TIP: Focus on prioritization, medical-surgical, and

fundamentals of nursing.
1.The nurse is teaching a mother whose daughter
has iron deficiency anemia. The nurse determines
the parent understood the dietary modifications,
if she selects?
a)
b)
c)
d)

Bread and coffee

Fish and Pork meat
Cookies and milk
Oranges and green leafy vegetables

2.Which of the following is the most common

clinical manifestation of G6PD following ingestion
of aspirin?
a)
b)
c)
d)

Kidney failure
Acute hemolytic anemia
Hemophilia A
Thalassemia

3.The nurse assesses a client with an ileostomy

for possible development of which of the
following acid-base imbalances?
a)
b)
c)
d)

Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
Respiratory alkalosis

4.The nurse anticipates which of the following

responses in a client who develops metabolic
acidosis.
a) Heart rate of 105 bpm
b) Urinary output of 15 ml
c) Respiratory rate of 30 cpm
d) Temperature of 39 degree Celsius
5. A client has a phosphorus level
of 5.0mg/dL. The nurse closely monitors the
client for?
a)
b)
c)
d)

___, ___, ___, ___, ___, ___

8.Which of the following has mostly likely
occurred when there is continuous bubbling in the
water seal chamber of the closed chest drainage
system?
a) The connection has been taped too tightly
b) The connection tubes are kinked
c) Lung expansion
d) Air leak in the system
9.Which if the following young adolescent and
adult male clients are at most risk for testicular
cancer?
a) Basketball player who wears supportive gear
during basketball games
b) Teenager who swims on a varsity swim team
c) 20-year-old with undescended testis
d) Patient with a family history of colon cancer
10.The nurse plans to frequently assess a postthyroidectomy patient for?
a) Polyuria
b) Hypoactive deep tendon reflex
c) Hypertension
d) Laryngospasm
11.An 18-month-old baby appears to have a
rounded belly, bowlegs and slightly large head.
The nurse concludes?
a) The child appears to be a normal toddler
b) The child is developmentally delayed
c) The child is malnourished
d) The childs large head may have neurological
problems.
12.A nurse is going to administer 500mg capsule
to a patient. Which is the correct route?

Signs of tetany
Elevated blood glucose
Cardiac dysrhythmias
Hypoglycemia

6. A nurse is caring for a child with pyloric

stenosis. The nurse would watch out for
symptoms of?
a) Vomiting large amounts
b) Watery stool
c) Projectile vomiting
d) Dark-colored stool
7.The nurse responder finds a patient
unresponsive in his house. Arrange steps for adult
CPR.
a)
b)
c)
d)
e)
f)

Assess consciousness
Give 2 breaths
Perform chest compression
Check for serious bleeding and shock
Open patients airway
Check breathing

13.An appropriate instruction to be included in

the discharge teaching of a patient following a
spinal fusion is?
a)
b)
c)
d)

Dont use the stairs

Dont bend at the waist
Dont walk for long hours
Swimming should be avoided

14.A nurse is preparing to give an IM injection of

Iron Dextran that is irritating to the subcutaneous
tissue. To prevent irritation to the tissue, what is
the best action to be taken?

20.During a basic life support class, the instructor

said that blind finger sweeping is not advisable
for infants. Which among the following could be
the reason?

a)
b)
c)
d)

a) The mouth is still too small

b) The object may be pushed deeper into the
throat
c) Sharp fingernails might injure the victim
d) The infant might bite

Apply ice over the injection site

Administer drug at a 45 degree angle
Use a 24-gauge-needle
Use the z-track technique

15.What should a nurse do prior to taking the

patients history?
a) Offer the patient a glass of water
b) Establish rapport
c) Ask the patient to disrobe and put on gown
d) Ask pertinent information for insurance
purposes

16.A pregnant woman is admitted for preeclampsia. The nurse would include in the health
teaching that magnesium will be part of the
medical management to accomplish the
following?
a)
b)
c)
d)

Control seizures
promote renal perfusion
To decrease sustained contractions
Maintain intrauterine homeostasis

17.A nurse is going to administer ear drops to a

4-year-old child. What is the correct way of
instilling the medicine after tilting the patients
head sidewards?
a)
b)
c)
d)

Pull the pinna back then downwards

Pull the pinna back then upwards
Pull the pinna up then backwards
Pull the pinna down then backwards

18.A nursing student was intervened by the

clinical instructor if which of the following is
observed?
a)
b)
c)
d)

Inserting a nasogastric tube

Positioning the infant in a sniffing position
Suctioning first the mouth, then the nose
Squeezing the bulb syringe to suction mouth

19.Choose amongst the options illustrated below

that best describes the angle for an intradermal
injection?

21.A nurse enters a room and finds a patient lying

on the floor. Which of the following actions should
the nurse perform first?
a)
b)
c)
d)

Call for help

Establish responsiveness of patient
Ask the patient what happened
Assess vital signs

22.A patient with complaints of chest pain was

rushed to the emergency department. Which
priority action should the nurse do first?
a) Administer morphine sulfate intravenously
b) Initiate venous access by performing
venipunture
c) Administer oxygen via nasal cannula
d) Complete physical assessment and patient
history
23.A rehab nurse reviews a post-stroke patients
immunization history. Which immunization is a
priority for a 72-year-old patient?
a)
b)
c)
d)

Hepatitis A vaccine
Hepatitis B vaccine
Rotavirus Vaccine
Pneumococcal Vaccine

24.Several patients from a reported condominium

fire incident were rushed to the emergency room.
Which should the nurse attend to first?
a) A 15-year-old girl, with burns on the face and
chest, reports hoarseness of the voice
b) A 28-year-old man with burns on all
extremities
c) A 4-year-old child who is crying inconsolably
and reports severe headache
d) A 40-year-old woman with complaints of
severe pain on the left thigh
25.The doctor ordered 1 pack of red blood cells
(PRBC) to be transfused to a patient. The nurse
prepares the proper IV tubing. The IV tubing
appropriate for blood transfusion comes with?
a)
b)
c)
d)

Air vent
Microdrip chamber
In-line filter
Soluset

26.The expected yet negative (harmful ) result for

posthemodialysis is a decrease in?

a)
b)
c)
d)

Creatinine
BUN
Phosphorus
Red blood cell count

27.A patient was brought to the emergency room

after she fell down the stairs. Which of the
following is the best indicator for increased
intracranial pressure in head and spinal injury?
a)
b)
c)
d)

Inability to move extremities

Decreased respiratory rate
Increase in pulse and blood pressure
Decrease level of consciousness

28.A new nurse is administering an enema to a

patient. The senior nurse should intervene if the
new nurse?
a) Hangs the enema bag 18 inches above the
anus
b) Positions the client on the right side
c) Advances the catheter 4 inches into the anal
canal
d) Lubricates 4 inches of the catheter tip
29.The medication nurse is going to give a
patient his morning medications. What is the
primary action a nurse should do before
administering the medications?
a)
b)
c)
d)

Provide privacy
Raise head of the bed
Give distilled water
Check clients identification bracelet

30.A 30-year-old client is admitted with

inflammatory bowel syndrome (Crohns disease).
Which of the following instructions should the
nurse include in the health teaching?Select all
that apply
a) Corticosteroid medication is part of the
treatment
b) Include milk in the diet
c) Aspirin should be administered
d) Antidiarrheal medication can help

5.) Answer: A Normal phosphorus level is 2.5

4.5 mg/dL .The level reflects hyperphosphatemia
which is inversely proportional to calcium. Client
should be assessed for tetany which is a
prominent symptom of hypocalcemia.
6.) Answer: C Clinical manifestations of pyloric
stenosis include projectile vomiting, irritability,
constipation, and signs of dehydration, including
a decrease in urine output.
7.) Answer: A, E, F, C, B, D
In accordance with the new guidelines,
remember AB-CABS. A-airway B-breathing
normally? C-chest compression A-airway
open B-breathing for patient S-serious bleeding,
shock, spinal injury. The nurse should first assess
consciousness of the patient. Next, open patients
airway to check for breathing. When there is no
breathing, immediately perform chest
compression then give 2 breaths, do the cycle of
care over. Finally, check for serious bleeding,
shock, and spinal injury.
8.) Answer: D Continuous bubbling seen in
water-seal bottle/ chamber indicates an air leak
or loose connection, and air is sucked
continuously into the closed chest drainage
system.
9.) Answer: C Testicular cancer is most likely to
affect males in late adolescence. Undescended
testis is also one major risk for testicular cancer.
10.) Answer: D Hypocalcemia occurs when
there is accidental removal or destruction of
parathyroid tissue during surgical removal of the
thyroid gland. Laryngospasm is one of the clinical
manifestations of tetany, an indicator of
hypocalcemia.
11.) Answer: A Its normal for a toddler to have
bowlegs and a protruding belly. The head still
appears somewhat large in proportion from the
rest of the body.
12.) Answer: D

1.) Answer: D Dark green leafy vegetables are

good sources of iron. Oranges are good sources of
vitamin C that enhances iron absorption in the
small intestines.
2.) Answer: B Individuals with G6PD may
exhibit hemolytic anemia when exposed to
infection, certain medications or chemicals.
Salicylates such as Aspirin damages plasma
membranes of erythrocytes, leading to hemolytic
anemia.
3.) Answer: B Lower GI fluids are alkaline in
nature and can be lost via ileostomy. Thus, loss of
HCO3, results to metabolic acidosis.
4.) Answer: C Initially, respiratory system will
try to compensate metabolic acidosis. Patients
with metabolic acidosis have high respiratory
rate.

13.) Answer: B There is 6-8 months activity

restriction following a spinal fusion. Sitting, lying,
standing, normal stair climbing, walking, and
gentle swimming is allowed. Bending and twisting
at the waist should be avoided, along with lifting
more than 10 lbs.
14.) Answer: D Z-track technique is used to
administer drugs especially irritating to the
subcutaneous tissue. This method promotes
absorption of the drug by preventing drug
leakage into the subcutaneous layer.
15.) Answer: B Establishing rapport is a way to
gain trust that will lead for a patient to relax. You
can get more insights and information from a
patient when rapport is established.
16.) Answer: A Low magnesium
(hypomagnesemia) produces clinical

manifestations like increased reflexes, tremors,

and seizures. Magnesium Sulfate is the drug of
choice to prevent seizures in pre-eclampsia and
eclampsia.
17.) Answer: C Ear canal of children ages
3years and above can be straightened by pulling
the pinna up then backwards. For children below
3 years of age, the ear canal can be straightened
by pulling the pinna down then backwards.
18.) Answer: A Infants are nose breathers. A
gastric tube may be inserted to facilitate lung
expansion and stomach decompression, but not a
nasogastric tube as it can occlude the nare, thus,
making breathing difficult for the infant.
19.) Answer: B
20.) Answer: B Blind finger sweeps are not
recommended in all CPR cases especially for
infants and children because the foreign object
may be pushed back into the airway.

30.) Answer: A , D Crohns disease is a chronic

inflammation of the colon with symptoms of
diarrhea, abdominal pain, and weight loss.
Corticosteroid is a treatment for Crohns disease.
Antidiarrheal can give relief to diarrheal episodes.
Aspirin should be avoided as it can worsen
inflammation. Those with Crohns disease are
mostly lactose intolerant, so choice no. (2) is
incorrect.

This is a multiple-choice type of questions consisting of 30-items. Each

question tests your knowledge on the basic subjects in nursing such as
Fundamentals of Nursing, Pharmacology, Medical-Surgical Nursing,
Oncology, Psychiatric Nursing, Maternal and Newborn and Pediatric
Nursing.
The topics included are the following:
Nursing assessment
Nursing procedures
Labor and Delivery
Prioritization of Care

21.) Answer: B First step in cardiopulmonary

resuscitation (CPR) is assessing responsiveness of
the patient.

Nurse-Client Relationship
Jurisprudence
Musculoskeletal, Endocrine, Cardiac and Respiratory
disorders

22.) Answer: C Priority nursing action is to

administer oxygen to patients with chest pain.
Chest pain is caused by insufficient myocardial
oxygenation.
23.) Answer: D Pneumococcal Vaccine is a
priority immunization for the elderly. Seniors,
ages 65 years old and above, have higher risk for
serious pneumococcal infection and likely have
low immunity. This is administered every 5 years.

1.The client presented with complaints of body weakness, dizziness

and chest pain. Upon careful assessment, the nurse suspects Angina
Pectoris. Which of the following statements made by the client can
confirm this?
a. I suddenly felt a pain on my chest which radiates to my back and
arms.
b. I suddenly felt a sharp pain on my lower abdomen.
c. The pain does not subside even if I rest.
d. The pain goes all the way down to my stomach.
2.The client from the OR is transferred to the post-anesthesia care unit

24.) Answer: A Burns on the face and neck can

cause swelling of the respiratory mucosa that can
lead to airway obstruction manifested by
hoarseness of voice and difficulty in breathing.
Maintaining an airway patency is the main
concern.

after surgical repair of abdominal aortic aneurysm. Which of the

following assessment findings would indicate that the repair was
successful?
a. Urine output of 50 mL/hr.
b. Presence of non-pitting, peripheral edema.
c. Clear sclera.
d. Presence of carotid bruit.

25.) Answer: C An in-line filter is required for

blood transfusions.

3.The client is scheduled for cardiac catheterization because the

physician wants to view the right side of the heart. Which of the

26.) Answer: D Negative outcome: Hemodialysis

decreases red blood cell count which worsens
anemia, because RBCs are lost in dialysis from
anticoagulation during the procedure, and from
residual blood that is left in the dialyzer.
27.) Answer: D Decrease in level of
consciousness and headache are early signs of
increase in intracranial pressure (ICP). Altered
level of consciousness is the most common
symptom that indicates a deficit in brain function.

following would the nurse expect to see in this procedure?

a. A dye is injected to facilitate the viewing of the heart
b. Thallium is injected to facilitate the scintillation camera
c. A probe with a transducer tip is swallowed by the client.
d. A tiny ultrasound probe is inserted into the coronary artery
4.The client is being treated for hypovolemia. To assess the
effectiveness of the treatment, the Central Venous Pressure (CVP) of
the client is being monitored. Which of the following is TRUE about
CVP?
a. The CVP is measured with a central venous line in the inferior vena
cava.

28.) Answer: B Recall the anatomy of the colon.

The appropriate position is left lateral to facilitate
flow of enema by gravity into the colon.

b. The normal CVP is 7 to 9 mmHg.

c. The zero point on the transducer needs to be at the level of the left
atrium.
d. The client needs to be supine, with the head of the bed elevated at

29.) Answer: D Recall the 12 Rights of

administration. Checking the patients name is
critical for client-safety.

45 degrees.
5.The clients ECG tracing shows ventricular tachycardia secondary to
low magnesium level. Which of the following electrocardiogram tracing
results is consistent with this finding?

a. The appearance of a U wave

predisposes the client to develop which among the following

b. Shortened ST segment and a widened T wave.

complications? Select all that apply.

c. Tall, peaked T waves

d. Tall T waves and depressed ST segment

a. Infection
b. Tissue necrosis

6.The nurse is teaching the client how to use a dry powder inhaler

c. Disfigurement

(DPI). Which of the following are correct instructions given by the

d. Loss of function

nurse? Select All That Apply.

e. Amputation
f. Delayed healing

a. Load the drug first by turning to the next dose of drug, or inserting
the capsule into the device, or inserting the disk or compartment into
the device.
b. Never wash or place the inhaler in water.
c. Shake your inhaler prior to use.
d. The drug is a dry powder that is why you will taste the drug as you

13.Nursing interventions commonly performed when the client is

inhale.

experiencing Autonomic Dysreflexia will include the following. Select

e. Never exhale into the inhaler.

all that apply.

f. Do not remove the inhaler from your mouth as soon as you have
breathe in.

a. Use digital stimulation to empty the bowel.

b. Have the client sit up straight and raise his head so that he is

7.The nurse is assigned to render care for a client who has a chest

looking ahead.

tube drainage system. Which of the following are appropriate nursing

c. Remove clients stockings or socks.

actions? Select All That Apply.

d. Manually compress or tap the bladder to allow urine to flow down

the catheter.

a. Strip the chest tube.

e. Administer prescribed vasodilators.

b. Empty collection chamber when the drainage makes contact to the

bottom of the tube.

14.Neurologic conditions can be manifested by changes in breathing

c. Keep chest tube as straight as possible.

patterns. The client presents with symptom of Cheyne-Stokes

d. Notify the physician of drainage is greater than 70mL/hr.

respirations. The nurse knows that this kind of breathing pattern

e. Assess bubbling in the water seal chamber.

shows:

f. Keep drainage system at the level of the clients chest

a. Completely irregular breathing pattern with random deep and
8.The client with DKA is receiving bicarbonate IV infusion for treatment

shallow respirations

of severe metabolic acidosis. The nurse notes that the latest ABG

b. Prolonged inspirations with inspiratory and /or expiratory pauses

shows a pH of 7.0. What should the nurse keep in mind in giving the

c. Sustained regular rapid respirations of increased depth

drug?

d. Rhythmic waxing and waning of both rate and depth of respiration

with brief periods of interspersed apnea

a. Check vital signs before giving the drug and monitor serum sodium
level.

15.The physician is assessing the clients sensorium by using the

b. Perform a sensitivity test prior to drug administration.

Glasgow Coma Scale. Which of the following is true about the Glasgow

c. Mix the drug with D10W 500 ml IV fluid and infuse for over 4 to 8

Coma Scale?

hours.
d. Administer the drug slowly and monitor the potassium leve

a. If the client does not respond to painful stimuli, the score is 0.

b. A score lower than 10 indicates that the client is in a coma.

9.The client with a gunshot wound on the abdomen starts to get

c. A score of 8 indicates that the client is alert and oriented.

lethargic, is breathing heavily, and the wound dressing is fully soaked

d. A score of 4 indicates that the client sustained severe head trauma.

with blood. The nurse is expected to immediately perform which of the

following actions?

16.The nurse on duty is caring for a client with Amyotrophic Lateral

Sclerosis and is concerned with the clients impaired physical mobility.

a. Loosen tight clothing and administer oxygen supply.

The following nursing interventions are geared towards maintaining

b. Apply warm blanket to prevent heat loss.

optimal physical mobility EXCEPT:

c. Apply large gauze on the bleeding site to put direct pressure or

place a tourniquet on the artery near the bleeding site.

a. Maintain an exercise program.

d. Initiate IV access.

b. Encourage participation in activities.

c. Instruct client related safety measures.

10.The nurse is providing home instructions to a client with increased

d. Schedule activities in the morning.

adrenocorticotrophic hormone. The nurse is aware that the client with

excessive corticosteroids is suffering from what condition?

17.An elderly client had a cerebrovascular accident or stroke. The left

brain is affected and is at risk for impaired verbal communication. The

a. Cushings syndrome

nurse asked a question and noted that the client has difficulty talking

b. Addisons disease

and communicating his thoughts. Which of the following terms should

c. Hypothyroidism

the nurse use to document the finding?

d. SIADH
a. Receptive Aphasia
11.The nurse is assigned to a post-thyroidectomy client and is

b. Expressive Aphasia

monitoring for signs of hypocalcemia. The nurse gently tapped the

c. Global aphasia

area below the zygomatic bone just in front of the ear. This action will

d. Apraxia

elicit:
18.The client diagnosed with Alzheimers disease is starting to show
a. Facial tremor

signs and symptoms. The nurse wants to assess for graphesthesia.

b. Hyperreflexia

This is performed by:

c. Chvostek sign
d. Trousseau sign

a. Testing for the clients ability to identify an object that is placed on

the hand with eyes closed.

12.The nurse is caring for a client with an antineoplastic IV hooked on

b. Testing for the clients ability to recognize the written letter or

the right hand. The nurse notices that IV site is swelling and feels cool

number in the clients skin while the eyes are closed.

when touched. The nurse recognizes this as extravasation. This

c. Making the client stand, with the arms at the side, feet together,
with the eyes open and then closed. The client is then observed for any

swaying.

a. On the same level after delivery

d. Testing for the presence of pain once the leg is flexed at the hip,

b. Decreased by 1 cm/day

and then extended.

c. Decreased by 1.5 cm/day

d. Decreased by 2 cm/day

19.The pediatric client presents with the following signs and

symptoms: high fever, drooling, difficulty of breathing and leaning

25.The granddaughter of the client asked the nurse if it is normal for

forward in a tripod position. Immunization history shows that the client

elderly people to feel sleepy despite sleeping for long hours. Which of

never received any Hib vaccine. Which of the following is the priority of

the following conditions would the nurse suspect?

the healthcare provider?

a. Somatoform Disorder
a. Continuous oxygen therapy and constant monitoring of oxygen

b. Malingering

saturation rate.

c. Anxiety

b. A well regulated IV infusion and timely administration of antibiotics.

d. Amnesia

c. Vaccination of Hib and other remaining vaccines to complete

required immunizations.

26.Chemotherapy is one of the treatments for uterine cancer. The

d. Avoiding any throat examination or agitation of the child.

client asked the nurse how chemotherapeutic drugs work. Which of the
following statements will be the best explanation?

20.The physician prescribed Clarithromycin (Biaxin) 250mg BID x 7

days for the clients infection. Incorrect drug frequency and duration

a. Chemotherapeutic agents alter molecular structure of DNA.

would cause inaccurate transfer time of the drug to specific tissues in

b. Chemotherapeutic agents hasten cell division.

the body. The nurse explains to the client that accumulation of the

c. Cancer cells are sensitive only to chemotherapeutic agents.

drug in specific tissues is the concept of:

d. Chemotherapeutic agents act on all rapidly dividing cells.

a. Absorption

27.Vomiting is one of the most common side effects of chemotherapy.

b. Distribution

The nurse should be aware of which acid-base imbalance?

c. Metabolism
d. Excretion

a. Ketoacidosis
b. Metabolic acidosis

21.The nurse is to administer Meperidine (Demerol) 35 mg through the

c. Metabolic alkalosis

intramuscular route. Available meperedine is 50mg/mL. Which of the

d. Respiratory alkalosis

following is the least favorable injection site for intramuscular

medication?

28.The client develops a 2nd degree skin reaction from radiation

therapy. The nurse should expect the following symptoms EXCEPT:

a. Ventrogluteal
b. Vastus lateralis

a. The skin is scaly.

c. Deltoid muscle

b. There is an itchy feeling.

d. Dorsogluteal

c. There is dry desquamation present.

d. The skin is reddened.

22.The client presented with complaint of leg cramps. Upon checking

the clients chart, the nurse noted that the client is hypertensive and is

29.The nurse is assessing the muscle coordination and mobility of the

prescribed with a Thiazide diuretic. The appropriate nursing

client with musculoskeletal disorder. The nurse noted impulsive and

intervention for this client is:

brief muscle twitching of the face and the limbs. This finding is called:

a. Stop the Thiazide diuretic

a. Tremor

b. Refer to the physician for evaluation of electrolyte level of the client

b. Chorea

c. Switch the client to a loop diuretic

c. Athetosis

d. Give the client a non-steroidal anti-inflammatory drug (NSAID)

d. Dystonia

23.The client is wheeled into the delivery room and is ready for

30.The nurse is assigned to render care to a client with altered

childbirth. While crowning occurs, the labor nurse applies gentle

mobility. Which of the following statements is true regarding body

pressure over the perineum and fetal head. The maneuver performed

mechanics when moving clients?

is called:
a. Stand at arms length from the working area.
a. Brandt-Andrews maneuver

b. Elevate adjustable beds to hip level.

b. McRoberts maneuver

c. Swivel the body when moving the client.

c. Schultz mechanism

d. Move the client with wide base and straight knees.

d. Ritgens maneuver
24.The nurse is monitoring the condition of the postpartum client. As a
part of the postpartum adaptations, the nurse monitors for descent of
the uterus and expects the fundus to be: