NP4 - DIAGNOSTIC EXAM

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NP4 - PREBOARD EXAM

Choose the best answer for each item.

Situation: Nurses working on the medical unit are experiencing

difficulties stabilizing the clients’ nasogastric tubes. In order to offer
the clients the best choice of care, the nurse must do data gathering.

1. Before data gathering, which of the following should be initiated

by the nurse?*
1 point

a. Develop the question or problem statement that best defines the need
b. Begin with a concept and seek how to best implement the concept into client care
c. Secure consent from the clients for their involvement
d. Organize a team to conduct the study and obtain their comment

2. The next step that the nurses should do is:*

1 point

a. Analyze the extent of literature

b. Define the problem
c. Secure evidence
d. Formulate framework

3. Following the review and evaluation of the data, the nurses

should:*
1 point

a. Recommend measures to meet the need

b. Extrapolate information
c. Choose the most relevant information
d. Decide the level of evidence

4. With the information obtained to promote evidence-based

practice, the nurse should:*
1 point

a. Apply findings to clients with NGT

b. Conduct a pilot study to selected clients in several units of the study
c. Make recommendation and apply into NGT practices in the unity
d. Communicate findings to nurses in other units

5. Following the success in stabilizing NGT in their unit, the nurses

share the literature they found on NGT stabilization with nurses in the
ICU. In order to reflect currently published knowledge, which of the
following appropriate actions should critical nurses do?*
1 point

a. Review all the studies, summarize findings, and completely revise NGT stabilization policy
b. Revise practice-based guidelines and procedures of clinical intervention
c. Gather enough evidences to substantiate the findings of the nurses in the medical unit
d. Conduct a similar research in the ICU

Situation: The nurse’s accurate assessment is very crucial in

preventing complication during the severe post burn period.

6. Corazon sustained circumferential thermal burns of the left upper

extremity and chest. You noted that pulse could not be appreciated in
his injured extremity. Which of the following will you do first?*
1 point

A. elevate the injured extremity to increase blood flow to the heart

B. remove the dead tissues which impede circulation
C. try to take the pulse in the uninjured extremity
D. notify the physician immediately as this requires emergency intervention

7. While loading containers with chemicals from a truck, Shoogar

accidentally spilled the whole can of corrosive chemicals all over his
body. Which of the following would you consider as the priority
intervention in the emergency management of Shoogar.*
1 point

A. wash the chemical off with cool water

B. maintain a patent airway
C. assess for associated injuries
D. remove all clothing containing the chemicals

8. A 165-lbs trauma client was rushed to the emergency with full

thickness burns of the whole face, right and left arm, and at the
anterior chest sparing the abdominal area. He also has superficial
partial thickness burn at the posterior trunk and at the half upper
portion of the left leg. In caring for the patient during the emergent
phase of burn, using the Parkland’s formula, you know that during the
first 8 hours of burn; the amount of fluid that will be given is:*
1 point

A. 5,400 mL
B. 10,600 mL
C. 9,450 mL
D. 6,750 mL

9. Janine, who has partial thickness burns on the face, inquires about
skin care after discharge. Which of the following should you include in
your discharge teaching?*
1 point

A. Avoid facial makeup for at least a year

B. Continue to eat high caloric food for the next month
C. Wear a pressure garment daily for one year
D. Avoid sunlight for the next three months

10. You are caring for Leo who sustained severe burn injury and he is
in the emergent phase of burn injury. As his nurse, you gathered the
following: hemoglobin 13.5g/100mL., hematocrit 50%, serum Na 130
mEq/L. How will you explain the laboratory results?*
1 point

A. They are slightly abnormal but will normalize once IV fluids have been started
B. These are due to hemodilution from rapid IV fluid replacement
C. All the laboratory tests are within normal range
D. These are due to a loss of serum and interstitial fluid through the burn wounds

Situation: Colorectal cancer can affect old and younger people.

Surgical procedures and other modes of treatment are done to ensure
quality of life. You are assigned in the Cancer Institute to take care of
patients with this type of cancer.

11. Hans, 55 years old who is suspected of colorectal cancer, is

admitted to the clinic. After taking the history and vital signs, the
physician does which test as a screening test for colorectal cancer?*
1 point

A. barium enema
B. carcinoembryonic antigen
C. annual digital rectal examination
D. proctosigmoidoscopy

12. To confirm his impression of colorectal cancer, Hans will require

which diagnostic study?*
1 point

A. carcinoembryonic antigen
B. stool hematologic test
C. abdominal computed tomography (CT) test
D. proctosigmoidoscopy

13. The following are risk factors for colorectal cancer, except:*
1 point

A. inflammatory bowels
B. high fat, high fiber diet
C. smoking
D. genetic factors-familial adenomatous polyposis

14. Symptoms associated with cancer of the colon include:*

1 point

A. constipation, ascites and mucus in the stool

B. blood in the stools, anemia and pencil-shaped stools
C. diarrhea, heartburn and excruciating pain
D. anorexia, hematemesis, and increased persitalsis

15. Several days prior to bowel surgery, Hans may be given

sulfasuxidine and neomycin primarily to:*
1 point

A. reduce the bacterial content of the colon

B. promote rest of the bowel by minimizing persitalsis
C. soften the stool by retaining water in the colon
D. empty the bowel of solid waste

Situation: Infection can cause debilitating consequences when host

resistance is compromised and virulence of microorganisms and
environmental factors are favorable. Infection control is one important
responsibility of the nurse to ensure the quality of care.

16. Tonnie, who has been complaining of anorexia and is always

feeling tired, develops jaundice. After a work-up, he is diagnosed of
having Hepatitis A. His wife asks you about gamma globulin for herself
and her household help. Your most appropriate response would be:*
1 point

A. “Don’t worry, your husband’s type of hepatitis is no longer communicable.”

B. “Gamma globulin provides passive immunity for Hepatitis B.”
C. “You should contact your physician immediately about getting gamma globulin.”
D. “A vaccine has been developed for this type of hepatitis.”
17. Greg develops a nosocomial respiratory tract infection. He asks
you what that means. Your response would be:*
1 point

A. “You acquired infection after you have been admitted to the hospital.”
B. “This is a highly contagious infection which requires complete isolation.”
C. “You should contact your physician immediately about getting gamma globulin.”
D. “this type of infection usually resolves on its own.”

18. As a nurse, you know that one of the complications that you have
to watch out for when caring for Fritz who is receiving total parenteral
nutrition is:*
1 point

A. stomatitis
B. hepatitis
C. infection
D. dysrhythmia

19. A solution used to treat pseudomonas wound infection is:*

1 point

A. Dakin’s solution
B. half strength hydrogen peroxide
C. acetic acid
D. betadine

20. Which of the following is most reliable in diagnosing wound

infection?*
1 point

A. purulent drainage from a wound

B. culture and sensitivity
C. WBC count of 20,000/µL
D. gram staining

Situation: As a member of the health and nursing team, you have a

crucial role to play on ensuring that all members participate actively
on the various tasks agreed upon.

21. While eating his meal, Matt accidentally dislodges his IV line and
bleeds. Blood oozes on the surface of the over bed table. It is most
appropriate that you instruct the housekeeper to clean the table with:*
1 point

A. acetone
B. alcohol
C. ammonia
D. bleach

22. You are a member of the infection control team of the hospital.
Based on a feedback during a meeting of the committee there is an
increased incidence of pseudomonas infection in the burn unit (3 out
of 10 patients had positive blood and wound culture). What is your
priority activity?*
1 point

A. Establish policies of surveillance and monitoring

B. Assign point persons who can implement policies
C. Do data gathering about the possible sources of infection (observation, chart review,
interview)
D. Meet with the nursing group working in the burn unit and discuss problem with them

23. Part of your responsibility as a member of the diabetes core group

is to get referrals from the various wards regarding diabetic patients
needing diabetes education. Prior to discharge today, 4 patients are
referred to you. How would you start prioritizing your activities?*
1 point

A. Determine their learning needs then prioritize

B. Bring your diabetes teaching kit and start your session taking into consideration their distance
from your office
C. Contact the nurse-in-charge and find out from her the reason for the referral
D. Involve the whole family in the teaching class

24. You have been designated as a member of the task force to plan
activities for the Cancer Consciousness week. Your committee has 4
months to plan and implement the plan. You are assigned to contact
the various cancer support groups in your hospital. What will be your
priority activity?*
1 point

A. clarify objectives of the activity with the task force before contacting the support groups
B. find out if there is budget for this activity
C. determine the VIPs and celebrities who will be invited
D. Find out how many support groups there are in the hospital and get the contact numbers of
their president

25. You are invited to participate in the medical mission activity of

your alumni association. In the planning stage, everybody is expected
to identify what they can do during the medical mission and what
resources are needed. You thought it is also your chance to share
what you can do to others. What will be your most important role
where you can demonstrate the impact of nursing in health?*
1 point

A. conduct health education on healthy lifestyle

B. take the initial history and document findings
C. be a triage nurse
D. act as a coordinator

Situation: As a nurse in the Oncology Unit, you have to be prepared to

provide safe, efficient and effective care to your patients.

26. Which one of the following nursing interventions would be most

helpful in preparing the patient for radiation therapy?*
1 point

A. offer tranquilizers and antiemetics

B. instruct the patient of the possibility of radiation burn
C. emphasis on the therapeutic value of the treatment
D. map out the precise course of treatment

27. What side effects are most apt to occur to patient during radiation
therapy to the pelvis?*
1 point

A. urinary retention
B. abdominal, vaginal, or perineal discharge
C. paresthesia of the lower extremities
D. nausea, vomiting, and diarrhea

28. Which of the following can be used on the irradiated skin during a
course of radiation therapy?*
1 point

A. adhesive tape
B. mineral oil
C. talcum powder
D. Zinc oxide treatment

29. Earliest sign of skin reaction to radiation therapy is:*

1 point

A. desquamation
B. erythema
C. atrophy
D. pigmentation

30. What is the purpose of wearing a film badge while caring for the
patient who is radioactive?*
1 point

A. identify the nurse who is assigned to care for such patient

B. prevent radiation-induced sterility
C. protect the nurse from radiation effects
D. measure the amount of exposure to radiation

Situation: In a disaster, there must be a chain of command in place

that defines the roles of each member of the response team. Within
the health care group, there are pre-assigned roles based on
education, experience, and training on disaster.

31. As a nurse, to which of the following groups are you best prepared
to join?*
1 point

A. transport group
B. treatment group
C. triage group
D. morgue department

32. There are important principles that should guide the triage team in
disaster management that you have to know if you were to volunteer
as part of the triage team. The following principles should be observed
in disaster triage, except:*
1 point

A. any disaster plan should have resources available to triage at each facility and at the disaster
site if possible
B. do the greatest good for the greatest number of casualties
C. make the most efficient use of available resources
D. training on disaster is not important to the response in the event of a real disaster because
each disaster is unique in itself

33. Which of the following categories of conditions should be

considered first priority in a disaster?*
1 point

A. intracranial pressure and mental status

B. lower gastrointestinal problems
C. respiratory infection
D. trauma

34. A guideline that is utilized in determining priorities is to assess the

status of the following, except:*
1 point

A. perfusion
B. locomotion
C. respiration
D. mentation

35. Induction of vomiting is indicated for the accidental poisoning

patient who has ingested:*
1 point

A. aspirin
B. rust remover
C. gasoline
D. toilet bowl cleaner

Situation: Quality management is essential in nursing and has been a

critical part of nursing administration. As nurses, it is important to
know by heart the concepts related to such.

36. Which statement made by a nurse about the goal of total quality
management or continuous quality improvement in a health care
setting is correct?*
1 point

A. “It is to observe reactive service and product problem solving.”

B. “Improvement of the processes in a proactive, preventive mode is paramount.”
C. “A chart audits to find common errors in practice and outcomes associated with goals.”
D. “A flow chart to organize daily tasks is critical to the initial stages.”

37. The nurse manager identifies that time spent by staff charting is
excessive, requiring overtime for completion. The nurse manager
states that “staff will form a task force to investigate and develop
potential solutions to the problem, and report on this at the next staff
meeting.” The nurse manager’s leadership style is best described as:*
1 point

A. participative
B. laissez-faire
C. autocratic
D. group
38. The nurse manager informs the nursing staff at morning report that
the clinical nurse specialist will be conducting a research study on
staff attitudes toward client care. All staff are invited to participate in
the study if they wish. This affirms the ethical principle of:*
1 point

A. participativeness
B. autonomy
C. anonymity
D. justice

39. The hospital has sounded the call for a disaster drill on the evening
shift. Which of these clients would the nurse put first on the list to be
discharged in order to make a room available for new admission?*
1 point

A. A middle-aged client with a history of being ventilator dependent for over 7 years and
admitted with bacterial pneumonia five days ago
B. An elderly client with a history of hypertension, hypercholesterolemia and lupus, and was
admitted with Steven-Johnson Syndrome that morning
C. A young adult with diabetes mellitus type 2 for over 10 years and admitted with antibiotic-
induced diarrhea 24 hours ago
D. An adolescent with a positive HIV test and admitted for acute cellulites of the lower leg 48
hours ago

40. A triage nurse has these 4 clients who arrived in the emergency
department within 15 minutes. Which client should the triage nurse
send back to be seen first?*
1 point

A. A teenager who got a singed beard while camping

B. A middle-aged client with intermittent pain behind right scapula
C. A 2 month old infant with a history of rolling off the bed and has bulging fontanels with crying
D. An elderly client with complaints of frequent liquid brown-colored stools

Situation: Manolo, a registered nurse, witnessed an old woman hit by a

motorcycle while crossing a train railway. The old woman fell at the
railway. Monolo rushed at the scene.

41.As a registered nurse, Manolo knew that the first thing that he will
do at the scene is:*
1 point

A. Stay with the person and encourage her to remain still and immobilize the leg while waiting
for the ambulance
B. Leave the person for a few moments to call for help
C. Reduce the fracture manually
D. Move the person to a safer place

42. Manolo suspects a hip fracture when he noticed that the old
woman’s leg is:*
1 point

A. Lengthened, abducted and internally rotated

B. Shortened, abducted and externally rotated
C. Shortened, adducted and internally rotated
D. Shortened, adducted and externally rotated

43. The old woman complains of pain. Agua noticed that the knee is
reddened, warm to touch and swollen. Manolo interprets that this
signs and symptoms are likely related to:*
1 point

A. Infection
B. Inflammation
C. Thrombophlebitis
D. Degenerative disease

44. Barbara, the old woman was now immobilized and brought to the
emergency room. The x-ray shows a fractured femur and pelvis. The
ER nurse would carefully monitor Barbara for which of the following
sign and symptoms? *
1 point

A. Tachycardia and hypotension

B. Fever and bradycardia
C. Bradycardia and hypertension
D. Fever and hypertension

45. Which of the following serious complications can occur with long
bone fractures?*
1 point

A. Bone emboli
B. Fat emboli
C. Platelet emboli
D. Serous emboli

Situation: Postoperative infection complication is still a concern in

surgical client’s care. Hospital staff needs to review practices to
adhere to the standards of care to improve quality and safe care
delivery.

46. Nurse Alona is setting up for an emergency Cesarean Section. The

linen packs were damp although these were just taken from the
sterilizer. The nurses’ appropriate action is:*
1 point

A. Bring the linen packs back to the central supply section for quality control
B. open the linen pack and allow to dry
C. change the damp linen pack
D. do not use the damp linen

47. The clinical instructor assigned a nursing student to assist in the

operation. When the nursing student entered the OR suite, her curly
long hair was not completely covered by the head cap. What would the
circulating nurse do?*
1 point

A. assist the nursing student to tuck-in all her hair inside the head cap
B. welcome the nursing student to the OR
C. request the clinical instructor to tell the nursing student to use the head cap properly
D. do not allow the nursing student to scrub in

48. After the surgeon finished doing the surgical hand scrub, she came
into the OR suite swinging her hands casually. The scrub nurse would
do which of the following appropriate action?*
1 point

A. offer a sterile towel to dry her hands

B. serve the surgeon her sterile gown and gloves as usual
C. tell the circulating nurse to pour alcohol 70% to the surgeon’s hands
D. remind the surgeon to scrub again

49. When the intern-in-charge did the skin prep and catheterized the
client, the circulating nurse noticed when the intern withdrew the
catheter from the vagina. What is your appropriate and immediate
action?*
1 point

A. stop the intern and do the catheterization yourself

B. offer to change the catheter
C. alcoholize the tip of the catheter before reinserting the catheter
D. hold the hand of the intern to stop him from reinserting the catheter
50. After the last stitch, the surgeon is ready to apply dressing to the
incision wound. Which of the following does the nurse expect the
surgeon to do?*
1 point

A. remove his gloves and apply the dressings

B. apply the dressings and tape and then remove his gloves
C. put the dressings and remove his gloves to apply the tape
D. tape the dressings and remove his gloves

Situation: A 55 year old male client, Herald, post Billroth II was

admitted to the post anesthesia care unit (PACU) from the OR. The
client is still sedated but responsive to commands. He has nasogastric
tube (NGT) draining orange-yellow fluid to a drainage bottle.

51. The nurse who admitted the patient recognizes that Billroth II
procedure means:*
1 point

A. gastroduodenostomy
B. gastrojejunostomy
C. enterostomy
D. esophagojunostomy

52. After admitting the client to the PACU, the first action of the nurse
should be:*
1 point

A. assess patency of the airway

B. assess the client’s pain
C. monitor vital signs
D. check the rate of the IV infusion

53. As the nurse monitors the client, she notices a bright red spot on
the dressings which measure 4 cm in diameter. The nurse would
initially do which appropriate nursing intervention?*
1 point

A. notify the client’s surgeon of a potential hemorrhage

B. assess for presence of drainage
C. change the top dressing
D. continue to monitor the vital signs
54. In assisting the client to do deep breathing, coughing and turning
to the sides on the first postoperative day, which nursing action would
be most helpful for the client?*
1 point

A. restate the importance of respiratory exercises

B. give the client reassurance that he can cough, breathe deeply, and turn to sides safely
C. administer the prescribed analgesics round the clock
D. apply abdominal splint while coughing

55. The client complained of abdominal pain, nausea and vomiting,

with abdominal distention. The nurse anticipates which of the
following priority management after referring to the surgeon?*
1 point

A. possible surgery
B. endoscopy
C. rectal tube insertion
D. gastric decompression

Situation: Nurse Mak admitted patientLouie for management of

acromegaly.

56. Nurse Mak is aware that acromegaly is a condition when growth

hormone occurs in excess in adulthood or after epiphyses of the long
bones have fused. The following are the typical physical features of
the disorder, except:*
1 point

A. the soft tissues continue to grow

B. hands and feet are enlarged
C. client grows taller
D. broad and bulbous nose

57. The client was prescribed Ocreotide acetate (Sandostatin). Nurse

Jayne would monitor for which of the following side effects?*
1 point

A. dysuria
B. hypotension
C. abdominal pain
D. constipation

58. For effective dosing, Ocreotide acetate must be administered by

which appropriate route three times weekly?*
1 point

A. intravenously
B. subcutaneously
C. orally
D. intramuscularly

59. Priority discharge plans should include which of the following?

Select all that apply. 1. fasting blood sugar 2. bone assessment 3.
intake and output 4. urine output*
1 point

A. 2 and 3
B. all except 1
C. 1,2 and 3
D. 1 and 2

60. Acromegaly often develops insidiously that nurses should

understand that the client with disorder would seek medical care
because of:*
1 point

A. alteration in fat and carbohydrate metabolism

B. changes in blood sugar level
C. changes in appearance
D. alteration in their voice

Situation: A 35 year old female client, Claire is with Grave’s disease

was admitted for treatment. The physician prescribed Prophyl Thraci
(prophylthiouracil) to treat the disorder.

61. Before the nurse administers the medication, which of the

following is most relevant for the nurse to ask?*
1 point

A. “Do you experience gastric discomforts?”

B. “Do you prefer a liquid form of medication?”
C. “When was the last time you took alcohol?”
D. “When was your last menstruation?”

62. The client is prepared for surgery in about 10 days time. Lugol’s
solution 4 gtts P.O. was prescribed for 10 days. The client asked the
nurse for the purpose of the drug. Which response of the nurse is
correct?*
1 point
A. It eliminates the need to take hormone replacements
B. It decreases the risk of bleeding
C. It decreases the risk for thyroid crisis
D. It stabilizes your immune system to withstand surgery

63. When the client returns to the unit after surgery, which technique
is most appropriate to monitor bleeding from the incision?*
1 point

A. remove the dressings to directly inspect the incision wound

B. weigh all gauze dressing before and after changing wound dressings
C. assess for dampness at the back of the client’s neck
D. pass a flashlight across the incision wound on top of the dressings

64. Which of the following assessment findings when observed in a

post thyroidectomy client is indicative of a thyroid crisis?*
1 point

A. spasm in the hand

B. falling blood pressure
C. regular and noisy respiration
D. high fever

65. At the start of thyroid replacement post total thyroidectomy, the

nurse must monitor for side effects. Which side effects would the
nurse expect to assess? Select all that apply. 1. hypertension
2.tremors 3.hirsutism 4. insomnia 5. tachycardia 6. hyperglycemia*
1 point

A. 1,2,4 and 5
B. 3,4,5 and 6
C. 1,2,3 and 5
D. 1,3,4 and 5

Situation: It is often said that “ignorance of the law excuses no one.”

In the practice of professional nursing the same applies.The following
questions are related to ethico- legal dimension in the practice of
nursing.

66. For failure of the nurse to check the nasogastric tube placement
before administering feeding, the patient aspirated and died. The nurse
may incur:*
1 point

A. Administrative liability
B. Civil liability
C. All liability may be filed
D. Criminal liability

67. The following are sources of laws/rules/policies that affect the

nursing practice in the Philippines: 1. International Council of Nurses/
Philippine Nurses Association Advisories 2. Board of Nursing
Promulgations e.g. Resolutions and Memorandum 3. DOH
Administrative Order and CHED Memorandum Order 4. House Bills/
Senate Bills*
1 point

A. All are recognized sources

B. 1 and 4
C. 2 and 3
D. 1 and 4

68. The following are true about the requirements for applying to take
the Licensure Examination in the Philippines except: 1. The applicant
must be a person of Good Moral Character 2. The applicant must have
gotten an average of 75% with no grade lower than 60% in any subject
in the NLE 3. The applicant must have finished a BSN degree from an
accredited school 4. The applicant must be a Filipino citizen*
1 point

A. 1and 3
B. 1and 4
C. 1, 3, and 4
D. only 2

69. ASEAN countries now engage in Mutual Recognition Arrangement

(MRA) negotiations consistent with liberalization measures of the
General Agreement on Trade in Services (GATS). The applicable mode
for this kind of agreement is:*
1 point

A. Via Reciprocity
B. Via Examination
C. Via Temporary/ Special permit
D. Via Movement of Natural Persons

70. Upon full implementation of Board of Nursing Resolution No.22,

series of 2009 (National Nursing Career Progression Program), the
following are deemed legally practicing nursing except: 1. A “trained”
nurse phlebotomist 2. A duly certified hemodialysis nurse who primes
a hemodialysis machine before initiating hemodialysis to a client 3. An
ACLS- trained and Certified Nurse clinician who intubates a patient
under accepted ICCU protocol 4. A certified Critical Care Nurse
Specialist who extracts arterial blood every hour for ABG monitoring of
patients*
1 point

A. only 1
B. only 4
C. only 3
D. only 2

Situation: Nurse Katelyn admitted a 33 years old, married, for thyroid

work-up.

71. Which admission assessment would make you suspect that

Lucille has hypothyroidism? Select all that apply. (1) Heat
intolerance (2) Diarrhea (3) Bradycardia (4) Coarse and dry skin
(5) Somnolence (6) Decreased appetite*
1 point

a. 2,3,5,6
b. All except 5
c. 3,4,5,6
d. 1,2,3,4

72. Lucille was ordered to undergo radioactive iodine uptake the

following day. The nurse understands that this test determines which
of the following?*
1 point

A. Absorption of the iodine isotope

B. Ingestion of the iodine isotope
C. Stimulation of the iodine isotope
D. Reaction of the iodine isotope

73. If the doctor will prescribe Basal Metabolic Rate (BMR) to Lucille,
which of the following is NOT indicated?*
1 point

a. Nothing by mouth for 10-12 hours

b. Blood extraction upon waking up
c. Instruct the client not to get out of bed until the test is over
d. A good night sleep of 8-10 hours

74. Cytomel (Liothyronine) was prescribed to Lucille. Before

administering the drug, Nurse Karen should not only verify the doctors
order but also:*
1 point

a. Take the BP and PR

b. Take the temperature and respiratory rate
c. Take the weight of the client
d. Advise the client to stay in bed

75. Lucille asked the nurse which diet is most appropriate for her.
The correct response of the nurse would be:*
1 point

a. Low salt, low fat

b. Low calorie and high fiber
c. High calorie and high fiber
d. High protein but low residue

Situation:Jojo and Jan Jan, a scrub nurse and circulating nurse

respectively, are preparing for hydrocelectomy, their last case for the
day.

76. Jojo discovered a cut in her palm while she was opening the
sterile packs, Jojo should:*
1 point

A. Scrub but put on double gloves

B. Ask to be relieved as a scrub nurse
C. Scrub if the cut is properly bandaged
D. Scrub after writing an incident report

77. Before any member of the surgical team proceed to do the

surgical hand scrub, he/she should have complete operating room (OR)
attire. Identify all the attire appropriate for this case: (1) Head Cap
Goggles (2) Face mask (3) Sterile gown (4) Gloves*
1 point

A. 2,3,4
B. 1,2,3
C. 1,2
D. 3,4,5
78. A sterile set up has been prepared. The OR was notified of a
delay in transporting the client from the ward to the OR. Which of the
following guidelines should the circulating nurse follows?*
1 point

A. Keep door of the operating room closed all the time to maintain the “sterile set up”
B. “Sterile set up” should be replaced after an hour
C. Cover appropriately “sterile set up”
D. Prepare another “sterile set up”

79. Identify which appropriate gloving technique will the assistant

surgeon use when he performs the skin preparation?*
1 point

A. Gloving self-closed technique

B. Scrub nurse serves the gloves
C. Any gloving technique is accepted
D. Gloving self-open technique

80. The intern 2nd assistant surgeon contaminated his gown while
the surgery is ongoing. He is expected to change his gown and gloves.
Which of the following is the CORRECT technique to be followed?*
1 point

A. The intern removes his gown and gloves then puts on another sterile gown and gloves.
B. The circulating nurse unties the gown. The intern removes his gown then removes the gloves
and puts another sterile gown and gloves.
C. The intern removes his gloves, then his gown does a 3 minutes hand scrub and don another
sterile gown and gloves
D. The intern unties his gown removes his gown and put on another gown and gloves.

Situation: Poon Day, who has an increased risk for cervical cancer
asks you different points about the condition.

81. With your knowledge of cervical cancer, which of these would

you include in your teaching on its risk factors? Select all that apply.*
1 point

a. i, iii iv, v
b. ii, iv
c. ii, iii, iv, v, vi
d. i, iii, iv, vi

82. Cervical cancers metastasize if not detected and treated. What is

commonly the first metastatic location of cervical neoplasms?*
1 point

a. Inguinal lymph node

b. Cervical node
c. Pelvic lymph nodes
d. Axillary lymph nodes

83. A surgery is suggested to treat the patient’s cervical cancer.

However, she exclaims that she still plans to bear a child. Which of the
following procedures may be done to the patient granting her wish?*
1 point

a. Radical hysterectomy
b. Radical vaginal hysterectomy
c. Radical trachelectomy
d. Simple bilateral salphingoectomy

84. Norma underwent hysterectomy and was transferred to your

ward 3 hours post-surgery. Which of these assessments would warrant
you to notify the doctor?*
1 point

a. Pain on the incision site

b. Chest pain
c. Vaginal bleeding
d. Post-operative edema

85. Early ambulation for a patient who underwent surgery for

cervical cancer is encouraged to prevent:*
1 point

a. Severe hemorrhage
b. Contractures
c. Deep vein thrombosis
d. Bladder retention

Situation: A patient who has Stevens - Johnson syndrome is newly-

admitted to the medical ward. You are assigned to take the history
and plan for the care of the patient.
86. While you take your history, which of these signs and symptoms
would be part of the prodromal stage of the syndrome?*
1 point

a. Dysuria
b. Sore throat
c. Corneal lesion
d. Vaginal stenosis

87. Which of these statements by the patient would give you an

information of the cause of the syndrome?*
1 point

a. “I am not sure if I am able to drink at least 8 glasses of water because of my busy schedule.”
b. “I am fond of eating grilled barbecue and isaw after work. I buy and eat them almost
everyday.”
c. “I take penicillin whenever I feel like I will have cough or colds.”
d. “Paracetamol is my go-to medication, especially when I started feeling weak.”

88. In reviewing the workup of the patient, which of these laboratory

findings do you expect her to manifest?*
1 point

a. Elevated arterial blood pH

b. Elevated C-reactive protein
c. Decreased partial thromboplastin time
d. Decreased platelet count

89. Which of these complaints by the patients indicate a progression

to a complication of SJD?*
1 point

a. “I have a difficulty swallowing liquids.”

b. “My eyes feel like they are drying.”
c. “My whole body is itching terribly.”
d. “Anything that touches my skin causes extreme pain.”

90. Which of these interventions would you not include in caring for
the patient?*
1 point

a. Shift to nasogastric gavage from IV infusions in fluid administration as soon as possible.

b. Prescribed topical antibiotic may be applied in conjunction with hydrotherapy in a tub.
c. Ask the patient to limit blinking and eye movement to prevent aggravating the complication.
d. Administer analgesics before the painful procedures or treatments are done.
Situation: You are a nurse in Indonesia who has been assigned as part
of the triage team in the recent earthquake in the capital city. You
assess and prioritize patients according to their status and needs.
Different emergency nursing concepts apply during this process.

91. Which of these should be done during your secondary survey of

the patients?*
1 point

a. Cervical spine stabilization

b. Establishing a patent airway.
c. Splinting of suspected fractures
d. Immediate closed reductions on pulseless extremity

92. In a reversed advanced type of triage, whom would you give

prioritization to?*
1 point

a. A gasping patient, with estimated blood loss of 900mL

b. An elderly client with a fractured femur, mobile, can respond to voice command
c. A head trauma patient, unconscious, HR 40bpm, RR 10 cycles/min, BP 145/70
d. A pulseless infant, with cold and clammy skin

93. Critical incident stress management is what type of prevention in

disaster management?*
1 point

a. Primordial
b. Secondary
c. Primary
d. Tertiary

94. Following the external triage system, which among these

patients would you highly prioritize?*
1 point

a. An unresponsive patient with capillary refill time of more than 2 seconds, and an RR of 10
breaths/min
b. A pregnant client, with rib fractures, responsive to voice commands, HR 120bpm, RR
20cycles/min
c. A patient with sustained head injuries, gasping for air, with bluish appearance
d. A patient with severe blood loss, PR of 75 bpm, RR of 10 cycles/min

95. Which of these principles is not included in performing START

triage in emergencies and disasters?*
1 point

a. Never go against the flow and go back to a previous casualty

b. Tag under the black category those persons who are gasping for air
c. Provide treatment for all patients requiring intensive care
d. Begin where you stand.

Situation: Bed rest is a therapeutic intervention that achieves

beneficial effect. However prolonged bed rest can be
counterproductive to the clients’ recovery. The inactivity imposed by
bed rest may cause structural changes in joints and shorten muscles.
Moving, turning, and positioning of clients are essential aspect of
nursing care.

96. Nurse Monilia is giving the 8:00am medication to a client who

happens to have slid down the bed from the fowler’s position. Which of
the following interventions is most effective when the nurse
repositions the client?*
1 point

a. Raise the head of the bed to the height of the center of gravity – Raise the BED to the height
of the center of gravity
b. Remove all pillows then place against the head of the bed
c. Ask the client to flex the hips and knees and position the feet for effective pushing up
d. Adjust the head of the bed to a flat position or as low as the client can tolerate

97. Using an overhead trapeze for repositioning the client can be

accomplished by instructing the client to grasp the:*
1 point

a. Overhead trapeze with one hand and push with the heels upward
b. Overhead trapeze with both hands and lift and pull during the move
c. Head of the bed with one hand and maneuvering for an upward movement
d. Head of the bed with one arm and the overhead trapeze with the other arm then lift and pull
upward

98. A client on bed rest is rolled to a lateral position by the nurse. The
nurse is negotiating the move correctly when he:*
1 point

a. Positions himself at the mid part of the bed and places both hands at the back of the client
and roll client onto side
- Pull/roll the client toward you to the lateral position
b. Places one hand on the client’s far hip and the other on the client’s far shoulder, rock
backward and roll onto side of the body facing him
c. Assume a broad stance with the foot nearest the bed placing his arms under the client’s
thighs and shoulder and roll client onto side
d. Supports the back and buttocks of the client and shifts his own weight from the forward to the
backward foot and roll the client onto side

99. A client with injured left leg is sitting on the bed preparing to
transfer to a wheelchair. The nurse is assisting the client and
positions the wheel chair on the:99. Which of these manifestations is
an early indication of compartment syndrome?*
1 point

a. Foot part of the bed

b. Client’s right side
c. Head part of the bed
d. Client’s left side

100. A client has difficulty walking and needs a wheelchair to

facilitate performance of daily activities. Anticipating the needs of the
client, the nurse should have the wheelchair ready by placing it at:*
1 point

a. 80- degree angle

b. 45- degree angle Rationale: Lessen the amount of body rotation required
c. 90- degree angle
d. 30- degree angle

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