in all
directions and involve workers in decision making. Which form of organizational structure is this?
A. Centralized
B. Decentralized
C. Matrix
D. Informal

91. When documenting information in a client’s medical record, the nurse should:
A. erase any errors.
B. use a #2 pencil.
C. leave one line blank before each new entry.
D. end each entry with the nurse’s signature and title.

92. Which of the following factors are major components of a client’s general background drug history?
A. Allergies and socioeconomic status
B. Urine output and allergies
C. Gastric reflex and age
D. Bowel habits and allergies
93. Which procedure or practice requires surgical asepsis?
A. Hand washing
B. Nasogastric tube irrigation
C. I.V. cannula insertion
D. Colostomy irrigation
94. The nurse is performing wound care using surgical asepsis. Which of the following practices violates
surgical asepsis?
A. Holding sterile objects above the waist
B. Pouring solution onto a sterile field cloth
C. Considering a 1″ (2.5-cm) edge around the sterile field contaminated
D. Opening the outermost flap of a sterile package away from the body
95. On admission, a client has the following arterial blood gas (ABG) values: PaO2, 50 mm Hg; PaCO2,
70 mm Hg; pH, 7.20; HCO3–, 28 mEq/L. Based on these values,
the nurse should formulate which nursing diagnosis for this client?
A. Risk for deficient fluid volume
B. Deficient fluid volume
C. Impaired gas exchange
D. Metabolic acidosis

96. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis

97. In Integrated Management of Childhood Illness, severe conditions generally require urgent referral to
a hospital. Which of the following severe conditions DOES NOT always require urgent referral to a
hospital?
A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease

98. A mother brought her daughter, 4 years old, to the RHU because of cough and colds. Following the
IMCI assessment guide, which of the following is a danger sign that indicates the need for urgent referral
to a hospital?
A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days

99. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. R.A. 8976
mandates fortification of certain food items. Which of the following is among these food items?
A. Sugar
B. Bread
C. Margarine
D. Filled milk

100. The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac
Answers and Rationales: PNLE Exam 1
1. C. Check for any change in responsiveness every two hours until the follow-up visit. Signs of an
epidural hematoma in children usually do not appear for 24 hours or more hours; a follow-up visit
usually is arranged for one to two days after the injury.
2. A. Arteriolar constriction occurs.The early compensation of shock is cardiovascular and is seen in
changes in pulse, BP, and pulse pressure; blood is shunted to vital centers, particularly heart and
brain.
3. A. Allow the client to open canned or pre-packaged food. The client’s comfort, safety, and
nutritional status are the priorities; the client may feel comfortable to eat if the food has been sealed
before reaching the mental health facility.
4. D. “Joining a support group of parents who are coping with this problem can be quite
helpful. Taking with others in similar circumstances provides support and allows for sharing of
experiences.
5. B. Observe the dressing at the back of the neck for the presence of blood. Drainage flows by gravity.
6. C. Prepare her for a pelvic examination. Pelvic examination would reveal dilation and effacement
7. D. On the right side of the heart. Pulmonic stenosis increases resistance to blood flow, causing right
ventricular hyperthropy; with right ventricular failure there is an increase in pressure on the right
side of the heart.
8. A. Eating patterns are altered. A new dietary regimen, with a balance of foods from the food
pyramid, must be established and continued for weight reduction to occur and be maintained.
9. B. “It is Ok to cry; I’ll just stay with you for now”. This portrays a nonjudgmental attitude that
recognizes the client’s needs.
10. C. Lactated Ringer’s solution. Lactated Ringer’s solution replaces lost sodium and corrects
metabolic acidosis, both of which commonly occur following a burn. Albumin is used as adjunct
therapy, not primary fluid replacement. Dextrose isn’t given to burn patients during the first 24 hours
because it can cause pseudodiabetes. The patient is hyperkalemic from the potassium shift from the
intracellular space to the plasma, so potassium would be detrimental.
11. C. Twitching and disorientation. Excess extracellular fluid moves into cells (water intoxication);
intracellular fluid excess in sensitive brain cells causes altered mental status; other signs include
anorexia nervosa, nausea, vomiting, twitching, sleepiness, and convulsions.
12. B. Resume the usual diet as soon as desired. As long as the client has no nausea or vomiting, there
are no dietary restriction.
13. B. Shrinkage of the residual limb must be completed. Shrinkage of the residual limb, resulting from
reduction of subcutaneous fat and interstitial fluid, must occur for an adequate fit between the limb
and the prosthesis.
14. A. Change the maternal position. Stimulation of the sympathetic nervous system is an initial
response to mild hypoxia that accompanies partial cord compression (umbilical vein) during
contractions; changing the maternal position can alleviate the compression.
15. A. Perform a finger stick to test the client’s blood glucose level. The client has signs of diabetes,
which may result from steroid therapy, testing the blood glucose level is a method of screening for
diabetes, thus gathering more data.
16. C. Heart block. This is the primary indication for a pacemaker because there is an interfere with the
electrical conduction system of the heart.
17. A. With meals and snacks. Pancreases capsules must be taken with food and snacks because it acts
on the nutrients and readies them for absorption.
18. B. Put a hat on the infant’s head. Oxygen has cooling effect, and the baby should be kept warm so
that metabolic activity and oxygen demands are not increased.
19. C. Wear an Ultra-Filter mask when they are in the client’s room. Tubercle bacilli are transmitted
through air currents; therefore personal protective equipment such as an Ultra-Filter mask is
necessary.
20. D. Cerebral cortex compression. Cerebral compression affects pyramidal tracts, resulting in
decorticate rigidity and cranial nerve injury, which cause pupil dilation.
21. A.Mediastinal shift. Mediastinal structures move toward the uninjured lung, reducing oxygenation
and venous return.
22. C. Prevent situations that may stimulate the cervix or uterus. Stimulation of the cervix or uterus may
cause bleeding or hemorrhage and should be avoided.
23. C. Severe shortness of breath. This could indicate a recurrence of the pneumothorax as one side of
the lung is inadequate to meet the oxygen demands of the body.
24. A. Suction equipment. Respiratory complications can occur because of edema of the glottis or injury
to the recurrent laryngeal nerve.
25. A. Strong desire to improve her body image. Clients with anorexia nervosa have a disturbed self
image and always see themselves as fat and needing further reducing.
26. B. Attempting to reduce or limit situations that increase anxiety. Persons with high anxiety levels
develop various behaviors to relieve their anxiety; by reducing anxiety, the need for these obsessive-
compulsive action is reduced.
27. C. Becomes fussy when frustrated and displays a shortened attention span. Shortened attention span
and fussy behavior may indicate a change in intracranial pressure and/or shunt malfunction.
28. B. Maintaining the ordered hydration. Promoting hydration maintains urine production at a higher
rate, which flushes the bladder and prevents urinary stasis and possible infection.
29. C. Taking the client’s pedal pulse in the affected limb. Monitoring a pedal pulse will assess
circulation to the foot.
30. A. “Where are you?”. “Where are you?” is the best question to elicit information about the client’s
orientation to place because it encourages a response that can be assessed.
31. D. Bleeding from the venipuncture site. This indicates a fibrinogenemia; massive clotting in the area
of the separation has resulted in a lowered circulating fibrinogen.
32. D. blowing pattern. Clients should use a blowing pattern to overcome the premature urge to push.
33. A. Cheeseburger and a malted. Of the selections offered, this is the highest in calories and protein,
which are needed for increased basal metabolic rate and for tissue repair.
34. B. Cyanotic lips and face. Central cyanosis (blue lips and face) indicates lowered oxygenation of the
blood, caused by either decreased lung expansion or right to left shunting of blood.
35. A. Notify the physician of the findings because the level is dangerously high. Levels close to 2
mEq/L are dangerously close to the toxic level; immediate action must be taken.
36. C. Days 15 to 17. Ovulation occurs approximately 14 days before the next menses, about the 16th
day in 30 day cycle; the 15th to 17th days would be the best time to avoid sexual intercourse.
37. C. Assure that informed consent has been obtained from the client. An invasive procedure such as
amniocentesis requires informed consent.
38. D. Prevent development of respiratory distress. Respiratory distress or arrest may occur when the
serum level of magnesium sulfate reaches 12 to 15 mg/dl; deep tendon reflexes disappear when the
serum level is 10 to 12 mg/dl; the drug is withheld in the absence of deep tendon reflexes; the
therapeutic serum level is 5 to 8 mg/dl.
39. A. Obtaining the child’s daily weight. Weight monitoring is the most useful means of assessing fluid
balance and changes in the edematous state; 1 liter of fluid weighs about 2.2 pounds.
40. C. Reduces the inflammatory response of tissues. Corticosteroids act to decrease inflammation
which decreases edema.
41. D. An audible click on hip manipulation. With specific manipulation, an audible click may be heard
of felt as he femoral head slips into the acetabulum.
42. B. Allow the denial but be available to discuss death. This does not remove client’s only way of
coping, and it permits future movement through the grieving process when the client is ready.
43. B. Divide food into four to six meals a day. The volume of food in the stomach should be kept small
to limit pressure on the cardiac sphincter.
44. B. “I feel washed out; there isn’t much left”. The client’s statement infers an emptiness with an
associated loss.
45. A. Vitamin K is not absorbed. Vitamin K, a fat soluble vitamin, is not absorbed from the GI tract in
the absence of bile; bile enters the duodenum via the common bile duct.
46. D. Leg weakness with muscle cramps. Impulse conduction of skeletal muscle is impaired with
decreased potassium levels, muscular weakness and cramps may occur with hypokalemia.
47. D. Simian lines on the hands. This is characteristic finding in newborns with Down syndrome.
48. B. Eyes. Rheumatoid arthritis can cause inflammation of the iris and ciliary body of the eyes which
may lead to blindness.
49. A. Accept the client’s decision without discussion. This is all the nurse can do until trust is
established; facing the client to attend will disrupt the group.
50. D. Provide a simple explanation of the procedure and continue to reassure the client. The nurse
should offer support and use clear, simple terms to allay client’s anxiety.
51. D. If I have difficulty in inserting the irrigating tube into the stoma”. This occurs with stenosis of the
stoma; forcing insertion of the tube could cause injury.
52. C. Blood loss of 850 ml after a vaginal birth. Excessive blood loss predisposes the client to an
increased risk of infection because of decreased maternal resistance; they expected blood loss is 350
to 500 ml.
53. A. Provide frequent saline mouthwashes. This is soothing to the oral mucosa and helps prevent
infection.
54. B. “Society makes people react in old ways”. The client is incapable of accepting responsibility for
self-created problems and blames society for the behavior.
55. A. Taste and smell. Swelling can obstruct nasal breathing, interfering with the senses of taste and
smell.
56. A. Fatigue. Fatigue is a major problem caused by an increase in waste products because of catabolic
processes.
57. A. Offer the client assistance to the bathroom. Statistics indicate that the most frequent cause of falls
by hospitalized clients is getting up or attempting to get up to the bathroom unassisted.
58. D. Turn completely over, sit momentarily without support, reach to be picked up. These abilities are
age-appropriate for the 6 month old child.
59. D. Feed the baby on the unaffected breast first until the affected breast heals. The most vigorous
sucking will occur during the first few minutes of breastfeeding when the infant would be on the
unaffected breast; later suckling is less traumatic.
60. D. Place sterile cotton loosely in the external ear of the client. This would absorb the drainage
without causing further trauma.
61. D. Airing their feelings regarding the transmission of the disease to the child. Discussion with
parents who have children with similar problems helps to reduce some of their discomfort and guilt.
62. A. Suspicious feelings. The nurse must deal with these feelings and establish basic trust to promote a
therapeutic milieu.
63. A. Surgical menopause will occur. When a bilateral oophorectomy is performed, both ovaries are
excised, eliminating ovarian hormones and initiating response.
64. D. Pointing out to the client that death can occur with malnutrition. The client expects the nurse to
focus on eating, but the emphasis should be placed on feelings rather than actions.
65. B. Medication is not adequately effective. The expected effect should be more than a one point
decrease in the pain level.
66. B. Assisting the parents to stimulate their baby through touch, sound, and sight. Stimuli are provided
via all the senses; since the infant’s behavioral development is enhanced through parent-infant
interactions, these interactions should be encouraged.
67. D. Recognize himself as an independent person of worth. Academic deficits, an inability to function
within constraints required of certain settings, and negative peer attitudes often lead to low self-
esteem.
68. B. Monitoring the child’s blood pressure. Because the tumor is of renal origin, the rennin
angiotensin mechanism can be involved, and blood pressure monitoring is important.
69. A. Nursing unit manager. Controlled substance issues for a particular nursing unit are the
responsibility of that unit’s nurse manager.
70. D. Encourage coughing, deep breathing, and range of motion to the arm on the affected side. All
these interventions promote aeration of the re-expanding lung and maintenance of function in the
arm and shoulder on the affected side.
71. A. For people to attain their birthrights of health and longevity. According to Winslow, all public
health efforts are for people to realize their birthrights of health and longevity.
72. C. Swaroop’s index. Swaroop’s index is the percentage of the deaths aged 50 years or older. Its
inverse represents the percentage of untimely deaths (those who died younger than 50 years).
73. D. Public health nursing focuses on preventive, not curative, services.. The catchment area in PHN
consists of a residential community, many of whom are well individuals who have greater need for
preventive rather than curative services.
74. B. Ensure the accessibility and quality of health care. Ensuring the accessibility and quality of health
care is the primary mission of DOH.
75. B. Efficiency. Efficiency is determining whether the goals were attained at the least possible cost.
76. D. Rural Health Unit. R.A. 7160 devolved basic health services to local government units (LGU’s ).
The public health nurse is an employee of the LGU.
77. A. Act 3573. Act 3573, the Law on Reporting of Communicable Diseases, enacted in 1929,
mandated the reporting of diseases listed in the law to the nearest health station.
78. A. Primary. The purpose of isolating a client with a communicable disease is to protect those who
are not sick (specific disease prevention).
79. B. It provides an opportunity to do first hand appraisal of the home situation. Choice A is not correct
since a home visit requires that the nurse spend so much time with the family. Choice C is an
advantage of a group conference, while choice D is true of a clinic consultation.
80. B. Should minimize if not totally prevent the spread of infection. Bag technique is performed before
and after handling a client in the home to prevent transmission of infection to and from the client.
81. A. Recognizes staff for going beyond expectations by giving them citations. Path Goal theory
according to House and associates rewards good performance so that others would do the same.
82. D. Inspires others with vision. Inspires others with a vision is characteristic of a transformational
leader. He is focused more on the day-to-day operations of the department/unit.
83. A. Psychological and sociological needs are emphasized. When the functional method is used, the
psychological and sociological needs of the patients are neglected; the patients are regarded as ‘tasks
to be done”
84. B. Preparing a nursing care plan in collaboration with the patient. The best source of information
about the priority needs of the patient is the patient himself. Hence using a nursing care plan based
on his expressed priority needs would ensure meeting his needs effectively.
85. C. Unity of command. The principle of unity of command means that employees should receive
orders coming from only one manager and not from two managers. This averts the possibility of
sowing confusion among the members of the organization.
86. A. Increase the patient satisfaction rate. Goal is a desired result towards which efforts are directed.
Options AB, C and D are all objectives which are aimed at specific end.
87. A. Uses visioning as the essence of leadership. Transformational leadership relies heavily on
visioning as the core of leadership.
88. C. Avoidance. This strategy shuns discussing the issue head-on and prefers to postpone it to a later
time. In effect the problem remains unsolved and both parties are in a lose-lose situation.
89. A. Staffing. Staffing is a management function involving putting the best people to accomplish tasks
and activities to attain the goals of the organization.
90. B. Decentralized. Decentralized structures allow the staff to make decisions on matters pertaining to
their practice and communicate in downward, upward, lateral and diagonal flow.
91. D. end each entry with the nurse’s signature and title. The end of each entry should include the
nurse’s signature and title; the signature holds the nurse accountable for the recorded information.
Erasing errors in documentation on a legal document such as a client’s chart isn’t permitted by law.
Because a client’s medical record is considered a legal document, the nurse should make all entries
in ink. The nurse is accountable for the information recorded and therefore shouldn’t leave any blank
lines in which another health care worker could make additions.
92. A. Allergies and socioeconomic status. General background data consist of such components as
allergies, medical history, habits, socioeconomic status, lifestyle, beliefs, and sensory deficits. Urine
output, gastric reflex, and bowel habits are significant only if a disease affecting these functions is
present.
93. C. I.V. cannula insertion. Caregivers must use surgical asepsis when performing wound care or any
procedure in which a sterile body cavity is entered or skin integrity is broken. To achieve surgical
asepsis, objects must be rendered or kept free of all pathogens. Inserting an I.V. cannula requires
surgical asepsis because it disrupts skin integrity and involves entry into a sterile cavity (a vein). The
other options are used to ensure medical asepsis or clean technique to prevent the spread of
infection. The GI tract isn’t sterile; therefore, irrigating a nasogastric tube or a colostomy requires
only clean technique.
94. B. Pouring solution onto a sterile field cloth. Pouring solution onto a sterile field cloth violates
surgical asepsis because moisture penetrating the cloth can carry microorganisms to the sterile field
via capillary action. The other options are practices that help ensure surgical asepsis.
95. C. Impaired gas exchange. The client has a below-normal value for the partial pressure of arterial
oxygen (PaO2) and an above-normal value for the partial pressure of arterial carbon dioxide
(PaCO2), supporting the nursing diagnosis of Impaired gas exchange. ABG values can’t indicate a
diagnosis of Fluid volume deficit (or excess) or Risk for deficient fluid volume. Metabolic acidosis
is a medical, not nursing, diagnosis; in any event, these ABG values indicate respiratory, not
metabolic, acidosis.
96. A. Stream seeding. Stream seeding is done by putting tilapia fry in streams or other bodies of water
identified as breeding places of the Anopheles mosquito.
97. B. Severe dehydration. The order of priority in the management of severe dehydration is as follows:
intravenous fluid therapy, referral to a facility where IV fluids can be initiated within 30 minutes,
Oresol/nasogastric tube, Oresol/orem. When the foregoing measures are not possible or effective,
tehn urgent referral to the hospital is done.
98. A. Inability to drink. A sick child aged 2 months to 5 years must be referred urgently to a hospital if
he/she has one or more of the following signs: not able to feed or drink, vomits everything,
convulsions, abnormally sleepy or difficult to awaken.
99. A. Sugar. R.A. 8976 mandates fortification of rice, wheat flour, sugar and cooking oil with Vitamin
A, iron and/or iodine.
100. A. Palms. The anatomic characteristics of the palms allow a reliable and convenient basis for
examination for pallor.
PNLE Exam 2
1. A woman in a child bearing age receives a rubella vaccination. Nurse Joy would give her which of the
following instructions?
A. Refrain from eating eggs or egg products for 24 hours
B. Avoid having sexual intercourse
C. Don’t get pregnant at least 3 months
D. Avoid exposure to sun

2. Jonas who is diagnosed with encephalitis is under the treatment of Mannitol. Which of the following
patient outcomes indicate to Nurse Ronald that the treatment of Mannitol has been effective for a patient
that has increased intracranial pressure?
A. Increased urinary output
B. Decreased RR
C. Slowed papillary response
D. Decreased level of consciousness

3. Mary asked Nurse Maureen about the incubation period of rabies. Which statement by the Nurse
Maureen is appropriate?
A. Incubation period is 6 months
B. Incubation period is 1 week
C. Incubation period is 1 month
D. Incubation period varies depending on the site of the bite

4. Which of the following should Nurse Cherry do first in taking care of a male client with rabies?
A. Encourage the patient to take a bath
B. Cover IV bottle with brown paper bag
C. Place the patient near the comfort room
D. Place the patient near the door

5. Which of the following is the screening test for dengue hemorrhagic fever?
A. Complete blood count
B. ELISA
C. Rumpel-leede test
D. Sedimentation rate

6. Mr. Dela Rosa is suspected to have malaria after a business trip in Palawan. The most important
diagnostic test in malaria is:
A. WBC count
B. Urinalysis
C. ELISA
D. Peripheral blood smear

7. The Nurse supervisor is planning for patient’s assignment for the AM shift. The nurse supervisor
avoids assigning which of the following staff members to a client with herpes zoster?
A. Nurse who never had chicken pox
B. Nurse who never had roseola
C. Nurse who never had german measles
D. Nurse who never had mumps
8. Clarissa is 7 weeks pregnant. Further examination revealed that she is susceptible to rubella. When
would be the most appropriate for her to receive rubella immunization?
A. At once
B. During 2nd trimester
C. During 3rd trimester
D. After the delivery of the baby

9. A female child with rubella should be isolated from a:

A. 21 year old male cousin living in the same house
B. 18 year old sister who recently got married
C. 11 year old sister who had rubeola during childhood
D. 4 year old girl who lives next door

10. What is the primary prevention of leprosy?

A. Nutrition
B. Vitamins
C. BCG vaccination
D. DPT vaccination

11. A bacteria which causes diphtheria is also known as?

A. Amoeba
B. Cholera
C. Klebs-loeffler bacillus
D. Spirochete

12. Nurse Ron performed mantoux skin test today (Monday) to a male adult client. Which statement by
the client indicates that he understood the instruction well?
A. I will come back later
B. I will come back next month
C. I will come back on Friday
D. I will come back on Wednesday, same time, to read the result

13. A male client had undergone Mantoux skin test. Nurse Ronald notes an 8mm area of indurations at the
site of the skin test. The nurse interprets the result as:
A. Negative
B. Uncertain and needs to be repeated
C. Positive
D. Inconclusive

14. Tony will start a 6 month therapy with Isoniazid (INH). Nurse Trish plans to teach the client to:
A. Use alcohol moderately
B. Avoid vitamin supplements while o therapy
C. Incomplete intake of dairy products
D. May be discontinued if symptoms subsides

15. Which is the primary characteristic lesion of syphilis?

A. Sore eyes
B. Sore throat
C. Chancroid
D. Chancre
16. What is the fast breathing of Jana who is 3 weeks old?
A. 60 breaths per minute
B. 40 breaths per minute
C. 10 breaths per minute
D. 20 breaths per minute

17. Which of the following signs and symptoms indicate some dehydration?
A. Drinks eagerly
B. Restless and irritable
C. Unconscious
D. A and B

18. What is the first line for dysentery?

A. Amoxicillin
B. Tetracycline
C. Cefalexin
D. Cotrimoxazole

19. In home made oresol, what is the ratio of salt and sugar if you want to prepare with 1 liter of water?
A. 1 tbsp. salt and 8 tbsp. sugar
B. 1 tbsp. salt and 8 tsp. sugar
C. 1 tsp. salt and 8 tsp. sugar
D. 8 tsp. salt and 8 tsp. sugar

20. Gentian Violet is used for:

A. Wound
B. Umbilical infections
C. Ear infections
D. Burn

21. Which of the following is a live attenuated bacterial vaccine?

A. BCG
B. OPV
C. Measles
D. None of the above

22. EPI is based on?

A. Basic health services
B. Scope of community affected
C. Epidemiological situation
D. Research studies
23. TT? Provides how many percentage of protection against tetanus?
A. 100
B. 99
C. 80
D. 90
24. Temperature of refrigerator to maintain potency of measles and OPV vaccine is:
A. -3c to -8c
B. -15c to -25c
C. +15c to +25c
D. +3c to +8c
25. Diptheria is a:
A. Bacterial toxin
B. Killed bacteria
C. Live attenuated
D. Plasma derivatives

26. Budgeting is under in which part of management process?

A. Directing
B. Controlling
C. Organizing
D. Planning

27. Time table showing planned work days and shifts of nursing personnel is:
A. Staffing
B. Schedule
C. Scheduling
D. Planning

28. A force within an individual that influences the strength of behavior?

A. Motivation
B. Envy
C. Reward
D. Self-esteem

29. “To be the leading hospital in the Philippines” is best illustrate in:
A. Mission
B. Philosophy
C. Vision
D. Objective

30. It is the professionally desired norms against which a staff performance will be compared?
A. Job descriptions
B. Survey
C. Flow chart
D. Standards

31. Reprimanding a staff nurse for work that is done incorrectly is an example of what type of
reinforcement?
A. Feedback
B. Positive reinforcement
C. Performance appraisal
D. Negative reinforcement

32. Questions that are answerable only by choosing an option from a set of given alternatives are known
as?
A. Survey
B. Close ended
C. Questionnaire
D. Demographic
33. A researcher that makes a generalization based on observations of an individuals behavior is said to be
which type of reasoning:
A. Inductive
B. Logical
C. Illogical
D. Deductive

34. The balance of a research’s benefit vs. its risks to the subject is:
A. Analysis
B. Risk-benefit ratio
C. Percentile
D. Maximum risk

35. An individual/object that belongs to a general population is a/an:

A. Element
B. Subject
C. Respondent
D. Author

36. An illustration that shows how the members of an organization are connected:
A. Flowchart
B. Bar graph
C. Organizational chart
D. Line graph

37. The first college of nursing that was established in the Philippines is:
A. Fatima University
B. Far Eastern University
C. University of the East
D. University of Sto. Tomas

38. Florence nightingale is born on:

A. France
B. Britain
C. U.S
D. Italy

39. Objective data is also called:

A. Covert
B. Overt
C. Inference
D. Evaluation

40. An example of subjective data is:

A. Size of wounds
B. VS
C. Lethargy
D. The statement of patient “My hand is painful”
41. What is the best position in palpating the breast?
A. Trendelenburg
B. Side lying
C. Supine
D. Lithotomy

42. When is the best time in performing breast self-examination?

A. 7 days after menstrual period
B. 7 days before menstrual period
C. 5 days after menstrual period
D. 5 days before menstrual period

43. Which of the following should be given the highest priority before performing physical examination
to a patient?
A. Preparation of the room
B. Preparation of the patient
C. Preparation of the nurse
D. Preparation of environment

44. It is a flip over card usually kept in portable file at nursing station.
A. Nursing care plan
B. Medicine and treatment record
C. Kardex
D. TPR sheet

45. Jose has undergone thoracentesis. The nurse in charge is aware that the best position for Jose is:
A. Semi fowlers
B. Low fowlers
C. Side lying, unaffected side
D. Side lying, affected side

46. The degree of patient’s abdominal distension may be determined by:

A. Auscultation
B. Palpation
C. Inspection
D. Percussion

47. A male client is addicted with hallucinogen. Which physiologic effect should the nurse expect?
A. Bradyprea
B. Bradycardia
C. Constricted pupils
D. Dilated pupils

48. Tristan a 4 year old boy has suffered from full thickness burns of the face, chest and neck. What will
be the priority nursing diagnosis?
A. Ineffective airway clearance related to edema
B. Impaired mobility related to pain
C. Impaired urinary elimination related to fluid loss
D. Risk for infection related to epidermal disruption
49. In assessing a client’s incision 1 day after the surgery, Nurse Betty expect to see which of the
following as signs of a local inflammatory response?
A. Greenish discharge
B. Brown exudates at incision edges
C. Pallor around sutures
D. Redness and warmth

50. Nurse Ronald is aware that the amiotic fluid in the third trimester weighs approximately:
A. 2 kilograms
B. 1 kilograms
C. 100 grams
D. 1.5 kilograms

51. After delivery of a baby girl. Nurse Gina examines the umbilical cord and expects to find a cord to:
A. Two arteries and two veins
B. One artery and one vein
C. Two arteries and one vein
D. One artery and two veins

52. Myrna a pregnant client reports that her last menstrual cycle is July 11, her expected date of birth is
A. November 4
B. November 11
C. April 4
D. April 18

53. Which of the following is not a good source of iron?

A. Butter
B. Pechay
C. Grains
D. Beef

54. Maureen is admitted with a diagnosis of ectopic pregnancy. Which of the following would you
anticipate?
A. NPO
B. Bed rest
C. Immediate surgery
D. Enema

55. Gina a postpartum client is diagnosed with endometritis. Which position would you expect to place
her based on this diagnosis?
A. Supine
B. Left side lying
C. Trendelinburg
D. Semi-fowlers

56. Nurse Hazel knows that Myrna understands her condition well when she remarks that urinary
frequency is caused by:
A. Pressure caused by the ascending uterus
B. Water intake of 3L a day
C. Effect of cold weather
D. Increase intake of fruits and vegetables
57. How many ml of blood is loss during the first 24 hours post-delivery of Myrna?
A. 100
B. 500
C. 200
D. 400

58. Which of the following hormones stimulates the secretion of milk?

A. Progesterone
B. Prolactin
C. Oxytocin
D. Estrogen

59. Nurse Carla is aware that Myla’s second stage of labor is beginning when the following assessment is
noted:
A. Bay of water is broken
B. Contractions are regular
C. Cervix is completely dilated
D. Presence of bloody show

60. The leaking fluid is tested with nitrazine paper. Nurse Kelly confirms that the client’s membrane have
ruptures when the paper turns into a:
A. Pink
B. Violet
C. Green
D. Blue

61. After amniotomy, the priority nursing action is:

A. Document the color and consistency of amniotic fluid
B. Listen the fetal heart tone
C. Position the mother in her left side
D. Let the mother rest

62. Which is the most frequent reason for postpartum hemorrhage?

A. Perineal lacerations
B. Frequent internal examination (IE)
C. CS
D. Uterine atomy

63. On 2nd postpartum day, which height would you expect to find the fundus in a woman who has had a
caesarian birth?
A. 1 finger above umbilicus
B. 2 fingers above umbilicus
C. 2 fingers below umbilicus
D. 1 finger below umbilicus

64. Which of the following criteria allows Nurse Kris to perform home deliveries?
A. Normal findings during assessment
B. Previous CS
C. Diabetes history
D. Hypertensive history
65. Nurse Carla is aware that one of the following vaccines is done by intramuscular (IM) injection?
A. Measles
B. OPV
C. BCG
D. Tetanus toxoid

66. Asin law is on which legal basis:

A. RA 8860
B. RA 2777
C. RI 8172
D. RR 6610

67. Nurse John is aware that the herbal medicine appropriate for urolithiasis is:
A. Akapulco
B. Sambong
C. Tsaang gubat
D. Bayabas

68. Community/Public health bag is defined as:

A. An essential and indispensable equipment of the community health nurse during home visit
B. It contains drugs and equipment used by the community health nurse
C. Is a requirement in the health center and for home visit
D. It is a tool used by the community health nurse in rendering effective procedures during home visit

69. TT4 provides how many percentage of protection against tetanus?

A. 70
B. 80
C. 90
D. 99

70. Third postpartum visit must be done by public health nurse:

A. Within 24 hours after delivery
B. After 2-4 weeks
C. Within 1 week
D. After 2 months

71. Nurse Candy is aware that the family planning method that may give 98% protection to another
pregnancy to women
A. Pills
B. Tubal ligation
C. Lactational Amenorrhea method (LAM)
D. IUD

72. Which of the following is not a part of IMCI case management process
A. Counsel the mother
B. Identify the illness
C. Assess the child
D. Treat the child
73. If a young child has pneumonia when should the mother bring him back for follow up?
A. After 2 days
B. In the afternoon
C. After 4 days
D. After 5 days

74. It is the certification recognition program that develop and promotes standard for health facilities:
A. Formula
B. Tutok gamutan
C. Sentrong program movement
D. Sentrong sigla movement

75. Baby Marie was born May 23, 1984. Nurse John will expect finger thumb opposition on:
A. April 1985
B. February 1985
C. March 1985
D. June 1985

76. Baby Reese is a 12 month old child. Nurse Oliver would anticipate how many teeth?
A. 9
B. 7
C. 8
D. 6

77. Which of the following is the primary antidote for Tylenol poisoning?
A. Narcan
B. Digoxin
C. Acetylcysteine
D. Flumazenil

78. A male child has an intelligence quotient of approximately 40. Which kind of environment and
interdisciplinary program most likely to benefit this child would be best described as:
A. Habit training
B. Sheltered workshop
C. Custodial
D. Educational

79. Nurse Judy is aware that following condition would reflect presence of congenital G.I anomaly?
A. Cord prolapse
B. Polyhydramios
C. Placenta previa
D. Oligohydramios

80. Nurse Christine provides health teaching for the parents of a child diagnosed with celiac disease.
Nurse Christine teaches the parents to include which of the following food items in the child’s diet:
A. Rye toast
B. Oatmeal
C. White bread
D. Rice
81. Nurse Randy is planning to administer oral medication to a 3 year old child. Nurse Randy is aware
that the best way to proceed is by:
A. “Would you like to drink your medicine?”
B. “If you take your medicine now, I’ll give you lollipop”
C. “See the other boy took his medicine? Now it’s your turn.”
D. “Here’s your medicine. Would you like a mango or orange juice?”

82. At what age a child can brush her teeth without help?
A. 6 years
B. 7 years
C. 5 years
D. 8 years

83. Ribivarin (Virazole) is prescribed for a female hospitalized child with RSV. Nurse Judy prepare this
medication via which route?
A. Intra venous
B. Oral
C. Oxygen tent
D. Subcutaneous

84. The present chairman of the Board of Nursing in the Philippines is:
A. Maria Joanna Cervantes
B. Carmencita Abaquin
C. Leonor Rosero
D. Primitiva Paquic

85. The obligation to maintain efficient ethical standards in the practice of nursing belong to this body:
A. BON
B. ANSAP
C. PNA
D. RN

86. A male nurse was found guilty of negligence. His license was revoked. Re-issuance of revoked
certificates is after how many years?
A. 1 year
B. 2 years
C. 3 years
D. 4 years

87. Which of the following information cannot be seen in the PRC identification card?
A. Registration Date
B. License Number
C. Date of Application
D. Signature of PRC chairperson

88. Breastfeeding is being enforced by milk code or:

A. EO 51
B. R.A. 7600
C. R.A. 6700
D. P.D. 996
89. Self governance, ability to choose or carry out decision without undue pressure or coercion from
anyone:
A. Veracity
B. Autonomy
C. Fidelity
D. Beneficence

90. A male patient complained because his scheduled surgery was cancelled because of earthquake. The
hospital personnel may be excused because of:
A. Governance
B. Respondent superior
C. Force majeure
D. Res ipsa loquitor

91. Being on time, meeting deadlines and completing all scheduled duties is what virtue?
A. Fidelity
B. Autonomy
C. Veracity
D. Confidentiality

92. This quality is being demonstrated by Nurse Ron who raises the side rails of a confused and
disoriented patient?
A. Responsibility
B. Resourcefulness
C. Autonomy
D. Prudence

93. Which of the following is formal continuing education?

A. Conference
B. Enrollment in graduate school
C. Refresher course
D. Seminar

94. The BSN curriculum prepares the graduates to become?

A. Nurse generalist
B. Nurse specialist
C. Primary health nurse
D. Clinical instructor

95. Disposal of medical records in government hospital/institutions must be done in close coordination
with what agency?
A. Department of Health
B. Records Management Archives Office
C. Metro Manila Development Authority
D. Bureau of Internal Revenue

96. Nurse Jolina must see to it that the written consent of mentally ill patients must be taken from:
A. Nurse
B. Priest
C. Family lawyer
D. Parents/legal guardians
97. When Nurse Clarence respects the client’s self-disclosure, this is a gauge for the nurses’
A. Respectfulness
B. Loyalty
C. Trustworthiness
D. Professionalism

98. The Nurse is aware that the following tasks can be safely delegated by the nurse to a non-nurse health
worker except:
A. Taking vital signs
B. Change IV infusions
C. Transferring the client from bed to chair
D. Irrigation of NGT

99. During the evening round Nurse Tina saw Mr. Toralba meditating and afterwards started singing
prayerful hymns. What would be the best response of Nurse Tina?
A. Call the attention of the client and encourage to sleep
B. Report the incidence to head nurse
C. Respect the client’s action
D. Document the situation

100. In caring for a dying client, you should perform which of the following activities
A. Do not resuscitate
B. Assist client to perform ADL
C. Encourage to exercise
D. Assist client towards a peaceful death

101. The Nurse is aware that the ability to enter into the life of another person and perceive his current
feelings and their meaning is known:
A. Belongingness
B. Genuineness
C. Empathy
D. Respect

102. The termination phase of the NPR is best described one of the following:
A. Review progress of therapy and attainment of goals
B. Exploring the client’s thoughts, feelings and concerns
C. Identifying and solving patients problem
D. Establishing rapport

103. During the process of cocaine withdrawal, the physician orders which of the following:
A. Haloperidol (Haldol)
B. Imipramine (Tofranil)
C. Benztropine (Cogentin)
D. Diazepam (Valium)

104. The nurse is aware that cocaine is classified as:

A. Hallucinogen
B. Psycho stimulant
C. Anxiolytic
D. Narcotic
105. In community health nursing, it is the most important risk factor in the development of mental
illness?
A. Separation of parents
B. Political problems
C. Poverty
D. Sexual abuse

106. All of the following are characteristics of crisis except

A. The client may become resistive and active in stopping the crisis
B. It is self-limiting for 4-6 weeks
C. It is unique in every individual
D. It may also affect the family of the client

107. Freud states that temper tantrums is observed in which of the following:
A. Oral
B. Anal
C. Phallic
D. Latency

108. The nurse is aware that ego development begins during:

A. Toddler period
B. Preschool age
C. School age
D. Infancy

109. Situation: A 19 year old nursing student has lost 36 lbs for 4 weeks. Her parents brought her to the
hospital for medical evaluation. The diagnosis was ANOREXIA NERVOSA. The Primary gain of a client
with anorexia nervosa is:
A. Weight loss
B. Weight gain
C. Reduce anxiety
D. Attractive appearance

110. The nurse is aware that the primary nursing diagnosis for the client is:
A. Altered nutrition : less than body requirement
B. Altered nutrition : more than body requirement
C. Impaired tissue integrity
D. Risk for malnutrition

111. After 14 days in the hospital, which finding indicates that her condition in improving?
A. She tells the nurse that she had no idea that she is thin
B. She arrives earlier than scheduled time of group therapy
C. She tells the nurse that she eat 3 times or more in a day
D. She gained 4 lbs in two weeks

112. The nurse is aware that ataractics or psychic energizers are also known as:
A. Anti-manic
B. Anti-depressants
C. Antipsychotics
D. Anti-anxiety
113. Known as mood elevators:
A. Anti-depressants
B. Antipsychotics
C. Anti-manic
D. Anti-anxiety

114. The priority of care for a client with Alzheimer’s disease is

A. Help client develop coping mechanism
B. Encourage to learn new hobbies and interest
C. Provide him stimulating environment
D. Simplify the environment to eliminate the need to make chores

115. Autism is diagnosed at:

A. Infancy
B. 3 years old
C. 5 years old
D. School age

116. The common characteristic of autism child is:

A. Impulsitivity
B. Self-destructiveness
C. Hostility
D. Withdrawal

117. The nurse is aware that the most common indication in using ECT is:
A. Schizophrenia
B. Bipolar
C. Anorexia Nervosa
D. Depression

118. A therapy that focuses on here and now principle to promote self-acceptance?
A. Gestalt therapy
B. Cognitive therapy
C. Behavior therapy
D. Personality therapy

119. A client has many irrational thoughts. The goal of therapy is to change her:
A. Personality
B. Communication
C. Behavior
D. Cognition
120. The appropriate nutrition for Bipolar I disorder, in manic phase is:
A. Low fat, low sodium
B. Low calorie, high fat
C. Finger foods, high in calorie
D. Small frequent feedings
121. Which of the following activity would be best for a depressed client?
A. Chess
B. Basketball
C. Swimming
D. Finger painting
122. The nurse is aware that clients with severe depression, possess which defense mechanism:
A. Introjection
B. Suppression
C. Repression
D. Projection

123. Nurse John is aware that self-mutilation among Bipolar disorder patients is a means of:
A. Overcoming fear of failure
B. Overcoming feeling of insecurity
C. Relieving depression
D. Relieving anxiety

124. Which of the following may cause an increase in the cystitis symptoms?
A. Water
B. Orange juice
C. Coffee
D. Mango juice

125. In caring for clients with renal calculi, which is the priority nursing intervention?
A. Record vital signs
B. Strain urine
C. Limit fluids
D. Administer analgesics as prescribed

126. In patient with renal failure, the diet should be:

A. Low protein, low sodium, low potassium
B. Low protein, high potassium
C. High carbohydrate, low protein
D. High calcium, high protein

127. Which of the following cannot be corrected by dialysis?

A. Hypernatremia
B. Hyperkalemia
C. Elevated creatinine
D. Decreased hemoglobin

128. Tony with infection is receiving antibiotic therapy. Later the client complaints of ringing in the ears.
This ototoxicity is damage to:
A. 4th CN
B. 8th CN
C. 7th CN
D. 9th CN

129. Nurse Emma provides teaching to a patient with recurrent urinary tract infection includes the
following:
A. Increase intake of tea, coffee and colas
B. Void every 6 hours per day
C. Void immediately after intercourse
D. Take tub bath everyday
130. Which assessment finding indicates circulatory constriction in a male client with a newly applied
long leg cast?
A. Blanching or cyanosis of legs
B. Complaints of pressure or tightness
C. Inability to move toes
D. Numbness of toes

131. During acute gout attack, the nurse administer which of the following drug:
A. Prednisone (Deltasone)
B. Colchicines
C. Aspirin
D. Allopurinol (Zyloprim)

132. Information in the patients chart is inadmissible in court as evidence when:

A. The client objects to its use
B. Handwriting is not legible
C. It has too many unofficial abbreviations
D. The clients parents refuses to use it

133. Nurse Karen is revising a client plan of care. During which step of the nursing process does such
revision take place?
A. Planning
B. Implementation
C. Diagnosing
D. Evaluation

134. When examining a client with abdominal pain, Nurse Hazel should assess:
A. Symptomatic quadrant either second or first
B. The symptomatic quadrant last
C. The symptomatic quadrant first
D. Any quadrant

135. How long will Nurse John obtain an accurate reading of temperature via oral route?
A. 3 minutes
B. 1 minute
C. 8 minutes
D. 15 minutes

136. The one filing the criminal case against an accused party is said to be the?
A. Guilty
B. Accused
C. Plaintiff
D. Witness

137. A male client has a standing DNR order. He then suddenly stopped breathing and you are at his
bedside. You would:
A. Call the physician
B. Stay with the client and do nothing
C. Call another nurse
D. Call the family
138. The ANA recognized nursing informatics heralding its establishment as a new field in nursing
during what year?
A. 1994
B. 1992
C. 2000
D. 2001

139. When is the first certification of nursing informatics given?

A. 1990-1993
B. 2001-2002
C. 1994-1996
D. 2005-2008

140. The nurse is assessing a female client with possible diagnosis of osteoarthritis. The most significant
risk factor for osteoarthritis is:
A. Obesity
B. Race
C. Job
D. Age

141. A male client complains of vertigo. Nurse Bea anticipates that the client may have a problem with
which portion of the ear?
A. Tymphanic membranes
B. Inner ear
C. Auricle
D. External ear

142. When performing Weber’s test, Nurse Rosean expects that this client will hear
A. On unaffected side
B. Longer through bone than air conduction
C. On affected side by bone conduction
D. By neither bone or air conduction

143. Toy with a tentative diagnosis of myasthenia gravis is admitted for diagnostic make up. Myasthenia
gravis can confirmed by:
A. Kernigs sign
B. Brudzinski’s sign
C. A positive sweat chloride test
D. A positive edrophonium (Tensilon) test

144. A male client is hospitalized with Guillain-Barre Syndrome. Which assessment finding is the most
significant?
A. Even, unlabored respirations
B. Soft, non-distended abdomen
C. Urine output of 50 ml/hr.
D. Warm skin
145. For a female client with suspected intracranial pressure (ICP), a most appropriate respiratory goal is:
A. Maintain partial pressure of arterial oxygen (Pa O2) above 80mmHg
B. Promote elimination of carbon dioxide
C. Lower the PH
D. Prevent respiratory alkalosis
146. Which nursing assessment would identify the earliest sign of ICP?
A. Change in level of consciousness
B. Temperature of over 103°F
C. Widening pulse pressure
D. Unequal pupils

147. The greatest danger of an uncorrected atrial fibrillation for a male patient will be which of the
following:
A. Pulmonary embolism
B. Cardiac arrest
C. Thrombus formation
D. Myocardial infarction

148. Linda, A 30 year old post hysterectomy client has visited the health center. She inquired about BSE
and asked the nurse when BSE should be performed. You answered that the BSE is best performed:
A. 7 days after menstruation
B. At the same day each month
C. During menstruation
D. Before menstruation

149. An infant is ordered to recive 500 ml of D5NSS for 24 hours. The Intravenous drip is running at 60
gtts/min. How many drops per minute should the flow rate be?
A. 60 gtts/min.
B. 21 gtts/min
C. 30 gtts/min
D. 15 gtts/min

150. Mr. Gutierrez is to receive 1 liter of D5RL to run for 12 hours. The drop factor of the IV infusion set
is 10 drops per minute. Approximately how many drops per minutes should the IV be regulated?
A. 13-14 drops
B. 17-18 drops
C. 10-12 drops
D. 15-16 drops
Answers: PNLE Exam 2
1. C. Don’t get pregnant at least 3 months
2. A. Increased urinary output
3. D. Incubation period varies depending on the site of the bite
4. B. Cover IV bottle with brown paper bag
5. C. Rumpel-leede test
6. D. Peripheral blood smear
7. A. Nurse who never had chicken pox
8. D. After the delivery of the baby
9. B. 18 year old sister who recently got married
10. C. BCG vaccination
11. C. Klebs-loeffler bacillus
12. D. I will come back on Wednesday, same time, to read the result
13. C. Positive
14. B. Avoid vitamin supplements while o therapy
15. D. Chancre
16. A. 60 breaths per minute
17. D. A and B
18. D. Cotrimoxazole
19. C. 1 tsp. salt and 8 tsp. sugar
20. B. Umbilical infections
21. A. BCG
22. C. Epidemiological situation
23. D. 90
24. B. -15c to -25c
25. A. Bacterial toxin
26. D. Planning
27. B. Schedule
28. A. Motivation
29. C. Vision
30. D. Standards
31. D. Negative reinforcement
32. B. Close ended
33. A. Inductive
34. B. Risk-benefit ratio
35. A. Element
36. C. Organizational chart
37. D. University of Sto. Tomas
38. D. Italy
39. B. Overt
40. D. The statement of patient “My hand is painful”
41. C. Supine
42. A. 7 days after menstrual period
43. B. Preparation of the patient
44. C. Kardex
45. C. Side lying, unaffected side
46. D. Percussion
47. D. Dilated pupils
48. A. Ineffective airway clearance related to edema
49. D. Redness and warmth
50. B. 1 kilograms
51. C. Two arteries and one vein
52. D. April 18
53. A. Butter
54. C. Immediate surgery
55. D. Semi-fowlers
56. A. Pressure caused by the ascending uterus
57. B. 500
58. D. Estrogen
59. C. Cervix is completely dilated
60. D. Blue
61. B. Listen the fetal heart tone
62. D. Uterine atomy
63. C. 2 fingers below umbilicus
64. A. Normal findings during assessment
65. D. Tetanus toxoid
66. C. RI 8172
67. B. Sambong
68. A. An essential and indispensable equipment of the community health nurse during home visit
69. D. 99
70. B. After 2-4 weeks
71. C. Lactational Amenorrhea method (LAM)
72. B. Identify the illness
73. A. After 2 days
74. D. Sentrong sigla movement
75. B. February 1985
76. D. 6
77. C. Acetylcysteine
78. A. Habit training
79. B. Polyhydramios
80. D. Rice
81. D. “Here’s your medicine. Would you like a mango or orange juice?”
82. A. 6 years
83. C. Oxygen tent
84. B. Carmencita Abaquin
85. A. BON
86. D. 4 years
87. C. Date of Application
88. A. EO 51
89. B. Autonomy
90. C. Force majeure
91. A. Fidelity
92. D. Prudence
93. B. Enrollment in graduate school
94. C. Primary health nurse
95. A. Department of Health
96. D. Parents/legal guardians
97. C. Trustworthiness
98. B. Change IV infusions
99. C. Respect the client’s action
100. D. Assist client towards a peaceful death
101. C. Empathy
102. A. Review progress of therapy and attainment of goals
103. D. Diazepam (Valium)
104. B. Psycho stimulant
105. C. Poverty
106. A. The client may become resistive and active in stopping the crisis
107. B. Anal
108. D. Infancy
109. C. Reduce anxiety
110. A. Altered nutrition : less than body requirement
111. D. She gained 4 lbs. in two weeks
112. C. Antipsychotics
113. A. Anti-depressants
114. D. Simplify the environment to eliminate the need to make chores
115. B. 3 years old
116. D. Withdrawal
117. D. Depression
118. A. Gestalt therapy
119. D. Cognition
120. C. Finger foods, high in calorie
121. D. Finger painting
122. A. Introjection
123. B. Overcoming feeling of insecurity
124. C. Coffee
125. D. Administer analgesics as prescribed
126. A. Low protein, low sodium, low potassium
127. D. Decreased hemoglobin
128. B. 8th CN
129. C. Void immediately after intercourse
130. A. Blanching or cyanosis of legs
131. B. Colchicines
132. A. The client objects to its use
133. D. Evaluation
134. B. The symptomatic quadrant last
135. A. 3 minutes
136. C. Plaintiff
137. B. Stay with the client and do nothing
138. A. 1994
139. B. 2001-2002
140. D. Age
141. B. Inner ear
142. C. On affected side by bone conduction
143. D. A positive edrophonium (Tensilon) test
144. A. Even, unlabored respirations
145. B. Promote elimination of carbon dioxide
146. A. Change in level of consciousness
147. C. Thrombus formation
148. B. At the same day each month
149. B. 21 gtts/min.
150. A. 13-14 drops