NURSING PRACTICE III CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS

Situation I: Leo lives in the squatter area. He goes to nearby school. He helps his mother gather molasses after school. One day, he was absent because of
fever, malaise, anorexia, and abdominal discomfort.
1.

Upon assessment, Leo was diagnosed to have hepatitis A. Which mode of transmission has the infection agent taken?
a.
Fecal oral
b.
Droplet
c.
Airborne
d.
Sexual contact

2.

Which of the following is concurrent disinfection in the case of Leo?

a.
Investigation of contact
b.
Sanitary disposal of feces, urine and blood
c.
Quarantine of the sick individual
d.
Removing all detachable objects in the room, cleaning lighting and air duct surfaces in the ceiling and cleaning everything downward to the
floor

3.

Which of the following must be emphasized during mothers class to Leos mother?
a.
Administration of immunoglobulin to families
b.
Thorough had washing before and after eating and toileting
c.
Use of attenuated vaccines
d.
Boiling of food especially meat

4.

Disaster control should be undertaken when there are 3 or more hepatitis A cases. Which of these measures is a priority?
a.
Eliminate fecal contamination from foods
b.
Mass vaccination of uninfected individuals
c.
Health promotion and education to families and opportunities about the disease, its cause and transmission
d.
Mass administration of Immunoglobulin

5.

What is the average incubation period of Hepatitis A?

a.
30 days
b.
60 days
c.
50 days
d.
14 days

Situation 2: As a nurse researcher, you must have a very good understanding of the common terms of concept used in research.
6.

The information that an investigator collects from the subjects or participants in a research study is usually called
a.
Hypothesis
b.
Data
c.
Variable
d.
Concept

7.

Which of the following usually refers to the independent variables in doing research?
a.
Result
b.
Cause
c.
Output
d.
Effect

8.

The recipients of experimental treatment is an experimental design or the individuals to be observed in a non-experimental design are called
a.
Setting
b.
Subjects
c.
Treatment
d.
Sample

9.

The device or techniques an investigator employs to collect data is called

a.
Sample
b.
Instrument
c.
Hypothesis
d.
Concept

10.

The use of another persons ideas or workings without giving appropriate credit results from inaccurate or incomplete attribution of materials to its
sources. Which of the following is referred to when another persons idea is inappropriately credited as ones own?
a.
Plagiarism
b.
Quotation
c.
Assumption
d.
Paraphrase

Situation 3: Mrs Pichay is admitted to your ward. The MD ordered prepare for thoracentesis this pm to remove excess air from the pleural cavity.

11.

Which of the following nursing responsibilities is essential in Mrs. Pichay who will undergo thracentesis?
a.
Support and reassure client during the procedure
b.
Ensure that informed consent has been signed
c.
Determine if client has allergic reaction to local anesthesia
d.
Ascertain if chest x-rays and other tests have been prescribed and completed

12.

Mrs. Pichay who is for thoracentesis is assigned by the nurse to which of the following positions?
a.
Trendelenburg position
b.
Supine position
c.
Dorsal recumbent position
d.
Orthopneic position

13.

During thoracentesis, which of the following nursing intervention will be most crucial?
a.
Place patient in a quiet and cool room
b.
Maintain strict aseptic technique
c.
Advise patient to sit perfectly still during needle insertion until it has been withdrawn from the chest
d.
Apply pressure over the puncture site as soon as the needle is withdrawn

14.

To prevent leakage of fluid in the thoracic cavity, how will you position the client after thoracentesis?
a.
Place flat in bed
b.
Turn on the unaffected side
c.
Turn on the affected side
d.
On bed rest

15.

Chest x-ray was ordered after thoracentesis. When your client asks what is the reason for another chest x-ray, you will explain
a.
To rule out pneumothorax
b.
To rule out any possible perforation
c.
To decongest
d.
To rule out any foreign body

Situation 4: A computer analyst, Mr. Ricardo J. Santos, 25, was brought to the hospital for diagnostic workup after he had experienced seizure in his office.
16.

Just as the nurse was entering the room, the patient who was sitting on his chair begins to have a seizure. Which of the following must the nurse do
first?
a.
Ease the patient to the floor
b.
Lift the patient and put him on the bed
c.
Insert a padded tongue depressor between his jaws
d.
Restrain patients body movement

17.

Mr. Santos is scheduled for CT Scan for the next day, noon time. Which of the following is the correct preparation as instructed by the nurse?
a.
Shampoo hair thoroughly to remove oil and dirt
b.
No special preparation is needed. Instruct the patient to keep his head still and steady
c.
Give a cleansing enema and give fluids until 8AM
d.
Shave scalp and securely attach electrodes to it

18.

Mr. Santos is placed on seizure precaution. Which of the following would be contraindicated?
a.
Obtain his oral temperature
b.
Encourage to perform his own personal hygiene
c.
Allow him to wear his own clothing
d.
Encourage him to be out of bed

19.

Usually, how does the patient behave after his seizure has subsided?
a.
Most comfortable walking and moving about
b.
Becomes restless and agitated
c.
Sleeps for a period of time
d.
Say he is thirsty and hungry

20.

Before, during and after seizure, the nurse knows that the patient is ALWAYS placed in what position?
a.
Low fowlers
b.
Modified trendelenburg
c.
Side lying
d.
Supine

Situation 5: Mrs. Damian, an immediate post-op cholecystectomy and choledocholithotomy patient, complained of severe pain at the wound site.
21.

Choledocholithotomy is
a.
The removal of the gallbladder
b.
The removal of the stones in the gallbladder
c.
The removal of the stones in the common bile duct
d.
The removal of the stones in the kidney

22.

The simplest pain relieving technique is

a.
Distraction
b.
Taking aspirin
c.
Deep breathing exercise
d.
Positioning

23.

Which of the following statement on pain is TRUE:

a.
Culture and pain are not associated
b.
Pain accompanies acute illness
c.
Patients reaction to pain varies
d.
Pain produces the same reaction such as groaning and moaning

24.

In pain assessment, which of the following condition is a more reliable indicator?

a.
Pain rating scale of 1 to 10
b.
Facial expression and gestures
c.
Physiological responses
d.
Patients description of the pain sensation

25.

When a client complains of pain, your initial response is:

a.
Record the description of pain
b.
Verbally acknowledge the pain
c.
Refer the complaint to the doctor
d.
Change to a more comfortable position

Situation 6: You are assigned at a surgical ward and clients have been complaining of post pain at varying degrees. Pain as you know is very subjective.
26.

A one-day post-operative abdominal surgery client has been complaining of severe throbbing abdominal pain described as 9 in a 1-10 pain rating.
Your assessment reveals bowel sound on all quadrants and the dressing is dry and intact. What nursing intervention would you take?
a.
Medicate client as prescribed
b.
Encourage client to do imagery
c.
Encourage deep breathing and turning
d.
Call surgeon stat

27.

Pentoxidone 5mg IV every 8 hours was prescribed for post-abdominal pain. Which will be your priority nursing action?
a.
Check abdominal dressing for possible swelling
b.
Explain he proper use of PCA to alleviate anxiety
c.
Avoid overdosing to prevent dependence/tolerance
d.
Monitor VS, more importantly RR

28.

The client complained of abdominal distention and pain. Your nursing intervention that can alleviate pain is?
a.
Instruct client to go to sleep and relax
b.
Advise the client to close the lips and avoid deep breathing and talking
c.
Offer hot and clear soup
d.
Turn to sides frequently and avoid too much talking

29.

Surgical pain might be minimized by which nursing action in the O.R.?

a.
Skill of surgical team and lesser manipulation
b.
Appropriate preparation for the scheduled procedure
c.
Use of modern technology in closing the wound
d.
Proper positioning and draping of clients

30.

Inadequate anesthesia is said to be one the common cause of pain both in intra and post op patients. If general anesthesia is desired, it will involve
loss of consciousness. Which of the following are the 2 general types of GA?
a.
Epidural and spinal
b.
Subarachnoid block and intravenous
c.
Inhalation and regional
d.
Intravenous and inhalation

Situation 7: Nurses attitudes toward the pain influence the way they perceive and interact with clients in pain.
31.

Nurses should be aware that older adults are at risk of underrated pain. Nursing assessment and management of pain should address the following
beliefs EXCEPT:
a.
Older patients seldom tend to report pain than the younger ones
b.
Pain is a sign of weakness
c.
Older patients do not believe in analgesics, they are tolerant.
d.
Complaining of pain will lead to being labeled a bad patient

32.

Nurses should understand that when a client responds favorable to a placebo, it is known as the placebo effect. Placebos do not indicate whether
or not a client has
a.
Conscience

b.
c.
d.

Real pain
Disease
Drug tolerance

33.

You are the nurse in the pain clinic where you have client who has difficulty specifying the location of pain. How can you assist such clients?
a.
The pain is vague
b.
By charting it hurts all over
c.
Identify the absence and presence of pain
d.
Ask the client to point to the painful area by just one finger

34.

What symptom more distressing than pain should the nurse monitor when giving opioids especially among elderly clients who are in pain?
a.
Forgetfulness
b.
Constipation
c.
Drowsiness
d.
Allergic reaction like pruritus

35.

Physical dependence occurs in anyone who takes opioid over a period of time. What do you tell a mother of a dependent when asked for advice?
a.
Start another drug and slowly lessen the opioid dosage
b.
Include in recreational outdoor activities
c.
Isolate opioid dependent to a restful resort
d.
Instruct slow tapering of the drug dosage and alleviate physical withdrawal symptoms

Situation 8: The nurse is performing health education activities for Janevi Segovia, a 30 year-old dentist with insulin dependent diabetes mellitus.
36.

Janevi is preparing a mixed dose of insulin. The nurse is satisfied with her performance when she
a.
Draw insulin from the vial of clear insulin first
b.
Draw insulin from the vial of the intermediate acting insulin first
c.
Fill both syringes with the prescribed insulin dosage then shake the bottle vigorously
d.
Withdraw the intermediate acting insulin first before withdrawing the short acting insulin first

37.

Janevi complains of nausea, vomiting, diaphoresis and headache. Which of the following nursing intervention are you going to carry out first?
a.
Withhold the clients next insulin injection
b.
Test the clients blood glucose level
c.
Administer Tylenol as ordered
d.
Offer fruit juice, gelatin and chicken bouillon

38.

Janevi administers regular insulin at 7 am and the nurse should instruct Jane to avoid exercising at around
a.
9 11 am
b.
After 8 hours
c.
Between 8 am to 9 am
d.
In the afternoon after taking lunch

39.

Janevi was brought at the emergency room after four months because she fainted in her clinic. The nurse should monitor which of the following test
to evaluate the overall therapeutic compliance of a diabetic patient?
a.
Glycosylated hemoglobin
b.
Fasting blood glucose
c.
Ketone levels
d.
Urine glucose levels

40.

Upon the assessment of Hba1c of Mrs. Segovia, the nurse has been informed of a 9% Hba1c result. In this case, she will teach the patient to:
a.
Avoid infection
b.
Take adequate food and nutrition
c.
Prevent and recognize hyperglycemia
d.
Prevent and recognize hypoglycemia

41.

The nurse is teaching a plan of care for Jane with regards to proper foot care. Which of the following should be included in the plan?
a.
Soak feet in hot water
b.
Avoid using mild soap on the feet
c.
Apply a moisturizing lotion to dry feet but not between the toes
d.
Always have a podiatrist to cut your toe nails. Never cut them yourself

42.

Another patient was brought to the emergency room in an unresponsive state and a diagnosis of hyperglycemic hyperosmolar non-ketotic syndrome
is made. The nurse immediately prepared to initiate which of the following anticipated physicians order?
a.
Endotracheal intubation
b.
100 units of NPH insulin
c.
Intravenous infusion of normal saline
d.
Intravenous infusion of sodium bicarbonate

43.

Jane eventually developed DKA and is being treated in the emergency room. Which finding would the nurse expect to note as confirming this
diagnosis?

a.
b.
c.
d.

Comatose state
Decreased urine output
Increased respiration and an increase in pH
Elevated blood glucose level and low plasma bicarbonate level

44.

The nurse teaches Jane to know the difference between hypoglycemia and ketoacidosis. Jane demonstrates understanding of the teaching by
stating that glucose will be taken if which of the following symptoms develops?
a.
Polyuria
b.
Shakiness
c.
Blurred vision
d.
Fruit breath odor

45.

Jane has been schedule to have a FBS taken in the morning. The nurse tells Jane not to eat or drink after midnight. Prior to taking the blood
specimen, the nurse noticed that Jane is holding a bottle of distilled water. The nurse asked Jane if she drank any, and she said yes. Which of the
following is the best nursing action?
a.
Administer syrup of ipecac to remove the distilled water from the stomach
b.
Suction the stomach content using NGT prior to specimen collection
c.
Advise to physician to reschedule to diagnostic examination next day
d.
Continue as usual and have the FBS analysis performed and specimen be taken

Situation 9: Elderly clients usually produce unusual signs when it comes to different diseases. The aging process is a complicated process and the nurse should
understand that it is an inevitable fact and she must be prepared to care for the growing elderly population.
46.

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

47.

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

48.

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

49.

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

50.

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 10: in the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all these to safeguard the safety and quality
of patient delivery outcome.
51.

Which of the following should be given highest priority when receiving patient in the OR?
a.
Assess level of consciousness
b.
Verify patient identification and informed consent
c.
Assess vital signs
d.
Check for jewelry, gown, manicure, and dentures

52.

Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but considered dirty cases. When are there
procedures best scheduled?
a.
Last case
b.
In between cases
c.
According to availability of anesthesiologist
d.
According to the surgeons preference

53.

OR nurses should be aware that maintaining the clients safety is the overall goal of nursing care during the intraopertive phase. As the circulating
nurse, you make certain that throughout the procedure
a.
The surgeon greets his client before induction of anesthesia
b.
The surgeon and anesthesiologist are in tandem
c.
Strap made of strong non-abrasive materials are fastened securely around the joints of knees and ankles and around the 2 hands around an
arm board
d.
Client is monitored throughout the surgery by the assistant anesthesiologist

54.

Another nursing check that should not be missed before the induction of general anesthesia is
a.
Check for presence of underwear
b.
Check for presence of dentures
c.
Check patients ID
d.
Check baseline vital signs

55.

Some lifetime habits and hobbies affect post-operative respiratory function. If you client smokes 3 packs of cigarettes a day for the past 10 years,
you will anticipate increased risk for
a.
Perioperative anxiety and stress
b.
Delayed coagulation time
c.
Delayed wound healing
d.
Post-operative respiratory infection

Situation 11: Sterilization is the process of removing ALL living microorganism. To be free of ALL living microorganism is sterility.
56.

There are 3 general types of sterilization used in the hospital. Which one is not included?
a.
Steam sterilization
b.
Chemical sterilization
c.
Sterilization
d.
Sterilization by boiling

57.

Autoclave of steam under pressure is the most common method of sterilization in the hospital. The nurse knows that the temperature and time is set
to the optimum level to destroy not only the microorganism, but also the spores. Which of the following is the ideal setting of the autoclave machine?
a.
10,000 degrees Celsius for 1 hour
b.
5,000 degrees Celsius for 30 minutes
c.
37 degrees Celsius for 15 minutes
d.
121 degrees Celsius for 15 minutes

58.

It is important that before a nurse prepares the material to be sterilized, a chemical indicator strip should be placed above the package, preferable
Muslin sheet. What is the color of the stripe produced after autoclaving?
a.
Black
b.
Blue
c.
Gray
d.
Purple

59.

Chemical indicators communicate that

a.
The items are sterile
b.
That the items had undergone sterilization process but not necessarily sterile
c.
The items are disinfected
d.
That the items had undergone disinfection process but not necessarily disinfected

60.

If a nurse will sterilize a heat and moisture labile instrument, it is according the AORN recommendation to use which of the following method of
sterilization?
a.
Ethylene oxide gas
b.
Autoclaving
c.
Flash sterilizer
d.
Alcohol immersion

Situation 22: Nurses hold a variety of roles when providing care to a perioperative patient.
61.

Which of the following role would be the responsibility of the scrub nurse?
a.
Assess the readiness of the client prior to surgery
b.
Ensure that the airway is adequate
c.
Account for the number of sponges, needles, supplies used during the surgical procedure
d.
Evaluate the type of anesthesia appropriate for the surgical client

62.

As a peiroperative nurse, how can you best meet the safety need of the client after administering pre-operative narcotic?
a.
Put side rails up and ask the client not to get out of bed
b.
Send the client to OR with the family
c.
Allow client to get up to go to the comfort room
d.
Obtain consent form

63.

It is the responsibility of the pre-op nurse to do skin prep for patient undergoing surgery. If hair at the operative site is not shaved, what should be
done to make suturing easy and lessen chance of incision infection?
a.
Drape
b.
Pulled
c.
Clipped
d.
Shampooed

64.

It is also the nurses function to determine when infection is developing in the surgical incision. The perioperative nurse observe for what signs of
impending infection?
a.
Localized heat and redness
b.
Serosanguinous exudates and skin blanching
c.
Separation of the incision
d.
Blood clots and scar tissue are visible

65.

Which of the following nursing interventions is done when examining the incision would and changing the dressing?
a.
Observe the dressing and type and odor of drainage if any
b.
Get patients consent
c.
Wash hands
d.
Request the client to expose the incision wound

Situation 13: The pre-operative nurse collaborates with the client significant others, and healthcare providers.
66.

To control environmental hazards in the OR, the nurse collaborates with the following departments EXCEPT:
a.
Biomedical division
b.
Chaplaincy services
c.
Infection control committee
d.
Pathology department

67.

An air crash occurred near the hospital leading to a surge of trauma patient. One of the last patients will need surgical amputation but there are no
sterile surgical equipments. In this case, which of the following will the nurse expect?
a.
Equipments needed for surgery need not be sterilized if this is an emergency necessitating life saving measures
b.
Forwarding the trauma client to the nearest hospital that has available sterile equipments is appropriate
c.
The nurse will need to sterilize the item before using it to the client using the regular sterilization setting at 121 degree Celsius in 15 minutes
d.
In such cases, flash sterilizer will be used at 132 degrees Celsius in 3 minutes

68.

Tess, the PACU nurse, discovered that Malou, who weighs 110 lbs. prior to surgery, is in severe pain 3 hours after cholecystectomy. Upon checking
the chart, Malou found out that she has an order of Demerol 100mg I.M. prn for pain. Tess should verify the order with
a.
nurse supervisor
b.
anesthesiologist
c.
surgeon
d.
intern on duty

69.

Rosie, 57, who is diabetic, is for debridement for incision of wound. When the circulating nurse checked the present IV fluid, she found out that there
is no insulin incorporated as ordered. What should the circulating nurse do?
a.
Double check the doctors order and call the attending MD
b.
Communicate with the ward nurse to verify if insulin was incorporated or not
c.
Communicate with the client to verify if insulin was incorporated
d.
Incorporate insulin as ordered

70.

The documentation of all nursing activities performed is legally and professionally vital. Which of the following should NOT be included in the
patients chart?
a.
Presence of prosthetoid devices such as dentures, artificial limbs, hearing aid, etc
b.
Baseline physical, emotional, and psychosocial data
c.
Arguments between nurses and payments regarding treatments
d.
Observed untoward signs and symptoms and interventions including contaminant intervening factors

Situation 14: Team effort is the best demonstrated in the OR.

71.

If you are the nurse in charge for scheduling surgical cases, what important information do you need to ask the surgeon?
a.
Who is your internist?
b.
Who is your assistant and anesthesiologist, and what is your preferred time and type of surgery?
c.
Who are your anesthesiologist, internist and assistant?
d.
Who is your anesthesiologist?

72.

In the OR< the nursing tandem for every surgery is:

a.
Instrument technician and circulating nurse
b.
Nurse anesthetist, nurse assistant, and instrument technician
c.
Scrub nurse and nurse anesthetist
d.
Scrub and circulating nurses

73.

While team effort is needed in the OR for efficient and quality patient care delivery, we should limit the number of people in the room for infection
control. Who comprises this team?
a.
Surgeon, anesthesiologist, scrub nurse, radiologist, orderly
b.
Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
c.
Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
d.
Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

74.

Who usually act as an important part of the OR personnel by getting the wheelchair or stretcher, and pushing them towards the operating room?
a.
Orderly/clerk
b.
Nurse supervisor
c.
Circulating nurse
d.
Anesthesiologist

75.

The breakdown in teamwork is often times a failure in

a.
Electricity
b.
Inadequate supply
c.
Leg work
d.
Communication

Situation 15: Basic knowledge on Intravenous solutions in necessary for care of clients with problems with fluid and electrolytes.
76.

A client involved in a motor vehicle crash presents to the emergency department with severe internal bleeding. The client is severely hypotensive
and unresponsive. The nurse anticipates which of the following intravenous solutions will most likely be prescribed to increase intravascular volume,
replace immediate blood loss and increase blood pressure?
a.
0.45% sodium chloride
b.
Normal saline solution
c.
0.33% sodium chloride
d.
Lactated ringers solution

77.

The physician orders the nurse to prepare an isotonic solution. Which of the following IV solution would the nurse expect the intern to prescribe?
a.
5% dextrose in water
b.
10% dextrose in water
c.
0.45% sodium chloride
d.
5% dextrose in 0.9% sodium chloride

78.

The nurse is making initial rounds on the nursing unit to assess if the condition of assigned clients. The nurse notes that the clients IV site is cool,
pale, and swollen and the solution is not infusing. The nurse concludes that which of the following complications has been experienced by the client?
a.
Infection
b.
Phlebitis
c.
Infiltration
d.
Thrombophlebitis

79.

A nurse reviews the clients electrolyte laboratory report and notes that the potassium level is 3.2 mEq/L. Which of the following would the nurse note
on the electrocardiogram as a result of the laboratory value?
a.
U waves
b.
Absent P waves
c.
Elevated T waves
d.
Elevates ST segment

80.

One patient had a runaway IV of 50% dextrose. To prevent temporary excess of insulin or transient hyperinsulin reaction, what solution you prepare
in anticipation of the doctors order?
a.
Any iv solution available to KVO
b.
Isotonic solution
c.
Hypertonic solution
d.
Hypotonic solution

81.

An informed consent is required for

a.
Closed reduction of a fracture
b.
Insertion of intravenous catheter
c.
Irrigation of the external ear canal
d.
Urethral catheterization

82.

Which of the following is not true with regards to the informed consent?
a.
It should describe different treatment alternatives
b.
It should contain a thorough and detailed explanation of the procedure to be done
c.
It should describe the clients diagnosis
d.
It should give an explanation of the clients prognosis

83.

You know that the hallmark of nursing accountability is the

a.
Accurate documentation and reporting

b.
c.
d.

Admitting your mistakes

Filling an incidence report
Reporting a medication error

84.

A nurse is assigned to care for a group of clients. On review of the clients medical records, the nurse determined that which client is at risk for
excess fluid volume?
a.
The client taking diuretics
b.
The client with renal failure
c.
The client with an ileostomy
d.
The client who requires gastrointestinal suctioning

85.

A nurse is assigned to care for a group of clients. On review of the clients medical records, the nurse determines that which client is at risk for
deficient fluid volume?
a.
A client with colostomy
b.
A client with congestive heart failure
c.
A client with decreased kidney function
d.
A client receiving frequent wound irrigation

Situation 16: As a perioperative nurse, you are aware of the correct processing methods for preparing instruments and other devices for patient use to prevent
infection.
86.

As an OR nurse, what are your foremost considerations for selecting chemical agent for disinfection?
a.
Material compatibility and efficiency
b.
Odor and availability
c.
Cost and duration of disinfection process
d.
Duration of disinfection and efficiency

87.

Before you use a disinfected instrument, it is essential that you

a.
Rinse with tap water followed by alcohol
b.
Wrap the instrument with sterile water
c.
Dry the instrument thoroughly
d.
Rinse with sterile water

88.

You have a critical heat labile instrument to sterilize and are considering to use high level disinfectant. What should you do?
a.
Cover the soaking vessel to contain the vapor
b.
Double the amount of high level disinfectant
c.
Test the potency of the high level disinfectant
d.
Prolong the exposure time according to manufactures direction

89.

To achieve sterilization using disinfectants, which of the following is used?

a.
Low level disinfectants immersion in 24 hours
b.
Intermediate level disinfectants immersion in 12 hours
c.
High level disinfectants immersion in 1 hour
d.
High level disinfectant immersion in 10 hours

90.

Bronchoscope, thermometer, endoscope, ET tube, cytoscope are all BEST sterilized using which of the following?
a.
Autoclaving at 121 degree Celsius in 15 minutes
b.
Flash sterilizer at 132 degree Celsius in 3 minutes
c.
Ethylene oxide gas aeration for 20 hours
d.
2% glutaraldehyde immersion for 10 hours

Situation 17: The OR is divided into three zones to control traffic flow and contamination.
91.

What OR attires are worn in the restricted area?

a.
Scrub suit, OR shoes, head cap
b.
Head cap, scrub suit, mask, OR shoes
c.
Mask, OR shoes, scrub suit
d.
Cap, mask, gloves, shoes

92.

Nursing intervention for a patient on low dose IV insulin therapy includes the following EXCEPT:
a.
Elevation of serum ketones to monitor ketosis
b.
Vital signs including BP
c.
Estimates serum potassium
d.
Elevation of blood glucose levels

93.

The doctor ordered to incorporate 1000 u insulin to the remaining on going IV. The strength is 500/ml. How much should you incorporate into the IV
solution?
a.
10 ml
b.
2 ml
c.
0.5 ml

d.

5 ml

94.

Multiple vial-dose-insulin when in use should be

a.
Kept at room temperature
b.
Kept in the refrigerator
c.
Kept in narcotic cabinet
d.
Store in freezer

95.

Insulins using insulin syringe are given using how many degrees of needle insertion?
a.
45
b.
180
c.
90
d.
15

Situation 18: Maintenance of sterility is an important function a nurse should perform in any OR setting.
96.

Which of the following is true with regards to sterility?

a.
Sterility is time related. Items are not considered sterile after a period of 30 days of being not used
b.
For 9 months, sterile items are considered sterile as long as they are covered with sterile muslin cover and stored in a dust proof covers
c.
Sterility is event related, not time related
d.
For 3 weeks, items double covered with muslin are considered sterile as long as they have undergone the sterilization process

97.

2 organizations endorsed that sterility are affected by factors other than the time itself. These are:
a.
The PNA and the PRC
b.
AORN and JCAHO
c.
ORNAP and MCNAP
d.
MMDA and DILG

98.

All of this factors affect the sterility of the OR equipments. These are the following except:
a.
The material used for packaging
b.
The handling of the materials as well as its transport
c.
Storage
d.
The chemical or process used in sterilizing the material

99.

When you say sterile, it means:

a.
The material is clean
b.
The material as well as the equipments are sterilized and had undergone a rigorous sterilization process
c.
There is a black stripe on the paper indicator
d.
The material has no microorganism nor spores present that might cause an infection

100. In using liquid sterilizer versus autoclave machine, which of the following is true?
a.
Autoclave is better in sterilizing OR supplies versus liquid sterilizer
b.
They are both capable of sterilizing the equipments, however, it is necessary to soak supplies in the liquid sterilizer for a longer period of time
c.
Sharps are sterilized using autoclave and not cidex
d.
If liquid sterilizer is used, rinsing it before using is not necessary
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