Beruflich Dokumente
Kultur Dokumente
You are given one minute per question. Spend your time wisely!
Answers and rationales (if any) are given below. Be sure to read them.
If you need more clarifications, please direct them to the comments section.
Questions
EXAM MODE
PRACTICE MODE
TEXT MODE
In Text Mode: All questions and answers are given for reading and answering at your own pace. You can
also copy this exam and make a print out.
Situation 1 – Concerted work efforts among members of the surgical team is essential to the success of
the surgical procedure.
1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a
need for sterile supply which is not in the sterile field, who hands out these items by opening its outer
cover?
a. Circulating nurse
b. Anesthesiologist
c. Surgeon
d. Nursing aide
2. The OR team performs distinct roles for one surgical procedure to be accomplished within a
prescribed time frame and deliver a standard patient outcome. White the surgeon performs the surgical
procedure, who monitors the status of the client like urine output, blood loss?
a. Scrub nurse
b. Surgeon
c. Anesthesiologist
d. Circulating nurse
3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of
the floor or ward where the patient is confined. For orthopedic cases, what department is usually
informed to be present in the OR?
a. Rehabilitation department
b. Laboratory department
c. Maintenance department
d. Radiology department
4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team who else
to be present when a client undergoes laparoscopic surgery?
a. Information technician
b. Biomedical technician
c. Electrician
d. Laboratory technician
5. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to
be alerted to coordinate closely with the patient’s family for immediate blood component therapy?
a. Security Division
b. Chaplaincy
d. Pathology department
Situation 2 – You are assigned in the Orthopedic Ward where clients are complaining of pain in varying
degrees upon movement of body parts.
6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain. Which
of the following observation would prompt you to call the doctor?
7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at 5 pm.
The next dose of Demerol 50 mg I.M. is given:
c. At 11pm
d. At 12pm
8. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors-indicate
appropriate adaptation?
a. The client reports pain reduction and decreased activity
9. Pain in Ortho cases may not be mainly due to the surgery. There might be other factors such as
cultural or psychological that influence pain. How can you alter these factors as the nurse?
a. Explain all the possible interventions that may cause the client to worry.
d. Promote client’s sense of control and participation in pain control by listening to his concerns
10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your
nursing priority care in such a case?
Situation 3 – Records are vital tools in any institution and should be properly maintained for specific use
and time.
11. The patient’s medical record can work as a double-edged swords. When can the medical record
become the doctor’s/nurse worst enemy?
a. When the record is voluminous
c. When it is missing
12. Disposal of medical records in government hospitals/institutions must be done in close coordination
with what agency?
13. In the hospital, when you need-the medical record of a discharged patient for research, you will
request permission through:
a. Doctor in charge
14. You readmitted a client who was in another department a month ago. Since you will need the
previous chart, from whom do you request the old chart?
15. Records Management and Archives Offices of the DOH is responsible for implementing its policies on
record, disposal. You know that your institution is covered by this policy it;
Situation 4 – 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 to patient delivery outcome.
16. Which of the following should be given highest priority when receiving patient in the OR?
17. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but
considered ‘dirty cases’. When are these; procedures best scheduled?
a. Last case
b. In between cases
18. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing care
during the intraoperative phase. As the circulating nurse, you make certain that throughout the
procedure…
c. strap made of strong non-abrasive material are fastened securely around the joints of the knees and
ankles and around the 2 hands around an arm board
19. Another nursing check that should not be missed before the induction of general anesthesia is:
20. Some different habits and hobbies affect postoperative respiratory function. If your client smokes 3
packs of cigarettes a day for the part 10 years, you will anticipate increased risk for:
21. Which of the following role would be the responsibility of the scrub nurse?
c. Account for the number of sponges, needles, supplies, Used during the surgical procedure
22. As a perioperative nurse, how can you best meet the safety need of the client after administering
preoperative narcotic?
a. Put side rails up and ask client not to get out of bed
23. It is the responsibility of the pre-op, nurse to do skin prep for patients 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. Draped
b. Pulled
c. Clipped
d. Shampooed
24. It is also the nurse’s function to determine when infection is developing in the surgical incision. The
perioperative nurse should observe for what signs of impending infection?
25. Which of the following nursing intervention is done when examining the incision wound and
changing the dressing?
c. Wash hands
Situation 6 – Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min and he
appears to be in acute respiratory distress.
b. Promote expectoration
d. Suppress cough
28. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction will
include the following EXCEPT:
29. The asthmatic client asked you what breathing technique he can best practice when asthmatic attack
starts. What will be the best position?
30. As a nurse you are always alerted to monitor status asthmaticus who will likely and initially manifest
symptoms of:
a. metabolic alkalosis
b. respiratory acidosis
c. respiratory alkalosis
d. metabolic acidosis
Situation 7 – Joint Commission on Accreditation of Hospital Organization (JCAHO) patient safety goals
and requirements include the care and efficient use of technology in the OR arid elsewhere in the
healthcare facility.
31. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm systems?
32. Over dosage of medication or anesthetic can happen even with the aid of technology like infusion
pump, sphygmomanometer, and similar devices/machines. As a staff, how can you improve the safety of
using infusion pumps?
b. Select your brand of infusion pump like you do with your cellphone
33. JCAHO’s universal protocol for surgical and invasive procedures to prevent wrong site, wrong person,
and wrong procedures/surgery includes the following EXCEPT:
a. Mark the operative site if possible
34. You identified a potential risk of pre and postoperative clients. To reduce the risk of patient harm
resulting from fall, you can implement the following EXCEPT:
a. Assess potential risk of fail associated with the patient’s the following EXCEPT: medication regimen
b. Take action to address any identified risks through Incident Report (IR)
35. As a nurse you know you can improve on accuracy of patient’s identification by 2 patient identifiers,
EXCEPT:
a. identify the client by his/her wrist tag and verify with family members
36. 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?
37. In the OR, the nursing tandem for every surgery is:
38. 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 comprise this team?
39. When surgery is on-going, who coordinates the activities outside, including the family?
a. Orderly/clerk
b. Nurse supervisor
c. Circulating nurse
d. Anaesthesiologist
40. The breakdown in teamwork is often times a failure in:
a. Electricity
b. Inadequate supply
c. Leg work
d. Communication
41. Skin care around the stoma is critical. Which of the following is not indicated as a skin care barriers?
c. Clean the area daily with soap and water before applying bag
42. What health instruction will enhance regulation of a colostomy (defecation) of clients?
c. Liquid stool
44. The following are appropriate nursing interventions during colostomy irrigation EXCEPT:
a. Increase the irrigating solution flow rate when abdominal cramps is felt
45. What sensation is used as a gauge so that patients with ileostomy can determine how often their
pouch should be drained?
a. Sensation of taste
b. Sensation of pressure
c. Sensation of smell
d. Urge to defecate
Situation 10 – As a beginner in research, you are aware that sampling is an essential element of the
research process.
a. Control group
b. Study subjects
c. General population
d. Universe
a. Randomization
b. Appropriate location
c. Appropriate number
d. Representativeness
49. Which of the following sampling methods allows the use of any group of research subject?
a. Purposive
b. Convenience
c. Snow-bail
d. Quota
50. You decided to include 5 barangays in your municipality and chose a sampling method that would get
representative samples from each barangay. What should be the appropriate method for you to use in
this care?
a. Cluster sampling
b. Random sampling
c. Stratifies sampling
d. Systematic sampling
Situation 11 -After an abdominal surgery, the circulating and scrub nurses have critical responsibility
about sponge and Instrument count.
52. What major supportive layer of the abdominal wall must be sutured with long tensile strength such
as cotton or nylon or silk suture?
a. Fascia
b. Muscle
c. Peritoneum
d. Skin
53. Like sutures, needles also vary in shape and uses. If you are the scrub nurse for a patient who is
prone to keloid formation and has a low threshold of pain, what needle would you prepare?
a. Round needle
b. A traumatic needle
d. Tapered needle
54. Another alternative “suture” for skin closure is the use of:
a. Staple
b. Therapeutic glue
c. Absorbent dressing
d. invisible suture
55. Like any nursing interventions, counts should be documented. To whom does the scrub nurse report
any discrepancy of country so that immediate ‘and appropriate action in instituted?
a. Anesthesiologist
b. Surgeon
c. Or nurse supervisor
d. Circulating nurse
Situation 12 – As a nurse, you should be aware and prepared of the different roles you play.
56. What role do you play, when you hold all clients’ information entrusted to you in the strictest
confidence?
a. Patient’s advocate
b. Educator
c. Patient’s Liaison
d. Patient’s arbiter
57. As a nurse, you can help improve the effectiveness of communication among healthcare givers
58. As a nurse, your primary focus in the workplace is the client’s safety. However, personal safety is also
a concern. You can communicate hazards to your co-workers through the use of the following EXCEPT:
a. Formal training
b. Posters
59. As a nurse, what is one of the best way to reconcile medications across the continuum of care?
b. Communication a complete list of the patient’s medication to the next provider of service
c. Endorse in writing
d. Endorse the routine and ‘stat’ medications every shift
60. As a nurse, you protect yourself and co-workers from misinformation and misrepresentations
through the following EXCEPT:
a. Provide information to clients about a variety of services that can help alleviate the client’s pain and
other conditions
b. Advising the client, by virtue of your expertise, that which can contribute to the client’s well-being
c. Health education among clients and significant others regarding the use of chemical disinfectant
61. A one-day postoperative abdominal surgery client has been complaining of severe throbbing
abdominal pain described as 9 in a 1-10 pain rating. Your assessment reveals bowel sounds on all
quadrants and the dressing is dry and intact. What nursing intervention would you take?
62. Pentoxicodone 5 mg IV every 8 hours was prescribed for post abdominal pain. Which will be your
priority nursing action?
b. Advise the client to close the lips and avoid deep breathing and talking
64. Surgical pain might be minimized by which nursing action in the OR:
b. Prolonged surgery
d. Inadequate anesthetic
Situation 14 – You were on duty at the medical ward when Zeny came in for admission for tiredness, cold
intolerance, constipation, and weight gain. Upon examination, the doctor’s diagnosis was
hypothyroidism.
66. Your independent nursing care for hypothyroidism includes:
67. As the nurse, you should anticipate to administer which of the following medications to Zeny who is
diagnosed to be suffering from hypothyroidism?
a. Levothyroxine
b. Lidocaine
c. Lipitor
d. Levophed
68. Your appropriate nursing diagnosis for Zeny who is suffering from hypothyroidism would probably
include which of the following?
69. Myxedema coma is a life threatening complication of long standing and untreated hypothyroidism
with one of the following characteristics.
a. Hyperglycemia
b. hypothermia
c. hyperthermia
d. hypoglycemia
70. As a nurse, you know that the most common type of goiter is related to a deficiency
a. thyroxine
b. thyrotropin
c. iron
d. iodine
Situation 15 – Mrs. Pichay is admitted to your ward. The MD ordered “Prepared for thoracentesis this pm
to remove excess air from the pleural cavity.”
71. Which of the following nursing responsibility is essential in Mrs. Pichay who will undergo
thoracentesis?
d. Ascertain if chest x-rays and other tests have been prescribed and completed
72. Mrs. Pichay, who is for thoracentesis, is assisted by the nurse to any of the following positions,
EXCEPT:
a. straddling a chair with arms and head resting on the back of the chair
b. lying on the unaffected side with the bed elevated 30-40 degrees
c. lying prone with the head of the bed lowered 15-30 degrees
d. sitting on the edge of the bed with her feet supported and arms and head on a padded overhead table
73. During thoracentesis, which of the following nursing intervention will be most crucial?
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
74. To prevent leakage of fluid in the thoracic cavity, how wilt you position the client after thoracentesis?
d. On bed rest
75. Chest x-ray was ordered after thoracentesis. When you client asks what is the reason for another
chest x-ray, you will explain:
c. to decongest
76. You are initiate an IV line to your patient, Kyle, 5, who is febrile. What IV administration set will you
prepare?
b. Macroset
c. Volumetric chamber
d. Microset
77. Kyle is diagnosed to have measles. What will your protective personal attire include?
a. Gown
b. Eyewear
c. Face mask
d. Gloves
78. What will you do to ensure that Kyle, who is febrile, will have a liberal oral fluid intake?
c. Provide a calibrated pitcher of drinking water and juice at the bedside and monitor intake and output
79. Before bedtime, you want to ensure Kyle’s safety in ‘bed. You will do which of the following:
a. Put the lights on
80. Kyle’s room is fully mechanized. What do you teach the watcher and Kyle to alert the nurse for help?
c. Call system
d. Remote control
Situation 17 – Tony, 11 years old, has ‘kissing tonsils’ and is scheduled for tonsillectomy and
adenoidectomy or T and A.
81. You are the nurse of Tony who will undergo T and A in the morning. His mother asked you if Tony will
be put to sleep. Your teaching will focus on:
a. spinal anesthesia
b. anesthesiologist’s preference
c. local anesthesia
d. general anesthesia
82. Mothers of children undergoing tonsillectomy and adenoidectomy usually ask what food prepared
and give their children after surgery. You as the nurse will say:
a. balanced diet when fully awake
83. The RR nurse should monitor for the most common postoperative complication of:
a. hemorrhage
c. esopharyngeal edema
d. epiglottis
84. The PACU nurse will maintain postoperative T and A client in what position?
85. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy.
You as the RN will make sure that the family knows to:
86. Which of the following action would be of highest priority with regards to the external shunt?
b. Instruct the client not to exercise the arm with the shunt
87. Diet therapy for Rudy, who has acute renal failure, is tow-protein, low potassium and sodium. The
nutrition instruction should include:
a. Recommend protein of high biologic value like eggs, poultry and lean meat
c. Allowing the client cheese, canned foods, and other processed food
d. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet
88. Rudy undergoes hemodialysis for the first time and was scared of disequilibrium syndrome. He asked
you how this can be prevented. Your response is:
c. initial hemodialysis shall be done for 30 minutes only so as not to rapidly remove the waste from the
blood than from the brain
d. Monitoring diet
90. A renal failure patient was ordered for creatinine clearance. As the nurse you will collect
Situation 19 – Fe is experiencing left sharp pain and occasional hematuria. She was advised to undergo
IVP by her physician.
91. Fe was so anxious about the procedure and particularly expressed her low pain threshold. Nursing
health instruction will include:
a. assure the client that the pain is associated with the warm sensation during the administration of the
Hypaque by IV
d. assure the client that x-ray procedure like IVP is only done by experts
92. What will the nurse monitor and instruct the client and significant others, post IVP?
93. Post IVP, Fe should excrete the contrast medium. You instructed the family to include more
vegetables in the diet and
b. barium enema
c. cleansing enema
d. gastric lavage
94. The IVP reveals that Fe has small renal calculus that can be passed out spontaneously. To increase the
chance of passing the stones, you instructed her to force fluids and do which of the following?
a. Balanced diet
b. Ambulance more
d. Bed rest
b. Nephrolithiasis
c. Ureterolithiasis
d. Urolithiasis
Situation 20 – At the medical-surgical ward, the nurse must also be concerned about drug interactions.
96. You have a client with TPN. You know that in TPN, like blood transfusion, there should be no drug
incorporation. However, the MD’s order read; incorporate insulin to present TPN. Will you follow the
order?
b. Yes, because insulin is chemically stable with TPN and can enhance blood glucose level
97. The RN should also know that some drugs have increased absorption when infused in PVC container.
How will you administer drugs such as insulin, nitroglycerine hydralazine to promote better therapeutic
drug effects?
98. One patient has a ‘runaway’ IV of 50% dextrose. To prevent temporary excess of insulin transient
hyperinsulin reaction, what solution should you prepare in anticipation of the doctors order?
a. Any IV solution available to KVO
b. Isotonic solution
c. Hypertonic solution
d. Hypotonic solution
100. In insulin administration, it should be understood that our body normally releases insulin according
to our blood glucose level. When is insulin and glucose level highest?
a. After excitement
c. After an exercise
Answers
Here are the answers for the exam. Unfortunately, rationales are not given. If you need clarifications or
disputes, please direct them to the comments section and we’ll be glad to give you an explanation.
A. Circulating Nurse
C. Anesthesiologist
D. Radiology department
B. Biomedical technician
C. At 11 pm
D. Promote client’s sense of control and participation in control by listening to his concerns
A. Last case
C. strap made of strong non-abrasive materials are fastened securely around the joints of the knees and
ankles and around the 2 hands around an arm board.
C. Account for the number of sponges, needles, supplies, used during the surgical procedure.
A. Put side rails up and ask the client not to get out of bed
C. Clipped
C. respiratory alkalosis
B. Who is your assistant and anesthesiologist, and what is your preferred time and type of surgery?
C. Circulating Nurse
D. Communication
A. Increased weight
A. Increase the irrigating solution flow rate when abdominal cramps is felt
B. Sensation of pressure
C. General population
B. Appropriate location
B. Convenience
C. Stratified sampling
B. Before peritoneum is closed
D. Skin
B. Atraumatic needle
A. Staple
B. Surgeon
A. Patient’s advocate
C. Endorse in writing
D. Inadequate anesthetic
A. Levothyroxine
B. Hypothermia
D. iodine
D. Ascertain if chest x-rays and other tests have been prescribed and completed
D. Orthopneic position
C. Advice patient to sit perfectly still during needle insertion until it has been withdrawn from the chest
C. Face mask
C. Provide a calibrated pitcher of drinking water and juice at the bedside and monitor intake and output
C. Call system
D. general anesthesia
A. hemorrhage
A. Avoid taking BP or blood sample from the arm with the shunt
A. Recommend protein of high biologic value like eggs, poultry and lean meats
C. initial hemodialysis shall be done 30 minutes only so as not to rapidly remove the waste from the
blood than from the brain
A. assure the client that the pain is associated with the warm sensation during the administration of the
Hypaque by IV
B. Ambulate more
D. Urolithiasis
B. Yes, because insulin is chemically stable with TPN and can enhance blood glucose level
B. Isotonic solution