INTEGRATED COMPREHENSIVE TEST | TION: Select the correct ans: following questions. Mark only one an bby marking the box corresponding to ‘choice on the answer sheet prc ded, ERASURES ALLOWED. Use pencilno. 1 TSITUATION 4. One of the important roies of a fare of her patients is that of being a health educ In any teaching-leamning situation, the nurse mu 0 apply the vatious teaching-learning principies ar ‘always demonstrate the postive atitude of an Which of the following factors least ‘readiness of an adult learner? ‘A. The individuals level or stage of development B. Ability to concentrate on information to be learned fence the learning G,_ The individuals psychosocial adaptation to nis tines ~_D. __Inlernal impulse that drive the person to take action hich ofthe folowing is the most important condition for patients to learn how to contol thei diet? ‘of pamphlets and other materials during heath on to be symptom-free j of the patient to understand teaching lity to bathe her newbom baby and to clean her he decides to breastfeed her baby. Which of 3 domain will you classity the above goals? Psychomotor C. Affective Cognitive ©. Atitudinal 'en you prepare your teaching plan for a group of tensive patients, you first formulate your Shectives, Which of the folowing steps in the nursing ‘cess correspond tothe writing of leaming objectives? A. Planning C..Evaluation 8. Implementation D. Assessment Rose, 50 years old, a newly diagnosed diabetic ‘must leam self injection of insulin. Which of the following physical attibutes is not related to her ability to self inject insulin? A. Strength ©. Body built B. Coordination D. Sensory acuity SITUATION 2. Patient education ‘important responsibilties of the nurse. To be is necessary for the nurse to render appropriate teaching according to the specific health of clients, In educating male clients regarding cancer, which ofthe following statements ‘A. “Excess alcohol intake of‘cancer is the leading cause of death in middle-age group ‘cancer is a disease of the elderty.” instructions are very important to ail ‘f the following instructions should you 40 prevent recurrence in a patient treated for eri ig urine output "Maintenance or perineal hygiene "Limiting uid intake to 1 liter a day Discontinuance of antibiotic therapy when the client feels better “On discharge, the nurse teaches the client diagnosed to Rave Meniere's syndrome to care for herself at home by hich ofthe following: ‘Avoiding quick movement of the head "Forcing fuids to decrease hemaconcentration Reducing loud and excessive noise in the ‘environment lncreasing activity such as walking rapidly to help nt who has had vagotomy is about to be discharged. ithe following should the nurse teach about the ‘client, diagnosed with cheumatoid arthritis the nurse to do range of mation (ROM) preparation for discharge. In implementing a plan of for the patiant, which ofthe following should a nurse d ‘Allow long rest periods between exercises 2 Point out small accomplishments made by the client Praise the client only when she mak ‘accomplishment s Do simple things for the clents so she knows the nurse is supportive of her SITUATION 3, Nurse use a variety of ways to communicate information about clients, The more nurses know about a ient, the better prepared they are to render high quality Which of the following are general guidelines that must be’ followed to ensure quality documentation and feportng? {. Factual and accurate 2. Complete and current 3. Organized and confident 4. Computerized and code A. 2,3and4 c. 1,2and4 B 1,2and3 D. 1,3and4 Which of the folowing is the appropriate Purp healt care records when a nurse reviews cients char ‘Besist her in planning patient care during her shift ‘A. Communication c, Audiing B. Educationis organized into separate sections land nurse is known by which of the |problem-oriented record oriented record just fnished your morning duty shift. Which of 9 is NOT pat of the verbal report curing your tothe afternoon shift? been uncooperative and “*Mis. Cruz is for barium enema in A.M.” Mi Santos pulse is fluctuating it was Zimin at 6:00 “-am.and 100/min at 11:30 a.m basis for endorsement while doing nursing ‘during a change of shift is primarily which one of Imedication and therapy nt's health needs ‘nursing care }8 20 year old primigravida, weighs 150 tall, She is 3 months pregnant and A 8 B10 Which of the folowing is a major cause of pregnant women? Poor marital relationship Sedentary ifestyle Heredity Psychological belief of having to eat for tM persons Interventions for Karla include any of the EXCEPT: Modify her eating habits B. Allow her to discuss her feeling about food i C. Use food as a threat for the possibilty of o. ‘complications in pregnancy Replace the syrbole use of food wah emollenal satisfaction Lat type of activity is appropriate for Karla based on| pregnant condition? ‘A. Leisure walking © Swimming B. Climbing stars © High impact Which food would give Kara's feeling of delays gastric emptying? A Fats B Proteins SITUATION 5, Mrs. Blanca del Prado, 30 ther 38 weeks AOG, is admitted 10 the |a1, 23, ‘medical management of her insulin dependent diabetes ' ‘elitus (DOM). She is receiving 30 units NPH daily A diabetic mother's metabolism is significantly altereg during pregnancy as a result of ‘A. “Increased glucose tolerance level ofthe bios B. Increase effect of insulin ©. Decreased renal threshold for glucose D. Hormonal effect of pregnancy of carbohydrate ang fat metabolism Urine testing for sugar for Mrs. Del Pra: not ‘conducive during pregnancy. What is the for this? ‘A Sugars metabolized more rapidly B. Sugar can normally be found in the urine of a pregnant woman ©. Basal metabolic rate is increased 1D. Insulin requirement is increased ‘The daily does of insulin requirement for Mrs, Del Prado fs likely to be: ‘A. Increased to 45 units B. Reduced 20 units © Adjusted as needed based on her increased dietary needs D. The same until she delivers Mrs. Del Prado delivers a baby gist weighing 4,545 Grams, She asks how many pounds does her baby ‘weigh? The baby weighs pounds: A 12 © 10 B98 on 25. Her baby develops tremors, apnea, cyanosis and poor sucking reflex, which are signs of A. Congenital defect of the islets of Langerhans 8. Hypoglycemia C. Hyperkalemia D. Hyperglyeemia SITUATION 6. Melanie, a 33-year old G,P. at 32 weeks station is admitted to the regional hospital with iagnosis of pregnancy induced hypertension (PIM): Magnesium sulfate is ordered per IV. Which of the following should prompt the nurse to refer to the obstetrician prior to drug administration? A BP= 180/100 B. Urine output is 40 milf. C.RR= 12 breaths per minute 1D. (+) Deep tendon reflex 27. The nurse knows that Melanie is knowledgeable about the occurrence of PIH when she remarks: ‘A. “Itusually appears anytime during pregnancy.” 8. Its similar to cardio-vascular disease.” ©. “PH occurs during the first trimester.” . “PiH occurs after the 20" week AOG.” 28. After several hours of Mg SO4 administration to Melanie, she should observed for clinical manifestations of. A Hyperkalemia C. Hypermagnesemia B. Hypoglycemia D. Hypercalcemia29, 30. wing The nurse includes M: of seizures associat wll she likely identify A. Urine output of B. () Deep tendon r ©. Sudden increa: D. Epigastric pain d BEST Which of the following nursing prevent from possible injury? A. Provide a dim and quiet environment B. Monitor VS ©. Prepare a padded tongue depr D. Avoid stimulation 1 at the bedside SITUATION 7. Tuberculosis, a primary respiratory disease is 34 ‘common’ among malnourished individuals living in Growded places. The Depariment of Health survey of 1997 reveals that there are 600,000 actively spreading the diseases, and 16 millon Fiipinos are afficted The bacteria producing the disease is: A. Mycobacterium bovis B. Mycobacterium tuberculosis, C. Mycobacterium africanum D. Mycobacterium leprae Which of the following is the mode of transmission of ‘pulmonary tuberculosis? A. ingested food . Airborne droplet 8. Skin contact D. Used utensils Eh Which vaccine is a preventive measure and grade school entants? ona ©. opr A BCG Tubercutin, ©. opv As a nurse, which of the folowing topies is considered in your health teaching in cases of communicable diseases: ‘A. Prevalence of the diseases in the community 8. Annual risk of infection C. Mode of spread and control measures D. Mortality rate among adults and infants 35. Which of the following comprehensive strategies is used to detect and cure tuberculosis? A. Category and Treatment Regimen B. Case finding and Maintenance C. Direct Observed Treatment Short Course . Strengthen National TB Control Program SITUATION 8. Rico is @ 2-year old. He attended a birthday party of a playmate. When he came home, he vomited ‘about one cup of semi-digested food. 36. You are the nurse and Rico's His mother called you to advise her what to do. What would you tell Rico's mother? ‘A Gothe hospital right away B. Tell you what food Rico ale atthe party. C. Take vital signs of Rico 1D. Call the doctor in the neighborhood 37. Vomiting is a sign of gastro intestinal disturbance. WhatOO Cother symptom would you anticipate when there is history ‘of eating spoiled food? A Diarthea B Fever 98. The preparation at home that Rico's mother Rico to replace fluid loss is salt and sugar solut formula is correct for one iter of water? ‘A. One tablespoon salt to two tablespoon of su B. One portion of salt and one portion of sugar C. One cup salt and one cup sugar D. One teaspoon salt and eight teaspoons suga 39. If vomiting and diarrhea persist, Rico's stools should be examined. Which bacteria could be identified from Contaminated food such as eggs, meat, poultry and water? A Clostridium botulinum B. Salmonella typhimunum C. — Staphylococcus’aureus D. Escherichia Coli - ETEC 40. If Rico is hospitalized, which intravenous fluid is usually prescribed by physicians? A. Dextrose 50% B. Normal salt solution C. Dextrose § % in water D. Lactated Ringers solution SITUATION 9. Influenza is a viral disease of the respiratory tract characterized by fever, headache, myalgia, sore throat and cough. 43 48. ‘Your friend, Joy, asked you tl hert sont how Ge oot Out wat A Sexual contact 8. Skin to skin contact C. Droplet spread D. Kissing infected person During outbreak of influenza, the nurse function fs which of the folowing? ‘A. Recording of mortality rate B. Surveillance of affected persons ©. Monitor morbidity 1D. Watch out for epidemics Complication of influenza among elderly persons is. respiratory problem. Which one is prevalent among) ‘elderly persons? ‘A. Pulmonary obstructive lung disease Viral or bacterial pneumonia C. Respiratory faiure D. Pulmonary lung disease Laboratory confirmation of influenza during the febrile state is made by isolation of viruses. Where should ‘secretions be taken from? ‘A Nasopharyngeal BL Cervical ©. Auricular D. Celular When immunization is indicated, which of the following ‘group is given priority to prevent Reye's Syndrome? A Military staft B. Patients familiesSITUATION 40. Mr. Ferdie Femandez is conf 46. 47. © Thosoon aspkin thera D. Health pereornd ned in the Medical Ward, and is suffering from pneumonia, having pneumonia A. Chest auscuttation reveals bronchial breath sounds B. Equal chest wall expansion occurs during inspiration C. Tactile fremitus is decreased over the affected area 1D. Percusion is cleared over areas of pneumonia Mucomyst was ordered, the action of ths isto: ‘A. ilate the bronchioles, thus increasing the viscosity of secretions B. Reduce the viscosity of secretions ©. Increase the viscosity of secretions D. _tnhibit the growth of microorganism The correct analgesic to minimize his chest pain especially when breathing ‘The right antibiotic which would be most helpful The patient will be ascertained proper positioning Percuss only in areas where there ie no increased pain Do this only an hour after his meal ‘Allow im {0 continue the session despite of iscomfort Plan apical secretion drainage, if several areas require drainage 50. What nursing care should follow right after his postural drainage? A. Give oral hygiene 3. Serve the breakfast C. Allow him to have a shower D. Suction the secretion SITUATION 11. Ms. Angie Lu is admitted in the hospital because of easy fatigabilly forthe past few months. After series of examinations, a diagnosis of hyperthyroidism was confirmed. 51. An assessment was made, thé least symptom that she: would experience is: ‘A. Fine tremors of the hands. B. Hyperactive C. —Palptation D. Drowsiness 52. Anti-thyroid drug was prescribed. Which of the following is not an antithyroid drug? A. Cytomel ‘Synthroid* OOD Og§ 8. Tapazote D. Tagamet 53. Your nursing responsibitty is to assess hi ‘symptoms of thyrotoxicosis. Which of the symptom of thyrotoxicosis? A Anorexia C. Shortness of breath 8. Increased appetite 0. _Diarrh 54. The following are the diagnostic examinatio function that measures the amount of 02 co {he body during a given time: A Thyrotropin-releasing hormone B. TS resin uptake €. _ Ratioiodine uptake and excretion test D. Basal metabolic rate for thyroid sumed by 55. Your health teaching should include the importance of: C. Soy sauce D. Rawsalt SITUATION 12. Gen, Vice-President ofthe firm was brought, to the hospital because of sever epigastric pain which ‘comes on and off. Impression in peptic ulcer. 58. Occult blood examination was ordered upon admission to the hospital. The specimen that you will need from Gen is: A Sputum C. Blood Urine D. Stool B ‘57. Which of these should you instruct him to abstain from 48 ‘hours prior to collection of the specimen? 70 A. Antibiotic ©. Meal B. Papaya D. High fiber dot 58. With his diagnosis, pain usually tart: ‘Three hours pe. B. Two hours ac. ‘C. Two hours pe. D. Onehour ac. 59, Gen’ physician advised him to avold spicy food frome his et. This is ‘A. Bland's diet ©. Sippy's diet 8B. Fulldiet D. Softdiet 60. As her nurse during his bronchoscopy, which of these, should you do? ‘A. Instructiencourage him to breathe deeply B. Offer sips of water C.__ Tell him the doctor is very competent D. Inform him what is happening SITUATION 13: Capt. Ramon, age fifty-two was admitted to the hospital with a diagnosis of chronic obstructive lung. disease. He admits of smoking 2 packs of cigarettes daily for the past twenty years. 61. Capt. Ramon's doctor states, “Do nat give oxygen” The baal forts overs hat hs cengen at this point of time may produce: A Bronchial spasm Pal vypertension B Gerdaterdon of emphysematous avet D. Respiratory arest63, Which manifestation is charac chronic obstructive pulmonary emp! A. Persistent breathlessness wit ed expiratory phase B. _Hypermobilty of the diaphragm ©. Periods of “apnea alternating D. periods. of tiyperpnea Improvement in pulmonary ventilation during Petiods of moderate physical activity Postural drainage is ordered for Capt. Ramon. immedi ‘hursing care following postural drainage: A. Administration of oral hygiene B. Feeding the patient C. Giving oral medicines D. Administration of LV. ate Which exercise would you expect a patient with ‘emphysema will perform? A Blowing candies B. Abdominal exercises to increase inspiration C. Blowing rapidly into a paper bag D. Panting exercises ‘Capt. Ramon's most productive and extensive periods of ‘coughing are likely to occur: A Lateinthe day C. Upon awakening B. When humidity is ow D. Soon after eating SITUATION 14, Manding’s history was taken upon admission. Impression is peptic ulcer. (66. His common discomfort experience due to his peptic A. Nausea ©. Vomiting 8. Eructation ©. Constipation 67. Which of this diagnostic measure is not appropriate for ‘Manding's condition? A. Papanicolau's test B. Gastric analysis C. Gastrointestinal series D. Patient's history 68. Prescribed diet indicated for him is: A Sippy's c. Full 8 Karelt's D. Bland 69. The rationale for his dietary management: ‘A Neutralize acidity of gastric secretions 8. Prevent melena and hematuria C. Prevent melena only 1D. Neutralize free HCI in the stomach 70. Rationale of prescribing antacids to Manding: ‘A Decrease gastric motility 8. _Aidin the digestion process C. Neutralize ©. Prevent constipation SITUATION 16. Mr. Danny Ang, an alcoholic, is admitted to © the hospital due to ciosis ofthe iver.71. 4 hich ofthe fotowing isthe eaty symptom that he may Manifest and would lead to progression Into hepa, coma? Soe ©. Nystagmus By Oyen D. Behavioral changes ‘What would include the symptoms indicating that three is Drogression into hepatic coma? |. Nystagmus Fetid breath Flapping tremor 4. Fruity tremor Fnulty odor breath ands Yand2 gore ©. 2end3 D. 2and3 ‘What isthe rationale of giving him low-protein diet? A. Dectease formation of ammonia pre 00 EIAW SO 8. Control bleeding C. Enhance blood circulation D. Proper nutrition SITUATION 16. Mr. Arap is a sixty years old, slightly aundiced with a history of alcoholism. He has ascites, and a diagnosis of cirhosis of the liver has been established. 76. The cause of his ascites is most likely due to: A. Decrease in the leukocyte counts, B. Deficiency in the synthesis ofthe bile ©. _Increase'in the intravascular pressure on the portal vessels D. Increase production of plasma protein 77. The most common cause of cirhosis of the liver is: A. Malnutrition C. Alcoholism B. Cachexia D. Frequent diarhea 78. His ascites progresses, causing increased discomfort. You are aware that the most probable cause of this Condition is due to: ‘A. Obstruction ofthe portal circulation 8 Decreased reabsorption of uids C. Increased absorption of fluids from the intestinal tissues D. Increase intravascular protein 79. Paracentesis was done, with 500 cc of fluid obtained. You observed that the fluid was draining rapidly. Which of these would indicate an untoward reaction to the Paracentesis:iE A Vertigo ©. Vomiting B. Rapid pulse D. Headache 80. Your health teaching includes the recommended diet for ‘him and this is A. High-calorie, high protein B. High-calorie, low fat ©. High-calorie, high vitamin D. Low-calorie, low fat SITUATION 17. Ms. Louie is complaining of blurring of vision 81. 83. Pilocarpine was prescribed. The effect is: A Analeptic with pain in both eyes. She sought the help of the ‘opthalmologist anti came up with a diagnosis of chronic ‘simple glaucoma. ‘During examination, her opthaimologist may discover one Of the following: ‘A. Sensitivity and clouding of the cornea B. Congestion of the comea C. Sensitivity of comea causing the inability to close the eyes completely D. Sensitivity of the comea upon exposure to the sun Pathophysiology of primary open angle glaucoma its: A Pressure of the anteriorly displaced iris against the fitration network Hardening of the comea Displacement of the comea D. —Clouding and insensitivity of the cornea Oe C. Sedative . 84 8. Constrictor SD. Mlotic The order for the administration of the drug is, OU, This ‘A. Rightcomea only C, _Right eye ©. Both eyes, B. Lefteye Which of these (6 not your nursing consideration while she is having pilocarpine therapy? ‘A Warm patient that vision will be temporarily cleared. 8. Transient brow pain are common at frst C. Teach patient how to instil the drug 0. Contrainicated in acute cases and use ‘continuously in hypertension SITUATION 18. Vicky age 44, is brought to the hospital by her husband who stated that she has been eating very little, has diffcuty of sleeping and has lost weight ‘considerably. She was observed to have neglected family responsibilities for the past two Assessment further reveals that this started after her daughter, an OCM died in Saudi Arabia. Diagnosis is ‘major depressive disorder. Immediately after admission, Vicky isolates herself in her ‘oom. Which one of the following is the rationale for this behavior? ‘A. Vicky probably believes that it is better not to - socialize with the other patients B. Depressed patient like Vicky has suicidal ideation C. Depressed patient like Vicky needs privacy 1D. Vicky is isolating herself because she believes no ‘one can help her ii87. Initially, the nurse identifies one of the f Patient's problem: ‘A. Impaired social interaction B. Dysfunctional grieving ©. Altered thought process D. Potential for violence, self-i Vicky did not respond to drug statement, so Electric Convuisive Therapy (ECT) was ordered. Which of the following statement is TRUE of ECT? A. It is snot indicated for depressed patient ‘experiencing psychotic symptoms B. Its not indicated for acutely suicidal patients C. tis indicated for depression associated with stress D. It is most effective for persons suffering from depression After ECT, if Vicky is fully awake, which of the following ‘nursing interventions is most appropriate? A. Allow her to rest B. Orient her to time and place C. Take her vital signs D. Observe her for untoward side effects ‘The most common side effects after ECT are which of the following: .- ‘A. Hypertension and change in cardiac rate B. Headache and dizziness. C. Temporary memory loss and confusion D. Nausea and vomiting SITUATION 19 A 30 year old military man, Jun, separated OIE EE 1 92 83. rom his wife and three children is brought to the hospital y nis sister who relates that he has not slept for two days and Keeps on saying that he has heard voices ‘cling him to jump from a building. Diagnosis: ‘Schizophrenia, Paranoid An appropriate nursing diagnosis would be one of the following! A. Impaired social interaction B. Ineffective individual coping C. Sensory perceptual alteration D. Altered thought process One of the following actions should be avoided by the staff which will increase Jun’ anxiety and suspiciousness: ‘A Initiating a one-on-one conversation with Jun. Staying with Jun for short time during the day distance of Jun Whispering with others which can be observed by Jun’ B. *C. Talking with the family members within hearing D. ‘The physician orders Haloperidol, (Haldol). To be sure that Jun swallow medication, it should be taken in which Of the following forms: ‘A. Suppository C. Tablet BL Liquid D. Capsule ‘After taking Haldol for three days, the nurse observed Jun to be restless and cannot sit stil: He is showing signs of which of the following:95, A Tardive dyskinesia © C.Par B. Dystonia D. Akathisi ‘Jun claims to be hearing voices telling him to jump from a building. This is an example of what type of hallucination A Tactile C. Olfactory B. Visual D. Auditory SITUATION 20. Ricky, age 18, a cocaine user for two years 7. is brought tothe rehabilitation center for detoxification, He is a school drop-out and prefer to be with his friends. Initially, upon admission, the nurse identifies one of the following diagnoses: ‘A. Impaired social interaction B. Ineffective individual coping C. Self-esteem disturbance D. Impaired adjustment Which of the following physical complications would Confirm that he is co¢aine user: ‘A. Impaired lung structure B. Bacterial endocarditis, C. Perforated nasal septum D. Peripheral vascular disease The nurse knows that one of the following cluster of ‘symptoms will indicate cocaine intoxication: ‘A Constrcted pupils, decrease in blood pressure, slurred speech 8. Unsteady gait, increased appetite, increase ia temperature, pulse and respiration 100, ©. Dilated puis, tachycardia and ©. Tremors, palitaton, decease n lood pressure The physlan orders wich one it the process of wihdaval fom cecane, “own Sung Imoromine HCL (Tete, Benacropne Mey (Cogent Halopel alo) Diazepam (alum) pop> \hich one of the flowing statement best oseibes long-term treatment for drug dependents? he A tears fst heb groupe of ehabiated org sci toheip ug adacs ecover 8. Is conducted to help ug adds cfain fom ‘sing prohted and regulate ge gen ©. Uses vant of teatnent vali D. fs danein an outpatient aus fo encourage the person to maintain quay ee