The JAY BALICHA Predictor test 1. First board exam a. 1920 b. 1915 c. 1953 d. 1944 (Answer) A.

RA 2493 was passed during this year. Also the year where first board exam in the Philippines was given by the board of examiners for nurses (d) April of 1944, graduate nurses took the first board examination at the Iloilo Mission Hospital. (Venzon p140) 2. First True Philippine Nursing Law a. RA 2808 b. RA 877 c. RA 887 d. RA 2880 (Answer) A. In 1919 RA 2808 was passed. Also known as the first true nursing law. It created the first board of examiners for nurses. (B) Philippine Nursing law enacted on June 19, 1953 which pertains to the need for registration as nurse before anyone may practice nursing in the Philippines. (venzon p140) 3. You will soon be a registered nurse. Which of the following best describe contemporary nursing practice? Humanistic caring b. People-oriented c. Knowledge-based d. Technically focused 4. A nursing change of shift report has indicated that a clients pulse volume is described as 1 (one). The nurses first action after report is to do which of the following? a. Notify the physician c. Document that the pulse volume is normal b. Assess the client right away d. Change the clients position (Answer) B. The nurse should recognize that a pulse volume of 1 indicates the clients pulse is difficult to feel, thready, and the clients circulatory status is altered. The first action is to check the clients condition and circulatory status. If the nurse notified the physician first, the nurse will be reporting another nurses assessment, which is not an appropriate nursing practice. The other options are not applicable to the situation. (book #18) Pulse volume is the pulse strength or amplitude, refers to the force of blood with each beat. Usually the pulse volume is the same with beat. It can range from bounding to absent. (Kozier p146) 0 Absent pulse: no pulsation is felt despite extreme pressure 1 Thready pulse. It can easily be obliterated. 2 Weak pulse. Stronger than a thready pulse, light pressure causes it to disappear 3 a normal pulse. Which can be felt with moderate pressure 4 full or bounding. It can be obliterated only with great pressure (Taylor p413) 5. A client who is unconscious needs frequent mouth care. While performing mouth care, in what position should the client be placed? a. Fowlers position b. Side-lying position c. Supine position d. Trendelenburg position (Answer) B. In this position, the saliva and other liquid automatically runs out of the mouth by gravity or pool in the side of the mouth where it could be suctioned rather than being aspirated into the lungs (kozier p730) 6. Which of the following is not a physical hazard? a. Unstable and slippery stairway c. Inadequate lighting on inside and outside home b. Large windows for good ventilation d. Unfixed electrical circuits 7. Jordan Luis appears quite thin and dehydrated. What data would you initially need to determine his level of nutrition: a. Nutrition noted by dietitian c. Foods he ate yesterday b. A sample of his daily diet d. His height and weight 8. When dressing contaminated wounds, you must keep in mind the following, except a. Apply cold around wound area after dressing c. Use a non-irritating disinfectant solution b. Disinfect all instruments d. Isolate patient from those with clean wounds (Answer) D. Isolation is not necessary in this case

9. Dan Paolo, a student nurse believes that all patients should be treated as individuals. The ethical principle that this reflect: a. Beneficence b. Nonmaleficence c. Respect for others d. Autonomy (Answer) C. Beneficence The principle that imposes on the practitioner a duty to seek the good for the patient under all circumstances. (Edge p44) Nonmalecicence The principle that imposes the duty to avoid or refrain from harming the patient (edge p46) Respect for others having empathy for others and not using people as a means to an end Autonomy Independent, self-governing, self-determination (kozier p 73) 10. Doing a nursing procedure without the patients informed consent may bring nurse Andrei to the court of law for this violation: a. Negligence b. Assault c. Battery d. Tort (Answer) D. tort is a legal wrong doing, committed against a person or property independent of a contract which renders the person who has been liable for damages in a civil action. Battery is an example of tort. It is an intentional, unconsented touching of another person. Assult is the imminent treat of harmful or offensive bodily contact Negligence refers to the commission or omission of an act, pursuant to a duty, that a reasonably prudent person in the same or similar circumstance would or would not do. (Answer) (book 54 mosbys dictionary) 11. What leadership style works well with professional groups but does not in health care settings? a. Laissez faire b. Situational c. Autocratic d. Democratic (Answer) A. Laissez faire also known as nondirective leadership. The leader participates minimally and often only on request of the members. Also known as permissive or ultraliberalism. Situational manage as the need arises Autocratic under one command Democratic rule of the majority 12. Nurse Reggie assigns the new nurse to be charge nurse for the evening shift because the regular nurse has called in sick. This would be an example of which of the following? a. Over delegation c. Reverse delegation b. Substitution delegation d. Expert power A. overdelegation occurs when too much authority or accountability is transferred to the delegate. Substitution delegation is not a recognized term. Reverse delegation occurs when authority is transferred to an individual of higher rank. Expert power is power vested in the skills and talents on the individuals. 13. Which type of research inquiring and investigating the issues of human complexities (e.g. understanding human expertise) a. Logical position b. Natural inquiry c. Quantitative research d. Positivism (Answer) B. Positivism a direct relationship between two variables; as one increases, the other can be expected to increase. Logical positioning deals with the rules and test of sound thinking and proof of reasoning Natural inquiry study of the phenomenon as it unravels or qualitative research (book 169) Quantitative research - use of statistical methods to analyze data (mosbys dicationary) 14. What is the research design used? a. Experimental b. Quasi-experimental c. Descriptive d. Exploratory (Answer) A. Experimental an inquiry on cause and effect relationships. The researcher consciously manipulates and control situations related to the study. It has four elements: Randomization, control, validity and manipulation Quasi-experimental an experiment that lacks one or more of the elements of the true experiment. It is based on human judgment. Descriptive an applied research that described the nature of the phenomenon under investigation of after a survey of current trends, practices, and conditions that relate to that phenomenon. (Answer) Exploratory also known as investigative research

15. Bert can be advised that his brother can be treated involuntarily if: a. Nobody can take care of him at home c. He is dangerous to others b. He has suicidal tendencies d. all of these (Answer) D. involuntary means an individual who has the legal capacity to consent to mental treatment refuses to do so. Persons considered dangerous to self and others because of mental disorder can be involuntarily treated. The third condition is being gravely disabled. (keltner p48) 16. Using IMCI model, the pink row needs: a. No specific treatment such as antibiotics b. Specific antibiotics c. No urgent measures Urgent referral 17. What is the recommended treatment for patients classified under the yellow row having blood in the stool? a. Urgent referral b. Advise the mother on feeding a child who has PERSISTENT DIARRHEA c. Oral antibiotics for 5 days Give fluid and food to treat diarrhea at home 18. During the patients clinic visit, it is the PHNs duty to carry out one of the following, EXCEPT: a. Carry out physicians order as giving medication or injection b. Explain and reinforce physicians orders and advises c. Seek information regarding health status of other family members a. Instruct midwife to give the medication to the client 19. Which of the following specific preventive method is the role of the nurse to the family? a. Advise the family to consult the physician as soon as symptoms occur b. Explain the mechanism of actions of the drugs c. Interpret nature of disease and discuss proper preventive practices Encourage the patient to increase fluid intake 20. Margot visits her gynecologist to confirm a suspected pregnancy. During the nursing history, she states that her last menstrual period began on April 11. Cathy states that some spotting occurred in May 8. The nurse calculates that her due date is: a. January 10 c. February 12 January 18 d. February 15 21. During labor, station +1 indicates that the presenting part is: a. On the perineum C. Slightly below the ischial spines b. High in the false pelvis D. Slightly above the ischial spine c. 22. Four hours after a vaginal delivery Mrs. Reyes still has not voided. The nurses initial action should be to: a. Palpate her suprapubic area for distention b. Encourage voiding by placing her on a bedpan frequently c. Place her hands in warm water to encourage micturation Inform the physician of her inability to void and await orders 23. The community health survey aims to analyze: a. the status of health education b. health education program c. date of introducing charges the population and environment that influence the health of community SITUATION 4 A child is admitted to the pediatric unit with a diagnosis of acute glomerulonephritis. 24. The action that has priority is: a. Assessing for dysuria c. Monitoring blood pressure Observing for Jaundice d. Testing vomits for occult blood 25. A mother whose child has glomerulonephritis is fearful that her other child may get the disease. To allay the fears of the mother, the nurse should tell her that: a. The cause of acute glomerulonephritis is unknown, so it is difficult to know how to prevent b. Acute glomerulonephritis is inherited by an autosomal recessive trait but usually occurs only in males

c. Acute glomerulonephritis is caused by clot formation in the small renal tubules secondary to systemic function d. Acute glomerulonephritis is caused by an antigen-antibody response secondary to group A betahemolytic streptococcus ANSWER: ( D ) The beta-hemolytic streptococcal immune complex becomes trapped in the glomerular capillary loop, causing glomerulonephritis. SITUATION 5 A young man is admitted in chronic renal failure and scheduled for kidney transplant. 26. Which of the following pre-operative assessment is important for a client who will undergo kidney transplant: a. Urine output b. Signs of graft rejection c. Signs and symptoms of infection Clients support system and understanding of life style changes 27. Which of the following symptoms indicate acute rejection of a transplanted kidney? a. Fever and weight gain c. Oliguria b. Hematuria and seizure d. Muscle atrophy ANSWER: ( A ) Signs of rejection increase WBC and fever because the body is recognizing the graft as foreign and attempting to fight. 28. The client is at the physicians office for a follow-up visit. The client tells the office nurse. I am not worried about rejection. I am not going to be here weekly. The nurse interprets his reaction to constant follow-up care as an example of: a. Projection c. Denial b. Intellectualization d. Regression ANSWER: ( C ) Denial disowning intolerable thoughts. Client denying feelings of anxiety and seriousness of potential rejection of the organ. 29. The client with renal transplant has started cyclosporine therapy to prevent graft rejection. Which of the following conditions is a major complications of this drug therapy: a. Depression c. Infection Hemorrhage d. Peptic ulcer disease SITUATION 6 Jane Santos has an acute episode of right-sided heart failure and is receiving furosemide (Lasix). 30. When taking Mrs. Santos admission history, the nurse would expect her to complain of: a. Dyspnea, edema, fatigue c. Weakness, palpitations, nausea b. Fatigue, vertigo, headache d. A feeling of distress when breathing ANSWER ( A ) Congestive Heart Failure is the failure of the heart to pump adequately to meet the needs of the body, resulting in a backward build up of pressure in the venous system. Adaptations by the body include edema, ascites, hepatomegaly, tachycardia, dyspnea, and fatigue. 31. The nurse can best assess the degree of edema in an extremity by: a. Checking for pitting c. Measuring the affected area b. Weighing Mrs. Santos d. Observing intake and output ANSWER ( C ) Measuring an area is an objective assessment and is not subject to individual interpretations. 32. Mrs. Santos has edematous ankles. To limit edema of the feet the nurse should prepare to: a. Restrict fluids c. Apply elastic bandages Elevate the legs d. Do range-of-motion exercises 33. The nurse is having difficulty assessing peripheral pulses. The most appropriate action for the nurse to take is to: a. Ask him to lie on his stomach c. Asks him to flex and extend his foot b. Have him do 20 jumping jacks d. Ask him to elevate his leg ANSWER: ( A ) Asking to lie in prone position will provide greater exposure to the popliteal space and thereby make assessment easier. Flexing and extending the foot may obliterate the pulse. 34. An adult female experiences painful arterial spasm in her hands due to Raynauds phenomenon.

Which of the following should the nurse include in the teaching plan for her? a. Drink a hot beverage such as tea or coffee to relieve spasms b. Reduce intake of high fat or high cholesterol foods c. Raise the hands above the head to relieve spasms d. Wear gloves when handling refrigerated foods ANSWER: ( D ) Cold induces arterial spasm. When hands will be exposed to cold, warm gloves or mittens should be worn. 35. What is the most common symptoms in a client with abdominal aortic aneurysm? a. Abdominal pain c. Headache Diaphoresis d. Upper back pain SITUATION 8 Mr. Simon is admitted with cirrhosis of the liver, malnutrition, ascites, and elevated BP. 36. The nurse recognizes that the main role of the liver in relation to fat metabolism is: a. Producing phospholipids b. Storing fat for energy reserves c. Oxidizing fatty acids to produce energy d. Converting fat to lipoproteins for rapid transport out into the body ANSWER ( D ) In the liver a simple protein combines with a lipid to form a lipoprotein. Lipoproteins circulates freely in the blood and can be utilized easily and quickly in various metabolic processes. 37. The most therapeutic diet for Mr. Simon would be: a. High protein, low carbohydrate, low fat b. Low protein, low carbohydrate, high fat, soft c. High carbohydrate, low saturated fat, 1200 calories Low sodium, protein to tolerance, moderate fat, high calorie, high vitamin, soft 38. Mr. Simons emergency medical treatment for bleeding esophageal varices that is unrelated to the control of hemorrhage is: a. Gastric lavage c. Balloon tamponade b. Gastric suctioning d. Aminocaproic acid (Amicar) d. ANSWER ( D ) Low sodium controls fluid retention, blood pressure, and consequently edema; low protein controls ammonia formation in proportion to the livers ability to detoxify ammonia in forming urea; moderate fat and high calories and vitamins help repair a long-standing nutritional deficit. 39. When admitting a 4-year-old child with nephrotic syndrome to the hospital, the nurse should assess for: a. Severe lethargy c. Dark, frothy urine output b. Chronic hypertension d. Flushed, ruddy complexion ANSWER ( C ) This is a characteristic of a child in nephrotic syndrome, large amounts of protein in the urine cause it to have a dark, frothy appearance. 40. During the first 24 hours the colostomy does not drain. The nurse should realize this is a result of: a. Intestinal edema c. The absence of gastrointestinal motility a. A presurgical decrease in fluid intake d. Proper functioning of nasogastric suctions SITUATION 11 A client was admitted to the hospital diagnosed with myocardial infarction. 41. Which laboratory result should the nurse report to the physician? a. Blood urea nitrogen of 15 mg/ dl c. Blood glucose level of 40 mg b. Serum albumin level of 3. 5 g d. Serum creatinine level of 0.6 mg ANSWER: ( C ) Glucose level 60 120 mg. 40 mg hypoglycemiaimpair brain and neurological systems ability to function. BUN ( N ) 10 - 20 mg increase kidney disease. Crea ( N ) .4 1.5 mg 42. Eight weeks after MI, the client tells the nurse My wife wants to make love; but I dont think I can, Im worried that it might kill me. Which of the following responses from the nurse would be appropriate? a. Tell me about your feelings b. Lets increase your rehabilitation schedule c. Let me call the doctor for you d. Tell your wife when youre able to make love

ANSWER: ( A ) Nurse must address patients concern. Ask to verbalize permit to gain insight into problem. 43. She appears withdrawn after a mastectomy although her recovery is uneventful the nurse can be helpful during this period by: a. Allowing the patient time alone so that she can reflect on her surgery b. Encouraging the patient to talk to her family c. Offering the patient the name of a support group d. Encouraging the patient to become involve in her exercises ANSWER ( C ) Mastectomy support groups provide an opportunity for patient to talk with other women who have had similar surgery. 44. The nurse recognizing the need to decrease the size and vascularity of the thyroid gland prior to thyroidectomy, would expect the physician to order? a. Propythiuracil c. Potassium permanganate b. Lugols iodine solution d. Liothyronine sodium (Cytomel) ANSWER: (B) Adds iodine to body fluids, exerting negative feedback on thyroid tissue and decrease its metabolism and vascularity. A & D anti thyroid. 45. A client has chest tubes attached to a chest tube drainage system. When caring for this client, the nurse should: a. Clamp the chest tubes when suctioning b. Palpate the surrounding area for crepitus c. Change the dressing daily using aseptic technique d. Empty the drainage chambers at the end of the shift ANSWER: ( B ) Leakage of air into subcutaneous tissue is evidenced by a crackling sound when the area is gently palpated. This is referred as crepitus, although hemostat should be available. SITUATION 18 Sheila is a 3 year old who has asthma. 46. Sheilas initial treatment is to be aminophylline IV, for 20 minutes every 8 hours. Which of the following actions should the nurse implement with administration of the drug? a. Assess Sheilas vital signs c. Check Sheilas temperature b. Place Sheila in a croup tent d. Administer oxygen to Sheila ANSWER: ( A ) Xanthenes can cause either hypotension or tachycardia. It would be essential for the nurse to monitor her cardiovascular response to the drug. This is best done by assessing her baseline vital signs prior to and with administration. 47. Which of the following nursing interventions is appropriate to correct dehydration for a 2 year old client with asthma? a. Give warm liquids c. Provide three meals and three snacks b. Give cold juice or ice pops d. Give IV fluids boluses ANSWER: ( A ) Liquids are best tolerated if theyre warm. Cold liquids may cause bronchospasm and should be avoided. Dehydration should be corrected slowly overhydration may increase interstitial pulmonary fluid and exacerbate small airway obstruction. Small frequent meals should be provided to avoid abdominal distension that may interfere with diaphragm excursion. 48. The client was taking regular and NPH insulin. She asks the nurse why she must mix the 2 insulin. The nurse explains that regular and NPH are mixed to ensure: a. Immediate onset of the regular insulin b. Onset of the regular insulin within 2 hours c. A peak action of the NPH insulin at 2 hours d. A total duration of action of 24 hours ANSWER: ( D ) NPH is an intermediate acting insulin, Regular is rapid acting insulin, Mixing the 2 gives insulin over a 24 hours period requiring fewer injections for the client. 49. When the nurse enters the room to administer the morning dose of regular and NPH insulin, the client complains of dizziness, diaphoresis and nausea. The nurse does a blood glucose which is 30. What is the next nursing action? a. Give the usual dose of regular insulin and get the clients breakfast tray b. Hold the NPH insulin but give the regular insulin c. Hold the regular and NPH insulin and call the physician d. Give the client a glass of orange juice, hold all insulin and call the doctor ANSWER: ( D ) Symptom indicate hypoglycemia, 10 grams of rapidly absorbed CHO in prescribed. Repeated in 5 minutes, if client does not feel better. Hold insulin but should administer concentrated

CHO. 50. Which of the following chronic complications is associated with diabetes mellitus? a. Dizziness, dyspnea on exertion and angina b. Retinopathy, neuropathy and coronary artery disease c. Leg ulcers, cerebral ischemia events, and pulmonary infarcts d. Fatigue, nausea, vomiting, muscle weakness and cardiac arrhythmias ANSWER: ( B ) All chronic complications A- symptoms of aortic valve stenosis. D symptoms of hyper parathyroidism. C complication of sickle cell anemi