SIMULATION 9 NP1

SITUATION: Rocky is reviewing the concepts of Community Organizing Participatory Action

Research (COPAR)
1. COPAR is best described as:
A. A sustained and continuous process of educating and mobilizing the people to solve their
own problems
B: Essential healthcare made universally accessible to the people by means acceptable to them
C. "Is a specialized field of nursing practice that renders care to individuals, families and
communities; focusing on health promotion and disease prevention through people
empowerment".
D. "The process of enabling people to increase control over and improve their health"
2. In selecting a site for COPAR, Rocky should include the following criteria, except:
A. With serious peace and order problem
B. 100 or more families
C. Economically depressed
D. Accessibility
3. In COPAR, Rocky uses this process in gathering, collating, processing and analyzing data to
determine community problem.
A. Community Mobilization
C. Community interview
B. Community Diagnosis
D. Survey
4. In assessing the community, Rocky starts gathering the demographic data of Community X
that includes:
A. Education
B. Occupation
C. Waste Managment
D. Civil status
5. Rocky is now ready to select potential leaders, the criteria for the selection should include
EXCEPT
A. Belongs to the economically marginalized sector
B. Politically inclined and formal leaders
C. Non-formal leaders
D. Well respected in the community
Situation: The nurse has been asked to administer and injection via Z-TRACK technique.
Questions 6 to 10 refer to this.
6. The nurse prepares an IM injection for an adult client using the Z tract technique 4 ml of
medication is to be administered to the client. Which of the following site will you choose?
A. Deltoid
B. Rectus
C. Ventrogluteal
D. Vastus Lateralis
7. In infants 1 year old and below, which of the following is the site of choice for intramuscular
injection?
A. Deltoid
B. Rectus femoris
C. Ventrogluteal
D. Vastus lateralis
8. In order to decrease discomfort in Z track administration, Which of the following the nurse
should do?
A. Pierce the skin quickly and smoothly at a 90 degree angle.
B. Inject the medication readily at around 10 per milliliter
C. Pull back the plunger and aspirate for 1 minute to make sure that the needle did not hit a
blood vessel.
D. Pierce skin slowly and carefully at a 90 degree angle.
9. After injection using the Z-track technique, the nurse should know that she needs to wait for a
few seconds before withdrawing the needle and this is to allow the medication to disperse into
the muscle tissue thus decreasing the client's discomfort. How many seconds should the nurse
wait before withdrawing the needle?
A. 2 seconds
B. 5 seconds
C. 10 seconds
D. 15 seconds
10. The rationale using the Z tract technique in an intramuscular injection is:
A. It decrease the leakage of discoloring and irritating mediations into the subcutaneous tissues
B. It will allow a faster absorption of the medication
C. The Z track technique prevent of the muscle
D. It is much more convenient for the nurse

SITUATION: A client was rushed to the emergency room and you are his attending nurse. You
are performing a vital sign assessment.
11. All of the following are correct methods in assessment of the blood pressure EXCEPT:
A. Take the blood pressure reading on both arms for comparison
B. Listen to and identify the phases of korotkoff's sound
C. Pump the cuff to around 30 mmg above the point where the pulse is obliterated
D. Observe procedures for infection control
12. You attached a pulse oximeter to the client. You know that the purpose is to:
A. Determine if the client's hemoglobin level is low and if he needs blood transfusion
B. Check level of clients tissues perfusion
C. Measure the Sefficacy of the client's antihypertensive medications
D. Detect oxygen saturation of arterial blood before symptoms of hypoxemia develops
13. After a few hours in the Emergency Room, the client is admitted to the ward with an order of
hourly monitoring of blood pressure. The nurse finds that the cuff is too narrow and this will
cause the blood pressure reading to be:
A. Inconsistent
B. Low systolic and high diastolic
C. Higher than what the reading should be
D. Lower than what the reading should be
14. Through the client's health history, you gather that the patient smokes and drinks coffee.
When taking the blood pressure of a client who recently smoked or drank coffee, how long
should the nurse wait before taking the clients blood pressure for accurate reading?
A. 15 minutes
B. 30 minutes
C. 1 hour
D. 5 minutes
15. While the client has pulse oximeter on his fingertip, you notice that the sunlight is shining of
the area where the oximeter is Your action will be to:
A. Set and turn on the alarm of the oximeter
C. Cover the fingertip sensor with a towel or bed sheet
B. Do nothing since there is no identified problem
D. Change the location of the sensor every four hours
16. The nurse finds it necessary to recheck the blood pressure reading. In case of such re
assessment, the nurse should wait for a period of:
A. 15 seconds
B. 1 to 2 minutes
C. 30 minutes
D. 15 minutes
17. If the arm is said to be elevated when taking the blood pressure, it will create a:
A. False high reading
B. False low reading
C. True false reading
D. Indeterminate
18. You are to asses the temperature of the client the next morning and found out that he ate ice
cream. How minutes should you wait before assessing the client's oral temperature?
A. 10 minutes
B. 20 minutes
C. 30 minutes
D. 15 minutes
19. When auscultating the clients blood pressure the nurse hears the following: from 150 mmg
to 130 mmHg; silence, then: a thumping sound continuing down to 100 mmHg; muffled sound
continuing down to 80 mmHg and then silence.
What in the clients blood pressure?
A. 130/80
В. 150/100
C. 100/80
D. 150/100
20. In a client with a previous blood pressure of 130/80 4 hours ago, how long will it take to
release the blood pressure cuff to obtain an accurate reading?
A. 10-20 seconds
B. 30-45 seconds C. 1-1.5 minutes
D. 3-3.5 minutes
Situation: Oral care is an important part of hygienic practices and promoting client comfort
21. An elderly client, 84 years old, is unconscious. Assessment of the mouth reveals excessive
dryness and presence of sores. Which of the following is BEST to use for oral care?
A. Lemon glycerin
B. Hydrogen peroxide C. Mineral oil
D. Normal saline solution
22. When performing oral care to an unconscious client, which of the following is a special
consideration to prevent aspiration of fluids into the lungs?
A. Put the client on a sideling position with head of bed lowered
B. Keep the client dry by placing towel under the chin
C. Wash hand and observe appropriate infection control
D. Clean mouth with oral swabs in a careful and an orderly progression
23. The advantages of oral care for a client include all of the following EXCEPT.
A. Decrease bacteria in the mouth and teeth
B. Reduces need to use commercial mouthwash which irritate the buccal mucosa
C. Improves clients appearance and self confidence
D. Improves appetite and taste of food
24. A possible problem while providing oral care to unconscious clients is the risk of fluid
aspiration to lungs. this can be avoided by:
A. Cleaning teeth and mouth with cotton swabs soaked with mouthwash to avoid rinsing the
buccal cavity
B. Swabbing the inside of the cheeks and lips, tongue and gums with dry cotton swabs
C. Use fingers wrapped with wet cotton washcloth to rub inside the cheeks, tongue, lips and
gums
D. Suctioning as needed while cleaning the buccal cavity
25. Your client has difficulty of breathing and is mouth breathing most of the time. This causes
dryness of the mouth with unpleasant odor. Oral hygiene is recommended for the client and in
addition, you will keep the mouth moistened by using:
A. Salt solution
B. Water
C. Petroleum jelly
D. Mentholated ointment
SITUATION: The nurse in community empowers people by utilizing COPAR thru health
teachings
26. In the preparation of your teaching plan, the first thing you would do is:
A. Assess community needs for health education
B. Identify subjects for health teaching
C. Specify goals and targets
D. Identify who will support and type of support provided
27. You are an effective health educator if you can:
A. Listen to people's problem and help them decide the approach for meeting their needs.
B. Select the best strategy for health action for the people to implement
C. Direct the people's effort to implement community-based projects
D. Just tell your clients what to do for their problems and need
28. In teaching a responsible member of the family to perform a certain procedure for the
patient, what the best thing to do?
A. Do all the steps
C. Describe the procedure
B. Arrange for the practice of the procedure
D. Demonstrate the procedure
29. Proper attitudes of barangay health workers towards disease prevention can be developed
by using which of these teaching methods.
A. Providing information find examples of models
C. Providing experience and discussion
B. Any of these methods
D. Role-playing
30. In order to determine the success of your health teaching plan an have some basis for
modification, you should have:
A. Measurable outcome criteria
C. A written community diagnosis
B. Well-documented activities
D. Written assessment of community needs

SITUATION: Knowledge of the acid-base disturbance and the functions of electrolytes is

necessary to determine appropriate intervention and nursing actions.
31. A client with diabetes milletus has a blood glucose level of 644 mg/dL. The nurse interprets
that this clients is at most risk for the development of which type of acid-base imbalance?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
32. In a client in the health care clinic, arterial blood gas analysis gives the following results: pH
7.48, PCO2 32 mmHg, P02 94 mmHg, HCO3 24 mEq/L. The nurse interprets that the client has
which acid base disturbance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Matabolic acidosis
D. Metabolic alkalosis
33. A client has an order for ABG analysis on radial artery specimens. The nurse ensures that
which of the following has been performed or tested before the ABG specimens are drawn?
A. Guthrie test
B. Allen's test
C. Romberg's test
D. Weber's test
34. A nurse is reviewing the arterial blood gas values of a client and notes that the ph is 7.31,
PCO2 is 50 mmHg, and the bicarbonate is 27 mEq/L. The nurse concludes that which acid base
disturbance is present in this client?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
35. Allen's test checks the patency of the:
A. Ulnar artery
C. Carotid artery
B. Radial artery
D. Brachial artery
36, The chief life-threatening hazard for surgical patients with uncontrollable diabetes is:
A. Dehydration
C. Hypoglycemia
B. Hypertension
D. Glucosuria
37. After IVP a renal was confirmed, a left nephrectomy was done. Her post operative care
includes "daily urine specimen to be sent to the laboratory". Eileen as a Foley catheter attached
to a urinary drainage system. How will you collect the urine specimen?
A. Remove urine from drainage tube with sterile needle and syringe and empty urine from the
syringe into the specimen container
B. Empty a sample urine from the collecting bag into the specimen container
C. Disconnect the drainage tube from the indwelling catheter and allow urine to flow from
catheter into the specimen container
D. Disconnect the drainage from the collecting bag and allow the urine to flow from the catheter
into the specimen container
38. Where would the nurse tape Eileen's indwelling catheter in order to reduce urethral
irritation?
A. To the patients inner thigh
B. To the patients lower thigh
C. To the patients buttocks
D. To the patient lower abdomen
39. Which of the following menu is appropriate for one with low sodium diet?
A. Instant noodles, fresh fruits and ice tea
B. Ham and cheese sandwich, fresh fruits and vegetables
C. White chicken sandwiches, vegetable salad and tea
D. Canned soup and potato salad
40. How will you prevent ascending infection to Eileen who has an indwelling catheter?
A. See to it that the drainage tubing touches the level of the urine
B. Change the catheter every eight hours
C. See to it the drainage tubing does not touch the level of the urine
D. Clean catheter may be used since urethral meatus is not a sterile area
SITUATION: Hormones are secreted by the various glands in the body. Basic knowledge of the
endocrine system is necessary.
41. Somatotropin or the Growth hormone releasing hormone is secreted by the:
A. Hypothalamus
B. Anterior pituitary
C. Posterior pituitary gland
D. Thyroid gland
42. All of the following are secreted by the anterior pituitary gland except:
A. Somatotropin/Growth hormone
B. Follicle stimulating hormone
C. Thyroid stimulating hormone
D. Gonadotropin hormone releasing hormone
43. All of the following hormones are secreted by the Posterior pituitary gland except:
B. Oxytocin
A. Vasopressin
C. Anti diuretic hormone
D. Growth hormone
44. Calcitonin a hormone necessary for calcium regulation is secreted in the:
A. Thyroid gland
B. Hypothalamus
C. Parathyroid gland
D. Anterior pituitary gland
45. While Parathormone, a hormone that negates the effect of calcitonin is secreted by the:
A. Thyroid gland
B. Hypothalamus
C. Parathyroid gland
D. Anterior pituitary gland
SITUATION: The staff nurse supervisor request all the staff nurses to "brainstorm" and learn
ways to instruct diabetic clients on self-administration of insulin. She wants to ensure that there
are nurses available daily to do health education classes
46. The plan of the nurse supervisor is an example of:
A. In service education process
B. Efficient management of human resources
C. Increasing human resource
D. Primary Prevention
47. When Mrs. Guevarra, a nurse, delegates aspects of the clients care to the nursing-aid who
is an unlicensed staff, Mrs.
Guevarra
A. Makes the assignment to teach the staff member
B. Is assigning the responsibility to the aide but not the accountability for those tasks
C. Does not have to supervise or evaluate the aide
D. Must know how to perform task delegated
48. Connie, the new nurse appears tired and sluggish and lacks the enthusiasm she had six
weeks ago when she started the job. The nurse supervisor should:
A. Emphasize with the nurse and listen to her
C. Discuss how she is adjusting to her new job
B. Tell her to take the day off
D. Ask about her family life
49. Process of normal negotiations of working conditions between a group of registered nurses
and employer is:
A. Grievance
C. Collective bargaining
B. Arbitration
D. Strike
50. You are attending a certification on cardiopulmonary resuscitation (CPR) offered and
required by the hospital employing you. This is:
A. Professional course towards credits
C. Advance training
B. In-service education
D. Continuing Education
SITUATION: As a nurse, you are aware that proper documentation in the patient chart is your
responsibility.
51. Which of the following is not a legally binding document but nevertheless very important in
the care of all patients in any health care setting?
A. Bill of rights as provided in the Philippine constitution
B. Scope of nursing practice as defined by RA 9173
C. Board of nursing resolution adopting the code of ethics
D. Patients bill of rights
52. A nurse gives a wrong medication o the client. Another nurse employed by the sane hospital
as a risk manager will expect to receive which of the following communication?
A. Incident report
B. Oral report
C. Nursing kardex
D. Complain report
53. Performing a procedure on a client in the absence of an informed consent can lead to which
of the following charges?
A. Fraud
B. Assault and Battery
c. Harassment
D. Breach of confidentiality
54. Which of the following is the essence of informed consent?
A. It should have a durable power of attorney
B. It should have coverage from an insurance company
C. It should respect the clients freedom from coercion
D. It should disclose previous diagnosis, prognosis and alternative treatments available for the
client
55. Delegation is the process of assigning tasks that can be performed by a subordinate. The
RN should always be accountable and should not lose his accountability. Which of the following
is a role included in delegation?
A. The RN must supervise all delegates tasks
B. After a task has been delegated, It is no longer a responsibility of the RN
C. The RN is responsible and accountable for the delegated task in adjunct with the delegate
D. Follow up with a delegated task is necessary only if the assistive personnel is not trustworthy
SITUATION: When creating your lesson plan for cerebrovascular disease of STROKE. It is
important to include the risk factors of stroke.
56. The most important risk factor is:
A. Cigarette smoking
C. Binge drinking
B. Hypertension
D. Heredity
57. Part of your lesson plan is to talk about etiology or cause of stroke. The types of stroke
based on causes are the following EXCEPT:
A. Embolic stroke
B. Hemorrhagic stroke
C. Diabetic stroke D. Thrombotic stroke
58. Hemorrhagic stroke occurs suddenly usually when the person is active. all are causes of
hemorrhage, EXCEPT:
A. Phlebitis
B. Trauma
C. Damage to blood vessel
D. Aneurysm
59. The nurse emphasizes that intravenous drug abuse carries a high risk of stroke. Which drug
is closely linked to this?
A. Amphetamines
C. Shabu
B. Cocaine
D. Demerol
60. A participant in the STROKE class asks what a risk factor of stroke is. Your best response
is:
A. "more red blood cells thicken blood and make clots more possible"
B. "Increased RBC count is linked to high cholesterol."
C. "More red blood cell increase hemoglobin content."
D. "High RBC count increase blood pressure."
SITUATION: Recognition of normal values is vital in assessment of clients with various
disorders.
61. A nurse is reviewing the laboratory test results for a client with a diagnosis of severe
dehydration. The nurse would expect the hematocrit level for this client to be which of the
following?
A. 60%
B. 47%
C. 45%
D. 32%
62. A nurse is reviewing the electrolyte results of an assigned client and notes that the
potassium level is 5.6 mEq/L.
Which of the following would the nurse expect to note on the ECG as a result of this laboratory
value?
A. ST depression
B. Inverted T wave
C. Prominent U wave
D. Tall peaked T waves
63. A nurse is reviewing the electrolyte result of an assigned client and notes that the potassium
level is 3.2 mEq/L.
Which of the following would to note on the ECG as a result of this laboratory value?
A. U waves
B. Absent P waves
C. Elevated T waves
D. Elevated ST waves
64. Dorothy underwent diagnostic test and the result of the blood examination are back. On
reviewing the result the nurses notices which of the following as abnormal finding
A. Neutrophils 60%
C. Erythrocyte sedimentation (ESR) is 39 mm/hr
B. White blood cells (WBC) 9,000/mm
D. Iron 75 mg/100 ml
65. Which of the following laboratory test result indicates presence of an infectious process?
A. Erythrocyte sedimentation rate (ESR) 12 mm/hr
C. Iron 90 g/100 ml
B. White blood cells (WBC) 18,000/mm3
D. Neutrophils 67%
SITUATION: Pleural effusion is the accumulation of fluid in the pleural space. Questions 66 to
70 refer to this.
66. Which of the following is a finding that the nurse will be able to assess in a client with pleural
effusion?
A. Reduced or absent breath sound at the base of the lungs, dyspnea, tachpynea and shortness
of breath
B. Hypoxemia, hypercapnea and respiratory acidosis
C. Noisy respiration, crackles, stridor and wheezing
D. Tracheal deviation toward the affected side, increased fremitus and loud breath sounds
67. Thoracentesis is performed to the client with effusion. The nurse knows that the removal of
fluid should be slow.
Rapid removal of fluid in thoracentesis might cause:
A. Pneumothorax
B. Pleurisy or pleuritis C. Cardiovascular collapse
D. Hypertension
68. 3 days after thoracentesis, the client again exhibited respiratory distress. The nurse will
know that pleural effusion has reoccurred when she noticed a sharp stabbing pain during
inspiration. The physician orders a closed tube thoracotomy for the client. The nurse knows that
the primary function of the chest tube is to:
A. Restore positive intrathoracic pressure
B. Restore negative intrathoracic pressure
C. To visualize the intrathoracic content
D. As a method of air administration via ventilator
69. The chest tube is functioning properly if:
A. There is an oscillation
B. There is no bubbling in the drainage bottle
C. There is a continuous bubbling in the water seal
D. The suction control bottle has a continuous bubbling
70. In a client with pleural effusion, the nurse is instruction appropriate breathing technique.
Which of the following is included in the teaching?
A. Breath normally
B. Hold the breath after each inspiration for 1 full minute
C. Practice abdominal breathing
D. Inhale slowly and hold the breath for 3 to 5 seconds after each inhalation
SITUATION: Health care delivery system affects the health status of every Filipino. As a nurse,
knowledge of this system is expected to ensure quality of life.
71. When should rehabilitation commence?
A.The day before discharge
C. Upon admission
B. When the patient desires
D. 24 hours after discharge
72. What exemplified the preventive and promotive program in the hospital?
A. Hospital as a center to prevent and control infection
C. Program for alcoholics and addicts
B. Program for smokers
D. Hospital as wellness center
73. Which makes nursing dynamic?
A. Every patient is unique physical, emotional, social and spiritual being
B. The patient participates in the overall nursing care plan
C. Nursing practice is expanding in the light of modern developments that takes place
D. The health status of the patient is constantly changing and the nurse must be cognizant and
responsive to these changes
74. Prevention is an important responsibility of the nurse in:
A. Hospitals
B. Community
C. Workplace
D. All of the above
75. This form of health insurance provides comprehensive prepaid health services to enrollees
for a fixed periodic payment.
A. Health maintenance organization
C. Philippine health insurance act
B. Medicare
D. Hospital maintenance organization
SITUATION: Nursing ethics is an important part of the nursing profession. As the ethical
situation arises so is need to have an accurate and ethical decision making.
76. The purpose of having a nurse's code of ethics is:
A. Delineate the scope and areas of nursing practice
B. Identify nursing action recommended for specific health care situations
C. To help the public understand professional conduct expected of nurses
D. To define the roles and functions of the health care givers, nurses and clients
77. The principles that govern right and proper conduct of a person regarding life, Biology and
the health professionals is referred to as:
A. Morality
B. Religion
C. Values
D. Bioethics
78. A subjective feeling about what is right or wrong is said to be:
A. Morality
B. Religion
C. Values
D. Bioethics
79. Values are said to be the enduring believe about a worth of a person, ideas and belief. If
values are going to be a part of a research, this is categorized under:
A. Qualitative
B. Quantitative
C. Experimental
D. Non experimental

80. The most important nursing responsibility where ethical situations emerge in the care is to:
A. Act only when advised that the action is ethically sound
B. Not take sides, remain neutral and fair
C. Assume that ethical questions are the responsibility of the health team
D. Be accountable for his or her own actions
81. Why is there an ethical dilemma?
A. The choices involved do not appear to be clearly right or wrong
B. Why is there an ethical dilemma?
C. Decisions have to be made based o societal norms
D. Decisions has to be mad quickly often under stressful conditions
82. According to the code of ethics, which of the following is the primary responsibility of the
nurse?
A. Assist towards peaceful death
B. Health is a fundamental right
C. Promotion of health prevention of illness, alleviation of suffering and restoration of health
D. Preservation of health at all cost
83. Which of the following is FALSE about the code of Ethics of Filipino Nurses?
A. The Philippine Nurses Association for being the accredited professional organization
B. Code of Nurses was first formulated in 1942 published in the Proceedings of the third Annual
Convention of the PNA
House of Delegates
C. The present code utilized the Code of Good Governance for the Professions in the
Philippines
D. Certificates of Registration of registered nurses may be revoked or suspended for violations
of any provisions of the Code of Ethics.
84. Violation of the code of ethic might equate the revocation of the nursing license. Who
revokes the license?
A. PRC
B. PNA
C. DOH
D. BON
85. Based on the code of ethics for Filipino nurses, what is regarded as the hallmark of nursing
responsibility and accountability?
A. Human rights of clients, regardless of creed and gender
B. The privilege of being a registered professional nurses
C. Health being a fundamental right of every individual
D. Accurate documentation of actions and outcomes
SITUATION: As a profession, nursing is dynamic and its practice is directed by various
theoretical models. To demonstrate caring behavior, the nurse applies various nursing models in
providing quality nursing care.
86. When you clean the bedside unit and regularly attend to the personal hygiene of the patient
as well as washing your hands before and after procedure and in between patients, you indent
to facilitate the body's reparative processes.
Which of the following nursing theory are you applying in the above nursing action?
A. Hildegard Peplau
B. Virginia Henderson
C. Dorothea Orem
D. Florence Nightingale
87. A communication skill is one of the important competencies expected of a nurse.
Interpersonal process as viewed as human to human relationships. This statement is an
application of whose nursing model?
A. Joyce Travelbee
B. Calista Roy
C. Martha Rogers
D. Imogene King
88. The statement "The health status of an individual is constantly changing and the nurse must
be cognizant and responsive to the changes" best explains which of the following facts about
nursing:
A. Dynamic
B. Holistic
C. Client centered
D. Art

89. Virginia Henderson professes that the goal of nursing is to work interdependently with other
healthcare working in assisting the patient to gain independence as quickly as possible. Which
of the following nursing actions best demonstrates this theory in taking care of a 94 year old
client with dementia who is totally immobile?
A. Feeds the patient, brushes his teeth, gives the sponge bath
B. Supervise the watcher in rendering patient his morning care
c. Put the patient in semi fowlers position, set the over bed table so the patient can eat by
himself, brush his teeth, and sponge himself
D. Assist the patient to turn to his sides and allow him to brush and feed himself only when he
feels ready.
90. In the self care deficit theory by Dorothea Orem, Nursing care becomes necessary when a
patient unable to fulfill his physiological, psychological and social needs. A pregnant client
needing prenatal check up is classified as:
A. Wholly compensatory
B. Partially compensatory
C. Supportive educative
D. Non compensatory
SITUATION: Documentation and reporting are just as important as providing patient care. As
such the nurse must be factual and accurate to ensure quality documentation and reporting.
91. Health care reports have different purposes. The availability of patient's record to ail health
team members demonstrates which of the following purposes:
A. Legal documentation
B. Education
C. Research
D. Vehicle for communication
92. When a nurse commits medication error, she should accurately document client's response
and her corresponding action. This is very important for which of the following purposes:
A. Research
B. Nursing Audit
C. Legal documentation
D. Vehicle for communication
93. POMR has been widely used in many teaching hospitals. One of its unique features is
SOAPIE charting. The P in SOAPIE charting should include:
A. Prescription of the doctor to the patient's illness
B. Plan of care for patient
C. Patients perception of one's illness
D. Nursing problem and Nursing diagnosis
94. The medical records that are organized into separate section form doctors or nurses have
more disadvantages than advantages. This is classified as what type of recording?
A. POMR
B. SOAPIE
C. Modified POMR
D. SOMR
95. Which of the following is the advantage of SOMR or Traditional recording?
A. Increase efficient date gathering
B. Reinforces the use of the nursing process
C. The caregiver can easily locate proper section for making charting entries
D. Enhances effective communication among the care team members
SITUATION: June is a 24 year old client with symptoms of dyspnea, absent breath sounds on
the right lung and chest x ray revealed pleural effusion. The physician will perform
thoracentesis.
96. Thoracentesis is useful in treating all of the following pulmonary disorders except:
A. Hemothorax
C. Hydrothorax
B. Tuberculosis
D. Empyema
97. Which of the following psychological preparations is not relevant for him
A. Telling him that the gauge of the needle and anesthesia to be used
3. Telling him o keep still during the procedure to facilitate the insertion of the needle in the
correct place
C. Allow June to express his feelings and concerns
D. Physician's explanation on the purpose of the procedure and how it will be done
98. Before thoracentesis, The legal consideration you must check is:
A. Consent is signed by the client
B. Medicine preparation is correct
C. Position of the client is correct
D. Consent is signed by relative and physical
99. As a nurse, you know that the position for June before thoracentesis is:
A. Orthopneic
B. Knee-chest
C. Low fowlers
D. Side lying position on the affected side
100. Which of the following anesthetics drug is used for thoracentesis?
A. Procaine 2%
B. Valium 250 mg
C. Demerol 75 mg
D. Phenobarbital 50 mg

SIMULATION 9 NP2
SITUATION: Maria is a 31 year old lawyer who has been married for 6 months. She consults
you for guidance in relation with her menstrual cycle and her desire to get pregnant.
1. She wants to know the length of her menstrual cycle. Her previous menstrual period is
October 22 to 26. Her LMB is November 21. Which of the following number of days will be your
correct response?
A. 29.
B. 28.
C. 30
D. 31
2. You advise her to observe and record the signs of ovulation. Which of the following signs will
she likely note down?
1. 1 degree Fahrenheit rise in basal body temperature
2. Cervical mucus becomes mucus and clear
3. One pound increase in weight
4. Mittleschmerz
A. 1, 2, 4
B. 1, 2, 3
C. 2, 3, 4
D. 1, 3, 4
3. You instruct Mariah to keep of her basal temperature everyday, which of the following
instructions is incorrect?
A. If coitus has occurred, this should be reflected in the chart
B. It is best to have coitus in the evening following a drop in BBT to become pregnant
C. Temperature should be taken immediately after waking and before getting out of bed
D. BBT is lowest during the secretory phase
4. She reports an increase in BBT on December 16. Which hormone brings about this change in
her BBT?
A. Estrogen
B. Progesterone
C. Gonadotropine
D. Follicle stimulating hormone
5. The following month, Mariah suspects she is pregnant. Her urine is positive for Human
chorionic gonadotrophin.
Which structure produces HCG?
A. Pituitary gland
C. Uterine deciduas
B. Trophoblastic cells of the embryo
D. Ovarian follicles
SITUATION: Mariah came back and she is now pregnant
6. At 5 months gestation, which of the following fetal development would probably be achieved?
A. Fetal movement are felt by Mariah
B. Vernix caseosa covers the entire body
C. Viable if delivered within this period
D. Braxton hicks contractions are observed
7. The nurse palpates the abdomen of Mariah. Now at 5 month gestation. What level of the
abdomen can the fundic height be palpated?
A. Symphysis pubis
B. Midpoint between the umbilicus and the xiphoid process
C. Midpoint between the symphysis pubis and the umbilicus
D. Umbilicus
8. She worries about her small breast, thinking that she probably will not be able to breastfeed
her baby. Which of the following responses of the nurse is incorrect?
A. "the size of your breast will not affect your lactation"
B. "You can switch to bottle feeding"
C. "You can try to have exercise to increase the size of your breast"
D. "Manual expression of milk is possible"
9. She tells the nurse that does not take milk regularly. She claims that she does not want to
gain too much weight during her pregnancy. Which of the following nursing diagnosis is a
priority?
A. Potential self esteem disturbance related to physiologic changes in pregnancy
B. Ineffective individual copying related to physiologic changes in pregnancy
C. Fear related to the effect of pregnancy
D. Knowledge deficit regarding nutritional requirements of pregnancies related to lack of
information sources
10. Which of the following interventions will likely ensure compliance of Mariah?
A. Incorporate her food preferences that are adequately nutritious on her meal plan
B. Consistently counsel toward optimum nutritional intake
C. Respect her right to reject dietary information if she chooses
D. Inform her of the adverse effects of in adequate nutrition to her fetus
SITUATION: Susan is a patient in the clinic where you work. She is Inquiring about pregnancy.
11. Susan tells you she is worried because she develops breast later than most of her friends.
Breast development is called
A. Adrenarche
B. Mamarche
C. Thelarche
D. Menarche
12. Kevin, Susan's husband tells you that he is considering vasectomy. After the birth of their
new child. Vasectomy involves the incision of which organ?
A. The testes
B. The vas deferens C. The epididymis
D. The scrofum
13. On examination, Susan has been found of having a cystocele. A cystocele is:
A. A sebaceous cyst arising from the vulvar fold
B. Protrusion of intestines into the vagina
C. Prolapsed of the uterus in the vagina
D. Herniation of the bladder into the vaginal wall
14. Susan typically has menstrual cycle of 34 days. She told you she had coitus on days 8, 10,
15 and 20 of her menstrual cycle. Which is the day on which she is the most likely to conceive?
A. 8th day
B. 10th day
C. Day 15
D. Day 20
15. While talking with Susan, 2 new patients arrived and they are covered with large towels and
the nurse noticed that there are many cameraman and news people outside of the OPD. Upon
assessment the nurse noticed that both of them are still nude and the male client's penis is still
in the female client vagina and the male client said that "I can't pull it".
Vaginismus was your first impression. You know that the psychological cause of vaginismus is
related to:
A. The male client inserted the penis too deeply that it stimulates vaginal closure
B. The penis was too large that's why the vagina triggered it's defense to attempt to close it
C. The vagina do not want to be penetrated
D. It is due to learning patterns of the female client where she views sex as bad or sinful
Situation: Overpopulation is one problem in the Philippines that causes economic drain. Most
Filipinos are against in legalizing abortion. As a nurse, Mastery of contraception is needed to
contribute to the society and economic growth.
16. Supposed that Dana, 17 years old, tells you what she wants to use fertility awareness
method of contraception. How will she determine her fertile days?
A. She will notice that she feels hot. as if she has an elevated temperature
B. She should assess whether her cervical is thin, copious, clear and watery
C. She would monitor her emotions for sudden anger and crying
D. She should assess whether her breast feel sensitive to cool air
17. Dana chooses to use COC as her family planning method, what is the danger sign of COC
you would ask her to report?
A. A stuffy or runny nose
C. Slight weight gain
8. Arthritis like symptoms
D. Migraine headache
18. Dana asks about subcutaneous implants and she asks, how long will these implants be
effective? Your best answer is:
A. One month
B. Twelve months
C. Five years
D. 10 years
19. Dana asks about female condoms. Which of the following is true with regards to female
condoms?
A. The hormone the condom releases might cause mild weight gain
B. She should insert the condom before any penile penetration
C. She should coat the condom with spermicide before use
D. Female condoms, Unlike male condoms are reusable
20. Dana has asked about GIFT procedure. What makes her a good candidate for GIFT?
A. She has patent fallopian tubes, so fertilized ova can be implanted in them
B. She is RH negative, a necessary stipulation to rule out RH incompability
C. She has normal uterus, so the sperm can be injected through the cervix into it
D. Her husband is taking Sildenafil, so all sperms will be motile
SITUATION: Nurse Lorena is a Family Planning and Infertility Nurse Specialist and currently
attends to FAMILY PLANNING CLIENTS AND FERTILE COUPLES. The following conditions
pertain to meeting the nursing needs of this particular population growth.
21. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the
best answer?
A. Prostaglandins released from the cut fallopian tubes can kill sperm
B. Sperm cannot enter the uterus because the cervical entrance is blocked
C. Sperm can no longer reach the ova, Because the fallopian tubes are blocked
D. The ovary no longer releases ova as there is nowhere for them to go
22. The Dators are a couple undergoing testing for infertility is said to exist when
A. A woman has no uterus
B. A woman has no children
C. A couple has been trying to conceive for 1 year
D. A couple has wanted a child for 6 months
23. Another client named Lilia is diagnosed as having endometriosis. This condition interferes
with fertility because:
A. Endometrial implants can blocked the fallopian tubes
B. The uterine cervix becomes inflamed and swollen
C. The ovaries stop producing adequate estrogen
D. Pressure on the pituitary leads to decreased FSH level
24. Lilia is schedule to have a hysterosalphingogram. Which of the following instructions would
you give her regarding this procedure?
A. She will not be able to conceive for 3 months after the procedure
B. The sonogram of the uterus will reveal any tumors present
C. Many women experience mild bleeding as an after effect
D. She may feel some cramping when the dye is inserted
25. Lilia's cousin on the other hand, knowing nurse Lorena's specialization asks what artificial
insemination by donor entails. Which would be your best answer if you were Nurse Lorena?
A. Donor sperm are introduced vaginally into the uterus or cervix
B. Donor sperm are injected intra-abdominally into each ovary
C. Artificial sperm are injected vaginally to test tubal patency
D. The husband's sperm is intravenously weekly
SITUATION: Nursing is a profession. The nurse should have a background on the theories and
foundation of nursing as it influenced what is nursing today.
26. Nursing is the protection, promotion and optimization of health and abilities, prevention of
illness and injury, alleviation of suffering through the diagnosis and treatment of human
response and advocacy in the care of the individual's families, communities and the population.
This is the most accepted definition of nursing as defined by the:
A. PNA
B. ANA
C. Nightingale
D. Henderson
27. Advancement in Nursing leads to the development of the Expanded Career roles. Which of
the following is NOT an expanded career role for nurses?
A. Nurse practitioner
C. Nurse researcher
B. Clinical nurse specialist
D. Nurse anesthesiologist
28. The board of Nursing regulated the Nursing Profession in the Philippines and is responsible
for the maintenance of the quality of nursing in the country. Powers and duties of the board of
nursing are the following EXCEPT:
A. Issue, suspend, revoke certificates of registration
B. Issue subpoena duces tecum, and tetificandum
C. Open and close colleges of nursing
D. Supervise and regulate the practice of Nursing
29. A nursing student or a beginning staff nurse who has not yet experience enough real
situations to make judgements about them is in what stage of Nursing Expertise?
A. Novice
B. Newbie
C. Advance beginner
D. Competent
30. Benner's "Proficient" nurse level is different from the other levels in nursing expertise in the
context of having:
A. The ability to organize and plan activities
B. Having attained an advance level of education
C. A holistic understanding and perception of the client
D. Intuitive and analytic ability in new situations
Situation - Various Nursing concepts that one should have memorized by heart.
31. A preschooler's are able to see things from which of the following perspectives?
A. Their peers
C. Their own and their mother's
B. Their own and their caregivers
D. Only their own
32. In conflict management, the win-win approach occurs when:
A. There are two conflicts and the parties agree to each one
B. Each parties give in on 50% of the disagreements making up the conflict
C. Both parties involved are committed to solving the conflict
D. The conflict is settled out of court so the legal system and the parties win
33. According to the social-interactional perspective of child abuse and neglect, four factors
place the family members at risk for abuse. these risk factors are the family members at risk for
abuse. The risk factors are the family itself, the caregiver, the child and:
A. The presence of the family crisis
C. The national emphasis on sex
B. Genetics
D. Chronic poverty
34. Which of the following signs and symptoms would you most likely find when assessing and
infant with Arnold-Chiari malformation?
A. Weakness of the leg muscle, loss of sensation in the legs, and restlessness
B. Difficulty swallowing, diminished or absent gag reflex, and respiratory distress
C. Difficulty sleeping, hypervigilant and an arching of the back
D. Paradoxical irritability, diarrhea and vomiting
35. A parent calls you and frantically reports that her child has gotten into her famous ferrous
sulfate pills and ingested a number of these pills. Her child is now vomiting, has bloody diarrhea,
and is complaining of abdominal pain. You will tell the mother to:
A. Call emergency medical services (EMS) and get the child to the emergency room
B. Relax because these symptoms will pass and the child will be fine
C. Administer syrup of ipecac
D. Call the poison control center
36. A client that she heard from a friend that you stop having periods once you are in the "pill".
The most appropriate response would be:
A. "The pill prevents the uterus making such endometrial lining, that is why periods may often be
scant or skipped occasionally".
B. "If your friend has missed her period, she should stop taking the pills and get a pregnancy
test as soon as possible"
C. "The pill should cause a normal menstrual period every month. It sound like your friend has
not been taking the pills properly"
D. "Missed period can be very dangerous and may lead to the formation of precancerous cells"
37. The nurse assessing a newborn babies and infants during their hospital stay after birth will
notice which of the following symptoms as a primary manifestation of Hirschsprung's disease?
A. A fine rush over the trunk
B. Failure to pass meconium during the first 24-48 hours after birth
C. The skin turns yellow and then brown over the first 48 hours of life
D. High-grade fever
38. A client is 7 months pregnant and has just been diagnosed as having a partial placenta
previa. She is stable and has minimal spotting and is being sent home. Which of these
instructions to the client may indicate a need for further teaching?
A. Maintain bed rest and bathroom privileges
C. Call if contractions occur
B. Avoid intercourse for three days
D. Stay on left side as much as possible when lying down
39. A woman has been rushed to the hospital with ruptured membrane. Which of the following
should the nurse check first?
A. Check for the presence of infection
C. Check the maternal rate
B. Assess for prolapse of the umbilical cord
D. Assess the color of the amniotic fluid
40. The nurse notes that the infant is wearing a plastic-coated diaper if a topical medication
were to be prescribed and it were to go on the stomach or buttocks, the nurse would teach the
caregivers to:
A. Avoid covering the area of the topical medication with the diaper
B. Avoid the use of clothing on top of the diaper
C. Put the diaper on as usual
D. Apply an icepack for 5 minutes to the outside of the diaper
41. Which of the following factor is the most important in determining the success of
relationships used in delivering nursing care?
A. Type of illness of the client
C. Effective communication
B. Transference and counter transference
D. Personality of the participants
42. Grace sustained a laceration on her leg from automobile accident. Why are lacerations of
lower extremities potentially more serious among pregnant woman than the other?
A. Laceration can provoke allergic responses due to gonadotropic hormone release
B. A woman is less able to keep the laceration clean because of her fatigue
C. Healing is limited during pregnancy so these will not heal until after birth
D. Increased bleeding can occur from uterine pressure on leg veins
43. In working with the caregivers of a client with an acute or chronic illness, the nurse would
A. Teach care daily and let the caregivers do a return demonstration just before discharge
B. Difficulty swallowing, diminished or absent gag reflex and respiratory distress
C. Difficulty sleeping, hypervigilant, and an arching of the back
D. Paradoxical irritability, diarrhea and vomiting
44. Which of the following roles BEST exemplifies the exemplifies the expanded role of the
nurse?
A. Circulating nurse surgery
C. Obstetrical nurse
B. Medication nurse
D. Pediatric nurse practitioner
45. According to Derosa and Kochura's (2006) article entitled "Implement Cultural Competent
Health Care in your Workplace". Cultures have different patterns of verbal and non-verbal
communication. Which difference does NOT necessarily belong?
A. Personal behavior
B. Eye contact
C. Subject matter
D. Conversational style
46. You are near assigned to work with acute glomerulonephritis. By following the prescribed
treatment regimen, the child experiences a remission. You are now checking to make sure the
child does not have a relapse. Which finding would most lead you to the conclusion that a
relapse is happening?
A. Elevated temperature, cough, sore throat, changing complete blood count (CBC) with
differential
B. A urine dipstick measurement of 2+ proteinuria or more for 3 days or the child found to have
3 - 4+ proteinuria plus edema.
C. The urine dipstick showing glucose in the urine for 3 days, extreme thirst, increase in urine
output, and a moon face
D. A temperature of 37.8 degrees (100 degreed F), flank pain, burning frequency, urgency on
voiding and cloudy urine
47. The nurse is working with an adolescent who complains of being lonely and having a lack of
fulfillment in her life.
This adolescent shies away from intimate relationships at times yet at other times she appears
promiscuous. The nurse will likely work with this adolescent in which of the following areas?
A. Isolation
B. Loneliness
C. Lack of fulfillment
D. Identity
48. The use of interpersonal decision making psychomotor skills, and application of knowledge
expected in the role of a licensed health care professional in the context of public health welfare
and safety an example of:
A. Delegation
B. Supervision
C. Responsibility
D. Competence
49. The painful phenomenon known as back labor occurs in a client whose fetus in what
position?
A. Brow position
C. Breech position
B. Right Occipito-Anterior Position
D. Left Occipito-Posterior Position
50. FOCUS methodology stands for:
A. Focus, organize, clarify, Understand and Solution
B. Focus, Opportunity, Continuous, Utilize, Substantiate
C. Focus, Organize, Clarify, Understand, Substantine
D. Focus, Opportunity, Continuous (process), Understand Solution
SITUATION: The infant and child mortality rate in the low to middle income countries is ten
times higher than industrialized countries. In response to this, the WHO and UNICEF launched
the protocol integrated Management of Childhood illness to reduce the morbidity and mortality
against childhood illnesses.
51. If a child with diarrhea registers two signs in the yellow row in the IMCI chart, we can classify
the patient as.
A. Moderate dehydration
B. Some dehydration C. Severe dehydration D. No dehydration
52. Celeste has had diarrhea for 8 days. There is no blood in the stool, he is irritable, his eyes
are sunken, the nurse offers fluid to Celeste and he drinks eagerly. When the nurse pinched the
abdomen it goes back slowly. How will you classify Celeste's illness?
A. Moderate dehydration
B. Some dehydration
C. Severe dehydration D. No dehydration
53. A child who is 7 weeks has has diarrhea for 14 days but has no sign of dehydration is
classified
A. Persistent diarrhea
B. Severe dysentery
C. Dysentery
D. Severe persistent diarrhea
54. The child with no dehydration needs home treatment. Which of the following is not included
in the rules for home treatment in this case?
A. Forced fluids
C. Give Vitamin A supplement
B. When to return
D. Feeding mom
55. Fever as used in IMCI includes:
A. Axillary temperature of 37.5 or higher
B. Rectal temperature of 38 higher
C. Feeling hot to touch
D. All of the above
E. A and C only
SITUATION: Prevention of Dengue is an important nursing responsibility and controlling its
spread is a priority once outbreak has been observed.
56. An important role of the community health nurse in the prevention and control of dengue H
fever includes?
A. Advising the elimination of vectors by keeping water containers covered
B. Conducting strong health education drives/campaign directed towards proper garbage
disposal
C. Explaining to the individuals, families, groups and community the nature of the disease and
its causation
D. Practicing residual spraying with insecticides
57. community health nurses should be alert in observing a Dengue suspect. The following is
NOT an indicator for hospitalization of H fever suspects?
A. Marked anorexia, abdominal pain and vomiting
C. Cough of 30 days
B. Increasing hematocrit count
D. Persistent headache
58. The community health nurse's primary concern in the immediate control of hemorrhage
among patients with dengue is:
A. Advising low fiber and non-fat diet
B. Providing warmth through light weight covers
C. Observing closely the patient for vital signs leading to shock
D. Keeping the patient at rest
59. Which of these signs may NOT be REGARDED as a truly positive signs indicative of
Dengue H fever?
A. Prolonged bleeding time
B. Appearance of at least 20petechae within 1 cm square
C. Steadily increasing hematocrit count
D. Fall in the platelet count
60. Which of the following is the most important treatment of patients with Dengue H fever?
A. Give aspirin for fever
B. Replacement of body fluids
C. Avoid unnecessary movement of patient
D. Ice cap over the abdomen in case of melena
SITUATION: Health education and health promotion is an important part of nursing responsibility
in community.
Immunization is a form of health promotion that aims at preventing the common childhood
illnesses.
61. In correcting misconception and myths about certain diseases and their management, the
health worker should first:
A. Identify the myths and misconceptions prevailing in the community
B. Identify the source of these myths and misconception
C. Explain how and why these myths came about
D. Select the appropriate IEC strategies to correct them
62. How many percent of measures are prevented by immunization at 9 months of age?
A. 80%
B. 90%
C. 99% *
D. 95%
63. After TT3 vaccination a mother is said to be protected to tetanus by around:
A. 80%
B. 85%
C. 99%
D. 90%
64. If ever convulsions occur after administering DPT, What should the nurse best suggest to
the mother?
A. Do not continue DPT vaccination anymore
B. Advise mother to comeback after 1 week
C. Give DT instead of CPT
D. Give pertussis of the DPT and remove DT
65. These vaccines are given 3 doses at one month intervals
A. DPT, BCG, TT
B. DPT,TT,OPV
C. OPV,HEP B, DPT
D. Measles, OPV, DPT
SITUATION: With the increasing documented cases of CANCER the best alternative to
treatment still remains to be
PREVENTION. The following conditions apply.
66. Which among the following is the primary focus of prevention of cancer?
A. Elimination of conditions causing cancer
B. Diagnosis
C. Treatment at early stage
D. Early detection
67. In the prevention and control of cancer, which of the following activities is the most important
function of the community health nurse?
A. Conduct community assemblies
B. Referral to cancer specialist those clients with symptoms of cancer
C. Use the nine warning signs of cancer as parameters in our process of detection, control and
treatment modalities
D. Teach woman about proper/correct nutrition
68. Who among the following are recipients of the secondary level of care for cancer cases?
A. Those under early case detection
B. Those under post case treatment
C. Those scheduled for surgery
D. Those undergoing treatment
69. Who among the following are recipients to the tertiary level of care for cancer cases?
A. Those under early treatment
C. Those under early detection
B. Those under supportive care
D. Those scheduled for surgery
70. In community Health Nursing, despite the availability and use of many equipment and
devices to facilitate the job of the community health nurse. The best tool any nurse should be
well be prepared to apply is a scientific approach. This approach ensures quality of care even at
the community setting. This is nursing parlance is nothing less than the:
A. Nursing diagnosis
B. Nursing protocol
C. Nursing research
D. Nursing process
questions apply.
SITUATION: Two children were brought to you. One with chest indrawing and the other had
diarrhea. The following
71. Using Integrated Management and Childhood Illness (IMCI) approach. How would you
classify the 1st child?
A. Bronchopneumonia
C. Severe pneumonia
B. No pneumonia: cough or cold
D. Pneumonia
72. The 1st child who is 13 months has fast breathing using IMCI parameters he has:
A. 40 breaths per minute or more
C. 30 breathes per minute or more
B. 50 breathes per minute
D. 60 breathes per minute
73. Nina, the 2nd child has diarrhea for 5 days. There is no blood in the stool. She is irritable,
and her eyes are sunken.
The nurse offered fluids and the child drinks eagerly. How would you classify Nina's illness?
A. Some dehydration
B. Dysentery
C. Severe dehydration
D. No dehydration
74. Nina's treatment should include the following EXCEPT
A. Reassess the child and classify him for dehydration
B. For infants under 6 months old who are not breastfed, give 100-200ml clean water as well
during this period
C. Give in the health center the recommended amount of ORS for 4 hours
D. Do not give any other foods to the child for home treatment
75. While on treatment, Nina 18 months old weighed 18kgs and her temperature registered at
37 degrees C. Her mother says she developed cough 3 days ago. Nina has no general danger
signs. She has 45 breathes/minute, no chest-in drawing, no stridor. How would you classify
Nina's manifestation
A. No pneumonia
B. Severe pneumonia
C. Pneumonia
D. Bronchopneumonia
76. Carol is 15 months old and weights 5.5 kgs. and it is her initial visit. Her mother says that
Carol is not eating well and unable t breastfeed, he has o vomiting, has no convulsions and not
abnormally sleepy or difficult to awaken. Her temperature is 38.9 deg C. Using the Integrated
Management of Childhood illness or IMCI strategy. If you were the nurse in change of Carol,
how will you classify her illness?
A. A child at a general danger sign
C. Severe pneumonia
B. Very severe febrile disease
D. Severe malnutrition
77. Why are small gestational age newborns at risk for difficulty maintaining body temperature?
A. Their skin is more susceptible to conduction of cold
B. They are preterm so are born relatively small in size
C. They do not have as many fat stored as other infants
D. They are more active than usual so they throw off comes
78. Oxytocin is administered to Rita to augment labor. What are the first symptoms of water
intoxication to observe for during this procedure?
A. Headache and vomiting
C. A high choking voice
B. A swollen tender tongue
D. Abdominal bleeding and pain
79. Which of the following treatment should NOT be considered if the child has severe dengue
hemorrhagic fever?
A. Use plan C if there is bleeding from the nose of gums
B. Give ORS if there is skin petechiae, persistent vomiting, and positive tourniquet test
C. Give aspirin
D. Prevent low blood sugar
80. In assessing the patient's condition using the integrated Management of Childhood Illness
approach strategy, the first thing that a nurse should do is to:
A. Ask what are the child's problem
C. Check for the four main symptoms
B. Check the patient's level of consciousness
D. Check for the general danger signs
81. A child with no dehydration needs home treatment. Which of the following is NOT included
in the care for home management at this case?
A. How long the child has diarrhea
C. Presence of blood in the stool
B. Skin petechia
D. Signs of dehydration
82. The child with no dehydration needs home treatment. Which of the following is NOT
included in the care for home management at this case?
A. Give drugs every 4 hours
C. Give the child more fluids
B. Continue feeding the child
D. Inform when to return to the health center
83. Ms. Jordan, RN, believes that a patient should be treated as individual. This ethical principle
that the patient referred
to:
A. Beneficence
B. Nonmaleficence
C. Respect for person
D. Autonomy
84. When patients cannot make decisions for themselves, The nurse advocate relies on the
ethical principle of:
A. Justice and beneficence
C. Beneficence and nonmaleficence
B. Fidelity and nonmaleficence
D. Fidelity and justice
85. Being a community health nurse, you have the responsibility of participating in protecting the
health of people, Consider this situation: Vendors selling bread with their bare hands. You do not
see them washing their hands. What should you do?
A. "Miss, may i get the bread myself because you have not washed your hands"
B. "All of these"
C. "Miss, it id better to use a pick up forceps/ bread tong"
D. "Miss, your hands are dirty. Wash your hands first before getting the bread"
86. A female client asks the nurse about the use of a cervical cap. Which statement is correct
regarding the use of the cervical cap?
A. It may affect Pap smear results
C. It does not require the use of spermicide
B. It does not need to be fitted by the physician
D. It must be removed within 24 hours
87. The major components of the communication process are:
A. Verbally written and non verbal
B. Speaker listener and reply
C. Facial expression, tone of voice and gestures
D. Message, sender, channel, receiver and feedback
88. The extent of burns in children are normally assessed and expressed in terms of:
A. The amount of body surface that is unburned
B. Percentages of total body surface area (TBSA)
C. How deep the deepest burns are
D. The severity of the burns on a 1 to 5 burn scale
89. The school nurse a child who is wearing old, dirty, poor-fitting clothes; is always hungry; has
no lunch money; and is always tired. When the nurse asks the boy his tiredness, he talks of
playing outside until midnight. The nurse will suspect that this child is:
A. Being raised by a parent of low intelligence quotient (IQ)
B. An orphan
C. A victim of child neglect
D. The victim of poverty
90. Which of the following indicates the type(s) of acute renal failure?
A. Four types: hemorrhagic with and without clotting and nonhemorrhagic with and without
clotting
B. One type: acute
C. Three types: prerenal, Intrarenal and postrenal
D. Two types: acute and subacute
SITUATION: Mike 16 y/o has been diagnosed to have AIDS. He worked as entertainer in a
cruise ship:
91. Which method of transmission is common to contract AIDS?
A. Syringe and needles
B. Body fluids
C. Sexual contact
D. Transfusion
92. Causative organism in AIDS is one of the following;
A. Fungus
B. Bacteria
C. Retrovirus
D. Parasites
93. You are assigned in a private room of Mike. Which procedure should be of outmost
importance?
A. Alcohol wash
C. Washing isolation
B. Universal precaution
D. Gloving technique
94. What primary health teaching would you give to mike?
A. Daily exercise
B. Prevent Infection
C. Reverse isolation
D. Proper nutrition
95. Exercise precaution must be taken to protect health worker dealing with AIDS patients,
which among these must be done as priority?
A. Boil used syringe and needles
C. Label personal belonging
B. Use gloves when handling specimen
D. Avoid accidental wound
SITUATION: Ensuring safety before, during and after a diagnostic procedure is an important
responsibility of the nurse.
96. To help Fernan better tolerate the bronchoscopy, you should instruct him to practice which of
the following prior to the procedure?
A. Clenching his fist every 2 minutes
B. Breathing in and out through the nose with his mouth open
C. Tensing the shoulder muscles while lying on his back
D. Holding his breath periodically for 30 seconds
97. Following a bronchoscopy, which of the following complains to Fernan should be noted as a
possible complication:
A. Nausea and vomiting
B. Shortness of breath and laryngeal stridor
C. Blood tinged sputum and coughing
D. Sore throat and hoarseness
98. Immediately after bronchoscopy, you instructed fernan to :
A. Exercise the neck muscles
B. Breathe deeply
C. Refrain from coughing and talking
D. Clear his throat
99. Thoracentesis may be performed for cytologic study of pleural fluid. As a nurse your most
important function during the procedure is to
A. Keep the sterile equipment from contamination
B. Assist the physician
C. Open and close the three-way stopcock
D. Observe the patients vital signs
100. Right after thoracenthesis, which of the following is most appropriate intervention?
A. Instruct the patient not to cough or deep breath for two hours
B. Observe for symptoms of tightness of chest or bleeding
C. Place an ice pack to the puncture site
D. Remove the dressing to check for bleeding

SIMULATION 9 NP3
SITUATION: Leo lives in the squatter area. He goes to nearby school. He helps his mother
gather molasses after school.
One day, he was absent because of fever, malaise, anorexia and abdominal discomfort.
1. Upon assessment, Leo was diagnosed to have Hepatitis A. Which mode of transmission has
the infection agent taken?
A. Fecal oral
B. Droplet
C. Airborne
D. Sexual contact
2. Which of the following is concurrent disinfection in the case of Leo?
A. Investigation of contact
B. Sanitary disposal of feces, Urine and blood
C. Quarantine of the sick individual
D. Removing all detachable objects in the room, cleaning lighting and air dust surfaces in the
ceiling and cleaning everything downward to the floor
3. Which of the following must be emphasized during mother's class to Leo's mother?
A. Administration of immunoglobulin to families
B. Thorough handwashing before and after eating and toileting
C. Use of attenuated vaccines
D. Boiling of food especially meat
4. Disaster control should be undertaken when there are 3 or more hepatitis A cases. Which of
these measures is a priority?
A. Eliminate fecal contamination from foods
B. Mass vaccination of uninfected individuals
C. Health promotion and education to families and communities about the disease it's cause
and transmission
D. Mass administration of Immunoglobin
5. What is the average incubation period of Hepatitis A?
A. 30 days
B. 60 days C. 50 days
D. 14 days
SITUATION: As a nurse researcher you must have a very good understanding of the common
terms of concept used in research.
6. The information that an investigator collects from the subjects or participants in a research
study is usually called:
A. Hypothesis
B. Data
C. Variable
D. Concept
7. Which of the following usually refers to the independent variables in doing research
A. result
B. Cause
C. Output
D. Effect
8. The recipients of experimental treatment is an experimental design or the individuals to be
observe in a non experimental design are called:
A. Setting
B. Subjects
C. Treatment D. Sample
9. The device or technique an investigator employs to collect data is called:
A. Sample
B. Instrument
C. Hypothesis
D. Concept
10. The use of another person's ideas or wordings without giving appropriate credit results from
inaccurate or incomplete attribution of materials to its sources. Which of the following is referred
to when another persons idea is inappropriate credited as one's own:
A. Plagiarism B. Quotation C. Assumption D. Paraphrase
SITUATION: Mrs. Pichay is admitted to your ward. The MD ordered "prepare for thoracentesis
this pm to remove excess air from the pleural cavity."
11. Which of the following nursing responsibilities is essential in Mrs. Pichay who will undergo
thoracentesis?
A. Support and reassure client during the procedure
B. Ensure that informed consent ahs been signed
C. Determine if client has allergic reaction to local anesthesia
D. Ascertain if chest x-rays and other test have been prescribed and completed
12. Mrs. Pichay who is for thoracentesis is assigned by the nurse to which of the following
positions?
A. Trendelenburg position
B. Supine position
C. Dorsal Recumbent position
D. Orthopneic position
13. During thoracentesis, which of the following nursing intervention will be most crucial?
A. Place patient in a quiet and cool room
B. Maintain strict asceptic technique
C. Advice patient to sit perfectly still during needle insertion until it has been withdrawn from the
chest
D. Apply pressure over the puncture site as soon as the needle is withdrawn
14. To prevent leakage of fluid in the thoracic cavity, how will you position the client after
thoracentesis
A. Place flat in bed
C. Turn on the affected side
B. Turn on the inaffected side
D. On bed rest
15. Chest x-ray was ordered after thoracentesis. When your client asks what the reason for
another chest x-ray is, you will explain:
A. To rule out pneumothorax
C. To decongest
B. To rule out any possible perforation
D. To rule out any foreign body
SITUATION: A computer analyst, Mr. Ricardo J. Santos, 25 was brought to the hospital for
diagnostic workup after he had experienced seizure in his office.
16. Just as the nurse was entering the room, the patient who was sitting on his chair begins to
have a seizure. Which of the following must the nurse do first?
A. Ease the patient to the floor
B. Lift the patient and put him o the bed
C. Insert a padded tongue depressor between his jaws
D. Restraint patient's body movement
17. Mr. Santos is scheduled for CT SCAN for the next day, noon time. Which of the following is
the correct preparation as instructed by the nurse?
A. Shampoo hair thoroughly to remove oil and dirt
B. No special preparation is needed. instruct the patient to keep still and steady
C. Give a cleansing enema and give fluids until 8AM
D. Shave scalp and securely attach electrodes to it
18. Mr. Santos is placed on seizure precaution. Which of the following would be
contraindicated?
A. Obtain his oral temperature
B. Encourage to perform his own personal hygiene
C. Allow him to wear his own clothing D. Encourage him to be out of bed
19. Usually, how does the patient behave after is seizure has subsided?
A. Most comfortable walking and moving out
B. Becomes restless and agitated
C. Sleeps for a period of time
D. Say he is thirsty and hungry
20. Before, during and after seizure. The nurse knows that the patient is ALWAYS placed in
what position?
A. Low fowler's
B. Modified trendelenburg
C. Side lying
D. supine
SITUATION: Mrs. Damian an immediate post op cholecystectomy and choledocholithotomy
patient, complained of severe pain at the wound site.
21. Choledocholithotomy is
A. The removal of the gallbladder
C. The removal of the stones in the common bile duct
B. The removal of the stones in the gallbladder
D. The removal of the stones in the kidney
22. The simplest pain relieving technique is:
A. Distraction
B. taking aspirin
C. Deep breathing exercise
D. Positioning
23. Which of the following statement on pain is TRUE?
A. Culture and pain are not associated
B. Pain accompanies acute illness
C. Patient's reaction to pain varies
D. Pain produces the same reaction such as groaning and moaning
24. In pain assessment, which of the following condition is a more reliable indicator?
A. Pain rating scale of 1 to 10
B. Facial expression and gestures
C. Physiologic al responses
D. Patient's description of the pain sensation
25. When a client complains of pain, your initial response is:
A. Record the description of pain
C. Refer the complaint to the doctor
B. Verbally acknowledge the pain
D. Change to a more comfortable position
SITUATION: You are assigned at the surgical ward and clients have been complaining of post
pain at varying degrees.
Pain as you know is very subjective
26. A one-day postoperative abdominal surgery client has been complaining of severe throbbing
abdominal pain described as 9 in a 1-10 pain rating. Your assessment reveals bowel sounds on
all quadrants and the dressing is dry and intact. What nursing intervention would you take?
A. Medicate client a prescribed
C. Encourage deep breathing and turning
B. Encourage client to do imagery
D. Call surgeon stat
27. Pentoxicodone 5mg IV every 8 hours was prescribed for post abdominal pain. Which will be
your priority nursing action?
A. Check abdominal dressing for possible swelling
C. Avoid overdosing to prevent dependence/tolerance
B. Explain the proper use of PCA to alleviate anxiety
D. Monitor VS, more importantly RR
28. The client complained of abdominal distention and pain. Your nursing intervention that can
alleviate pain is:
A. Instruct the client to go to sleep and relax
B. Advice the client to close the lips and avoid deep breathing and talking
C. Offer hot clear soup
D. Turn to sides frequently and avoid too much talking
29. Surgical pain might be minimized by which nursing action on the O.R.
A. Skill of surgical team and lesser manipulation
B. Appropriate preparation for the scheduled procedure
C. Use of modern technology in closing the wound
D. Proper positioning and draping of clients
30. Inadequate anesthesia is said to be one of the common cause of pain both in intra and post
op patients. If general anesthesia is desired, it will involve loss of consciousness. Which of the
following are the 2 general types of GA?
A. Epidural and spinal
B. Subarachnoid
C. Inhalation and Regional
D. Intravenous and Inhalation
Situation: Nurse's attitudes toward the pain influence the way they perceive and interact with
client's pain.
31. Nurse's should be aware that older adults are at risk underrated pain, Nursing assessment
and management of pain should address the following beliefs EXCEPT:
A. Older patients seldom tent to report pain than the younger ones
B. Pain is a sign of weakness
C. Older patients do not believe in analgesics, they are tolerant
D. Complaining of pain will lead to being labeled a bad patient
32. Nurses should understand that when a client responds favorably to a placebo, It is known as
the "placebo effect".
Placebos do not indicate whether or not a client has:
A. Concscience
B. Real pain
C. Disease
D. Drug tolerance
33. You are the nurse in the pain clinic where you have client whos has difficulty specifying the
location of pain. How can you assist such client?
A. The pain is vague
C. Identify the absence and presence of pain
B. By charting-it hurts all over
D. Ask the client to point to the painful area by just one finger
34. What symptom more distressing than pain, should the nurse monitor when giving opioids
especially among elderly clients who are in pain?
A. Forgetfulness
B. Constipation
C. Drowsiness
D. Allergic reactions like pruritus
35. Physical dependence occurs in anyone who takes opioids over a period of time. What do
you tell a mother of a
'dependent' when asked for advice?
A. Start another drug and slowly lessen the opioid dosage
B. Indulge in recreational outdoor activities
C. Isolate opioid dependent to a restful resort
D. Instruct slow tapering of drug dosage and alleviate physical withdrawal symptoms
SITUATION: The nurse is performing health education activities Janevi segovia, a 30 year old
dentist with Insulin dependent Diabetes Mellitus.
36. Janevi is preparing a mixed dosed of insulin. The nurse is satisfied with her performance
when she:
A. Draw insulin from the vial of clear insulin first
B. Draw insulin from the vial of the intermediate acting insulin first
C. Fill both syringes with the prescribed insulin dosage then shake the bottle vigorously
D. Withdraw the intermediate acting insulin first before withdrawing the short acting insulin first
37. Janevi complains about nausea, vomiting, diaphoresis and headache. Which of the following
nursing intervention are you to carry out first?
A. Withhold the client's next insulin injection
C. Administer Tylenol as ordered
B. Test the client's blood glucose level
D. Offer fruit juice, gelatin and chicken bouillon
38. Janevi administered regular insulin at 7 A.M and the nurse should instruct Jane to avoid
exercising at round:
A. 9 to 11 A.M
C. Between 8 A.M to 9 A.M
B. After 8 hours
D. In the afternoon, after taking lunch
39. Janevi was brought at the emergency room after four months because she fainted in her
clinic. The nurse should monitor which of the following test to evaluate the overall therapeutic
compliance of a diabetic patient?
A. Glycosylated hemoglobin
B. Fasting blood glucose
C. Ketone levels
D. Urine glucose levels
40. Upon the assessment of Hba 1c of Mrs. Segovia, The nurse has been informed 90% Hba 1c
result. in case, she will teach the patient to:
A. Avoid infection
C. Prevent and recognize hyperglycemia
B. Take adequate food and nutrition
D. Prevent and recognize hypoglycemia
41. The nurse is teaching plan of care for jane with regards to proper foot care. Which of the
following should be included in the plan?
A. Soak feet in hot water
B. Avoid using mild soap on the feet
C. Apply a moisturizing lotion to dry feet but not between the toes
D. Always have a podiatrist to cut your toe nails; never cut them yourself
42. Another patient was brought to the emergency room in an unresponsive state and a
diagnosis of hyperglycaemic hyperosmular nonketotic syndrome is made. The nurse
immediately prepares to initiate which of the following anticipated physician's order?
A. Endotracheal intubation
C. Intravenous infusion of normal saline
B. 100 unites the NPH insulin
D. Intravenous infusion of sodium bicarbonate
43. Jane eventually developed DKA and is being treated in the emergency room. Which finding
should the nurse expect to note as confirming this diagnosis?
A. Comatose state
B. Decreased urine output
C. Increased respiration and increased in PH
D. Elevated blood glucose level and low plasma bicarbonate level
44. The nurse teaches Jane to know the difference between hypoglycemia and ketoacidosis.
Jane demonstrates understanding of the teaching by stating that glucose will be taken if which
of the following symptoms developed?
A. Polyuria
B. Shakiness
C. Blurred vision
D. Fruit breath odor
45. Jane has been scheduled to have a FBS taken in the morning. The nurse tells Jane not to
eat or drink after midnight.
Prior to taken the blood specimen, the nurse noticed that jane is holding a bottle of distilled
water. The nurse asked Jane if she drunk any and she said "yes". Which of the following is best
nursing action?
A. Administer syrup of ipecac to remove the distilled water in the stomach
B. Suction the stomach content using NGT to specimen collection
C. Advice to physician to reschedule to diagnostic examination next day
D. Continue as usual and have the FBS analysis performed and specimen be taken
SITUATION: Elderly clients usually produced unusual signs when it comes to different disease.
The ageing process is a complicated process and the nurse should understand that it is an
inevitable act and she must be prepared to care for the growing elderly population.
46. Hypoxia may occur in the older patient because of which of the following physiologic
changes associated with aging:
A. Ineffective airway clearance
B. Decreased alveolar surface area
C. Decreased interior-posterior chest
D. Dehyperventilation
47. The older patient is at higher risk for incontinence because of:
A. Dilated urethra
B. Increased glomerular filtration
C. Diureticusis
D. Decreased bladder capacity
48. Merle, age 86, is complaining of dizziness when she stands up this may indicate:
A. Dementia
B. A visual problem
C. Functional decline
D. Drug toxicity
49. Cardiac ischemia in an older patient usually produces:
A. ST-T wave changes
C. Chest pain radiating t the left arm
B. Very high creatinine kinase level
D. Acute confusion
50. The most dependable sign of infection in the older patient is:
A. Change in mental status
B. Fever
C. Pain
D. Decreased breath sounds with crackles
SITUATION: In the OR there are safety protocols that should be followed. The OR nurse should
be well versed, with all these to safeguard the safety, and quality of patient delivery outcome.
51. Which of the following should be given highest priority when receiving patient in the OR?
A. Assess level of consciousness
B. Verify patient identification and informed consent
C. Assess vital signs
D. Check for jewelry, gowns, manicure and dentures
52. Surgeries like I and D (incision and drainage) and debridement are relatively short
procedures but considered 'dirty cases'. When are these procedure best schedule:
A. Last cases
C. According to availability of anesthesiologist
B. In between cases
D. According to the surgeon's preference
53. OR nurses should be aware that maintaining the client safety is the overall scale of nursing
care during the intraoperative phase. As the circulating nurse, you make certain that throughout
the procedure:
A. The surgeon greets his client before induction of anesthesia
B. The surgeon and anesthesiologist are in tandem
C. Strap made of strong non- abrasive materials are fastened securely around the joints of the
knees and ankles and around the 2 hands around an arm board
D. Client is monitored throughout the surgery by the assistant anesthesiologist
54. Another nursing check that should not be missed before the induction of general anesthesia
is:
A. Check for presence underwear
B. Check for presence dentures
C. Check patient's ID
D. Check baseline vital signs
55. Some lifetime habits and hobbies affect postoperative respiratory function. If if your client
smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate increased risk for:
A. Perioperative anxiety and stress
B. Delayed coagulation time
C. Delayed wound healing
D. Postoperative respiratory infection
SITUATION: Sterilization is the process or removing ALL living microorganism. To be free of All
living microorganism is sterility
56. The following are examples of physical means of sterilization, except:
A. Moist heat
B. Ethylene oxide gas C. Microwave D. Autoclave
57. Autoclave or steam under pressure is the most common method of sterilization in the
hospital. The nurse knows that the temperature and time is set to the optimum level to destroy
not only the microorganism but also the spores. Which of the following is the ideal setting of the
autoclave machine?
A. 10,000 degree Celsius for 1 hour
B. 5,000 degree Celsius for 30 minutes
C. 37 degree Celsius for 15 minutes
D. 121 degree Celsius for 15 minutes
58. It is important that before a nurse prepares the material to be sterilized, A chemical indicator
strip should be placed above the package, preferably, Muslim sheet. What is the color of the
striped produces after autoclaving?
A. Black
B. Blue
C. Gray
D. Purple
59. Chemical indicator communicate that:
A. The items are sterile
B. That the items had undergone sterilization process but not necessarily sterile
C. The items are disinfected
D. That the items had undergone disinfection process but not necessarily disinfected
60. If a nurse will sterilize heat and moisture labile instruments, it is according to AORN
recommendation to use which of the following method of sterilization?
A. Ethylene oxide gas
B. Autoclaving
C. Flash sterilizer
D. Alcohol immersion
SITUATION: Nurses hold a variety of roles when providing care to a perioperative patient.
61. Which of the following role would be the responsibility of the scrub nurse?
A. Assess the readiness of the client prior to surgery
B. Ensure that the airway is adequate
C. Account for the number of sponges, needles, supplies, used during the surgical procedure
D. Evaluate the type of anesthesia
62. As a perioperative nurse, how can you best meet safety need of the client after
administering preoperative narcotic?
A. Put side rail up and ask the client not to get out of bed
C. Allow client to get up to go to the comfort room
B. Send the client to the OR with the family
D. Obtain consent form
63. It is the responsibility of the pre-op nurse to do skin prep for patients undergoing surgery. If
hair at the operative site is not shaved, what should be done to make suturing easy and lessen
chance of incision infection?
A. Draped
B. Pulled
C. Clipped
D. Shampooed
64. It is also the nurse's function to determine when infection is developing in the surgical
incision. The perioperative nurse should observe for what signs of impending infection?
A. Localized heat and redness
B. Serosanguinous exudates and skin blanching
C. Separation of the incision
D. Blood clots and scar tissue are visible
65. Which of the following nursing interventions is done when examining the incision wounds
and changing the dressing?
A. Observe the dressing and type and odor of drainage if any
B. Get patient's consent
C. Wash hands
D. Request the client to expose the incision wounds
SITUATION: The preoperative nurse collaborates with the client significant others, and
healthcare provider.
66. To control environmental hazards in the OR, the nurse collaborates with the following
departments EXCEPT:
A. Biomedical division
B. Chaplaincy services
C. Infection control committee
D. Pathology department
67. An air crash occurred near the hospital leading to a surge of trauma patients will need
surgical amputation but the are no sterile surgical equipments. In this case, which of the
A. Equipment needed for surgery for surgery need not to be sterilized if this is an emergency
necessitating life saving measures
B. Forwarding a trauma client to the nearest hospital that has available sterile equipments is
appropriate
C. The nurse will need to sterilize the item before using it to the client using the regular
sterilization setting at 121 degree Celsius in 15 minutes.
D. In such cases, flash sterilizer will be used at 132 degree Celsius in 3 minutes
68. Tess, the PACU nurse, discovered that Malou, who weights 110 Ibs prior to surgery, is in
severe pain 3 hrs. after cholecystectomy. Upon checking the chart, Malou found out that she
has an order of Demerol 100 mg I.M. pm for pains.
Tess should verify the order with:
A. Nurse supervisor
B. Anesthesiologist
C. Surgeon
D. Intern on duty
69. Rosie 57, who is diabetic, is for debridement if incision wound. When the circulating nurse
checked the present IV fluid, she found out that there is no insulin incorporated as ordered.
What should circulating nurse do?
A. Double check the doctor's order and call the attending MD
B. Communicate with the ward nurse to verify if insulin was incorporate or not
C. Communicates with the client to verify if insulin is incorporated
D. Incorporate insulin as ordered
70. The documentation of all nursing activities performed is legally and professionally vital.
Which of the following should NOT be included in the patient's chart?
A. Presence of prosthetoid devices such as dentures, artificial limb, hearing aid, etc
B. Baseline physical, emotional, anti psychosocial data
C. Arguments between nurse's and patient's regarding treatments
D. Observed untoward signs and symptoms and interventions including contaminant intervening
SITUATION: Team effort is best demonstrated in the OR:
71. If you are the nurse in charge for scheduling surgical cases, What important information do
you need to ask the surgeon?
A. Who is your internist?
B. Who are your assistant and anesthesiologist, and what is your preferred time and type of
surgery?
C. Who are your anesthesiologist, internist?
D. Who is your anesthesiologist
72. In the OR, the nursing tandem for every surgery is:
A. Instrument technician and circulating nurse
B. Nurse anesthetist, nurse assistant, and instrument technician
C. Scrub nurse and nurse anesthetist
D. Scrub and circulating nurses
73. While team effort is needed in the OR for efficient and quality patient care delivery, we
should limit the number of people in the room for infection control. Who comprise this team?
A. Surgeon, anesthesiologist, scrub nurse, radiologist orderly
B. Surgeon, Assistant, scrub nurse, circulating nurse, anesthesiologist
C. Surgeon, Assistant surgeon, anesthesiologist, scrub nurse, pathologist
D. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse
74. Who usually act as an important part of the OR personnel by getting the wheelchair or
stretcher, and pushing/ pulling them towards the operating room?
A. Orderly/clerk
B. Nurse supervisor C. Circulating nurse
D. Anesthesiologist
75. The breakdown in the framework is often times a failure in:
A. Electricity
B. Inadequate supply C. Leg work
D. Communication
SITUATION: Basic Knowledge on Intravenous solution is necessary for care of clients with
problems with fluids and electrolytes
76. A client involved in a motor vehicle crash presents to the emergency department with severe
internal bleeding. The client is severely hypotensive and unresponsive. The nurse anticipates
which of the following intravenous solutions will most likely prescribed to increase intravascular
volume, replace immediate blood loss and increase blood pressure?
A. 0.45% sodium chloride
C. 0.33% sodium chloride
B. Normal saline solution
D. Lactated ringer's solution
77. The physician orders the nurse to prepare isotonic solution. Which of the following four
solutions would the nurse expect the in tern to prescribe?
A. 5% dextrose in water
C. 0.4% sodium chloride
B. 10% dextrose in water
D. 5% dextrose in 0.9% sodium chloride
78. The nurse is making initial rounds on the nursing unit to assess the condition or assigned
clients. The nurse notes that the clients IV site is cool, pale and swollen and the solution is not
infusing. The nurse concludes that which of the following complications has been experience by
the client?
A. Infection
B. Phlebitis
C. Infiltration
D. Thrombophlebitis
79. A nurse reviews the clients electrolyte laboratory report and notes that the potassium level is
3.2. mEq/L. Which of the following would the nurse note on the electrocardiogram as a result on
the laboratory value?
A. U waves
B. Absent P waves
C. Elevated T waves
D. Elevated ST segments
80. One patient had a runaway IV of 50% dextrose. To prevent temporary excess of insulin or
transient hyperinsulin reaction. what solution you prepare in anticipation of the doctor's order?
A. Any IV solution to KVO
C. Hypertonic solution
B. Isotonic solution
D. Hypotonic solution
81. An informed consent is required for:
A. Closed reduction of a structure
C. Irrigation of external ear canal
B. Insertion of IV catheter
D. Urethral catheterization
82. Which of the following is NOT true with regards to the informed consent?
A. It should describe different treatment alternatives
B. It should contain a throughout and detailed explanation of the procedure to be done
C. It should describe the client's diagnosis
D. It should give an explanation of the client's prognosis
83. You know that the hallmark of the nursing accountability is the:
A. Accurate documentation and reporting
B. Admitting your mistakes
C. filing an incident report
D. Reporting a medication error
84. A nurse is assigned to care for a group of client's. On the review of the client's medical
records, the nurse determines that which client is at risk for excess fluid volume?
A. He client taking diuretics
C. The client with an ileostomy
B. The client with renal failure
D. The client who requires gastrointestinal suctioning
85. A nurse is assigned to care for a group of client's. On the review of the client's medical
records, the nurse determines that which client is at risk for deficient fluid volume?
A. A client with coloctomy
B. A client with congestive heart failure
C. A client with decreased kidney function
D. A client receiving frequent wound irrigation
SITUATION: As a perioperative nurse, you are aware of the correct processing methods for
preparing instruments and other devices for patients used to prevent infection.
86. As an OR nurse, what are your foremost considerations for selecting chemical agents for
disinfection?
A. Material compatibility and efficiency
B. Odor and availability
C. Cost and duration of disinfection process
D. Duration of disinfection and efficiency
87. Before you used a disinfected instrument it is essential that you:
A. Rinsed with tap water followed by alcohol
C. Dry the instrument thoroughly
B. Wrap the instrument with sterile water
D. Rinse with sterile water
88. You have a critical heat labile instrument to sterilize and are considering to use considering
to use high level disinfectant. What should you do?
A. Cover the soaking vessel to contain the vapor
B. Double the amount of high level disinfectant
C. Test the potency of the high level disinfectant
D. Prolong the exposure time according to manufacture's direction
89. To achieve sterilization using disinfectants, which of the following is used?
A. Low level disinfectants immersion in 24 hours
B. Intermediate level disinfectants immersion in 12 hours
C. High level disinfectants immersion in 1 hour
D. High level disinfectant immersion in 10 hours
90. Bronchoscopes, Thermometer, Endoscope, ET tube, Cystoscope are all BEST sterilized
using which of the following?
A. Autoclave at 121 degree Celsius in 15 minutes
B. Flash sterilizer at 132 degree Celsius in 3 minutes
C. Ethylene Oxide gas aeration for 20 hours
D. 2% Glutaraldehyde immersion for 10 hours
SITUATION: The OR is divided into three zones to control traffic flow and contamination.
91. What OR attires are worn in the restricted area?
A. Scrub suit, OR shores, Head cap
C. Mask, OR shoes, scrub suit
B. Head cap, scrub suit, mask, OR shoes
D. Cap, mask, gloves, shoes
92. Nursing intervention for a patient on low dose IV insulin therapy includes the following
EXCEPT:
A. Elevation of serum ketones to monitor ketones
B. Vital signs including BP
C. Estimate serum potassium
D. Elevation of blood glucose levels
93. The doctor ordered to incorporate 1000 "u "insulin to the remaining on going IV. The
strength is 500/ml. How much should you incorporate into IV solution?
A. 10 ml
B. 2 ml
C. 0.5 ml
D. 5 ml

94. Multiple vial-dose-insulin when in use should be:

A. Keep at room temperature
B. Kept in the refrigerator
C. Keep on narcotic cabinet
D. Store in the freezer
95. Insulin using insulin syringe are given using how many degrees of needle insertion?
A. 45
8.180
C. 90
D. 15

SITUATION: Maintenance of sterility is an important function a nurse should perform in any OR

setting.
96. Which of the following is true with regards to sterility?
A. Sterility is time related items are not considered sterile after a period of 30 days of being not
used.
B. For 9 months, sterile items are not considered sterile as long as they are covered with sterile
muslin cover and stored in the dust proof covers.
C. Sterility is event related, Not time related
D. For 3 weeks, items double covered with muslin are considered sterile as long as they have
underdone the sterilization
process
97. 2 organizations endorsed the sterility are affected by factors other than the time itself, these
are:
A. The PNA and the PRC
C. ORNAP and MCNAP
B. AORN and MCNAP
D. MMDA and DILG
98. All of these factors affect the sterility of the OR equipments, these are the following except:
A. The material used of packaging
B. The handling of the materials as well as its transport
C. Storage
D. The chemical or process used in sterilizing the material
99. When you say sterile, It means:
A. The material is clean
B. The material as well as the equipment's are sterilized and had undergone a rigorous
sterilization
C. There is a black stripe on the paper indicator
D. The material has no microorganism nor spores present that might cause an infection
100. In using liquid sterilizer versus autoclave machine, Which of the following is true?
A. Autoclave is better in sterilizing OR supplies versus liquid sterilizer
B. They are both capable of sterilizing the equipment; however, it is necessary to soak supplies
in the liquid sterilizer for a longer period of time
C. Sharps are sterilized using autoclave and not cidex
D. If liquid sterilizer is used, rinsing it before using is not necessary