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6. Which of the ff theories consider and utilize nature and environment in the
healing process?
a. Orlando
b. Nightingale
c. Rogers
d. King
9. Nursing theories should include descriptions of the four concepts such as:
a. Person, environment, health, nursing
b. Nursing, environment, health, illness
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c. Person, society, illness, health
d. Society, nursing, health, illness
10. She conceptualized the framework for psychiatric nursing, wherein a nurse
must established a therapeutic relationship with the client.
a. Peplau
b. Leninger
c. Hall
d. Neuman
Situation: Nurses assume a number of roles when the provide care to the
individual, family or community.
12. When a nurse assists the client in meeting his hygienic needs, the nurse
portrays what role?
a. Manager
b. Client advocate
c. Caregiver
d. Leader
13. Before Lira undergoes an operation, the nurse checked whether Lira
understood what is to be done to her. With this regard the nurse acts as a:
a. Client’s advocate
b. Manager
c. Caregiver
d. Teacher
14. You demonstrate a client advocate role to a client for operation when you:
a. Check her v/s and carries out pre-op orders.
b. Arrange services for clients
c. Check if the client knows what is to be done to her.
d. Question the order of the doctor
15. The actions people take understand their health state, maintain their
health or prevent illness and injury are called:
a. Health status
b. Health beliefs
c. Health behaviors
d. Health values
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17. A single mother of three school age children is concerned about
maintaining her present health status. Although she knows that she should
exercise regularly, her job and the classes she is taking at the local
community college require all her spare time. Where is the client at the
Dunn’s health grid?
a. High level wellness in a favorable environment
b. Emergent high level wellness in unfavorable environment
c. Protected poor health in a favorable environment
d. Poor health in an unfavorable environment
18. Mira was not able to attend to the taping of her movie because of
abdominal pain. Mira is said to be on what stage of illness behavior?
a. Symptom experience
b. Assumption of sick role
c. Medical care contact
d. Dependent client role
20. Health beliefs are affected by certain internal and external variables. What
is the best definition of health belief?
a. Actions taken by an individual related to health
b. Concepts related health
c. Health practices as a person
d. Health habits
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a. Assessment
b. Implementation
c. Planning
d. Evaluation
27. During the implementation process, the nurse needs to possess various
skills. If she is going to suction a neonate, which of the ff skills will mostly
be utilized by the nurse?
a. Cognitive
b. Interpersonal
c. Psychomotor
d. Communication
28. 28. A client comes to the clinic for comprehensive health assessment.
Upon obtaining the client’s biographic data, which of the ff questions
would be best to begin history taking?
a. “What brings you to the clinic today?
b. ”Would you describe your health as good?”
c. “Are you healthy?”
d. “Describe your health, now and in the past”
29. In formulating learning goals, which of the ff does not illustrate an
important factor to be considered at this stage of the teaching process?
a. Involvement of clients and their families in the development of
goals
b. Inclusion of teaching methods appropriate to client’s learning styles
c. Consideration of the primary learning domains in which to focus
teaching
d. Use of behavioral objectives in formulating goals
30. Making judgments and conclusions about the meaning of the data you
have collected in your assessment of Alfred is:
a. Analysis of data
b. Verifying data
c. Organizing data
d. Interpretation of data
31. Which of the ff techniques can be most helpful in identifying the degree of
distress and discomfort of a newly admitted client?
a. Review of nurses notes
b. Performing physical examination
c. Active listening on what the clients says
d. Observation of client’s behavior
32. Your admission data will include social data about your client. These are
examples of social data EXCEPT:
a. Client’s lifestyle
b. Perception of illness
c. Religious practices
d. Family home situation
33. The nurse should take the initiative in setting priorities when
a. In an emergency situation
b. The client is illiterate
c. The client is uncooperative
d. There are differences in cultures
34. What is the most appropriate method of temperature taking will the nurse
use?
a. Per Oral
b. Per Axilla
c. Per Rectal
d. None of the above
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35. How many degrees centigrade is the normal body temperature If taken by
such method (refer to above question)?
a. 37
b. 37.5
c. 37.8
d. 36.5
36. If the fever of Amihan fluctuates from 38 to 40.5 degrees centigrade, she
is said to have what type of fever?
a. Intermittent
b. Remittent
c. Constant
d. Relapsing
40. A few minutes after the nursing measures, Amihan’s fever goes down
gradually. This method of fever abatement is known as:
a. Crisis
b. Lysis
c. Acute
d. Chronic
SITUATION: All living things need oxygen. Alterations in the respiratory and
cardiovascular system will affect the individuals level of oxygenation.
41. The nurse palpated the clients back to assess the lung sounds. Which of
the following will reveal a normal lung sounds?
a. presence of vesicular sounds
b. absence of vesicular sounds
c. presence of tactile fremitus
d. absence of tactile fremitus
42. Purse lip breathing exercises was advised. What is the effect of this action
to the clients respiratory system?
a. prevents air trapping
b. maintains a patent airway
c. liquefies secretions
d. promotes ciliary function
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3. promote lung expansion
4. liquefy secretions
a. 1,2
b. 1,4
c. 2,3
d. 3,4
2. The process by which gases are exchange from the lungs into the
atmosphere and vice versa is known as:
a. Diffusion
b. Perfusion
c. Ventilation
d. Osmosis
6. The nurse discusses the need for a diet rich in calcium. Which of the
following foods are the best sources of calcium?
a. Meat, poultry
b. Orange, grapefruit
c. Potatoes, carrots
d. Cheddar cheese, sardines
7. Cooking vegetables quickly under low fire and with the least amount of
water possible in a covered container help avoid destroying what vitamin?
a. Vitamin C
b. Vitamin D
c. Vitamin A
d. Vitamin K
8. Alena tells the nurse that her 3 year-old son, Kalil does not like and will not
drink milk. Which of the following foods is an alternative source of
essential amino acids?
a. Beans
b. Gelatin
c. Fresh fruits
d. Fresh eggs
9. The nurse is correct when teaches that the vitamin is important for the
proper absorption and utilization of calcium in the body is:
a. Vitamin A
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b. Vitamin B
c. Vitamin C
d. Vitamin D
11. Pirena asks the nurse if her 12 year-old son, with a height of 1.2 meters
and a weight of 50 kgs, has a normal height? Based on his BMI, in which of
the following categories does the child belongs?
a. Underweight
b. Overweight
c. Normal weight
d. Obese
13. During your assessment, you noticed that there is hypertympanism when
you percussed your clients abdomen. Your client should be suffering from
what bowel problem?
a. Constipation
b. Fecal impaction
c. Flatulence
d. Diarrhea
15. Which of the following sites is best used for bowel sound auscultation/
a. Right upper quadrant
b. Left upper quadrant
c. Right lower quadrant
d. Left lower quadrant
16. A mother told the nurse that her 13-year-old son strains everytime he
defecates. Which of the following actions is more appropriate to the child?
a. Decrease his level of activity
b. Serve food neither too hot nor too cold
c. Modify his lifestyle
d. Include dark green leafy vegetables in his diet
17. What is the minimum safe range for the hourly urinary output from the
indwelling catheter?
a. 20-30cc
b. 90-120cc
c. 60-90cc
d. 30-60cc
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c. parasympathetic responses
d. relaxation of urinary sphincter
20. The best urine specimen for determining glucose in the urine is:
a. second voided urine
b. 24 hour urine collection
c. Early morning urine
d. Midstream urine
21. Which of the following urine specific gravity values will indicate that there
is dehydration?
a. 1.010
b. 1.005
c. 1.024
d. 1.035
SITUATION: Sleep is a state of conciousness but the persons awareness and
response to the environment is decreased.
2. In what stage of sleep does brain tissue and cognitive restoration occur?
a. NREM
b. Stage III
c. REM
d. Delta sleep
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4. pain sensitive
a. 1,2,3
b. 1,3,4
c. 2,3,4
d. All
2. Which among the following age group needs 16-20 hours of sleep?
a. Infant
b. Toddler
c. Preschooler
d. Adolescent
5. Which of the ff techniques in moving the client will most likely cause
decibitus ulcer formation?
a. Sliding client on a sheet to move him up on bed
b. Moving client to a chair with support
c. Lifting client from bed to stretcher
d. Turning client to her side with a draw sheet
7. In turning a client to her side using a logroll, which of the following actions
are correct?
1. Place a pillow between the legs
2. One nurse counts counts 1,2,3 then turn client to her side
3. Client’s arms are crossed over her chest
4. Pull the client to one side of the bed before turning her to side
a. 1,2,3
b. 1,3,4
c. 2,3,4
d. All
2. Which of the ff basic elements are involved in body movement?
a. Posture, balance and coordinated body movements
b. Range of action movement and exercise
c. Exercise, nutrition and posture
d. Activities of daily living and exercise
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3. Body mechanics is of value to the nurse as it:
a. Decrease risk for injury
b. Promote active exercise
c. Reduce extra body fats
d. Increase energy conservation
4. The doctor ordered for MgSO4 5 gram to be injected on each buttock? How
may cc will you inject on each buttock if the stock dose is 250 mg/cc in a
10 cc ampule?
a. 10cc
b. 20cc
c. 50cc
d. 100cc
5. The best site for injecting a drug to a 6 month old child is the:
a. Dorsogluteal
b. Vastus lateralis
c. Ventrgluteal
d. Rectus femoris
6. The nurse is going to irrigate the left ear of a 2 year-old child. What should
be her position?
a. Left lateral
b. Right lateral
c. Sitting with head tilted to the left
d. Sitting with head tilted to the right
9. The mother brought her child at the health center because of diarrhea. IVF
was inserted to rehydrate the client. The doctor ordered that the IVF
should be regulated at 30gtts/min for the first three hours and the
remaining solution should run for 8 hours. What will be the regulation of
the remaining solution?
a. 5-16gtts/min
b. 20-21gtts/min
c. 24-25gtts/min
d. 29-30gtts/min
10. The nurse teaches a client about insulin and how to inject it. The nurse
explains to the client techniques to prevent inflammation and damage to
tissue at the injection site. Which of the following techniques is best?
a. Injecting the needle at 45 degree angle
b. Administering the insulin in alternate sites
c. Avoiding massage at the injection site after giving insulin
d. Facing the bevel of the needle toward the patient when injecting
the needle
11. If a client is receiving iron pills, which of the following laboratory test
should be assessed?
a. Occult blood
b. Hematocrit
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c. RBC
d. Hemoglobin
12. When catheterizing a female client, all of the following are correct
procedures EXCEPT:
a. The client is positioned in horizontal recumbent
b. The vestibule is swab with antiseptic solution
c. The catheter is lubricated with a water soluble jelly
d. The catheter is inserted into the bladder
13. Which of the following techniques should be done when inserting a cathter
into an adult male penis?
1. lifting the penis at 45 degree angle to the clients body
2. insert the catheter 6-8 inches
3. sterile technique should be observed
4. use Fr. 12 catheter to avoid trauma to the urethral sphincter
a. 1,2
b. 1,2,3
c. 2,3,4
d. All
2. Why should the nurse should asks the client to hyperextend the neck
during the insertion of the NGT towards the nasopharynx?
a. Avoid insertion of the tube to the trachea
b. Lessen the nasopharyngeal curvature
c. Prevent aspiration
d. Close the glottis
3. Which of the following actions SHOULD NOT be done when giving NGT
feeding?
a. Place the client on fowler’s position
b. Assess tube placement
c. Allow the formula to flow by gravity
d. Assist the client comfortably in right Sims after the feeding
4. If a client makes the following comments after about half of the blood is
transfused, which one should cause the nurse to suspect that the client is
having a transfusion reaction?
a. “I am thirsty.”
b. “I feel so tired.”
c. “I feel cold.”
d. “I need to go to the toilet.”
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7. The nurses notes that the clients prothrombin time is 30 seconds. What
will be the best action of the nurse?
a. Apply the support stockings before getting out of bed.
b. Allow for rest periods while providing care.
c. Encourage client to ambulate.
d. Observe for bleeding tendencies.
SITUATION: Stress is always a fabric of life and may cause major life crisis.
12. Which of the following actions are most helpful to relieve Sam of his
stress?
a. Teach him about the different coping mechanisms which he can
utilize
b. Make an ongoing assessment of specific stressors, support given
and coping status
c. Respect his privacy by allowing him to be alone as much as
possible
d. Encourage his family and friends too encourage him to work out his
problems
13. Uma, 50 year-old and a cancer client, asked you to explain to him, his
illness. Which of the following will be your best response?
a. “Are you afraid to die?”
b. “Tell me how you feel about your illness?”
c. “What do you want to know?”
d. :Your doctor will explain to you more about your illness.”
14. Nurse Say is going to admit Mr. JB who is suffering from abdominal pain.
Which of the following objectives is more appropriate if Nurse Say will
utilize Adaptation Model of Stress?
a. Relief of pain
b. Relief of anxiety
c. Promote comfort
d. Prevent injury
15. After surgery (gastric resection) you will expect the drainage from the
nasogastric tube to be bloody for at least:
a. 6-12 hours
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b. 12-24 hours
c. 24-32 hours
d. 32-72 hours
17. Immediately after the physician told Mr. Panero that he is to have a
colostomy, what should the nurse do to support the patient?
a. give silent support to Mr. Panero’s feeling that the colostomy is
temporary
b. allow Mr. Panero to substitute the nurses strength for his weakness
c. explain to patient what procedures will be carried out before the
operation
d. let Mr. Panero take the lead to be angry, to deny or to retreat
19. What principle is used in giving tepid sponge bath to lower elevated body
temperature by assisting the skin in its thermoregulatory function?
a. dissipation
b. conduction
c. convection
d. radiation
21. Mr. Nebres has been started on sitz bath and will have to contribute them
at home. Instructions should include directions to be sure to take them:
a. after exercise
b. after bowel movement
c. before exercise
d. upon arising and at bedtime
22. Mr. De Luna asks you what to expect after his upper gastro intestinal
series (UGIS). Your most appropriate response will be:
a. you will be able to move your bowels easily
b. you will be given an enema or a cathartic to expel the contrast
media
c. your dietary regimen will be changed
d. you will notice that your stool is dark in color
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23. Because falls accounts for the highest cause of home accidents, what
home safety measures do NOT apply?
a. hand rails in bathrooms/ showers
b. risers in stairs marked with contrasting color plus good lighting
c. residential fire hazards
d. avoidance of slippery floor
24. Safety measures to prevent falls of hospital patients include bed side rails,
which group of patients do not need side rails?
a. weak but desiring to be independent
b. unconscious
c. those for executive/ general check-up
d. confused
28. When an accident victim gasps for air or make efforts to overcome
decreasing oxygenation. What is the proper term used?
a. laryngospasm
b. airway obstruction
c. carbon monoxide poisoning
d. asphyxia
31. Patients with cardiac arrests, are usually injected with atropine sulfate.
What is its principal action in this case?
a. causes vasoconstriction
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b. accelerates heart rate
c. return serum PH to normal level
d. suppresses ventricular fibrillation
34. Which of the following is correct using nursing diagnosis on Aling Coring’s
condition?
a. knowledge deficit regarding exercise
b. ineffective individual coping
c. knowledge deficit regarding home blood pressure recording
d. non-compliance due to lack of understanding about seriousness of
her illness
35. To enhance Aling Coring compliance, you should include in her care plan:
a. side effects of anti-hypertensive drugs
b. psychological characteristic of patient
c. active patient involvement
d. provide patient relationship
SITUATION: The nurse is doing nursing intervention to pave the way for Jim to get
rehabilitated.
37. The nurse assesses Jim’s ability to use his left hand to replace his right-
hand functions. This nursing behavior directs nursing care toward
replacing deficit with other skills to help him to:
a. show to his family bright hopes towards full recovery
b. adapt to changed caused by the illness
c. cooperate with other health team members in his treatment
regimen
d. unload some activities of the health team
38. Jim is beginning to compensate the bad for the good arm’s functions. The
nurse should evaluate the effect of the lack of arm function on Jim as a
whole. Based on the findings, the nurse now modifies care to maintain not
just the musculoskeletal but to maintain the function:
a. in all subsystems
b. gradually in most of the systems
c. moderately on the unaffected
d. partially on the unaffected
39. Helping Jim to make use of his left side as much as possible so that he
returns to school and previous levels of functioning sooner. These nursing
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behaviors clearly show that displacement from usual activities would
result in:
a. threat
b. deficit
c. problem
d. stress
40. The nurse arranges the overbed table so Jim can feed himself using his left
hand. The focus of nursing care is on Jim, in order to assess his ability to
complete self-care; may be wholly compensatory or care may be:
a. traditional
b. supportive-educational
c. comprehensive
d. occasional
41. The nurse considers a health program towards Jim’s full adaptation when
she includes all of the following, EXCEPT:
a. self-concept
b. interdependence
c. dependence
d. physiological factors
SITUATION: You followed-up Aling Elma, a 55 year old. She was discharged
from the hospital after a stroke. She has paralysis of the left side of the
body. You made an assessment.
42. You prepare a plan of care for Aling Elma. Which of the following would be
your priority objectives?
a. encourage a gradual increase in activity to provide relief
b. prevent or minimize the effects of immobilization in certain parts of
the body
c. teach a member of the family to check patient’s blood pressure
d. none of the above
44. You further explained to Aling Elma’s daughter the need of properly
position the patient in order to prevent:
a. muscular dystrophy and osteoporosis
b. contractures and pressure sores
c. osteoporosis
d. muscular atrophy
45. During your home visits, you always advise Aling Elma or daughter to
remind Aling Elma to do which of the following in order to prevent
hypostatic pneumonia:
a. body massage
b. deep breathing and coughing
c. take regular meals and snacks to increase body resistant
d. active and passive exercises
46. Concerned of Aling Elma’s health, you taught her daughter to explain a
nourishing well-balanced diet. As you teach, you must know that protein is
catabolized to meet energy needs when the diet is lacking in:
a. carbohydrates
b. vitamins
c. fats
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d. potassium
47. Which of the following may developed when a patient is under penicillin
treatment?
a. hypersensitivity
b. drug tolerance
c. infection at injection site
d. ringing at the ear
48. For pain, the doctor ordered Demerol IM 75mg, stat. The available stock is
50mg per ml in a 10cc. How much will you inject?
a. 1/2ml
b. 1 1/2ml
c. 1ml
d. 1.75ml
49. When giving any medication, which of the following is of prime importance
to record?
a. the expected effect of the drug
b. the action of the drug
c. the route of administration
d. side effects of the drug
138. The physician orders a platelet count to be performed on Mrs. Gonzaga after
breakfast. The nurse is responsible for:
a. Instructing the patient about the diagnostic test
b. Writing the order for this test
c. Giving the patient breakfast
d. All of the above
139. Give Mrs. Gonzaga breakfast at the scheduled time is a nursing intervention
belonging to which of the following categories?
a. referral
b. teaching
c. diagnosis
d. therapy
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141. An interdependent therapeutic nursing intervention for Mrs. Gonzaga would
be:
a. administer 30mg of oral Phenobarbital every four hours
b. escort the patient to the laboratory for a platelet count
c. refer the patient to the dietician
d. assess vital signs every four hours
142. Mrs. Gonzaga continues to have an elevated blood pressure of 184/106, and
the physician orders bed rest. The nurse explains to the patient the primary
reason for bed rest is to:
a. decrease cardiac output
b. decrease metabolic activity
c. conserve energy
d. reduce oxygen use
143. Mrs. Gonzaga has been given a copy of her diet. The nurse discusses the
foods allowed on a 500mg low sodium diet. These include:
a. a ham and swiss cheese sandwich on whole wheat bread
b. mashed potatoes and broiled chicken
c. a tossed salad with oil and vinegar and olives
d. chicken bouillon
144. A patient with signs and symptoms of congestive heart failure and leg
edema has been placed on diuretic therapy. Which of the following data would best
gauge his progress?
a. fluid intake and output
b. vital signs
c. weight
d. urine specific gravity
145. The best way to observe whether a patient is complying with fluid restriction
is through:
a. weight
b. fluid intake and output records
c. urine pH
d. urine specific gravity
150. A healthy adult’s body compensates for decreased urine output by:
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a. decreased sweating
b. increased sweating
c. thirst
d. bladder distention
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