NURSING PRACTICE IV – Care of Clients with Physiologic and

Psychosocial Alterations (Part B)

MULTIPLE CHOICE

Situation 1 – Because of the serious consequences of severe burns, management requires a

multidisciplinary approach. You have important responsibilities as a nurse.

1. While Sergio was lighting a barbecue grill with a lighter fluid, his shirt burns into flames.
The most effective way to extinguish the flames with as little further damage as possible
is to:

A. log roll on the grass/ground

B. slap the flames with his hands
C. remove the burning clothes
D. pour cold liquid over the flames

2. Once the flames are extinguished, it is most important to:

A. cover Sergio with a warm blanket

B. give him sips of water
C. calculate the extent of his burns
D. assess the Sergio’s breathing

3. Sergio is brought to Emergency Room after the barbecue grill accident. Based on the
assessment of the physician, Sergio sustained superficial partial thickness burns on his
trunk, right upper extremities and right lower extremities. His wife asks what that means?
Your most accurate response would be:

A. Structures beneath the skin are damage

B. Dermis is partially damaged
C. Epidermis and dermis are both damaged
D. Epidermis is damaged

4. During the first 24 hours after the thermal injury, you should asses Sergio for:

A. hypokalemia and hypernatremia

B. hypokalemia and hyponatremia
C. hyperkalemia and hyponatremia
D. hyperkalemia and hypernatremia

5. Teddy, who sustained deep partial thickness and full thickness burns of the face, whole
anterior chest and both upper extremities two days ago begins to exhibit extreme
restlessness. You recognize that this most likely indicates that Teddy is developing:

A. Cerebral hypoxia C. metabolic acidosis

B. Hypervolemia D. Renal failure
Situation 2 – You are now working as a staff nurse in a general hospital. You have to be
prepared to handle situations with ethico-legal and moral implifications.

6. You are in night duty in surgical ward. One of your patients Martin is a prisoner who
sustained an abdominal gunshot wound. He is being guarded by policeman from the local
police unit. During your rounds you heard a commotion. You saw the policeman trying to
hit Martin. You asked why he was trying to hit Martin. He denied the matter. Which
among the following activities will you do first?

A. Write an accident report

B. Call security officer and report the incident
C. Call your nurse supervisor and report the incident
D. Call the physician on duty

7. You are on morning duty in the medical ward. You have 10 patients assigned to you.
During your endorsement rounds, you found out that one of your patients was not in
bed. The patient next to him informed you that he went home without notifying the
nurses. Which among the following will you do first?

A. Make an incident report

B. Call security to report the incident
C. Wait for 2 hours before reporting
D. Report the incident to your supervisor

8. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You
found out that what is on record does not tally with the drugs used. Which among the
following will you do first?

A. Write an incident report and refer the matter to the nursing director
B. Keep your findings to yourself
C. Report the matter to your supervisor
D. Find out from the endorsement any patient who might have been given narcotics

9. You are on duty in the medical ward. The mother of your patient who is also a nurse,
came running to the nurses station and informed you that Fiolo went into
cardiopulmonary arrest.

A. Start basic life support measures

B. Call for the Code
C. Bring the crash cart to the room
D. Go to see Fiolo and assess for airway patency and breathing problems

10. You are admitting Jorge to the ward and you found out that he is positive for HIV. Which
among the following will you do first?
 A. Take note of it and plan to endorse this to next shift
B. Keep this matter to yourself
C. Write an incident report
D. Report the matter to your head nurse

Situation 3 - 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 care of patients with this type of cancer.

11. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the CI.
After taking the history and vital signs the physician does which test as a screening test
for colorectal cancer.

A. Barium enema
B. Carcinoembryonic antigen
C. Annual digital rectal examination
D. Proctosigmoidoscopy

12. To confirm his impression of colorectal cancer, Larry will require which diagnostic
study?

A. Carcinoembryonic antigen
B. Proctosigmoidoscopy
C. Stool hematologic test
D. Abdominal computed tomography (CT) test

13. The following are risk factors for colorectal cancer, EXCEPT:

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:

A. constipation, ascites and mucus in the stool

B. diarrhea, heart burn and eructation
C. blood in the stools, anemia, and “pencil shaped” stools
D. anorexia, hematemesis, and increased peristalasis

15. Several days prior to bowel surgery, Larry may be given sulfasuxidine and neomycin
primarily to:

A. promote rest of the bowel by minimizing peristalsis

B. reduce the bacterial content of the colon
C. empty the bowel of solid waste
D. soften the stool by retaining water in the colon
Situation 4 – ENTEROSTOMAL THERAPY is now considered a specialty in nursing.
You are participating in the OSTOMY CARE CLASS.

16. You plan to teach Fermin how to irrigate the colostomy when:

A. The perineal wound heals And Fermin can sit comfortably on the commode
B. Fermin can lie on the side comfortably, about the 3rd postoperative day
C. The abdominal incision is closed and contamination is no longer a danger
D. The stools starts to become formed, around the 7th postoperative day

17. When preparing to teach Fermin how to irrigate colostomy, you should plan to do the
procedure:

A. When Fermin would have normal bowel movement

B. At least 2 hours before visiting hours
C. Prior to breakfast and morning care
D. After Fermin accepts alteration in body image

18. When observing a return demonstration of a colostomy irrigation, you know that
more teaching is required if Fermin:

A. Lubricates the tip of the catheter prior to inserting into the stoma
B. Hangs the irrigating bag on the bathroom door cloth hook during fluid insertion
C. Discontinues the insertion of fluid after only 500 ml of fluid has been instilled
D. Clamps of the flow of fluid when felling uncomfortable

19. You are aware that teaching about colostomy care is understood when Fermin
states, “I will contact my physician and report:

A. If I have any difficulty inserting the irrigating tub into the stoma.”
B. If I noticed a loss of sensation to touch in the stoma tissue.”
C. The expulsion of flatus while the irrigating fluid is running out.”
D. When mucus is passed from the stoma between the irrigations.”

20. You would know after teaching Fermin that dietary instruction for him is effective
when he states, “It is important that I eat:

A. Soft food that are easily digested and absorbed by my large intestines.”
B. Bland food so that my intestines do not become irritated.”
C. Food low in fiber so that there is less stool.”
D. Everything that I ate before the operation, while avoiding foods that cause gas.”

Situation 5 – Ensuring safety is one of your most important responsibilities. You will
need to provide instructions and information to your clients to prevent
complications.
21. Randy has chest tubes attached to a pleural drainage system. When caring for him
you should:

A. empty the drainage system at the end of the shift

B. clamp the chest tube when suctioning
C. palpate the surrounding areas for crepitus
D. change the dressing daily using aseptic techniques

22. Fanny, came in from PACU after pelvic surgery. As Fanny’s nurse you know that
the sign that would be indicative of a developing thrombophlebitis would be:

A. a tender, painful area on the leg

B. a pitting edema of the ankle
C. a reddened area at the ankle
D. pruritus on the calf and ankle

23. To prevent recurrent attacks on Terry who has acute glumerulonephritis, you
should instruct her to:

A. seek early treatment for respiratory infections

B. take showers instead of tub bath
C. continue to take the same restrictions on fluid intake
D. avoid situations that involve physical activity

24. Herbert had a laryngectomy and he is now for discharge. He verbalized his concern
regarding his laryngectomy tube being dislodged. What should you teach him
first?

A. Recognize that prompt closure of the tracheal opening may occur

B. Keep calm because there is no immediate emergency
C. Reinsert another tubing immediately
D. Notify the physician at once

25. When caring for Larry after an exploratory chest surgery and pneumonectomy,
your priority would be to maintain:

A. supplementary oxygen
B. ventilation exchange
C. chest tube drainage
D. blood replacement

Situation 6 – 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 quality of care.

26. Honrad, who has been complaining of anorexia and feeling tired, develops
 jaundice, after a workup 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:

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
gammaglobulin.”
D. “A vaccine has been developed for this type of hepatitis”

27. Voltaire develops a nosocomial respiratory tract infection. He ask you what that
means? Your best response would be:

A. “You acquired the infection after you have been admitted to the hospital.”
B. “This is a highly contagious infection requiring complete isolation.”
C. “The infection you had prior to hospitalization flared up.”
D. “As a result of medical treatment, you have acquired a secondary infection.’

28. As a nurse you know that one of the complications that you have to watch out for
when caring for Omar who is receiving total parenteral nutrition is:

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

29. A solution used to treat Pseudomonas wound infection is:

A. Dakin’s solution
B. Half-strength hydrogen peroxide
C. Acetic acid
D. Betadine

30. Which of the following is the most reliable in diagnosing a wound infection?

A. Culture and sensitivity

B. Purulent drainage from a wound
C. WBC count of 20,000/μL
D. Gram stain testing

Situation 7 – As a nurse you need to anticipate the occurrence of complications of

stroke so that life threatening situations can be prevented.

31. Wendy is admitted to the hospital with signs and symptoms of stroke. Her
Glasgow Coma Scale is 6 on admission. A central venous catheter was inserted
an I.V. infusion was started. As a nurse assigned to Wendy what will be your
priority goal?
 A. Prevent skin breakdown
B. Preserve muscle function
C. Promote urinary elimination
D. Maintain a patent airway

32. Knowing that for a comatose patient hearing is the last sense to be lost, as Judy’s
nurse, what should you do?

A. Tell her family that probably she can’t hear them

B. Talk loudly so that Wendy can hear you
C. Tell her family who are in the room not to talk
D. Speak softly then hold her hands gently

33. Which among the following interventions should you consider as the highest
priority when caring for June who has hemiparesis secondary to stroke?

A. Place June on an upright lateral position

B. Perform range of motion exercises
C. Apply antiembolic stockings
D. Use hand rolls or pillows for support

34. Ivy, age 40, was admitted to the hospital with a severe headache, stiff neck and
photophobia. She was diagnosed with a subarachnoid hemorrhage secondary
to ruptured aneurysm. While waiting for surgery, you can provide a therapeutic
environment by doing which of the following?

A. honoring her request for a television

B. placing her bed near the window
C. dimming the light in her room
D. allowing the family unrestricted visiting privileges

35. When performing a neurologic assessment on Walter, you find that his pupils are
fixed and dilated. This indicated that he:

A. probably has meningitis

B. is going to be blind because of trauma
C. is permanently paralyzed
D. has received a significant brain injury

Situation 8 – With the improvement in life expectancies and the emphasis in the
quality of life it is important to provide quality care to our older
patients. There are frequently encountered situations and issues
relevant to the older patients.

36. Hypoxia may occur in the older patients because of which of the following
physiologic changes associated with aging.
 A. Ineffective airway clearance
B. Decreased alveolar surfaced area
C. Decreased anterior-posterior chest diameter
D. Hyperventilation

37. The older patient is at higher risk for incontinence because of:

A. dilated urethra
B. increased glomerular filtration rate
C. diuretic use
D. decreased bladder capacity

38. 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

39. Cardiac ischemia in an older patient usually produces:

A. ST-T wave changes

B. Very high creatinine kinase level
C. Chest pain radiating to the left arm
D. Acute confusion

40. 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 9 – A “disaster” is a large-scale emergency—even a small emergency left

unmanaged may turn into a disaster. Disaster preparedness is
crucial and is everybody’s business. There are agencies that are in
charge of ensuring prompt response. Comprehensive Emergency
Management (CEM) is an integrated approach to the management of
emergency programs and activities for all four emergency phases
(mitigation, preparedness, response, and recovery), for all types of
emergencies and disasters (natural, man-made, and attack) and for
all levels of government and the private sector.

41. Which of the four phases of emergency management is defined as “sustained

action that reduces or eliminates long-term risk to people and property from
natural hazards and their effects.”?
 A. Recovery
B. Mitigation
C. Response
D. Preparedness

42. You are a community health nurse collaborating with the Red Cross and working
with disaster relief following a typhoon which flooded and devastated the whole
province. Finding safe housing for survivors, organizing support for the family,
organizing counseling debriefing sessions and securing physical care are the
services you are involved with. To which type of prevention are these activities
included:

A. Tertiary prevention
B. Primary prevention
C. Aggregate care prevention
D. Secondary prevention

43. During the disaster you see a victim with a green tag, you know that the person:

A. has injuries that are significant and require medical care but can wait hours
with threat to life or limb
B. has injuries that are life threatening but survival is good with minimal
intervention
C. indicates injuries that are extensive and chances of survival are unlikely even
with definitive care
D. has injuries that are minor and treatment can be delayed from hours to days

44. The term given to a category of triage that refers to life threatening or potentially
life threatening injury or illness requiring immediate treatment:

A. Immediate
B. Emergent
C. Non-acute
D. Urgent

45. Which of the following terms refer to a process by which the individual receives
education about recognition of stress reaction and management strategies for
handling stress which may be instituted after a disaster?

A. Clinical incident stress management

B. Follow-up
C. Defriefing
D. Defusion

Situation 10 – As a member of the health and nursing team you have a crucial role to
play in ensuring that all the members participate actively is the
various tasks agreed upon.

46. While eating his meal, Matthew accidentally dislodges his IV lines 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:

A. Acetone
B. Alcohol
C. Ammonia
D. Bleach

47. You are a member of the infection control team of the hospital. Based on a
feedback during the 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?

A. Establish policies for surveillance and monitoring

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

48. 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?

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

49. 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?

A. Find out if there is a budget for this activity

B. Clarify objectives of the activity with the task force before contacting the
support groups
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 number of their president

50. 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 for others. What will be your
most important role where you can demonstrate the impact of nursing in
health?
 A. Conduct health education on healthy life style
B. Be a triage nurse
C. Take the initial history and document findings
D. Act as a coordinator

Situation 11 – One of the realities that we are confronted with is our mortality. It is
important for us nurses to be aware of how we view suffering, pain,
illness, and even our death as well as its meaning. That way we
can help our patients cope with death and dying.

51. Irma is terminally ill, she speaks to you in confidence. You now feel that Irma’s
family could be helpful if they knew what Irma has told to you. What should you
do first?

A. Tell the physician who in turn could tell the family

B. Obtain Irma’s permission to share the information in the family
C. Tell Irma that she has to tell her family what she told you
D. Make an appointment to discuss the situation with the family

52. Ruby who has been told she has terminal cancer, turns away and refuses to
respond to you. You can best help her by:

A. Coming back periodically and indicating your availability if she would like
you to sit with her
B. Insisting that Ruby should talk with you because it is not good to keep
everything inside
C. Leaving her alone because she is uncooperative and unpleasant to be
with
D. Encouraging her to be physically active as possible

53. Leo, who is terminally ill and recognizes that he is in the process of losing
everything and everybody he loves, is depressed. Which of the following would
best help him during his depression?

A. Arrange for visitors who might cheer him

B. Sit down and talk with him for a while
C. Encourage him to look at the brighter side of things
D. Sit silently with him

54. Which of the following statements would best indicate that Ruffy, who is dying,
has accepted his impending death?

A. “I’m ready to go.”

B. “I have resigned myself to dying.”
C. “What’s the use?”
D. “I’m giving up”
55. Marla, 90 years old has planned ahead for her death-philosophically, socially,
financially and emotionally. This is recognized as:

A. Acceptance that death is inevitable

B. Avoidance of the true situation
C. Denial with planning for continued life
D. Awareness that death will soon occur

Situation 12 – Brain tumor, whether malignant or benign, has serious management

implications. As a nurse, you should be able to understand the
consequences of the disease and the treatment.

56. You are caring for Conrad who has a brained tumor and increased Intracranial
Pressure (ICP). Which intervention should you include in your plan to reduce
ICP?

A. Administer bowel softener

B. Position Conrad with his head turned toward the side of the tumor
C. Provide sensory stimulation
D. Encourage coughing and deep breathing

57. Keeping Conrad’s head and neck alignment results in:

A. increased inthrathoracic pressure

B. increased venous outflow
C. decreased venous outflow
D. increased intrabdominal pressure

58. Which of the following activities may increase intracranial pressure (ICP)?

A. Raising the head of the bed

B. Manual hyperventilation
C. Use of osmotic diuretics
D. Valsalva’s maneuver

59. After you asses Conrad, you suspected increased ICP. Your most appropriate
respiratory goal is to:

A. maintain partial pressure of arterial O2 (PaO2) above 80 mmHg

B. lower arterial pH
C. prevent respiratory alkalosis
D. promote CO2 elimination

60. Conrad underwent craniotomy. As his nurse, you know that drainage on a
craniotomy dressing must be measured and marked. Which findings should you
report immediately to the surgeon?
 A. Foul-smelling drainage C. Greenish drainage
B. Yellowish drainage D. Bloody drainage

Situation 13 – As a Nurse, you have specific responsibilities as professional. You

have to demonstrate specific competencies.

61. The essential components of professional nursing practice are all the following
EXCEPT:

A. Culture C. Cure
B. Care D. Coordination

62. You are assigned to care for four (4) patients. Which of the following patients
should you give first priority?

A. Grace, who is terminally ill with breast cancer.

B. Emy, who was previously lucid but is now unarousable.
C. Aris, who is newly admitted and is scheduled for an executive check-up.
D. Claire, who has cholelithiasis and is for operation on call.

63. Brenda, the Nursing Supervisor of the intensive care unit (ICU) is not on duty
when a staff nurse committed a serious medication error. Which statement
accurately reflects the accountability of the nursing supervisor?

A. Brenda should be informed when she goes back on duty

B. Although Brenda is not on duty, the nursing supervisor on duty decides
to call her if time permits
C. The nursing supervisor on duty will nitify Brenda at home
D. Brenda is not duty therefore it is not necessary to inform her.

64. Which barrier should you avoid, to manage time wisely?

A. Practical planning
B. Procrastination
C. Setting limits
D. Realistic personal expectation

65. You are caring for Vincent who has just been transferred to the private room. He
is anxious because he fears he won’t be monitored as closely as he was in the
Coronary Care Unit. How can you allay his fear?

A. Move his bed to a room far from nurse’s station to reduce

B. Assign the same nurse to him when possible
C. Allow Vincent uninterrupted period of time
D. Limit Vincent’s visitors to coincide with CCU policies
Situation 14 – As a nurse in the Oncology Unit, you have to be prepared to provide
safe, efficient and effective care to your patients.

66. Which one of the following nursing interventions would be most helpful in
preparing the patient for radiation therapy?

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

67. What side effects are most apt to occur the patient during radiation therapy to the
pelvis?

A. Urinary retention
B. Abnormal vaginal or perineal discharge
C. Paresthesia of the lower extremities
D. Nausea and vomiting and diarrhea

68. Which of the following can be used on the irradiated skin during a course of
radiation therapy?

A. Adhesive tape
B. Mineral oil
C. Talcum powder
D. Zinc oxide ointment

69. Earliest sign of skin reaction to radiation therapy is:

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

70. What is the purpose of wearing a film badge while caring for the patient who is
radioactive?

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

B. Prevent radiation-induced sterility
C. Protect the nurse from radiation effects
D. Measure the amount of exposure to radiation

Situation 15 – In a disaster there must be a chain of command in place that defined

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.
71. As a nurse to which of the following groups are you best prepared to join?

A. Treatment group C. Morgue management

B. Triage group D. Transport group

72. 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:

A. any disaster plan should have resources available to triage at each

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

73. Which of the following categories of conditions should be considered first priority
in a disaster?

A. Intracranial pressure and mental status

B. Lower gastrointestinal problems
C. Respiratory infections
D. Trauma

74. A guideline that is utilized in determining priorities is to asses the status of the
following, EXCEPT:

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

75. The most important component of neurologic assessment is:

A. pupil reactivity
B. vital sign assessment
C. cranial nerve assessment
D. level of consciousness/responsiveness

Situation 16 – You are going to participate in a Cancer Consciousness Week. You

are assigned to take charge of the women to make them aware of
cervical cancer. You reviewed its manifestations and management,

76. The following are risk factors for cervical cancer EXCEPT:

A. immunosuppressive therapy
B. sex at an early age, multiple partners, exposure to socially transmitted
 disease, male partner’s sexual habits
C. viral agents like the Human Papilloma Virus
D. smoking

77. Late signs and symptoms of cervical cancer include the following EXCEPT:

A. urinary/bowel changes
B. pain in pelvis, leg or flank
C. uterine bleeding
D. lymph edema of lower extremities

78. When a panhysterectomy is performed due to cancer of the cervix, which of the
following organs are removed?

A. the uterus, cervix, and one ovary

B. the uterus, cervix, and two-thirds of the vagina
C. the uterus, cervix, tubes and ovaries
D. the uterus and cervix

79. The primary modalities of treatment for Stage 1 and IIA cervical cancer include the
following:

A. surgery, radiation therapy and hormone therapy

B. surgery
C. radiation therapy
D. surgery and radiation therapy

80. A common complication of hysterectomy is

A. thrombophelbitis of the pelvic and thigh vessels

B. diarrhea due to over stimulation
C. atelectasis
D. wound dehiscence

Situation 17 – The body has regulatory mechanism to maintain the needed electrolytes.
However there are conditions/surgical interventions that could
compromise life. You have to understand how management of these
conditions are done.

81. You are caring for Leda who is scheduled to undergo total thyroidectomy because of
a diagnosis of thyroid cancer. Prior to total thyroidectomy, you should instruct Leda
to:

A. Perform range and motion exercise on the head and neck

B. Apply gentle pressure against the incision when swallowing
C. Cough and deep breath every 2 hours
 D. Support head with the hands when changing position

82. As Leda’s nurse, you plan to set up an emergency equipment at her beside following
thyroidectomy. You should include:

A. An airway and rebreathing tube

B. A tracheostomy set and oxygen
C. A crush cart with bed board
D. Two ampules of sodium bicarbonate

83. Which of the following nursing interventions is appropriate after a total thyroidectomy?

A. Place pillows under your patient’s shoulders.

B. Raise the knee-gatch to 30 degrees
C. Keep you patient in a high-fowler’s position.
D. Support the patient’s head and neck with pillows and sandbags.

84. If there is an accidental injury to the parathyroid gland during a thyroidectomy which
of the following might Leda develop postoperatively?

A. Cardiac arrest C. Respiratory failure

B. Dyspnea D. Tetany

85. After surgery Leda develops peripheral numbness, tingling and muscle twitching
and spasm. What would you anticipate to administer?

A. Magnesium sulfate C. Potassium iodide

B. Calcium gluconate D. Potassium chloride

Situation 18 – NURSES are involved in maintaining a safe and healthy environment.

This is part of quality care management.

86. The first step in decontamination is:

A. to immediately apply a chemical decontamination foam to the area of

contamination
B. a through soap and water wash and rinse of the patient
C. to immediately apply personal protective equipment
D. removal of the patients clothing and jewelry and then rinsing the patient
with water

87. For a patient experiencing pruritus, you recommend which type of bath.

A. water C. saline
B. colloidal (oatmeal) D. sodium bicarbonate
88. Induction of vomiting is indicated for the accidental poisoning patient who has
ingested.

A. rust remover C. toilet bowl cleaner

B. gasoline D. aspirin

89. Which of the following term most precisely refer to an infection acquired in the
hospital that was not present or incubating at the same time of hospital
admission?

A. Secondary blood stream infections

B. Nosocomial infection
C. Emerging infectious disease
D. Primary blood stream infection

90. Which of the following guidelines is not appropriate to helping family members
cope with sudden death?

A. Obtain orders for sedation of family members

B. Provide details of the factors attendant to the sudden death
C. Show acceptance of the body by touching it and giving the family
permission to touch
D. Inform the family that the patient has passed on

Situation 19 – As a nurse you are expected to participate in initiating or participating

in the conduct of research studies to improve nursing practice. You
have to be updated on the latest trends and issues affecting
profession and the best practices arrived at by the profession.

91. You are interested to study the effects of meditation and relaxation on the pain
experienced by cancer patients. What type of variable is pain?

A. Dependent C. Independent
B. Correlational D. Demographic

92. You would like to compare the support system of patients with chronic illness to
those with acute illness. How will you best state your problem?

A. A Descriptive Study To Compare The Support System Of Patients With

Chronic Illness And Those With Acute Illness In Terms Of Demographic
Data And Knowledge About Interventions.
B. The Effect Of The Type Of Support System of Patients With Chronic
Illness And Those With Acute Illness.
C. A Comparative Analysis Of The Support System Of Patients With
Chronic Illness And Those With Acute Illness.
D. A Study To Compare The Support System Of Patients With Chronic
Illness And Those With Acute Illness.

93. You would like to compare the support system of patients with chronic illness to
those with acute illness. What type of research it this?
 A. Correlational
B. Descriptive
C. Experimental
D. Quasi-experimental

94. You are shown a Likert Scale that will be used in evaluating your performance in
the clinical area. Which of the following questions will you not use in critiquing the
Likert Scale?

A. Are the techniques to complete and score the scale provided?

B. Are the reliability and validity information on the scale described?
C. If the Likert scale is to be used for a study, was the development
process described?
D. Is the instrument clearly described?

95. In any research study where individual persons are involved, it is important that an
informed consent for the study is obtained. The following are essential
information about the consent that you should disclose to the prospective
subjects EXCEPT:

A. Consent to incomplete disclosure

B. Descriptions of benefits, risks and discomforts
C. Explanation of procedure
D. Assurance of anonymity and confidentiality

Situation 20 – Because severe burn can affect the person’s totality it is important
that-you apply interventions focusing on the various dimensions of
man. You also have to understand the rationale of the treatment.

96. What type of debridement involves proteolytic enzymes?

A. Interventional C. Surgical
B. Mechanical D. Chemical

97. Which topical antimicrobial is most frequently used in burn wound care?

A. Neosporin
B. Silver nitrate
C. Silver sulfadiazine
D. Sulfamylon

98. Hypertrophic burn scars are caused by:

A. exaggerated contraction
B. random layering of collagen
C. wound ischemia
D. delayed epithelialization
 99. The major disadvantage of whirlpool cleansing of burn wound is:

A. patient hypothermia
B. cross contamination of wound
C. patient discomfort
D. excessive manpower requirement

100. Oral analgesics are most frequently used to control burn injury pain:

A. upon patient request

B. during the emergent phase
C. after hospital discharge
D. during the acute phase