121.

The risk for the development of cancer greatly increases when positive family history of malignant
diseases and poor immune system is combined with all of the following, except:
a. smoking c. high fat diet
b. excessive alcohol intake d. exposure to oncogene

152. After undergoing a chemotherapy session, which of the following side effects may commonly occur:
a. hirsutism c. compartment syndrome
b. disequilibrium phenomenon d. nausea and vomiting

153. A 24 year old house wife was diagnosed to have cervical cancer: Predisposing factors for this condition
includes all of the following, except:
a. early age of sexual intercourse c. history of sexually transmitted disease
b. multiple sex partners d. chronic use of contraceptives

154. Which of this is not included among the manifestations of cervical cancer?
a. post-coital bleeding c. profuse or period abnormality
b. painful intercourse d. presence of palpable tumor

155. A child has been diagnosed with a Wilms' tumor and is being treated with chemotherapy. Since many
chemotherapeutic agents cause bone marrow depression, prior to administering the chemotherapy, the nurse will
determine if this child has any infection-fighting capability by monitoring the:
a. red blood cell count. c. hemoglobin.
b. absolute neutrophil count (ANC). d. platelets.

156. A child has cancer and has been treated with chemotherapy. The latest laboratory value indicates the
white blood cell count is very low. The nurse would expect to administer:
a. filgrastim (Neupogen).
b. epoietin a (human recombinant erythropoietin).
c. oprelvekin (Neumega).
d. ondansetron (Zofran).

157. The nurse works in an oncology clinic. A preschool-age child is being seen in the clinic, and the nurse
anticipates a diagnosis of cancer. The nurse prepares for the common reaction preschool-age children often have
to a diagnosis of cancer, which is:
a. thoughts that they caused their illness and are being punished.
b. unawareness of what the illness is.
c. acceptance, especially if able to discuss the disease with children their own age.
d. understanding of what cancer is and how it is treated.

158. The antiemetic drug ondansetron (Zofran) is being administered to a child receiving chemotherapy. It
should be administered:
a. before chemotherapy administration, as a prophylactic measure.
b. after the chemotherapy has been administered.
c. only if the child experiences nausea.
d. Never this antiemetic is not effective for controlling nausea and vomiting associated with chemotherapy.
159. A child has thrombocytopenia secondary to chemotherapy treatments. The nurse should not:
a. use palpation as a component of assessment.
b. administer intramuscular (IM) injections.
c. monitor intake and output.
d. perform oral hygiene.

160. A child undergoing chemotherapeutic treatment for cancer is being admitted to the hospital for fever and
possible sepsis. Cultures, antibiotics, and acetaminophen (Tylenol) have been ordered for this child. Which order
should the nurse do first?
a. administer the antibiotics c. any of the three
b. administer the Tylenol d. obtain the cultures

161. A child has been diagnosed with a Wilms' tumor. Preoperative nursing care would involve:
a. monitoring of behavioral status. c. maintenance of strict isolation.
b. careful bathing and handling. d. administration of packed red blood cells.

162. An adolescent is receiving methotrexate chemotherapy after undergoing limb salvage surgery for
osteogenic sarcoma. The nurse knows the teen understands the purpose of leucovorin therapy after the
methotrexate if the teen says:
a. I don't have any pain, so I won't need to take the leucovorin this time."
b. "I'm glad I only need one dose of the leucovorin."
c. "I don't have any nausea, so I won't need the leucovorin."
d. "I know I will be taking the leucovorin every 6 hours for about the next 3 days."

163. A child recently has been diagnosed with leukemia. The child's sibling is expressing feelings of anger and
guilt. This reaction by the sibling is:
a. normal, as the sibling is affected too, and anger and guilt are expected feelings.
b. unexpected, as the cancer is easily treated.
c. abnormal, and she should be referred to a psychologist.
d. unusual, as the illness doesn't affect the sibling.

164. A child with leukemia developed bone marrow depression after undergoing chemo and radiation
therapy. The nurse is aware that type of diet most likely to be ordered for this patient would be:
a. Small frequent feeding c. Low fat, low salt diet
b. Low bacteria diet d. Diet as preferred by the patient

165. A child with rhabdomyosarcoma is to undergo radiation therapy after surgical removal of the tumor. The
parents should be taught to:
a. vigorously scrub the area when bathing.
b. apply lotion to the area before radiation therapy.
c. apply sunscreen to the area when the child is exposed to sunlight.
d. remove any markings left after each radiation treatment.
166. The nurse must carefully assess a patient undergoing radiation therapy for skin changes in the area
involved. Which of this is not a usual observation on the skin:
a. swelling c. bleeding
b. redness d. pain

167. The child had been admitted to the hospital unit and was newly diagnosed with retinoblastoma. The
nurse would expect to see:
a. a red reflex. c. yellow sclera.
b. a white pupil. d. blue-tinged sclera.

168. Retinoblastoma is a cancer involving the eye. A common manifestation the nurse can observe in the
patient would be:
a. nystagmus c. cat’s eye reflex
b. ptosis d. opaque lens

169. Surgery and radiation therapy are usually recommended to treat retinoblastoma. The type of surgery
usually performed is known as:
a. keratoplasty c. retinorrhapy
b. enucleation d. laser iridotomy.

SITUATION: John, 19 years old, nursing students emphasizes the importance of Florence Nightingale’s theory as
it helps individuals to utilize resources for the clients’ recovery.

1. Which of the following determinants does John is focusing as it affects the health status of an individual
and may be a factor for a healthcare provider in achieving the best care for the client?
a. Personal behavior c. Employment and working conditions
b. Physical environment d. Health services

2. All of the following are determinants of health EXCEPT:

a. Education c. Physical environment
b. Income and social status d. OLOF

3. When John shared her knowledge about the importance of balanced eating and proper dealing with
normal life stressors , he is exemplifying the ability of an individual to identify factor that affect health as:
a. Gender c. Personal behavior
b. Educational level d. All of the above

4. Ecosystem affects the optimum levels of functioning as it also determines the health status of the
populations. The goal implies that no single factor affects the health of the people. Therefore , when considering
the health , who are the recipients of care ?
a. Individuals c. Communities
b. Families d. All of the above
5. During home visit, John decided to review the records of a family in the barangay sto.domingo with sickle
cell anemia. Which of the following determinants of health affects the family with this illness?
a. Genetics c. Personal behavior
b. Culture d. Healthcare services

SITUATION: A public health must educate the postpartum mother about the benefits of breastfeeding.

6. Which of the following information must be included in the nursing care plan about the benefits of human
milk compare with the cow's milk?
a. Lactose content is significantly higher in cow's milk
b. Fat in human milk is more digestible than cow's milk
c. Protein in human milk is higher than cow's milk
d. They have the same benefits in terms of fats and protein

7. When discussing about the proper breast-feeding, the mother is concerned about the development of
mastitis. Which of the following must the nurse teach to client about this?
a. Frequent breastfeeding c. Wash with soap
b. Breast pump is needed d. Warm compress application

8. Breast engorgement may be the factor for some mother. The nurse may help the client about this
concern:
a. Helping baby to breastfeed by initiating rooting and sucking reflex
b. Teach mother to latch on the nipple only
c. Apply warm compress
d. Use breast pump frequently

9. The most appropriate method for the nurse to correctly understand the proper breastfeeding is through:
a. Demonstration c. Listening attentively
b. Observation d. Writing after listening

10. Which of the following the nurse must consider when evaluating the mother about proper breastfeeding
taught by the nurse during the postpartum care?
a. Let the mother recite for the procedure
b. Observe the mother during breastfeeding
c. Ask the patient to explain about breastfeeding
d. Ask the mother to draw

SITUATION: Executive Order 102 delineates the major role of the Department of Health.

11. Innovation of new strategies in health is one the specific role of the DOH and it is under what major role?
a. Leadership in Health c. Enabler and Capacity builder
b. Community Organizer d. None of the above
12. The DOH is the leader, staunch advocate and model in promoting Health for All in the Philippines. This
describes the DOH’s;
a. Vision c. Goal
b. Mission d. Strategy

13. Which of the following describes the DOH’s mission?

a. Guarantee equitable, sustainable and quality of healthcare for all Filipinos , especially the poor and shall
lead the quest for excellence in health
b. The DOH is the leader and staunch advocate and model in promoting health for all in the Philippines
c. An essential healthcare made universally accessible to people
d. Roadmap for stakeholders in health and health related sectors

14. Which of the following is the overriding goal of the DOH?

a. HSRA c. FOURmula ONE for Health
b. NHIP d. PHC

15. In the implementation of HSRA, framework is adopted for a sector wide approach. Which of the following
is taken for effective management of this agenda?
a. FOURmula ONE for Health c. Healthcare financing
b. NHIP d. Health regulation

SITUATION: A mother is concerned about the possible feature a newborn may be if during assessment the nurse
may find an SGA or LGA newborn or a premature or post mature one.

16. Which of the following would help the nurse that newborn is post mature?
a. Poor sucking c. Long brittle fingernails
b. Flat ears d. Well developed eyebrows

17. The nurse expects to observe for newborn at age 39-40 weeks during assessment:
a. Flat ears c. Creases in soles of feet
b. Skin blanching d. Long brittle finger nail

18. A mother expresses concern about the her newborn observed to be having a "lazy eye". The nurse
correctly respond by saying:
a. the newborn needs surgery
b. It is just temporary
c. It is genetically inherited
d. The newborn will be needing an eyeglasses before reaching 1 year old

19. The stretching of the nerve fibers in the neck, shoulder and arm when the shoulder is being pulled away
from the neck during breach delivery would most like cause birth complication known as:
a. Cerebral palsy c. Broken arm
b. Brachial palsy d. Broken scapula
20. Asphyxia at birth can have a grave consequence, thus in the 24 hours after the neonate is successfully
resuscitated the measures should be instituted EXCEPT:
a. Feed the child with milk
b. Observe for seizures and bloody stools
c. Give oxygen as needed
d. Maintain good thermoregulation

SITUATION: Empowering the community through healthcare services must be emphasized by the PHN for each
health system requirement.

21. Components of ILHS are described for the partnership with the inter local government unit. All but which
of the following are components of ILHS?
a. People
b. Boundaries
c. Healthcare delivery
d. Health worker

22. In achieving the primary healthcare , a PHN will focus on the most important concept which includes:
I. Partnership and empowerment III. Regulation for the implementation
II. Active community participation IV. Support mechanisms

a. I and II c. II only
b. IV only d. I only

23. A public health nurse is correct if he/she identifies the following as part of the components of PHC in the
Philippines
I. Environmental sanitation
II. Control of non communicable diseases
III. Active community participation
IV. Maternal and child health
V. Use of appropriate technology

a. I,IV and V c. II and III

b. I and IV d. All of the above

24. Which of the following must a public health nurse when developing an operational plan?
a. Assess the community diagnosis
b. Prioritize the long term goal
c. Establish priorities according to needs
d. All of the above

25. Which part of community health nursing process , when a public health nurse carries out the nursing
procedures based on plans?
a. Assessment c. Implementation
b. Planning d. Evaluation
SITUATION: Joanna, 40 years old visit the rural health center for annual gynecology check up.

26. Which of the following gynecology health history is the primary concern of the nurse?
a. Exercising professional decorum to avoid embarrassing the client
b. Sexual activities and marital relationship
c. Emotional and intellectual assessment
d. Review of periodic gynecological screenings

27. Which one is LEAST considered when screening procedure must be done for Joanna during clinic visit?
a. Pap's smear c. Pelvic exam
b. Breast exam d. Stool analysis

28. When teaching about the performance of breast examination, it is important to include BSE is performed
a. One week after menstruation
b. One week before menstruation
c. On the same day of the month
d. Every 15 and 30th day of the month

29. When discussing about the indications of a breast cancer, the nurse correctly tells that the most common
symptom noted for client with this type of illness is:
a. Breast tissue dimpling
b. Skin peeling
c. Breast mass
d. Red orange discoloration with peeling skin along the breast

30. Which of the following is most appropriate nursing diagnoses for patient diagnosed with breast cancer?
a. Fear related to life threatening condition
b. Self care deficit related to breast mass
c. Activity intolerance related to disease process
d. Altered nutrition more than body requirements

SITUATIONS: Epidemiology serves as the backbone for disease prevention in the community.

31. The nurse is verifying the diagnosis used in epidemiological investigation when he or she asks which one of the
following questions?
a. Is the disease that which is reported to be?
b. Is it reasonably complete
c. Is there an unusual prevalence of the disease
d. None of the above

32. Which of the following essential concept of epidemiological investigation when a public health nurse would
take the relation of cases to age, group, sex , color, occupation, school attendance and past immunization?
a. Knowing about the present facts about the epidemic disease
b. Establishing the time and space relationship of the disease
c. Correlating all the data collected
d. Relationship to characteristics of groups to community
33. If a public health nurse follows the systematic collection, analysis and interpretation and dissemination of
health data during epidemiology, he or she is performing?
a. Public health surveillance
b. Research study and epidemiology
c. Review of literature
d. All of the above

34. Which of the following roles is most likely the PHN should perform during health surveillance?
a. Educator c. Researcher
b. Community organizer d. Collaborator

35. Providing an early warning on occurrences of outbreaks of disease is one of the most important objectives of:
a. Department of Health
b. Local Government Unit
c. National Epidemic Sentinel Surveillance System (NESSS)
d. Epidemiology

SITUATION: Yssa, 27 year old financial teller consults the company nurse because of nausea and vomiting. She
reveals to be amenorrheic for 2 months. Her LMP is August 18.

36. Yssa believes that she is pregnant. Which of the following is NOT a presumptive sign of pregnancy?
a. Amenorrhea c. Chadwick's sign
b. Nausea and vomiting d. Breast changes

37. She claims that this is her second pregnancy but her first was an abortion. Which of the following terms refer
to Yssa?
a. Nullipara c. Primipara
b. Multigravida d. Couvade syndrome

38. Yssa relates that her husband Tonya also experiences nausea and vomiting and mimics symptoms of
pregnancy. Which of the following refer to this condition?
a. Couvade syndrome c. Mimicry
b. Role playing d. Nesting syndrome

39. She ask the nurse if she can continue her aerobic exercises. Which of the following are absolute
contraindications of vigorous exercise?
l. Diagnosed cardiac desease
ll. History of more than three spontaneous abortion
lll. Incompetent cervix
lV. Diagnosis of placenta previa

a. l, lll, lV c. l, ll, lll

b. ll, lll, lV d. l, ll, lll, lV
40. Her next visit is scheduled on December 18. How many weeks AOG will she by the next visit.?
a. 18-19 c. 17-18
b. 16-17 d. 19-20

SITUATION: Field Health Services and Information System (FHSIS) provides summary of data of health services
delivery and selected programs accomplished, indicators of barangay, municipality, city , district to national levels.

41. All of the following are essential components of FHSIS EXCEPT:

a. Family treatment record c. Reporting form
b. Target/ client list d. Assessment form

42. The fundamental building block of FHSIS where chief complaints of the clients in the community are recorded:
a. Assessment form c. Reporting form
b. Family treatment record d. Output reports

43. Which of the following are included purposes of target/client list? Select all that apply:
I. To plan and carry out patient care
II. To facilitate monitoring and supervision for services
III. To report services delivered
IV. To provide a clinical data base

a. I and II only c. III and IV only

b. I,III and IV d. All of the above

44. FHSIS /E-I refers to:

a. Notification of death form c. Perinatal death form
b. Maternal death form d. Weekly report

45. FHSIS/A-1 reports of the annual catchment area tally sheet and report. FHSIS reports can be done:
a. Weekly c. Annually
b. Monthly d. All of the above

SITUATION: Maternal and Child health emphasizes the quality of care for the complete access of health care for
mother and child.

46. Which of the following parameters should the nurse include when developing a plan for postpartum mother?
a. Boggy uterus
b. Bleeding tendency
c. Lochia
d. All of the above
47. A mother suddenly tells her concern to the nurse, “I’ve been taking Atenolol as my maintenance drug to
control my blood pressure to shoot up. Why the doctor tell that I may not be given with Methergine?” Which of
the following is most appropriate for the nurse to reply?
a. “ The drug is allowed whether you are taking Atenolol or not once you experience postpartum bleeding”
b. “It is contraindicated for mother who has hypertension”
c. “I’ll get back to you after confirming with the doctor”
d. “The doctor is always right. Don’t question his knowledge”

48. Jenny , a public health nurse noted during assessment of mother with intestinal parasitesha staken
Mebendazole
during 2nd month of pregnancy. It is possible, based on the knowledge of Jenny, that this type of drug once taken
by pregnant client:
a. May cause congenital defect
b. May cause abortion on the 3rd month of pregnancy
c. May totally eliminate the intestinal parasites
d. May alter the nutritional status of the mother

49. Which of the following drugs may be taken by pregnant mother are recommended safe for them during health
education at Rural Health Center?
a. Vitamin A 10,000 IU
b. Iron 60mg/400mg daily
c. Mebendazole on the 2nd month of pregnancy
d. A and B

50. When developing a nursing care plan for mother in the stage of labor and delivery, the nurse would include
which of the following. Select all that apply.
I. LMP
II. Gravida and Para
III. Danger signs of pregnancy
IV. Marriage contract

a. I and IV c. All except IV

b. II and III d. All except III

51. In determining the stage of labor, a public health nurse must be sure in assessing which of the following
conditions of the mother. Select all that apply.
I. Regular contraction and urge to push down and bulging vulva
II. Leaking of amniotic fluid
III. Vaginal bleeding
IV. Irregular contraction with bloody show

a. All except I c. All except III

b. All except II d. All except IV
52. After giving birth, the nurse must educate the postpartum mother about the importance of Maternal and Child
Health which includes:
a. Birth registration
b. Importance of breastfeeding
c. Newborn screening
d. All of the above

53. A mother asks the nurse.” After today, when shall I visit again for my last post partum check up?” the most
appropriate response of the nurse is:
a. After 1 week c. After 6 weeks
b. After 4 weeks d. After 6 months

54. Which of the following the nurse must include in the plan of care about the proper birth sapcing and
addressing the right number of children. The nurse is correct when she includes the plan for patient who needs
educations about:
a. Family planning c. Public health program
b. Newborn screening d. Postpartum care

55. When developing a plan of care for mothers who consider family planning , the nurse emphasizes the
importance of the program to:
a. Decrease infant deaths c. Decrease maternal deaths
b. Decrease neonatal deaths d. All of the above

SITUATION: Nursing Roles define the specific responsibilities without overloading the role of each nurse working in
a community health facilities.

56. . Which of the following is the professional qualification to practice the public health nursing in a special field?
a. BSN graduate c. RN license
b. Certifies BLS and ACLS provider d. M.S.N degree

57. Which functions of a public health nurse is concerned with Planning, Organizing, Staffing, Directing and
Controlling to meet the objective of the local health agency ?
a. Management c. Nursing care
b. Supervisory d. Collaborating

58. Jessica, a 21 year old PHN used to formulate supervisory plan and conducts visits to implement the pans is
under what type of nursing function?
a. Management c. Nursing care
b. Supervisory d. Coordinating

59. Which one of the following functions is inherent and based on the science and art of caring in whatever setting
her maybe or role she may have?
a. Management c. Nursing care
b. Supervisory d. Teacher
60. When a public health nurse brings the activities or group of activities systematically into proper relation or
having harmony with each other, this is under what type of nursing function?
a. Manager c. Nurse
b. Supervisor d. Collaborator

SITUATION: Community health nursing process, nursing procedures, community organizing, health process and
education, surveillance , records and reports are important aspect of a PHN functions when dealing with
individuals, families and communities.

61. Community health nursing process is a systematic , scientific, dynamic and on going interpersonal process.
Select all that apply.
I. Assessment
II. Nursing diagnosis
III. Planning
IV. Implementation
V. Evaluation

a. All of the above c. I,II and III

b. All except II d. II,III, and V

62. Categories of health problems are included under assessment phase of CHN process. Which of the following
categories in which an individual has had history of repeated infection and miscarriages?
a. Health deficit c. Forseeable crisis
b. Health threat d. Health need

63. Which one of the following is expected when there is a health problem exist and it can be alleviated with
medical or social technology?
a. Health deficit c. Forseeable crisis
b. Health threats d. Health needs

64. Stressful occurrences such as death of a family member are included in one of the categories of health
assessment. Under which type it is included?
a. Health deficit c. Forseeable crisis
b. Health threat d. Health needs

65. Joseph has been assessed by a public health nurse during home visit. The nurse found out the joseph
immunization is incomplete. He has not received the last doe of Hep B vaccine and Measles vaccine. I categorizing
Joseph’s nature of problem, he is under:
a. Health deficit c. Forseeable crisis
b. Health threat d. Health needs
SITUATIONS: Macky, 9 year old is admitted in Ward 18 for tonsillectomy. His bed is adjacent to the bed of
Daniel who has a terminal case of acute lymphocytic leukemia. The two boys easily became friends.

66. What does hospitalization one mean for Macky at his age?
a. Exposure to a strange place
b. Separation from friends
c. Experiencing pain due to surgery
d. Separation from the family

67. Based on his level of cognitive development, which of the following is Macky capable of doing?
l. Forming attitudes and value system
ll. Interpersonal perceptions and concept of self
lll. Following rules and own responsibility for himself
lV. Reasoning and logical thought

a. Il, lll, lV c. l, ll, lV

b. l, ll, lll d. l, lll, lV

68. Macky cries out loud during lV insertion. Which of the following response of the nurse is therapeutic?
a. " you will feel more pain if you cry"
b. " next time we won't let your mother stay with you if you cry"
c. " I know it hurts so its okay to cry"
d. " big boys don't cry"

69. While Macky was sleeping, Daniel passed away. Which of the following BEST describes his concept of death?
a. Form of sleep c. Temporary departure
b. Cessation of corporal life d. Person

70. Which is the BEST response of the nurse when asked by Macky, what happened to Daniel.?
a. He is going to heaven
b. "he is just sleeping"
c. "he is now dead"
d. " the angels came and took him away"

SITUATION: PREGNANCY , LABOR AND DELIVERY are part of the nursing care plan to achieve Materna and Child
Health goals and objectives.

71. When panning for a health teaching about the purpose of Lamaze method, the nurse includes and correctly tell
to pregnant client that it will help the client :
a. To have a good baby during delivery
b. Prepare for labor and delivery
c. Enhance coping mechanism after giving birth
d. Increase bonding between the father, mother and newborn
72. The nurse is aware that folic acid for pregnant mother is necessary for fetal growth during prenatal period
because:
a. It treats pernicious anemia
b. Prevents allergic reaction
c. Promote hydration
d. Promote normal erythropoiesis

73. When a child experience the urge to push down at 9 cm dilation, the breathing pattern that the nurse should
instruct the client to use:
a. Deep breathing technique c. Exertional blowing
b. Pant blowing pattern d. Slow chest pattern

74. Which of the following increases the mother's risk for postpartum hemorrhage?
a. Delivered a baby who weighed 9lbs 8oz
b. Breastfeed in the delivery room
c. Normal gestational age
d. Complied the antenatal check up

75. When crowning is observed during the second stage of labor , a nurse would most likely take which of the
following actions?
a. Position the woman on her left side
b. Induce labor
c. Instruct the woman to bear down and push
d. Prepare the woman for immediate delivery

76. During the first hour after delivery of a newborn, it is essential that a nurse must assess the mother for:
a. Calf pain
b. Perineal pain
c. Uterine atony
d. Bowel impaction

77. Which of the following statements if made by a woman indicates a need for further instruction about the use
of diaphragms?
a. "I always wash my diaphragm with soap and water"
b. "My diaphragm is reusable as long as it is still intact"
c. "I can use the diaphragm with spermicide to increase my protection"
d. "I have a diaphragm that I can start to use as soon as I'm ready to have intercourse"

78. After delivery, the nurse encouraged the mother to breastfeed the newborn. When breastfeeding the
newborn, the mother asks about the benefits of breast milk to the newborn. The nurse is correct when
a. It satisfies the needs of the newborn
b. It safely dehydrates the newborn
c. It provides complete nutrition
d. All of the above
79. Which one of the following is a common finding for an 8 year old child admitted in the hospital with acute
glomerulonephritis?
a. History of frequent sore throat caused by streptococcal infection
b. Otitis medial
c. Gastroenteritis
d. Viral pneumonia

80. A nurse should infuse blood within four hours to a pediatric client in order to lessen the risk of:
a. Blood clotting in the bag c. Bacterial contamination
b. Thrombus formation d. Platelet aggregation

81. The nurse would advise the child's parent to perform which of the following measures after successfully
performing the Heimlich maneuver on an 18 month old child?
a. A thorough examination is needed so take the child to the nearest health facility
b. Assess the child for abdominal distention
c. Assess the child for signs of choking
d. Auscultate the child's lung every 2 hours at night

82. A nurse would expect for a pregnant client to have which of the following tests may screen for neural tube
defect ?
a. Serum alpha fetoprotein c. Serum amylase
b. Amniocentecis d. Serum creatinine

83. A newborn develops jaundice shortly after birth and receives phototherapy. While the newborn is receiving the
phototherapy, which of the following measures should be included in the newborn's care plan at regular intervals?
a. Changing the newborn's position
b. Testing newborn's urine for glucose
c. Assessing newborn for edema
d. Applying lotion to the newborn's skin

84. A patient of a two year old child asks the nurse in the RHU, "Why does my child have to have this Denver II test
done? The nurse's most appropriate response would be:
a. It identifies the child's developmental level
b. Measures the IQ and EQ
c. Measures the negative behavior
d. Assesses the child's ability to remain in one activity.

85. A nurse makes all of the following observations during a home visit to 6 day old, healthy , term newborn.
Which one would prompt the nurse to give further instructions?
a. Warms expressed breast milk in the microwave oven
b. Place the newborn supine in the crib after feeding
c. Applies isopropyl alcohol to the base of the cord stump after bathing
d. Washes the newborn' s after giving bath
Situation: COPAR is a tool for community development and people empowerment.

86. When a student nurse develops a plan for the community study. Which of the following is most important to
consider first:
a. Poorest sector of the community
b. Willingness to participate in community development
c. Development of project
d. Community members for community development

87. Among the groups of community to be studied. Which of the following is the priority?
a. Community with lack of knowledge about community development
b. Community who does not avail the basic and most essential health care services
c. Community in an underdeveloped area
d. Community with geographical problem and deprived sectors

88. Networking with government and non- government organizations is included in the pre entry phase of the
COPAR process. What is the most important thing to consider when linking with other people?
a. Objectives of the community
b. Capacity to collaborate with the projects in the community
c. Rules and regulations of the Core group
d. All of the above

89. Enhancement of personality of a student nurse is important for consciousness raising during community
immersion. How will the student nurses develops consciousness with the community?
a. Integration with the community
b. Related learning experiences
c. Community study
d. Implementation of activities

90. When eliciting participation of the community for the establishment of community project. Which of the
following will you consider?
a. The community works to solve their own problems
b. The direction is internal rather than external
c. The development of the capacity to establish a project is more important than the project
d. There is a consciousness-raising to perceive health and medical care within total structure of society

91. The core group members undergone self awareness and leadership training program. To find for the primary
leaders, the student nurse encourages the election of officers during what phase of the COPAR process?
a. Sustenance and strengthening phase
b. Community organization and capability building phase
c. Community action phase
d. Entry phase
92. The student nurse conducted a study on other community to find the most pressing need of the community.
The student nurse is considered as:
a. Expert as internal researcher c. Concern citizen
b. Expert as external researcher d. All of the above.

93. When defining the communication pattern and health related behavior of the community. The students nurse
should perform the;
a. Preliminary social investigation c. Deeper social investigation
b. Sensitization d. Social transformation

94. Traditionally, research has purpose of identifying and meeting individual needs within social context , but with
current application of participatory active research
a. Research seeks social transformation
b. Research externally adapt to communities
c. Research problem is studied by external researchers
d. All of the above

95. Consideration of site selection is under the pre entry phase. When a student nurse develops a medium
community plans, the activity is under what phase of the COPAR?
a. Sustenance and strengthening phase
b. Community organization and capability building phase
c. Community action phase
d. Entry phase

SITUATION: Family planning is the planning of when to have children, and the use of birth control and other
techniques to implement such plans. Other techniques commonly used include sexuality education, prevention
and management of sexually transmitted infections, pre-conception counseling, and management, and
infertility management.

96. When giving health education about family planning. What is the most important thing to consider?
a. The belief of the couple that it will help them improve their relationship
b. The culture that sets ,there are contraceptive methods against their culture
c. The decision of both couple to acquire information and choose the best for them
d. The effect of family planning in their status.

97. When planning to conduct a health education about family planning, the nurse should consider that the
content of the education should be based on:
a. Information about reproductive health
b. Knowledge about the effects of contraceptive methods
c. Understanding the nature of family planning
d. Matured decision about reproductive health

98. The client that would benefit most from the health education about reproductive health
a. Men and women 12- 35 years old c. Men and women 25- 35 years old
b. Men and women 15-49 years old d. Men and women 20-50 years old
99. One of the considerations the nurse should take when giving health education to clients with the appropriate
contraceptive method to use is:
a. Integrate the personal values to influence the client’s decision
b. Deciding for client on the appropriate method
c. How the method will affect the sexual enjoyment
d. Focus on the current issues and leaving the prior experiences as such

100. Ideally, the nurse would not consider which of these as part of the health education about the contraceptive
method to use?
a. Financial factors
b. Evenly Birth spacing
c. Availability

Situation: Improvement with the quality of healthcare serves for public and community remains to be the
sound goal of every healthcare providers in our country. The Philippines healthcare delivery system has
achieved several ways to develop the quality of services.

101. A common vision for the poverty reduction and sustain development in September 2000 has been
adopted. Which of the following strategy exemplifies for this particular healthcare improvement?
a. Millenium Development Goal (MDG)
b. FOURmula ONE for Health
c. Department of Health (DOH)
d. National Health Insurance Program (NHIP)

102. All of the following goals has been adopted to achieve the essentials of quality health or health related
concerns for poverty reduction, EXCEPT:
a. Eradicate extreme poverty and hunger
b. Achieve universal primary education
c. Reduce Child mortality
d. Improve maternal health

103. Which of the following correctly defines public health according to WHO?
a. A state of complete physical, mental and social well being, not merely the absence of disease or infirmity
b. Science and art of preventing disease, prolonging life through organized community effort
c. Art of applying science in the context of politics so as to reduce inequalities In health while ensuring the
best for the greatest number.
d. A science rendered by a professional nurse with communities in all settings.

104. A person’s health is determined by his circumstances wherein one of these considers the beliefs of every
families and friends affect the status. Which of the following determinants correctly define this situation?
a. Culture c. Health services
b. Personal behavior and coping skills d. Social support and network
105. Which of the following determinants of health is linked to a nursing diagnosis for patients with
“knowledge deficit”?
a. Income and social status c. Physical environment
b. Education d. Personal behaviors and coping skills

SITUATION: Knowledge about the proper use of contraceptives increases the client’s awareness for having
responsibility with their health status as an individual, mother and responsible citizen of our country.

106. A client asks the nurse for contraceptive information. Which of the following is correctly stated by the
nurse abOut contraception?
a. The rim of the condom must be held in place while withdrawing the penis from the vagina
b. Diaphragms are equally effective whether or not partners choose the spermicidal creams
c. No sperm can reach the ovum if the man uses coitus interreptus and withdraws before ejaculation
d. Individual using periodic abstinence should have intercourse on days when the woman has a rise in the
temperature

107. When counseling the client with diabetes mellitus who request for a contraceptive to use, it is most
important to suggest by the nurse to use:
a. Diaphragm c. Calendar method
b. IUD d. Standard days method

108. Which of the following contraceptive methods is/ are contraindicated for patients with DM I?
a. Depo provera c. Oral contraceptive pills
b. Diaphragm d. A and C

109. Which of the following side effects when a mother prefers the use of implantable progestin (Norplant)
should the nurse tell to the client?
a. Vertigo
b. Dyspareunia
c. Increase in breast size
d. Irregular menstrual bleeding

110. Which of the following is considered to be the most effective method in preventing the possible
transmission of sexually transmitted diseases?
a. Use of condom
b. Abstain from multiple sexual activities
c. Injection of depo provera
d. Use of oral contraceptive pills
SITUATION: Health care services in a community is one of the essential aspects of nursing care and for the
improvement of quality services for people in the community.

111. All structures, personnel and budgeting allocations from the provincial health level down to the barangays
were devolved to the LGU to facilitate health service delivery. Which of the following law describes the devolution
of healthcare services in the community?
a. RA 9173 c. RA 3573
b. RA 7160 d. RA 9288

112. Which of the following describes the major strategies, organizational and policy changes and public
investments needed to improve the way of healthcare is delivered, regulated and financed?
a. Health Sector Reform Agenda c. Primary Health Care
b. Local Government Unit d. Department of Health

113. All of the following are roles and functions of the Department of Health as mandated in Executive Order
102, EXCEPT:
a. Leadership in Health c. Enabler and Capacity Builder
b. Community Organizers d. Administrator of Specific Services

114. During an emergency response and disaster management , the DOH has the capacity to implement
actions for immediate care for the community groups who are affected and involved. Which of the following major
roles of the DOH clearly defines this role?
a. Leadership in Health c. Enabler and Capacity Builder
b. Community Organizer d. Administrator of Specific services

115. One of the roles of the Department of Health is to serve as an advocate in the adoption of health policies,
plans and programs to address the national and sectional concerns. Which of the following major roles of the DOH
greatly concern the advocacy for communities?
a. Leadership in Health c. Enabler and Capacity builder
b. Community Organizer d. All of the above

SITUATION: Increasing the survival of newborn may depend on the quality of nursing care provided. Hence
assessment must be made thoroughly for the newborn health status to maintain.
116. Immediately after birth, the nurse should expect the umbilical of the newborn to be:
a. One artery c. Inflamed
b. Two veins d. Whitish gray discoloration

117. Which of the following is expected by the nurse to a newborn responding well to feeding?
a. Active alert c. Lethargic
b. Drowsy d. Crying

118. Which one of the following about breastfeeding should the nurse reinforce for client's right learning?
a. Inserts the nipple and areola into the newborn's mouth after stimulating the rooting reflex
b. Leans forward to bring breast to the baby
c. Holds breast with 4 fingers along the bottom and thumb at the top
d. Places her finger into the newborn's mouth before removing the breast
119. The nurse recognizes that a new mother understood breastfeeding instruction when she states:
a. "My baby continues to suck for sometime on the 2nd breast after it is empty"
b. "I use two positions for feeding, football and traditional"
c. "It is important to breastfeed starting on right breast always"
d. "I must breastfeed my baby according to my mood"

120. Which common observations is noted by the nurse for a newborn at about 36 weeks gestation?
a. Lanugo all over the body c. Low set ears
b. Moro reflex d. Skin peeling

Situation: Various categories of health workers are made for the PHC team. Efforts are made for collaboration
and effective teamwork while providing health services in the community.

121. John, a PHN knows that healthcare workers for primary healthcare for different communities would
depend upon;
I. Available health manpower resources
II. Local health needs and problems
III. Political and financial feasibility

a. I and II c. II and III

b. I only d. All of the above

122. Aling Maria attends to a normal spontaneous delivery in a community for a safe and effective care for the
mother and baby. The community knows that she’s been a traditional birth attendant for 3 years. Aling Maria as
primary health worker in the community belongs to what category?
a. Village or Barangay Health Workers
b. Intermediate level Health Worker
c. Professional Health Worker
d. Rural Health Midwife

123. When levels of care are devolved to cities and municipalities to care and collaborate with Barangay Health
Station or Rural Health Unit, it is considered under what level of healthcare and referral system of PHC?
I. Primary
II. Secondary
III. Tertiary

a. I only c. II only
b. II and II d. All of the above
124. When a public health nurse refers Mang Ambo to seek consultation in a facility where specialists are
present and medical centers are recognized, it is under which of the following level/(s) of healthcare and referral
systems?
I. Primary
II. Secondary
III. Tertiary

a. I only c. III only

b. II only d. I and III

125. Physicians with basic trainings, facilities either privately owned or government operated is under what
level/(s) of healthcare and referral system?
I. Primary
II. Secondary
III. Tertiary

a. I only c. II and III

b. II only d. I and II

SITUATION: Janine, 34 years old G4P3 is admitted at De Los Santos Medical Center with a diagnosis of Pregnancy
Induced Hypertension (PIH).

126. When anticipating for the possible development of PIH , the nurse know that it occurs :
a. After 20th weeks AOG
b. First trimester
c. Before 16 weeks
d. During the duration of pregnancy

127. Which of the following is least considered by the nurse when the patient is receiving Magnesium sulfate?
a. Check the client for possible respiratory arrest
b. Check for clients decreased cardiac rate
c. Check for the client knee jerk reflex
d. Check for the client' s urine output

128. Magnesium SO4 toxicity must be carefully assessed by the nurse. Which of the following indicates that the
client is experiencing toxicity?
a. Respiratory depression and negative deep tendon reflex
b. Headache and vomiting
c. Diuresis and constipation
d. Pruritus

129. Which of the following drugs may be given to client to reverse the Magnesium toxicity?
a. Naloxone
b. Protamine sulfate
c. Vitamin K
d. Calcium gluconate
130. Which of the following is considered by the nurse during assessment as an impending sign for seizure
associated with PIH?
a. (-) knee jerk reflex c. Epigastric pain
b. Hypotension d. Polyuria

SITUATION: Community Health Nursing process emphasizes the systematic way of identifying data and
evaluating plans effectively.

131. Which of the following elements identified by the nurse than focus on the physical setting , instrumentations
and conditions through which nursing care is given with philosophy and objective?
a. Structure c. Outcome
b. Process d. Modified

132. When a public health nurse includes the nursing process itself for a quality nursing action, It is best identified
as what type of evaluation element?
a. Structure c. Outcome
b. Process d. None of the above

133. Changes in the client’s health status that results from nursing intervention is an element of evaluation
identified as
a. Structure c. Outcome
b. Process d. None of the above

134. When presenting the data about the occurrence of disease and death in a population, the nurse recorded the
trends of birth and death rates over a period of time. This type of presentation may be shown by using
a. Bar graph c. Pie chart
b. Line graph d. All of the above

135. When a public health nurse presents the relative importance disease in a population, it is the use of:
a. Bar graph c. Pie chart
b. Line graph d. All of the above

SITUATION: Vicky and Jayson are interested to know more about prepared childbirth. The couple decides to
attend classes two months prior to Vicky's EDC.

136. What method of delivery is based on the theory of stimulus-response conditioning to reduce pain secretion
during labor?
a. Bradley c. Lamaze
b. Leboyer d. Natural childbirth

137. Which of the following is NOT observed in Leboyer method.?

a. The cord is cut after the pulsation ceases
b. Birth occurs in a well-lighted and quiet room
c. Neonate is placed immediately on themother's abdomen
d. Neonate is emerged in a tub of warm water
138. Which of the following procedures will likely diminish pain during labor by cutaneous stimulation?
a. Pelvic rocking c. Tailor sitting
b. Kegel's d. Squatting

139. What will be the best intervention for Vicky if she develops hyperventilation during labor?
a. Encourage shallow breathing
b. Instruct her to deep breath and exhale through pursed lips
c. Instruct her to breathe through a paper bag
d. Administer oxygen through a nasal cannula

140. Which of the following procedures will likely diminish pain during labor by cutaneous stimulation?
a. Effleurage c. Imagery
b. Breathing technique d. Interacting with healthcare providers

SITUATION: Baby girl Roa is 2-month-old infant who is brought to the center for well-baby checked up.

141. Which two of the following reflexes normally fade at about 2months of age?
l. Moro
ll. Tonic neck
lll. Rooting
lV. Sucking

a. l and ll c. l and lV
b. ll and lll d. l and ll

142. At the age of 2months, Baby Roa shall already have the following immunizations
a. BCG; DPT2; OPV2; MMR c. BCG; DPT2; OPV1; Hepa B1
b. BCG, DPT1; OPV1 d. BCG, DPT2; OPV2

143. What important instructions will be given to Mrs. Roa after her baby receives OPV?
a. Feed the infant right away
b. Give antipyretic
c. Give fruit juice or glucose water
d. Withhold feeding for 30 minutes

144. What is the dose and route of administration of BCG vaccine?

a. 0.5 ml intradermal c. 0.5 ml lV
b. 0.2 ml subcutaneous d. 0.2 ml lM
145. After the dose of DPT vaccine, which 2 of the following should be done by the nurse?
l. Massage the injection site
ll. Give paracetamol at once
lll. Instruct the mother not to touch the injection site
lV. Instruct the mother to give paracetamol every 4 hours round the clock for the first 24 hours

a. l and IV
b. ll and lll
c. Il and lV
d. Ill and lV

SITUATION: Greg, 10 years old,is admitted after playing football with friends because he has fractured femur in
his right leg. At the orthopedic unit, he is placed in 90-90 degree skeletal traction.

146. When developing a nursing care plan for the Greg, a major consideration that should be included during
care is:
a. keeping his back off the mattress or bed linens
b. Avoiding any sudden movements of the bed or traction set up
c. Active ROM is indicated for patient most especially in the lower extremities
d. Encourage bobby to sit up after eating heavy meal

147. The nurse plans to check Greg frequently for evidence of skin breakdown, which is most likely to develop
a. Over the calf muscles c. On the popliteal
b. Over bony prominence d. On the hips

148. While the patient is in traction , the nurse must be concerned in which of the following findings during
assessment with the functions of traction?
a. A traction rope is out of a pulley groove
b. The patient asks food in between meals
c. The weigh of the traction are hanging freely
d. The foot of the bed is elevated on blocks

149. When developing a nursing care plan, the nurse must include :
a. Encourage a high fluid intake
b. Allow Greg to choose a diet high in roughage
c. Encourage Greg to have an active exercise while in traction with feet movement
d. Turning Greg on his side every 45 minutes

150. Which one of the following events noted by the nurse must be immediately reported to the nurse in
charge?
a. Discoloration of toes where the traction is applied
b. Anorexia during treatment
c. Persistent movement of the right leg
d. Irritable and upset when confronted about the fracture
151. The nurse notes that Greg's parents are concerned about his discomfort and are attempting to make him
comfortable. Which one of the following warnings should the nurse give to Greg's parents?
a. "Do not remove or touch the weighs attached to ropes"
b. "Do not give toys to Greg because he may hurt himself"
c. "It is best if you do not give Greg anything to drink. This should be done by the nurse"
d. "Leave Greg alone, He will be more comfortable in a few days"

152. Which of the following nursing interventions would most likely encourage an ill child to eat?
a. Feed the child to be sure she eats all food on the tray
b. Take the child to the playroom for all meals
c. Offer the child foods and fluid she likes
d. Withhold the dessert until intake is inadequate

SITUATION: Cindy , 6 months old is diagnosed with CHD (Congenital Hip Dislocation) and is scheduled for the
application of a bilateral hip spica cast.

153. The nurse is assigned to collect materials necessary for the application of the cast. To help eliminate skin
irritation from the edges of the cast, the nurse expects from the physician to
a. Petals the cast edges with strips and adhesives
b. Trims the cast edges with sandpaper
c. Covers the cast edges with plastic
d. Protects the cast edges with a disposable diaper

154. Following application of the cast, the nurse should observe Cindy for signs of complications.Which one of
the following might indicate that a neurovascular problem is occurring?
a. She cries evenly
b. She wiggles her toes
c. Her toes are pale and cold
d. She moves her feet

155. The most appropriate pain scale a nurse must utilze when assessing a preschool child about pain is:
a. Numerical analog
b. Wong Baker faces pain scale
c. Subjective assessment
d. Ask the mother scale

SITUATION: Jenny is born after 38 weeks gestation by breech presentation. She has the talipes equinovarus form
of bilateral clubfoot .The physician has recommended immediate treatment.

156. Which of the following reasons why immediate treatment is necessary for the client?
a. Later treatment is more expensive
b. Prevent progressive development of abnormality
c. Early treatment may prevent the need for surgery
d. The infant is very much happy and prepared for the immediate treatment
157. At a nursing conference , the nurse assistant asks the nurse why Jenny's legs and feet are to be elevated
on pillows after the cast has been applied. The most appropriate reponse by the nurse is
a. Prevents swelling of the feet
b. Hastens drying of the cast
c. Keeps his hips and lower back off from bedding
d. Helps avoid post op shock

158. Which of the following would be best for the nurse to use when moving the client with wet cast?
a. Handle with the palms of the hands
b. Handle with the fingers
c. Handle with sterile gloves
d. Handle with clean gloves

159. Jenny is 8 weeks old and her cast is need to be changed. Which of the following types of amusement can
the nurse use to determine if Jenny appears to be following a nor,al growth and development pattern?
a. Encourage the client to crawl on her crib
b. Play a peek a boo with her favorite blanket
c. Permit her to reach the cuddly toys
d. Place a brightly colored mobile over her crib

160. During discharge teaching , Jenny's mother says to the nurse, " I can barely feel the soft spot on the back
part of Jenny's head. Which of the following is the best response of the nurse?
a. Normal
b. Abnormal for female child
c. She's developing hyrdocephalus
d. B and C

SITUATION: Maria, 8 months was brought at the health center by the mother. Nurse’s assessment noted Maria
has existing illness. According to the mother, Maria has difficulty breastfeeding and feels hot to touch. Maria has
37.9 degree Celsius and noted the sunken eyes.

161. When assessing for the main symptoms included in the IMCI, which one is not included?
a. Cough or difficulty breathing c. Fever
b. Diarrhea d. Vomiting

162. The nurse is correct when she coded Maria under what color?
a. Pink c. Green
b. Yellow d. None of the above

163. What is Maria’s classification?

a. Severe dehydration c. No dehydration
b. Some dehydration d. None of the above
164. When identifying about Marias treatment, the nurse should initiate which of the following part of her
treatments?
a. Plan A c. Plan C
b. Plan B d. Plan D

165. When identifying the treatment indicated for Maria, the nurse is correct when she started giving fluids
using:
a. NGT c. Bottle
b. IVT d. All of the above

166. Patient with one sign in pink and one sign in yellow should be coded under what color in dehydration
classification?
a. Pink c. Green
b. Yellow d. None of the above

167. As a general rule, any problems of children with danger sign must be coded under what color?
a. Pink c. Green
b. Yellow d. None of the above

168. What is the child’s classification if he or she’s having diarrhea with sunken eyes
a. Severe dehydration c. No dehydration
b. Some dehydration d. None the above

169. Which of one of the following treatment regimen for children some dehydration
a. Intravenous fluid therapy
b. Oral Rehydrating solution through NGT
c. Oral Rehydrating solution to be consumed for 4 hours
d. Extra fluid for each loose watery stool

170. When developing a plan of care for patient given with Plan A treatment, the nurse must include
administering:
a. Intravenous fluid therapy
b. Oral Rehydrating solution through NGT
c. Oral Rehydrating solution to be consume in 4 hours
d. Extra fluid for each loose watery stool

Situation: John, 11 years old, has brain tumor and is admitted for hospital treatment.

171. The physician prescribed the osmotic diuretic Mannitol ( Osmitrol) to relieve the increased ICP due to cerebral
edema. Which of the following should the nurse include about the drug given to the client?
a. Increase CSF pressure
b. Increase urine output
c. Decrease in the client's pulse rate
d. Decrease in urine output
172. Which of the following statements would best help the patient cope with the effects of chemotherapy as
included in the treatment of the client? The nurse would tell the client,
a. "It will make you alright"
b. "You may feel better, but you you may feel sicker first"
c. "Immediately , it will cure your tumor"
d. "No side effects, don't worry"

173. Nausea and vomiting are expected once chemotherapy is initiated. The nurse places the client to what
position to prevent aspiration?
a. Supine c. Side lying
b. Prone d. Trendelenburg

174. Nasogastric tube feeding was ordered for the client. Which of the following the nurse should consider when
administering a tube feedings?
a. The height of the container holding the liquid feeding affect the rate of instillation
b. The method of feeding should never be administered for the patient
c. The family should decide for what the client should eat
d. Feeding formula must be asked by the nurse from the family member.

175. When helplessness being shown by the family because of poor prognosis, how will the nurse help the parents
in dealing with despair? It is most therapeutic for the nurse to:
a. Clarify feelings about the situation
b. Explore each feelings
c. Reflect from own experience and advise to the client about coping strategies
d. Sympathize with the client because death is inevitable

SITUATION: IMCI creation has provided a case management process to care for children with known diseases
that increases morbidity and mortality cases under 5 years old.

176. All of the following are considered danger signs EXCEPT:

a. Convulsion
b. Abnormally sleepy or difficulty to awaken
c. Inability to drink or breast feeding
d. Vomiting

177. During assessment at the health center, you noticed that other nurse has been trying to check whether the
child is positive with abnormally sleepy or difficulty to awaken. Which of the following is correct when assessing for
this danger sign?
a. noted that the child stares blankly
b. noted that the child does not respond when touched, shaken or spoken to
c. noted that the child seems not interested with the environment
d. all of the above are noted
178. When a nurse asks the mother to offer fluid for the child, which of the following danger sign the nurse is
trying look for?
a. Vomiting c. Convulsion
b. Inability to drink d. Abnormally sleepy

179. After assessing for danger signs, a nurse noted negative for all of these. The nurse next action is to:
a. Assess the client’s nutrition
b. Double check the assessment
c. Assess for main symptoms
d. Assess for potential feeding problems

180. A nurse asks the mother whether the child has fast breathing and cough and difficulty breathing. The mother
said that the child is 12 months. What is the child’s RR to be classified with fast breathing?
a. 60 breaths per minute or more
b. 50 breaths per minute or more
c. 40 breaths per minute or more
d. 30 breaths per minute or more

181. When giving health education to our clients, fast breathing is part of assessment to identify whether the child
is developing
a. Severe pneumonia c. Very severe disease
b. Pneumonia d. Bronchitis

182. Aside from fast breathing , the nurse must be careful in assessing about the period of cough and cold because
of the possibilities that the child might be suffering from other illnesses like:
a. Asthma and bronchitis c. Dengue hemorrhagic fever
b. Emphysema d. All of the above

183. What is the nurse’s next action after assessing the child for cough or difficult breathing?
a. Assess again for relapse of danger signs c. Assess for possible causes of fever
b. Assess for diarrhea d. Assess for ear infection

184. When assessing the patient with diarrhea, it is most important to include in the nursing care plan the possible
complication that decreased the child for survival and that is to check for the presence of
a. Sunken eyes c. Decrease capillary functions
b. Dehydration d. Drinks eagerly thirsty

185. After assessing the child’s illness about diarrhea, the next nursing action is to check for the possible causes of
fever which includes:
a. Malaria c. Dengue hemorrhagic fever
b. Measles d. All of the above
186. After assessing the child for possible causes of fever, the nurse should go down the next level of the chart and
check whether the child has:
a. Iron deficiency anemia c. Marasmus
b. Ear problems and infections d. Kwashiorkor

187. A child with diarrhea for more than 14 days with dehydration is classified under
a. Severe persistent diarrhea c. Dysentery
b. Persistent diarrhea d. Severe dehydration

188. A child with ear infection and pain but discharge has been noted for 8 days is classified under :
a. Mastoiditis c. Acute ear infection
b. Chronic ear infection d. No ear infection

189. A child who has fever must be assessed for the possible causes, which one is NOT included in the assessment?
a. Malaria c. HIV
b. Measles d. Dengue hemorrhagic fever

190. When patient is classified with very severe febrile disease/Malaria, the child is given initially an
a. IM anti malarial drug c. Oral mebendazole
b. Oral anti malarial d. Oral iron preparation

191. Which one of the following problems may lead to kwashiorkor and Marasmus?
a. Pneumonia c. Malnutrition
b. Diarrhea d. Ear infection

192. All but one is included in the assessment of a child, using IMCI:
a. Malnutrition c. Immunization
b. Vit C supplementation d. Potential feeding problems

193. When do you plan to check for danger signs?

a. After checking for main symptoms
b. Before asking the mother about the main symptoms
c. Before asking the mother about malnutrition
d. After checking for potential feeding problem

194. If you have noted during assessment that there are problems not specific in the IMCI chart but remain to be
the cause of illness of the child, what is the next nursing action?
a. Stop assessing the client since the problem is not specific with IMCI
b. Continue to assess and give practical nursing intervention
c. Refer immediately without completing the assessment
d. Ask someone to do the assessment for the child
195. When do you plan to check for diarrhea and dehydration?
a. After assessing for a child with cough or difficulty breathing
b. Before assessing the child for malnutrition
c. After assessing the child for danger signs
d. After getting the child’s profile from the mother

SITUATION: Nursing care for mothers in labor and delivery

196. When the nurse is assessing a laboring client for signs of transitional phase is beginning. The nurse would
expect the client to have:
a. Bulging of the perineum
b. Crowning
c. Rectal pressure during contractions
d. Reddish vaginal discharge

197. During assessment, a pregnant client tells the nurse, " I feel wet.I think I urinated". The nurse must include in
the assessment first:
a. Give her bedpan
b. Prepare for catheterization
c. Change the bed linens
d. Inspect the client's perineal area

198. A client in active labor starts screaming " The baby is coming!" .The nurse first action is:
a. Check the fetal position
b. Check the perineum
c. Administer methergine
d. Position the client in lithotomy

199. Which of the following a nurse must expect during placental separation?
a. The fundus is relaxed
b. Umbilical cord lengthening
c. Bleeding excessively
d. Severe abdominal pain is noted
1. The client speech pattern is related primarily to:
a. Under lying hostilities
b. Loose ego boundaries
c. Feeling of anxiety
d. Distortions in self-concept

2. Which of the following the nurse might expect during assessment of a client who’s in the state of heroin
withdrawal
a. Rhinorrhea , sneezing and intermittent fever
b. Papillary dilation, diaphoresis and weight loss
c. Puillary constriction, vomiting with episodes of gastritis
d. Frequent lip smacking

3. Another opiate is given for patient who has been withdrawing from heroin abuse and dependence like
methadone.Which of the following outcome is expected by the nurse?
a. Sedation
b. Anhedonia with bouts of euphoria
c. Extreme and heightened self esteem
d. Blocking the euphoric effect and eliminate the graving

4. How would you classify drugs like amphetamines and cocaine which increase individuals to become addict
once it is habitually use?
a. Stimulants
b. Opiate
c. Depressants
d. Analgesics

5. The nurse is caring for client with pinpoint pupils with hypotension, hypothermia, bradycardia and
bradypnea. When discussing these symptoms, more like to be observe for patients who has been taking:
a. Amphetamine with intoxication effect
b. Intoxicated from Opiate
c. Cannabis intoxication

SITUATION: DEATH and DYING ,GRIEF AND LOSS

6. Resolution of grief related to death is least likely to be complicated when:

a. Ambivalent feelings for the deceased
b. The death is accepted because of the chronicity of the illness presented beforehand
c. It is the first loss to be experienced
d. All of the above

7. Which behavior might the nurse expect from a patient with CHF who is in the grief stage of developing
awareness of the loss of a spouse?
a. Crying and anger c. Accepting the inevitability
b. Blaming self for what happened d. Apathetic with mild depression
8. When a client tells the nurse the he cannot sleep at night because of fear of dying. What would be the
most appropriate response ?
a. “Don’t worry, you won’t die, may be soon”
b. “Why are afraid about this?”
c. “Try to sleep. I’ll get you a glass of milk”
d. “It must be frightening for you to feel that way. Tell me more about it”

9. The nurse is caring for client who is dying of cancer. When the nurse is about to enter the room for
mediation administrations, she overhears making for plane reservations. The client confides with nurse that
Mexico flight was reserved to seek another doctor who can cure the client’s problem. The nurse understands that
the patient is in the state of:
a. Denial
b. Bargaining
c. Depression
d. Acceptance

10. While having conversation with the client, she tells suddenly to the nurse “I can’t walk, I have nothing to
say” and continues being silent. The most therapeutic response by the nurse is:
a. “All right. You don’t have to talk. Let’s play card instead”
b. Explain that talking is an important sign of getting well and the patient is expected to do so
c. Be silent until the patient speaks again
d. “It may be difficult for you to speak at this time; perhaps you can do so at another time.

SITUATION : Both delirium and dementia are cognitive problems that pose patient to be injured because of
progressive confusion and disorientation related to the diease.

11. Patient with dementia usually manifest confabulation which serve them to:
a. Impress others that they know everything
b. Protection of their self esteem
c. Maintaining their sense of humor
d. Part of self therapy

12. When caring for patient diagnosed with dementia, it is expected by the nurse to assess the client for
common symptoms like:
a. Memory loss from distant event
b. Increased resistance to change
c. Frequent nightmares
d. Increased anxiety when confronted about the problem

13. Which of the following the nurse must be considered first for patient diagnosed with dementia?
a. Restoring the client’s OLOF c. Promoting memory recall
b. Minimizing regression d. preventing further deterioration
14. When a client make up stories to fill in the gaps between memories, this is most likely observed in patient
with dementia and medically termed as:
a. Retrorgrade amnesia
b. Pinoy henyo
c. Confabulation
d. Anterograde amnesia

15. When the nurse is communicating with a client with substance-induced persisting dementia, the client
cannot remember facts and fills in the facts with imaginary information. The nurse is aware that this is typical of :
a. Concretism
b. Flight of ideas
c. Associative looseness
d. Confabulation

MENTAL HEALTH CONCEPT

16. When taking health history from a client with moderate dementia, the nurse would expect to note the
presence of:
a. Increased inhabitation
b. Hypervigilance
c. Accentuated premorbid traits
d. Enhanced intelligence

17. The most basic therapeutic tool used by the nurse to assist a client’s psychological coping is the:
a. Milieu
b. Self
c. Client’s intellect
d. Helping process

18. In an attempt to remain objective and support a client during a crisis, the nurse uses imagination and
determination to project the self into the client’s emotions. The nurse accomplishes this by using the technique
known as:
a. Sympathy
b. Empathy
c. Projection
d. Acceptance

19. Following a traumatic event a client is extremely upset and exhibits pressured and rambling speech. A
therapeutic technique that the nurse can use when a client’s communicationrambles is:
a. Focusing
b. Touch
c. Silence
d. Summarizing
20. A client with an inoperable occipital lobe tumor has been experiencing rather frightening visual
hallucinations especially when alone. The nurse can best help the client cope with these hallucinations by planning
to:
a. Move the client to a four-bed room closer to the nurses station
b. Have family or friends remain with the client until the hallucination stop
c. Suggest that the client not be alone and work out a schedule for visitors
d. Suggest that the client turn on the radio to television when alone

ALCOHOLISM

21. Which of the following would be the best measure for the client who has been experiencing delirium
tremens?
a. Provide a dark, quiet room restraints and side rails
b. Arrange the client’s bed near the nurses station and keeping the TV on all throughout the night
c. Increase interaction with the client
d. Provide a room with light that decreases shadows inside the room and ask someone for the client to be
observed

22. The nurse is caring for client with Wernicke’s encephalopathy. Which of the following the nurse must
emphasize to a family when serving food for the client?
a. Serve food rich in protein
b. Serve foods with Thiamine
c. Serve foods rich in niacin
d. Serve foods rich in Vit. C

23. Patients who developed Wernicke’s and korsakoff’s problem for chronic alcoholism are expected to be
treated with:
a. Oral thiamine administration
b. IM injection of thiamine
c. IV injection of Niacin
d. SQ injection of Disulfiram

24. A client admitted in the NCMH due to chronic alcoholism asks the nurse if he see the bugs crawling over
his bed. The most therapeutic response by the nurse is:
a. “Yes . they’re all big”
b. “No, I don’t see any bugs”
c. “These are not bugs, ants may be”
d. “Oh I’ll get it for you”

25. When a client develops Korsakoff’s psychosis from chronic alcoholism, the nurse expects for the client ot
experience during assessment:
a. GIT upset
b. Confabulation
c. Excessive sweating
SITUATION: Assessment for patients experiencing different types of crises.

26. A client asks the nurse, “Why do you think I should do about asking my boss for a raise?”.the nurse
replies.”What do you think about asking your boss for a raise?”. The nurse is using which therapeutic
communication?
a. Focusing
b. Broad opening
c. Reflecting
d. Restating

27. During psychosocial assessment, a client tearfully shouts that he is hearing a voice. An accurate
assessment must be made for the client, which of the following questions is most appropriate for the nurse to ask?
a. “Who is speaking to you?”
b. “What do the voices say?”
c. “How do you explain the voice?”
d. “When do you hear the voice?”

28. Which of the following nursing interventions would encourage a client to communicate who is withdrawn
and non-communicative in psychiatric unit?
a. Focus on non threatening approach
b. Try another client to talk with the client to promote social interaction
c. Ask simple question by answering “yes or no”
d. Sit with the client and don’t attempt to talk until the client feels to do so.

29. During admission in the National Center for Mental Health, a client diagnosed with bulimia reports that a
family member is physically abusive and requests that the nurse doesn’t release any information to anyone. When
the abusive family member calls the unit and demands information about the client’s treatment, the nurse best
response is:
a. “ I understand your concern, but I can’t give you any information for the protection of my client”
b. “It’s your way to find the information about the client goodluck”
c. “Since family is part of the treatment, you have the right to know more about the client”
d. “I’ll ask the doctor of the patient first, just wait and we’ll address your concern”
d. Intermittent fever

30. What is the nurse’s most therapeutic response when a client tells “ Life isn’t worth living, I am worthless
and hopeless to see my family”
a. “Sometimes when people feel depressed and helpless, they feel like hurting themselves. Do you feel like
hurting your self?”
b. “Perhaps, spend your time with your family”
c. “I understand how you feel, you’ll be fine once you have your vacation with family”
d. “ Tell me more about your feelings”
MOOD DISORDERS

31. Which of the following short term goal of the nurse when developing a plan of care is most applicable for
bipolar manic episode who is having difficulty sleeping?
a. Nighttime routine for the client
b. Exercise and bedtime stories
c. Writing the plans about ways to sleep
d. Medication as prescribed

32. Which of the following discharge instructions is most important to include when teaching the patient
about the compliance with Lithium (Eskalith)?
a. Limit the fluid intake for 1500 ml daily
b. Maintain 2-3L daily
c. Exercise is needed
d. OTC may be taken to enhance the drug

33. When developing a plan of care for client diagnosed with mood disorder manic episode, it is most
important to include by the nurse about:
a. Expression of feelings about anger and rage
b. Providing reality orientation
c. Reducing the environmental stimuli
d. Facilitating attendance in a group therapy

34. The nurse is working with a client who often threatens suicide to seek attention. In developing a plan of
care for this client, it is most important to :
a. Take it seriously as it being expressed by the patient
b. Ignore and focus with other clients
c. Let this patient realize his negative thoughts
d. Allow the patient to be alone first

35. Although this client has not verbalized the plan, it is most important to focus on the client’s behavior. This
behavior of the client signifies:
a. Aggression
b. Manipulation
c. Confrontation
d. Seeking attention
ALCOHOLISM

36. The client’s husbands tells the nurse that he is also drinks heavily in the evening anf would like to stop.
The nurse suggests that he attend Alcoholics Anonymous, “I went to one men’s meeting and all they did was swear
and brag about how drunk they got”. Which of the following responses is most appropriate?
a. “I can see how you might have been turned off with your experience, now I understand your feelings”
b. “Alcoholics Anonymous meetings vary from group to group. Have you thought about attending another
group?”
c. “ I understand how you feel” There are other therapies available”
d. “This is the only way to help yourself”

37. When client develops delirium tremens, it is most important for the nurse to carry out activities for client
as part of nurse’s plan.
a. Assigning a staff member for constant care
b. Obtaining an order for major tranquilizer
c. Restraining the client immediately
d. Secluding the patient in a safe room to prevent progression.

38. Which of the following would be therapeutic for client who says “there are bugs crawling over my bed”?
a. “I see spiders not bugs”
b. “There are no bugs in your bed”
c. “Get the bugs off your bed”
d. “I’ll ask some staff to get another bed linens”

39. Which of these symptoms in a patient are observable by the nurse when a client is in the state of alcohol
withdrawal and manifest impending delirium tremens?
a. Tongue twitching and lip smacking
b. Stiff neck and constipation
c. Agitations and hallucinations
d. Flapping tremors

40. A patient admitted due to chronic alcoholism. The patient is prescribed for Disulfiram (Antabuse). When
evaluating the client understanding about the drug, the patient responds positively if he says:
a. “Mouthwash may contain alcohol, so I must read the label before I purchase and use it”
b. “I still can take alcohol as long as it is limited to one glass per day”
c. “A glass of wine a day is not contraindicated with the drug”
d. “The drug will help me to eliminate voices I hear”
NURSING DIAGNOSES APPLIED FOR PATIENTS WITH PSYCHOLOGICAL ALTERATIONS

41. Jackie , age 22, broke off her one year engagement. Her mother states “She does nothing but cry and sit
and stare into space.I can’t get her to eat anything!” Jackie feels she can’t go on without her boyfriend. The nurse
should make which priority nursing diagnosis for Jackie?
a. Altered nutrition: less than body requirements
b. Risk for self directed violence
c. Ineffective individual coping
d. Defensive coping

42. Janice is admitted to the unit with a diagnosis of borderline personality disorder. She has angry outburst
and is impulsive and manipulative. She has laceration on her arm from self mutilation. The priority nursing
diagnosis for the nurse to formulate is:
a. High risk for violence: self
b. Body image disturbance
c. Ineffective individual coping
d. Personal identity disturbance

43. Which of the following nursing diagnoses would be most appropriate for a client who is diagnosed with
bipolar I disorder, single manic episode and intrusive, argumentative, and severely critical of peers?
a. Impaired social interaction related to narcissistic behavior as evidenced by inability to sustain
relationships
b. Risk for injury related to extreme hyperactivity as evidenced by increased agitation and lack of control
over behavior
c. Social isolation related to feelings of inadequacy in social interaction as evidenced by problematic
interaction with others
d. Defensive coping related to social learning interacting with others

44. A 4 year old girl , who is a victim of a bomb blast that demolished the building which housed her daycare,
constantly builds block houses and blows them up. She also has nightmares frequently. Which hone of the
following diagnoses is appropriate for the nurse to make regarding this child?
a. Sleep disturbance related to emotional trauma as evidenced by nightmare
b. Post-trauma response related to terrorist attack as evidenced by destructive by destructive behaviors and
sleep disturbances
c. Explosive disorder related to dysfunctional personality as evidenced by destructive behaviors
d. In effective individual coping related to internal stressors as evidenced by destructive behaviors and
nightmares

45. Jeff, a 15 year old gymnast present in the eating disorders clinic severely emaciated, with sallow skin
color, 20%body weight loss, amenorrhea for the past 12 months, and facial lanugo. Based on these findings, which
one of the following nursing diagnoses would be most appropriate for the nurse to make?
a. Impaired tissue integrity
b. Ineffective individual coping
c. Altered nutrition:less than body requirements
d. Knowledge deficit,nutritional
SITUATION: a client suspected of having post traumatic stress disorder is admitted to the hospital.

46. The nurse assesses the client with post traumatic stress disorder for which of the following problems?
a. Eating disorder
b. Suicide
c. Schizophrenia
d. “sundown” syndrome

47. Which of the following nursing actions would the nurse include in her care plan for this client who
describes his experiences as bad luck?
a. Help the client accept positive and negative feelings
b. Assist the client in defining the experience as a trauma
c. Encourage the client to verbalize the experience
d. Work with the client to take steps to move on with his life

48. Which of the following instructions should the nurse include relationships for the client with post
traumatic stress disorder?
a. Warn the client that he will have a tendency to be independent in relationship
b. Assess the clients discomfort when talking about feelings to the family
c. Explain that avoiding emotional attachment protect against anxiety
d. Encourage the client to resume former roles as soon as possible

49. While caring for the client with post traumatic stress disorder, the family notices that loud noise causes
serious anxiety response. Which of the following explanations would help the family understand the client’s
response?
a. Environmental triggers cause the client to react emotionally
b. The response indicates that another emotional problem needs investigation
c. Client often experience extreme fear about environment stimuli
d. After a trauma, the client cannot respond to stimuli in an appropriate manner

50. Which of the following actions explains why tricyclic antidepressant medication is given to a client with
serve post traumatic stress disorder?
a. It increases the clients ability to concentrate
b. It prevents hyperactivity and purposeless movements
c. It facilitates the grieving process
d. It helps prevent experiencing the trauma again

SITUATION: A student shows enthusiasm about patients admitted in the psychiatric setting diagnosed with
personality disorders.

51. During interview, a nurse is observing a patient and she noted behaviors as self sufficient , mainly powerful to
himself and superior to others. These behaviors are common to patients with:
a. Antisocial personality disorder c. Narcissistic personality disorder
b. Borderline personality disorder d. Paranoid personality disorder
52. Which of the following defense mechanism is most typical for patients with splitting personality?
a. Projection
b. Compensation
c. Conversion
d. Identification

53. Obsessive compulsive personality disorder is characterized by orderliness and perfectionism and classified
under what type of personality disorder?
a. Cluster of Odd and eccentric behavior
b. Overly dramatic cluster
c. Cluster A and B
d. Cluster C

54. Which of the following is most typical behavior for patient with narcissistic personality disorder?
a. Social withdrawal because of poor self esteem
b. Refusal to enter in a relationship because of fear of rejection
c. Self loving and ego centric
d. Overly dramatic and attention seeking

55. Joe has been in a psychiatric for 2 years, and today he is convincing the nurse that he deserves special
privileges and that an exception to the unit rules should be made for him. Which of the following is the response is
most appropriate?
a. “I believe we need to sit down and have a talk”
b. “Don’t you know better than not abiding the rules in the unit”
c. “What you are asking me to do for you id unacceptable”
d. “Why don’t you bring your request to the unit community meeting”

SITUATION: Domestic violence is a factor that increases people to develop psychiatric problems.

56. Joseph a 22 year old client has been rehabilitated for repeated act of beating his brother. He refuses to
participate in scheduled activities in the ward. He pushes another client in the unit. Which of the following
approach would be therapeutic for the client?
a. Allow the client to do what he wants
b. Coax the client gain strict compliance
c. Give him a praise for his attitude
d. Establish a clear and firm limits for the client’s behavior

57. The nurse must be aware that abuse may also happen in elderly years. Which of the following is most common
findings of an elderly who has been abused by a family member?
a. Malnutrition
b. Mark of restraints
c. Incomplete number of teeth
d. Visual impairment
58. Which of the following interventions is LEAST appropriate for the nurse while caring for a rape victim?
a. Remain with the client
b. Help the patient to ventilate feelings
c. Show a caring and empathetic attitude
d. Allow the client to take a bath to clean the body right away

59. Evidence based practiced provided findings about sexual disorders. People who experienced sexual abuse have
a tendency to experience which of the following behavior as they develop maladaptation with this crisis?
a. Become sex offenders themselves
b. Have increase sexual gratification compare with others
c. Decrease sexual desire during adulthood
d. Have normal response with sexual activities

60. Which of the following observations of the nurse is most common cause for child abuse?
a. Lack of discipline when directed
b. Poor parenting management
c. Mental illness of parents
d. Financial difficulties of the family

SITUATION: Defense mechanism if habitually use with no radical reason may become pathologic and may
increase the impairment with individual’s awareness of reality.

61. Patient who has been using the defense mechanism of reaction formations displays a behavior that:
a. Substitutes an activity for one that is truly desired
b. Rechanneling drives that turn into productive activity
c. Transforming mental conflict into physical symptoms
d. Doing exactly what is opposite

62. During orientation phase of the NPR, a nurse says to the client “ Tell me more about about this pain you are
having”. This is an example of:
a. Restating
b. Exploring
c. Asking for clarification
d. Providing feedback

63. When a husband gets angry with his wife and he yells at his children and pushes the door instead of hitting his
wife, he’s using the defense mechanism of:
a. Projection
b. Displacement
c. Repression
d. Suppression
64. Jenny with history of rape when she was 12 years old unconsciously forgets the event; it is identified as a
defense mechanism of:
a. Suppression
b. Conversion
c. Regression
d. Repression

65. Which of the following defense mechanism of a client in which she curls into fetal position everytime she
experiences an upsetting situation?
a. Fixation
b. Regression
c. Substitution
d. Symbolization

SITUATION: Client s diagnosed with thought problems need to be care with thoroughness according to the
needs of the client.

66. A nurse admitted a client diagnosed with catatonic schizophrenia. She appears weak and pale. Which of the
following the nurse would most likely observe for this patient?
a. Cat like cry when upset
b. Excessive suspiciousness
c. Stupurous withdrawal with hallucination and delusions
d. Bizarre behavior

67. When caring for Joanna, a 23 year old sales lady admitted catatonic schizophrenia, the nurse would most likely
observe during assessment is:
a. Has alternating appetite
b. Stands, sits or lies immobile
c. Overhydrated
d. Anorexic with bout of binge eating

68. Isolation is one the behaviors usually manifested by patients diagnosed with catatonia schizophrenia. When
developing goal for this specific behavior, the nurse:
a. Will communicate in a brief , clear and concise sentences
b. Will provide a colorful environment
c. Will avoid limit setting for the client
d. Encourage the client in a group therapy session

69. A 25 year old woman has been experiencing an acute attack of catatonia where conventional therapy is no
longer effective. The physician ordered for ECT. Prior to the c;ient new treatment, the nurse knows that preop
medication is given like:
a. Atropine
b. Inderal
c. Lithium
d. Chlorpromazine
70. In anticipation of a client with catatonia schizophrenias’ arrival to the unit, which of the following is the nurse’s
part of preparation for the client?
a. Place a specialty mattress overlay in the bed
b. Secure the unit with nursing staffs
c. Announce the arrival of the patient
d. Communicate the client’s therapy beforehand

SITUATION: Joshua, a 40 year old engineer voluntarily ask for admission for rehabilitation due to substance
abuse . He has been drinking RED HORSE beer for almost 9 years,2-3 bottles per day without occasion and time 3
if there’s an occasion. His job is in jeopardy and his wife threatened him for divorce.

71. When developing a plan of care for client that includes medication < it most likely the nurse would expect for
the client to have:
a. Chlordiazepoxide (Librium), multivitamins, thiamine and folic acid
b. Diazepam, multivitamins and Dilantin
c. Vit B1 and Vitamin B3 and Disulfiram
d. Tylenol ( Acetaminophen), multivitamins and Laxative

72. Which of the following would the nurse expect, when Joshua starts to experience early withdrawal symptoms?
a. Vomiting , diarrhea and bradycardia
b. Dehydration, hyperthermia and prupritus
c. Hypertension , convulsion and diaphoresis
d. Nervousness, excessive sweating and tremors

73. When a patient experience alcohol hallucination, it is best for the nurse to intervene with the client by:
a. Keeping the patient in restraint system
b. Vital signs monitoring specially BP every 15 minutes
c. Keeping the environment stimuli free and medication as needed
d. Restrain and vital signs monitoring every 30 minutes

74. Joshua experiences illusions at night, he screams.” There’s a snake in the corner”.The nurse can help Joshua by:
a. Allowing the patient in the room all night
b. Staying with the client all night
c. Leaving the lights ON in his room
d. Allowing him to sit near the nurse’s station

75. When a client is receiving a Disulfiram (Antabuse) ,the nurse would most likely inform the client about:
a. Weekly attendance for aversion preparation
b. Acceptance of alcoholism
c. Keeping alcohol free at least 12 hours before initiation of therapy
SITUATION: Maruja, age 25, is found sitting on the floor of the bathroom in the day treatment cleaning would
moderate lacerations to both wrists. Surrounded by broken glass, she sits starring blankly at her bleeding wrist
while staff nurses call for an ambulance.

76. How should the nurse approach Maruja initially?

a. Enter the room quietly and move besides Maruja to assess her injuries.
b. Call for back-up before entering the room and restraining Maruja.
c. Move as much glass away from Maruja as much as possible and quietly sit next to her
d. Approach Maruja slowly while speaking in a calm voice, calling her name and telling her that the nurse is
here to help her.

77. Maruja is taking to the hospital and admitted on a emergency basis for 72 hours, as provided of state law.
Maruja says to the admitting nurse, “I’m not staying here. I was a little upset and did stupid thing. I want to leave.”
Which response is most appropriate?
a. “unfortunately, you have no right to leave this time. You must evaluate be evaluated further."
b. “patting your wrist was a stupid thing to do. What where you trying to accomplish any way?”
c. “you have been admitted on an emergency basis and can be held by 72 hours. You have the right to
consult the lawyer about your admission.”
d. “I can see your up-set. Why don’t you try to relax? you can explain to the physician what upset you. If you
what you say is true, you’ll be released sooner.

78. Determining Maruja’s suicide potential during the mental status examination involves assessing several factors,
the most significant of which is her:
a. History of previous attempts
b. Suicidal plan
c. Emotional upset
d. Self-esteem
d. Remain alcohol free at least 8 hours before and after therapy

79. A client has just been transferred from a seclusion room after suicidal attempt. Which of the following nursing
interventions is most important at this time?
a. Increase suicide precautions
b. Assume that it will happen again
c. Ask family to be with the client
d. Be with the client as needed.

80. After the client has been evaluated, the client displays behavior as if nothing happened and observed to be
awake and alert but refuses to talk. What is the nurse’s priority at the time?
a. Establish rapport with the client’
b. Place the client in a seclusion room every now and then
c. Communicate in a simple conversation with joke
d. Maintain the safety by initiating suicide precautions
SITUATION: Mental health is a state of balance between emotions, behaviors and thoughts.

81. When having conversation during therapeutic relationship, A nurse must possess the most essential concept
when communicating with a client as part of therapeutic process.
a. Direct confrontation
b. Reassuring
c. Empathetic
d. Humor

82. Provision of psychotherapy is essential when a patient has been experiencing ineffective coping abilities to
solve the problems, in achieving a positive attitude about this situation, a nurse must improve:
a. Self awareness
b. Values
c. Sympathy
d. Understanding

83. A nurse evaluates a client’s thought content during psychosocial assessment when this client is determined
with:
a. False belief about certain behavior or attitude
b. Loss of memory
c. Perceptional misinterpretations
d. Difficulty sleeping

84. When assessing the clients’ level of consciousness, A nurse will explore the client during psychosocial
assessment about:
a. Antero and retrograde memory
b. Ability to respond and alertness
c. Articulation of speech
d. Mood and affect

85. An adolescent male client tells the nurse during interview that his father and mother have been arguing for
almost a week and he didn’t attempt to converse with younger sister because of insecurities about the attention of
his parents. Which of the following psychotherapy is indicated for this situation?
a. Behavioral therapy
b. Art therapy
c. Family therapy
d. Occupational therapy
SITUATION: Psychosocial assessment must be carried out by mental health nurse.

86. During the past 8 months, one student has been observed by school clinic nurse. The nurse found out that the
student has bitten several teachers and classmates, has stolen money from classroom charity project, has been
involved in numerous fights, has been truant and has been intoxicated while at school. What is the goal of crisis
therapy for this client?
a. Resolve all clients’ problems together with his family
b. Explore the parents behavior about the client’s attitude in the school and while at home
c. Explore the teachers’ feeling and check the records of the teachers about GMRC.
d. Decrease the incidence of the client’s behaviors as this reflect conduct disorder

87. The client appears disoriented and confused while walking along the street around a residential neighborhood.
He was picked up by the police at night as if nothing happens in the environment. Which of the following is the
nursing action of the best priority?
a. Assess and stabilize his psychosocial needs
b. Assess and stabilize his physical needs
c. Help the patient to recover in the rehabilitation unit
d. Telephone the family of this client to obtain an accurate history

88. Which of the following statements best describe the main advantage for using group therapy in helping a
patient to achieve mental health for patient admitted in mental health rehabilitation?
a. It decreases the clients stimuli and focus
b. It fosters physician client relationship
c. It confronts the clients’ weaknesses
d. It fosters a new learning environment

89. During a nurse-patient therapeutic session, a client openly discusses his problems, cries openly and expresses
feelings of anger. At the end of the conversation, a client feels a sense of relief. The nurse recognizes that this is a:

a. Ventilation
b. Reframing
c. Sublimation
d. Catharsis

90. When a nurse implements about reorientation of time, place and person, a nurse is positively achieve the
nursing action when she evaluates the client about:
a. Asking for a dinner to be served
b. Stating his birthday and the day of the week
c. Requesting spaghetti and meatballs for the mother’s birthday
d. Stating that he is unsure about his birthrate
SITUATION: Therapeutic communication is a tool for nurses to establish trust and rapport during period of care.

91. During the working phase of the NPR, a client opens up about his problem and expresses his fears. Which of
the following response by the nurse is non therapeutic?
a. “I’m sure everything will turn out to be fine”
b. “Are you worried about how long you will be ill?”
c. “I understand how you feel”
d. “Tell me more about your worries and fears”

92. Joseph, a 35 year old engineer presents to a triage area of an emergency department with uncontrollable
crying and anxiety. He states that his wife for 12 years filed for divorced. Joseph is observed fidgeting in a chair and
wringing her hands.Which response by the nurse is most therapeutic?
a. “You must stop crying so we can discuss your problems”
b. “ You’ll get better once you have a activity that will increase your attention”
c. “Don’t worry , you’ll be fine with my care”
d. “I can see how upset you are. Let’s sit and talk about how are you feeling”

93. A nurse is caring for client with somatoform disorders has developed paralysis of leg. During conversation, a
client says to the nurse,”You think I could walk if I wanted to?” Which of the following responses by the nurse is
the best?
a. “Yes , as long as you believe on it”
b. “Tell me why you’re concerned about it”
c. “Do you think you could walk?”
d. “I think you are unable to walk now, whatever the cause”

94. A client in psychiatric unit tells the nurse that his wife’s nagging really gets in his nerves. He asks the nurse if,
during the family session later in the day, she would talk his wife about her nagging. Which of the following
responses by the nurse would be most therapeutic?
a. “Tell me more about her complaints”
b. “Can you think of a reason why she might nag you so much”
c. “I’ll help you think about how to bring this up yourself”
d. “Why do you want me to initiate this discussion in the family session rather than you?”

95. Which of the following is considered as an effective technique of therapeutic communication?

a. Advising
b. Listening
c. Asking why
d. Medical jargon utilization
SITUATION: Increase in life expectancy is noted in our country. Hence, health care demands in caring for the
elderly increases too.

96. When assessing a 67 year old client, all of the following are considered normal occurrence part of physiological
changes except:
a. Systolic murmur is heard over the aortic area upon auscultation
b. Heart rate of 85 beats per minute
c. Blood pressure is slightly high
d. Increase dependence when performing the usual ADLs

97. Which of the following influences one’s outlook of an elderly as they experience challenges and changes with
their personal, emotional physical and spiritual belief?
a. Peer influence
b. Demands of society
c. Personal experiences
d. Value system imposed by the family and society

98. Which of the following is considered to be part of normal physiologic changes occurring in male client as their
age advances?
a. Premature ejaculation
b. Impotence
c. Declining testosterone production
d. Difficulty maintaining an erection

99. Nursing care for elderly is one the most important aspects of nursing profession. As elderly clients move
forward and increase their life expectancy, it is important for them to achieve which of the following aspect of
nursing care?
a. Optimum levels of functioning
b. Relief pain
c. Rehabilitation
d. Prevention of disease

100. A nurse must recognize that physiological changes are normal part of aging. Some organs may change like the
metabolism of drugs when an elderly client has been dependent with a certain drug for health maintenance.
Which of the following organ is most considered for an elderly who has changes with drug metabolism?
a. Kidney
b. Liver
c. Heart
d. Lungs
SITUATION: Psychiatric drugs help patient with psychosocial alteration to manage the symptoms of an illness.

101. The physician prescribes Phenelzine sulfate ( Nardil) 15 mg P.O tid to be continued at home. Which of the
following instructions id NOT included?
a. Avoid eating aged cheese
b. Limit the intake of wine , abstinence of alcohol is much preferred
c. Avoid operating motor problems
d. Take the medication before meal

102. A 25 year old female client admitted with depression has been receiving Sertraline (Zoloft) and is to
continue this medication upon discharge. Further teaching is needed for this client, when she states:
a. “I’ll take my medication in the morning after I brush my teeth”
b. ”I’ll take my medications after meal and with lots of fluids”
c. “I’ll continue to take my medications, even if I develop unexpected symptoms”
d. “I’ll continue to take this medication even when I feel less depressed”

103. Which of the following is best for the nurse to state for client who has been taking Fluoxetine ( Prozac)
for 3 weeks and complaining about headache ?
a. “CT scan is ordered as this symptom is expected for you”
b. “I’ ll hold your next dose until physician arrives”
c. “Take a rest for few weeks, it will be relieved”
d. “I’ll see if there’s an order for Tylenol”

104. In teaching the client about the possibilities of MAOI drug (Parnate) complications. A nurse must
emphasize that diet of this client should not contain:
a. Tyramine rich
b. Protein and fats rich
c. Calories and carbohydrates
d. None of the above

105. Which of the following foods may be permitted for a client to eat who is admitted for depression and has
been taking Tranylcypromine for 2 weeks?
a. Pizza
b. Free range poultry
c. Fresh fish
d. Whole grain bread
SITUATION: John, 36 years old arrives at the outpatient hospital department .He is observed to be anxious,
crying and shaking while conversing with the nurse. During assessment he tells the nurse that he has been
experiencing depression for almost a year, when his wife filed a divorce. After thorough assessment of the
physician, he is diagnosed with major depression.

106. When performing assessment, the nurse knows that which of the following factors may be the cause of
John’s depression?
a. A situational crisis
b. Maturational crisis
c. A social crisis
d. None of the above

107. Which of the following type of crises is correct when a certain situation is unexpected and most of the
community resources are affected i.e an airliner crashed in a residential community near a municipal airport?
a. Developmental
b. Accidental
c. Social
d. Adventitious

108. Which of the following constitutes a crisis for individual?

a. An anticipated breath taking event
b. An event with a pathological result
c. an event that is expected
d. an overwhelming emotional reaction to an event

109. in determining the best intervention for crisis, it is most important by the nurse to emphasize that
intervention for certain type:
a. identifies the precipitating event
b. restablishes the psychological equilibrium
c. decrease the occurrence of stressful event
d. facilates changes in personality and adaptation of individual to the environment

110. Which of the following crises intervention would be considered under primary prevention?
a. The nurse educates the first time mother about stress reduction technique
b. The nurse intervenes for a depressed client to increase suicide preacautions
c. The nurse helps the patients to attend a self help group to manage the alcoholism
d. The nurse administers medication to improve the health and prevent further complications for patient
diagnosed with DM I
SITUATION: Health education about the treatment for the client must be clearly understood by the patient for
increasing independence about care.

111. The aspect of electroconvulsive therapy that can result in the most serious complications is the use of:
a. Succinylcholine chloride (Anectine) to relax muscle
b. Positive pressure to inflate alveoli
c. Electric voltage to induce the seizures
d. Methohexital sodium (Brevital sodium) to induce sleep

112. The physician has ordered imipramine (Tofranil) 75 mf tid, for a client. An appropriate nursing action
when giving this drugs is to:
a. Observe the client for increased tolerance so that the therapeutic dosage is maintained
b. Avoid administration of barbiturates or steroids with this drug
c. Warm the client not to eat cheese, fermenting products and chicken liver
d. Have the client checked for intraocular pressure and provide instructions to watch for symptoms of
glaucoma

113. Drugs such as trihexphenidyl (Artane), biperidine (Akineton),or benztropine (Cogentin) is often prescribed
in conjunction with:
a. Antipsychotic agents/neuroleptics
b. Barbiturates
c. Antidepressants
d. Antianxiety agents/anxiolytics

114. An extrapyramidal symptoms that is a potentially irreversible side effect of antipsychotic drug is:
a. Toreticollis
b. Tardive dyskinesia
c. Oculogyric crisis
d. Pseudoparkinsonism

115. Photosensitization is a side effect associated with the use of:

a. Lithium carbonate (Lithane)
b. Sertraline (Zoloft)
c. Methylphenidate hydrochloride (Ritalin)
d. Chlorpromazine hydrochloride (Thorazine)
SITUATION: Betty, 17 y/o, is admitted in the psychiatric unit of the hospital. She has not being eating for the
past 3 days. The diagnosis is anorexia nervosa.

116. The initial goal of the management of severely malnourished client with anorexia nervosa is:
a. Restore the weight of the client according to height
b. Correct the fluid and electrolyte imbalance
c. Offer food in a stimulating environment
d. Weight the patient and tell the patient her weight

117. The nursing diagnosis for clients like Betty is:

a. Altered nutrition: less than body requirements
b. Impaired role performance
c. Risk for self mutation
d. Impaired social interaction

118. Betty is sitting in one corner of the room with a sad face, the BEST initial broad opening of the nurse is:
a. “you seem to enjoy sitting here in the corner”
b. “oh what a wonderful morning”
c. “how are you today, Betty?”
d. Fine weather were having today”

119. After a week, Betty’s weight has remained unchanged despite the fact that she has eaten all her meals,
the nurse will:
a. Request physician for additional Prozac
b. Monitor Betty for 2 hours after eating
c. Increase caloric intake before bedtime
d. Immediately infuse isotonic solution

120. The most fatal complication of anorexia nervosa is:

a. Hypotension
b. Seizures
c. Bradycardia
d. Arrhythmias

SITUATION: Mr. Ceballos was found wandering by neighbors in villa subdivision.

121. When a person shows dissociation symptoms following a distressing event this is:
a. Phobic disorder c. Acute stress disorder
b. Panic disorder d. Anxiety disorder

122. The onset of this kind of disorder occurs within a period of:
a. 3 weeks after the event
b. 4 weeks after the event
c. 1 week after the event
d. 2 weeks after the event
123. One month after the incident Mr. Ceballos was watching a telemovie when burglary occurred. He became
angry, and agitated. The response to Mr.Ceballos would be:
a. “you will be okay”
b. “Are you getting crazy?”
c. “hey, stop that”
d. “tell me how you feel”

124. They preferred modality to address disorders as that of Mr. Ceballos is:
a. Use of drugs
b. Debriefing
c. Desensitization
d. Psycodrama

125. Medication that maybe prescribed to ease fear and anxiety symptoms, sleep disturbances and
nightmares:
a. Clozaril
b. Benzodiazepines
c. Benztropine

SITUATION: A nurse for an adolescent female client with a diagnosis of anxiety disorder.

126. Which of the following behaviors demonstrate a caring attitudes by the nurse for this client?
a. Verbalize concern about the client
b. Arrange group activities for the client
c. Let the adolescent client sign the treatment and care plan
d. Hold psycho educational group on medication

127. Which of the following factors should the nurse consider when assisting this client in verbalizing her
feelings? The client may:
a. Decide that therapy is not beneficial
b. Believe the medication only are useful
c. Intellectualize the anxiety
d. Regard the problem as genetic

128. Which of the following symptoms would this client MOST likely display when assisted with muscle
tension?
a. Tachycardia
b. Difficulty in sleeping
c. Restlessness
d. Strong startle response
129. The client complaints to the nurse about several other minor health problems she is experiencing. Which
of the following concerns must the nurse keep in mind when caring for clients with anxiety disorder? Clients:
a. Are prone to unhealthy binge eating episode
b. Undergo an alternation in their self care skills
c. May have a variety of somatic symptoms
d. Will experience secondary gains from mental illness

130. Which of the following findings should the nurse expect when talking about school to this adolescent
client with anxiety disorders? The client:
a. Expresses concern about her grades
b. Has been lying to her parents and teachers
c. Has gained 10 lbs in the past month
d. Has been arguing with her classmates for the past
d. Phenothiazines

SITUATION: Mrs. Alonzo, 25 y/o sales supervisor, expressed fear of riding the elevator, she experienced
dizziness, shortness of breath and palpitation. She was brought to the emergency room for treatment. However,
the physician did not find any pathological basis for her symptoms.

131. Which of the following statements is TRUE of phobia?

a. Phobias do not interfere with patients everyday life
b. Phobias are associated with unreasonable fear of specific objects or situation
c. Phobias can not be logically explained
d. In phobia, patients behavior is directed toward reducing level of anxiety

132. Which one of the following is an appropriate initial nursing interversion of Mrs. Alonzo?
a. Teach her relaxation technique
b. Gradually expose her to the phobia reducing situation
c. Provide comfort and rest
d. Stay with her when level of anxiety is high

133. Which of the following medication would most likely be prescribed to decrease anxiety level of Mrs.
Alonzo?
a. Chlorpromazine HCL (thorazine)
b. Diazepam (valium)
c. Imipramine HCL (tofranil)
d. Fluphenaxine (prolixine)

134. The initial nursing diagnosis identified by the nurse is which one of the following?
a. Impaired adjustment
b. Defensive coping
c. Anxiety,mild
d. Self-esteem disturbance
135. An appropriate goal of care for Mrs.Alonzo would be one of the following?
a. Provide safe environment
b. Provide adequate rest and sleep
c. Identify anxiety reducing techniques
d. Identify the level of anxiety she is feeling

SITUATION: Increase anxiety may develop internal conflict. Thus development of somatoform is considered.

136. Which of the following best describes somatoform disorders?

a. An imbalance in neurotransmitter that leads to severe depression
b. An internal conflict that increases overtime when anxiety is not managed
c. A psychological defense to a stress
d. A conscious defense to anxiety

137. A person who completely converts his anxiety through physical complaints is an indication that the client
is experiencing
a. Psychosis
b. Neurosis
c. Defense mechanism
d. Pathologic condition

138. Which of the following types of somatoform disorder that a significant pain is actually real and specific to
the body structure of a patient but no pathologic condition is noted?
a. Pain
b. Conversion
c. Hypochondriasis
d. Body dysmorhic disorder

139. A type of somatoform disorder where a client experiences a fear of contracting certain disease example a
headache is interpreted as brain tumor.
a. Hypochondriasis
b. Conversion
c. Dysmorphophobia
d. Somatization

140. During physical examination , a nurse notes that there is no pathologic condition was found and when
laboratory data are reviewed everything is normal, but the patient is keep on complaining problems in different
organs of his body. Which of the following describes this type of somatoform?
a. Conversion
b. Hypochondria
c. Somatization
d. Pain
SITUATION: Kevin, 28 y/o is a client who suddenly became blind when he witnessed how his family was
massacred. The medical team cannot find an organic basis for his condition.

141. Which psychiatric condition is Arnold experiencing?

a. Body dysmorphic disorder
b. Malingering
c. Hypochondriasis
d. Conversion

142. Which defense mechanism contributes much in Kevin’s “blindness”?

a. Conversion
b. Reaction formation
c. Suppression
d. Repression

143. Which of the following is an appropriate nursing intervention for clients like Kevin?
a. Encourage Kevin to look at the different colors to restore vision
b. Consider the symptoms of Kevin and its connection with the incident
c. Focus in the feeling of Kevin about the traumatic incident
d. Discuss the symptoms with Kevin to reduce the level of anxiety

144. kevin felt a slight headache. He verbalized. “I think this is a brain tumor”. Which psychiatric condition is he
experiencing?
a. Conversation
b. Malingering
c. Psychophysiologic
d. Hypochondriasis

145. kevin’s symptoms are helpful in decreasing his anxiety about the traumatic incident. This is called:
a. Primary gain
b. Secondary gain
c. Tertiary gain
d. Superficial gain

SITUATION: Defense mechanism is one way of fighting for stress.

146. Rationalization is exemplified in one of the following situation:

a. An unfaithful husband gives a gift to his wife after a heated argument
b. A student says: I did not get good grades because the teacher does not like me”
c. An applicant for a job develops fever on the day of her personal interview
d. A patient says: I don’t like to think about my problems”
147. An example of maladaptive use of defense mechanism is:
a. A former drug addict helps in the rehabilitation of drug users
b. An individual resorts to drinking alcohol when under stress to diffuse tension
c. A short man excels in public speaking
d. A patient blames nurse for his family’s unacceptable ways

148. Upon admission, Lea says to the nurse, “Why am I here? I am not sick, I don’t have any health problems.”
This statement exemplifies a common defense mechanism used by anoretic patient know as one of the following:
a. Suppression
b. Nationalization
c. Denial
d. Substitution

149. Displacement is a defense mechanism exemplified by one of the following situation:

a. The patient shouts at the nurse after her family fails to visit he
b. A married woman is attracted to one of her husband’s male friends and treats him rudely
c. A nursing student is unable to report for duty because of several headache
d. A man does not recall hitting his son when he was a young child

150. Lita compliments her boss, but unconsciously does not like him because her boss terminated her. She is
exhibiting one of the following defense mechanism:
a. Introjections
b. Sublimation
c. Reaction formation
d. Displacement

SITUATION: Extreme sadness may develop into depression once it is not resolved immediately.

51. When developing a plan of care for patient who has been taking tricyclic antidepressants, it is most important
for the nurse to include in the plan of care:
a. Therapeutic effect may be noted after taking the drug
b. Depression may still be present for 4 weeks
c. Effect of the drug may vary from individuals
d. The side effect may lessen the depression for first week

52. A client tells the nurse in an outpatient mental health unit that he ran out of clonazepam (Klonopin) 5 days ago.
He tells the nurse “ I know I shouldn’t have just stopped the drug, but I feel fine”. The nurse most therapeutic
response is:
a. “ You may develop severe complication because of drug resistance”
b. “You could go through withdrawal symptoms for up to 2 weeks”
c. “The doctor should prescribe another drug for you”
d. “I will check if there’s another drug to be given for your illness”
53. When teaching the client about the therapeutic of TCA, It is most important for a nurse include in the
discussion of this drug to avoid which of the following that may potentially inhibit the drug effect?
a. Coffee
b. Alcohol
c. Orange juice
d. Ice tea

54. When developing a plan of care for patient who has been taking Clozapine (Clozaril).The nurse must include
monitoring the patient’s CBC for potential adverse effect ;
a. Leukemia
b. Agranulocytosis
c. Thrombocytopenia
d. Polycythemia vera

55. Which of the following extrapyramidal syndrome is potentially harmful for the client who has been taking
Chlorpromazine (Thorazine) because of involuntary muscle may be potentially irreversible once it is not recognized
earlier?
a. Akathisia
b. Tardive dyskinesia
c. Acute dystonia
d. Photosentivity

SITUATION : Somatoform disorders is an anxiety related disorders developed form inappropriate handling of
problems that increase anxiety.

56. When developing a plan of care for patient with somatoform disorder, a nurse must include :
a. Teaching coping strategies that would lessen the client physical complaints
b. Teaching amount medication compliance like antipsychotic
c. Implement reality presentation
d. Education about occupational and group therapy importance

57. Which of the following coping strategies may be taught by the nurse for the client to lessen the client’s physical
complaints?
a. Occupational therapy
b. Emotional and cognitive based
c. Milieu therapy
d. Daily activities with the family

58. Joe is scheduled for an group therapy, while listening to the instructions about increasing interaction , he
experiences left arm weakness as if he cant perform within the group session. After vital signs taking what should
be the focus of assessment by the nurse?
a. “when was the last time you feel the weakness?”
b. “Were there emotions involved before you feel the weakness?”
c. “Is this the first time you experience the weakness?”
d. “Aside from your arm, does it also affect the other parts of your body?”
59. When developing a plan of care for patient diagnosed with somatoform disorder, a nurse must focus on:
a. Emotional control for decreasing the client’s anxiety
b. Teaching about the connection of mind and body
c. Cognitive problem may be manage with stress reduction technique
d. All of the above

60. The nurse knows that sadness typically accompanies grief and depression. In determining the client’s response
to illness, it is expected to patient to experience:
a. Fear and lack of interest in communication
b. Withdrawal and negative attitude towards the environment
c. Defensive and dominating personality
d. Apathetic and self loving

SITUATION: ANXIETY AND ANXIETY RELATED

61. During assessment , the nurse notices that the behavior of a client may potentially harm himself and may pose
danger to others. In determining the level of anxiety, a patient is in the level of:
a. Mild
b. Moderate
c. Severe
d. Panic

62. Which of the following is considered as the most appropriate intervention for a 24 year old patient who has
been suffering from agoraphobia?
a. Let the patient get outside alone
b. Advise the client about proper deep breathing and exercise
c. Allow the client to stay in his room all throughout the day
d. Discuss the client’s feeling about the irrational fear and the possible cause that arises his anxiety

63. In determining the nurses’ priority for patients with severe anxiety over a recent failed relationship, it is
important to include in the nursing care plan:
a. Anxiolytic is given immediately
b. Pyshotherapy initially to ease anxiety
c. Decreasing the environmental stimulus
d. Restraint the client and place in the seclusion room

64. During assessment, a nurse documented that joel, 20 years old is coherent but experiencing tachypnea,
tachycardia and voice tremors. The nurse identifies that the patient is suffering from what level of anxiety?
a. Mild
b. Moderate
c. Severe
d. Panic
65. Cognitive behavioral approach is indicated for patient suffering from a low self esteem. A nurse must
emphasize that this therapy includes:
a. Classical conditioning
b. Analysis of ideas of reference
c. Use of unconditional positive regards
d. Assessing the negative thoughts patterns

SITUATION: Johnny lee is a 23-year old graduate student who has just been admitted to the unit with behaviors
of withdrawal, flat affect, and disregard of hygiene and grooming and associative looseness. His diagnosis is
paranoid schizophrenia.

66. Which of the following is not characteristics of the client with paranoid schizophrenia?
a. Delusions
b. Hallucinations
c. Decrease sensitivity
d. Ideas of reference

67. Which defense mechanism is most characteristics of the client with paranoid schizophrenia?
a. Undoing
b. Rejection
c. Rationalization
d. Suppression

68. Which of the following actions would not be helpful?

a. Help the client relate with real persons
b. Avoid giving attention to the content of the hallucinations or delusions after an initial investigation of
them.
c. Acknowledge the client’s belief in the perception, but also, indicate that is not shared by others.
d. Listen carefully to the content of the hallucinations and delusions and encourage client to describe them.

69. Mr. Lee approaches a staff member with hostile comments about another client who is ”out to get me.” in
responding to Mr. Lee, which of the following would not be appropriate?
a. Help Mr. Lee acknowledge and name feelings.
b. Explore appropriate outlets for hostility, such as physical, exercise and sports.
c. Confront Mr. Lee with his hostility
d. Explore the source of the hostility with Mr. Lee

70. A nurse has been working to a client admitted with schizophrenia and observed to be responding with his
hallucinations. The client yells out at intervals, “I’m not the one who kill him, you are crazy!, please keep away
from me”. When intervening with this client, the nurse should;
a. Sit quietly and not respond at all to the client’s statements
b. Communicate with the client and assess the content of perceptual disturbance
c. Ignore the client because symptoms will disappear immediately
d. Assume that the client might be upset at he will feel better for few minutes.
SITUATION: Psychiatric drugs help manage the untoward symptoms of patients admitted in a psychiatric setting
to prevent regression from illnesses.

71. Which of the following statements of the client signifies the health education of a nurse was effective after
discharge teaching about the drug to be taken at home (Thorazine)?
a. “I need to protect myself from too much UV rays by using Lotion more than 25%”
b. “I must swim this summer together with my friend, no need for any sun protection”
c. “I must apply the lotion 10 minutes before sun exposure”
d. “Sunlight won’t affect me after I take the drug”

72. A nurse must emphasize to the client that antipsychotic drug is prescribed for which of the following purposes?
a. To immediately restore the client healthy status
b. To manage the symptoms of the disease
c. To lessen the drug resistance
d. To immediately recover from psychosis syndrome

73. Which of the following facts must be noted for patient who is pregnant at has been taking Lithium to manage
the clients agitation?
a. Taking Lithium may affect the growth of the unborn child
b. Thyroid problems may arise
c. Kidney will be destructed by the drug
d. It may cause abortion if continued

74. Which of the following must be emphasized by the nurse when a client has been prescribed to take Lithium
carbonate as part of maintenance therapy?
a. Monitor for blood Lithium level, water and iron
b. Monitor for blood Lithium level, water and sodium content in the body
c. Monitor for blood Lithium Level, liver function, water and sodium content in the body
d. Monitor for blood Lithium level, kidney function, water and sodium content in the body

75. Which of the following client’s statement must be corrected by the nurse when client develops Lithium
toxicity?
a. “ I must withhold the next dose”
b. “I must notify the physician”
c. “I must ignore the symptoms”
d. “ I must be careful in determining the signs of toxicity”

SITUATION: Behavioral problems is included in the plan of care to manage rightfully.

76. An agitated client pathologically repeats words that the nurse has just said. It is a pathologic condition that
signifies alteration of client’s
a. Perception
b. Thoughts
c. Motor activity
d. All of the above
77. A pathologic condition in which patient repeats others’ action in response to psychotic diagnosis is known as
a. Waxy flexibility
b. Echopraxia
c. Catatonic posturing
d. Akathisia

78. Restless leg syndrome is also known as:

a. Neuroleptic malignant syndrome
b. Akathishia
c. Dyskinesia
d. Echopraxia

79. Which of the following signs and symptoms must alert the nurse because the client is developing NMS?
a. Hypotension with diaphoresis and hyperthermia
b. Hypertension with diaphoresis and hypothermia
c. Hypertension with excessive sweating and hyperthermia
d. Hyperthermia, hypotension and tachypnea

80. Mr.Guidotei, age 67 , was discharge from acute care facility 6 months ago. He has been taking Haloperidol (
Haldol) for a month. When he comes to the outpatient clinic , the nurse notes that he is grimacing and smacking
his lips with his tongue, which is protruding dramatically. The nurse identifies that he is potentially developing a :
a. Akathisia with acute dystonic effect
b. Neuroleptic Malignant syndrome
c. Tardive dyskinesia
d. Acute Dystonia

SITUATION: Alcoholism is not merely a vise but patients become dependent of this substance considered to be
suffering from a chronic disease.

81. During family interaction with the nurse, one family member clarifies the therapy session that deals with
supporting an alcoholic with the rehabilitation and asking for additional information about the member who needs
a self-help group. It would be most important to include in the plan that one’s family involved in the
rehabilitation, the family will support the alcoholic motivation for:
a. Al-Anon
b. Alcoholic Anonymous
c. Alateen
d. All of the above

82. Which of the following best describes drug abuse?

a. Increase physiologic dependence
b. Increase psychological dependence
c. Increase tolerance
d. Excessive drug use other than medical purpose
83. Which of the following intervention is most applicable in approaching the client experiencing hallucinations
related to withdrawal symptoms?
a. Seek the client’s permission to discuss the problem
b. Explain the hallucination causes
c. Do not discuss and present reality
d. Administer antipsychotic drug first

84. The chance of alcoholic people becomes continuously sober and variable. Which factor is most necessary for
sobriety to be maintained?
a. Willingness and the motivation for change
b. Asking for support from family and friends
c. Best rehabilitation for the client
d. Ability to decide for letting go of a chronic disease

85. Korsakoff’s psychosis may be the result of prolonged addiction with alcohol. When teaching about this
complication, the nurse is correct that it happens because:
a. Thiamine absorption is reduced due to destructed brain tissue
b. Convulsion increases the client to have brain damage as it impairs the client metabolism in the brain
c. Encephalopathy with bouts of convulsion
d. Severe memory loss and confabulation

SITUATION: Imbalances of neurotransmitters may impair emotion and thoughts.

86. When developing a plan of care for patient who has a suicidal ideation, the nurse must specifically and directly
ask the patient about:
a. When and how to carry out the plans
b. Who will be with the client when he /she carries the plan
c. Where the plan will be performed
d. What equipment will be needed

87. Which of the following nursing interventions must be included in the nursing care plan to be more effective in
lowering the risk for suicide?
a. Establish a no suicidal contract
b. Develop a strong therapeutic relationship
c. Using calm and non-threatening approach
d. Placing the client in restraints system

88. A nurse must include in the plan of care of a client with conversion disorder to increase the esteem:
a. Large goals must be set to increase positive gains
b. Focus on the client’s behavior rather than the symptoms
c. Discuss the effect of child abuse
d. Enhance coping mechanism about fear of contracting disease
89. When developing a plan of care about the diet of a patient diagnosed with bipolar mania, it is most important
to include which of the following food?
a. Roast beef
b. Cheeseburger
c. Soup
d. Ham and eggs

90. Which of the following behaviors would suggest that the treatment was effective for a 38 year old female client
who has been hospitalized for a mood disorder , manic episode?
a. The client sits down and finishes her meals
b. The client runs out most of the day
c. The client experiences bout of agitation
d. The client actively destroys others’ attention in the ward

SITUATION: Different treatment modalities are expected in a mental health facilities. Professional and other
health auxiliaries must be cognizant with the type of therapy for patient admitted in this setting.

91. After complete assessment by the nurse, the patient does not respond to conventional therapy, so the doctor
considers ECT for the patient. When teaching the patient about ECT, which of the following a nurse must include?
a. Patient will be given a premedication before the start of ECT
b. It is the most effective therapy for the patient
c. Permanent memory loss after therapy
d. No informed consent is needed

92. When the physician discusses the ECT with the family, the family asks the main mechanism of the therapy for
patient with severe depression. Which of the following is most applicable?
a. Electrical activities disturbs the neurotransmitters responsible for lessening the depression
b. Effective for complete loss of depression
c. Unclear at present
d. Consistent relief from depression

93. Which of the following medications is NOT include during ECT?

a. Atropine
b. Anectine
c. Brevital
d. None of the above

94. A need for the client to be positioned in a left or right side lying once patient is given a drug that decreases
bronchial and tracheal secretion because:
a. It relaxes the respiratory muscle
b. It decreases aspiration
c. It serves as an anesthesia
d. It opens the airway
95. When caring for a client with severe depression, it is most important for the nurse to help the patient to
increase the social interaction by means of:
a. Asking the patient to be in a solitary activities
b. Asking the patient to be with patients having sing along
c. Asking the patient to be with other patients with severe depression
d. Asking the patient to collect items from different department/ units in the ward

SITUATION: a client is admitted to the psychiatric unit accompanied by her husband. She brings six suitcases and
three shopping bags. She orders the nurse to carry her bags. Her husband states she has been purchasing items
by cannot afford and has not slept for 4 nights.

96. Which additional information would be a priority for the nurse to seek from the client’s husband?
a. The client fluid and food intake.
b. Their client’s financial status
c. The client’s usual sleeping patterns
d. Whether the client becomes agitated easily.

97. The nurse notes that the client is to busy to investigating the unit and overseeing the activities of other client
to eat dinner. To help the client obtain sufficient nourishment, which of the following plans would be the best?
a. Serves foods that she can carry with her.
b. Allow her to send out for her favorite food.
c. Serve food in small, attractively arrange portions.
d. Allow her to enter the unit kitchen for extra food as necessary.

98. The client’s illness is most likely related in which of the following factors?
a. Having been molested as a preschool age child.
b. A family history of mood disorders.
c. Having high levels of potassium in the brain.
d. Excessive alcoholic content.

99. When managing manic behavior or the unit, which of the following actions would not be helpful?
a. Suggest activities that require a long attention span.
b. Attempt to minimize environmental stimuli.
c. Encourage the client to complete short projects in occupational therapy.
d. Use distraction techniques when necessary in channel attention appropriately.

100. As the nurse approaches the lounge area , the client states “The sun is shinning. Where is my son? I Love
Lucy. Lets play ball .the client is displaying.
a. Concreteness
b. Flight of ideas
c. Depersonalization
d. Use of neogolism
101. Marco who was diagnosed with brain tumor was scheduled for craniotomy. In preventing the development of
cerebral edema after surgery, the nurse should expect the use of:
a. Diuretics c. Steroids
b. Antihypertensive d. Anticonvulsants

102. Halfway through the administration of blood, the female client complains of lumbar pain. After stopping the
infusion Nurse Hazel should:
a. Increase the flow of normal saline c. Notify the blood bank
b. Assess the pain further d. Obtain vital signs.

3. Nurse Maureen knows that the positive diagnosis for HIV infection is made based on which of the following:
a. A history of high risk sexual behaviors.
b. Positive ELISA and western blot tests
c. Identification of an associated opportunistic infection
d. Evidence of extreme weight loss and high fever

104. Nurse Maureen is aware that a client who has been diagnosed with chronic renal failure recognizes an
adequate amount of high-biologic-value protein when the food the client selected from the menu was:
a. Raw carrots c. Whole wheat bread
b. Apple juice d. Cottage cheese

105. Kenneth who has diagnosed with uremic syndrome has the potential to develop complications. Which among
the following complications should the nurse anticipates:
a. Flapping hand tremors c. Hypotension
b. An elevated hematocrit level d. Hypokalemia

106. A client is admitted to the hospital with benign prostatic hyperplasia, the nurse most relevant assessment
would be:
a. Flank pain radiating in the groin c. Perineal edema
b. Distention of the lower abdomen d. Urethral discharge

107. A client has undergone with penile implant. After 24 hrs of surgery, the client’s scrotum was edematous and
painful. The nurse should:
a. Assist the client with sitz bath c. Elevate the scrotum using a soft support
b. Apply war soaks in the scrotum d. Prepare for a possible incision and drainage.

108. Nurse hazel receives emergency laboratory results for a client with chest pain and immediately informs the
physician. An increased myoglobin level suggests which of the following?
a. Liver disease c. Hypertension
b. Myocardial damage d. Cancer

109. Nurse Maureen would expect the a client with mitral stenosis would demonstrate symptoms associated with
congestion in the:
a. Right atrium c. Aorta
b. Superior vena cava d. Pulmonary
110. A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be:
a. Ineffective health maintenance c. Deficient fluid volume
b. Impaired skin integrity d. Pain

111. Nurse Hazel teaches the client with angina about common expected side effects of nitroglycerin including:
a. high blood pressure c. headache
b. stomach cramps d. shortness of breath

112. The following are lipid abnormalities. Which of the following is a risk factor for the development of
atherosclerosis and PVD?
a. High levels of low density lipid (LDL) cholesterol
b. High levels of high density lipid (HDL) cholesterol
c. Low concentration triglycerides
d. Low levels of LDL cholesterol.

113. Which of the following represents a significant risk immediately after surgery for repair of aortic aneurysm?
a. Potential wound infection
b. Potential ineffective coping
c. Potential electrolyte balance
d. Potential alteration in renal perfusion

114. Nurse Josie should instruct the client to eat which of the following foods to obtain the best supply of Vitamin
B12?
a. dairy products c. Grains
b. vegetables d. Broccoli

115. Karen has been diagnosed with aplastic anemia. The nurse monitors for changes in which of the following
physiologic functions?
a. Bowel function c. Bleeding tendencies
b. Peripheral sensation d. Intake and out put

116. Lydia is scheduled for elective splenectomy. Before the clients goes to surgery, the nurse in charge final
assessment would be:
a. signed consent c. name band
b. vital signs d. empty bladder

117. What is the peak age range in acquiring acute lymphocytic leukemia (ALL)?
a. 4 to 12 years. c. 40 to 50 years
b. 20 to 30 years d. 60 60 70 years

118. Marie with acute lymphocytic leukemia suffers from nausea and headache. These clinical manifestations may
indicate all of the following except:
a. effects of radiation
b. chemotherapy side effects
c. meningeal irritation
d. gastric distension