B. Executive Orders
1. EO 51 - Milk code
2. EO 180 - Guidelines on the right to organize of government employees
3. EO 203 - List of regular holidays and special days
4. EO 2069 - Family code of the Philippines (amended by RA 6809)
5. EO 226 - Command responsibility
C. Board of Midwifery/Nursing Resolutions
1. #557 Series 1988 - Code of ethics for midwives
2. #100 Series 1983 - Implementing rules and regulations of RA 7392
3. #633 Series 1984 - ICN code of ethics
4. #1955 Series 1989 - PNA code of ethics
5. #08 Series 1994 - Special training on intravenous injections for the RN
6. #20 Series 1994- Implementing rules and regulations of RA 7164
7. PRC Res. #6 (July 1981) regulate review centers
D. Proclamation/Pronouncements & Letters of Instructions
1. Proc. #6 - United Nations goal on universal child immunization by 1990
2. Proc. #118 - Professional Regulation week -June 16-22
3. Proc. #539 - Nurses week - every last week of October
4. Proc. #1275 - Midwifery week - every 3rd week of October
5. LOI #949 - Legal basis of primary health care
6. LOI #1000 - Members of accredited professional organizations given preference in hiring or attendance to seminars
7. ILO Convention #149 - Improvement of life and work conditions of nursing personnel (ILO Recommendaions #157)
E. Republic Acts
1. Act 2808 - 1st True nursing law (1919); created 1st board of examiner; 1st board exam (1920)
2. RA 679 -Amends PD 148 ; women and child labor law no emplyment for 14 years old and below
3. RA 977 - Phil nursing law (1953)
4. RA 1054 - Free emergency medical treatment and dental attendance to employees/laborers of any commercial, industrial or agricultural establishments
5. RA 1080 - Civil service eligibility
6. RA 1082 - Creation of rural health units all over the Philippines
7. RA 1612 - Privilege tax/professional tax/omnibus tax
8. RA 1811 - Amends 1082 Rural health unit with 8 different categories and population groups to serve
9. RA 2382 - Philippine medical act
10. RA 2644 - Midwifery law
11. RA 3573 - Reporting communicable diseases
12. RA 4073 - Treatment of leprosy in a government skin clinic, rural health unit or by duly licensed physician
13. RA 4226 - Hospital licensure act
14. RA 4704 - 1st amendment of Philippine nursing law (1966)
15. RA 5181 - Permanent residence and reciprocity qualifications for examinations/registration
16. RA 5901 - Working hours (40 hours a week) , compensation and agencies with 100 bed capacity
17. RA 6111 - Philippine medical care act (SSS and GSIS)
18. RA 6136 - Injection and IV should be under the direction and with the presence of a doctor
19. RA 6475 - Dangerous drug act19. RA 6675 - Generics act of 1988
20. RA 6713 - Code of conduct and ethical standards for public officials and employees
21. RA 6725 - Prohibition on discrimination vs. women
22. RA 6727 - Wage rationalization
23. RA 6758 - Salary standardization of government employees
24. RA 6809 - Age of maturity is 18 years old
25. RA 6972 - Day care center in every barangay
26. RA 7160 - Local autonomy code
27. RA 7170 - Legacy of donation of all or part of human body after death
28. RA 7192 - Women in development and national building
29. RA 7277 - Magna carta for disabled persons
30. RA 7305 - Magna carta for public health workers
31. RA 7432 - Senior citizens benefits and privileges
32. RA 7600 - Rooming - in and breastfeeding act of 1992
33. RA 7610 - Special protection of children against abuse, exploitation and discrimination
34. RA 7624 - Drug education law
35. RA 7641 - New retirement law for employees in the private sector
36. RA 7658 - Law that prohibits the employment of children below 15 years of age
37. RA 7719 - National blood services act of 1994
38. RA 7875 - National health insurance act of 1995
39. RA 7876 - Senior citizen center for every barangay
40. RA 7877 - Anti-sexual harassment act of 1995
41. RA 7883 - Barangay health workers benefits and incentives act of 1992
42. RA 8042 - Migrant workers and overseas Filipino act of 1995
43. RA 8172 - Iodized salt
44. RA 8177 - Death through lethal injection
45. RA 8187 - Paternity leave act of 1995
46. RA 8282 - Social security law of 1997 (amended RA 1161)
47. RA 8291 - Government service insurance system act of 1997 (amended PD 1146)
48. RA 8344 - Hospitals/doctors to treat emergency cases referred for treatment
49. RA 8423 - The traditional and alternative medicine act (TAMA) of 1997
50. RA 8424 - Personal tax exemptions
51. RA 8493 - Herbal drafted
52. RA 8749 - Clean air act of 1999
53. RA 8976 - National food fortification
54. RA 8981 - PRC modernization act of 2000
55. RA 9003 - The ecological solid waste management act of 2000
56. RA 9165 - The comprehensive dangerous drugs act
57. RA 9173 - The Philippine nursing act of 2002
58. RA 9211 - Tobacco regulation
59. RA 9255 - Act allowing illegitimate children to use the surname of their father (amends RA 176 and EO 2069 - Family code of the Philippines)
60. RA 9257 - Expanded senior citizen act
61. RA 9262 - The anti-violence against women and children act of 2004
62. RA 9288 - Newborn screening

Herbal Medicine

1. Lagundi - Vitex negundo - For asthma and cough
2. Ulasimang Bato - Peperonica pellucida - For rheumatoid and gout arthritis
3. Bayabas - Psidium guavaja L. - For diarrhea, toothache and wound washing
4. Bawang - Allium sativum - For hypertension, toothache and lowers cholesterol
5. Yerba Buena - Mentha cordifelia - For cough, cold, insect bites, headache and stomach ache
6. Sambong - Blumea balsamifera - For urolithiasis, diuretics/anti-edema
7. Akapulko - Cassia alata L. - For skin disease, anti-fungal
8. Niyugniyogan - Quisqualis indica L. - Antihelmentic/ parasitism
9. Tsaang gubat - Carmona retusa - For diarrhea, stomach ache, infantile colic and replacement for flouride
10. Ampalaya - Momordica charantia L. - For DM Type II

ONCOLOGY

Oncology- treatment / management of cancer
Neo-new
Plasma-growth
Trophy-size
Toma-tumor
Statis-location
Colon cancer-depends on stage, extent or disease. Stage I, II, III
A-non
Ana-lack
Hyper-excessive
Meta-change
Dys-bad, deranged

Exam on Foundation of Professional Nursing Practice

Situation A: A nurse utilizes the nursing process in managing patient care. Knowledge of this process is essential to deliver high quality care and to focus on the client's response to their illness.

1. During the planning phase of the nursing process, which of the following is the product developed?
a. Nursing diagnosis
b. Nursing notes
c. Nursing history
d. Nursing care plan

2. Objective data are also known as:
a. Inferences
b. Covert data
c. Symptoms
d. Overt data

3. Data or information obtained from the assessment of a patient is primarily used by the nurse to:
a. Identify the patient's disease process
b. Ascertain the patient's response to health problems
c. Determine the effectiveness of the doctor's order
d. Assist in constructing the taxonomy of nursing intervention

4.What is an example of a subjected data?
a. Respiration of 14 breaths per minute
b. Color of wound drainage
c. Odor of breath
d. The patient's statment of "I feel sick to my stomach".

5.Which statement is a difference between comprehensive and focussed assessment?
a. Objective datas are only in comprehensive assessment
b. Focissed assessment are usually ongoing and concerning specific problems
c. Comprehensice assessments can't include any focus assesments
d. Focused assessments are more important than comprehensive assessessments


Answers on Foundation of Professional Nursing Practice
1. a
2. a
3. c
4. d
5. b


Exam on Physiologic and Psychosocial Alterations


Situation 1- Nurse's collaboration and teamwork

1. The most important role of the nurse as a member of the team is to :
a. Meet the needs for the physical well being of patients
b. Carry out medical orders
c. Keep a 24 hour watch for the patients
d. Coordinate the psychological care and management of clients

2. A biological/medical approach to patient care utilizes which of the following:
a. Somatic therapy
b. Milleu therapy
c. Behavioral therapy
d. Psychotherapy

3.Which of these nursing actions belong to the secondary level of preventive intervention:
a. Providing emergency psychiatric services
b. Providing mental health consultation to health care providers
c. Being politically active in relation to mental health issues
d. Providing mental health education to members of the community

4.When the nurse identifies a client who has attempted to commit suicide, the nurse should call:
a. Counsel the client
b. Call a priest
c. Refer the client to the psychiatrist
d. Refer the matter to the police

5. The community health nurse was invited by the principal of an elementary school and was asked to give a talk to parents. an appropriate topic would be:
a. How to discipline children at home and at school
b. The legal aspect of drug abuse
c. Marital crises
d. The problem of out of school youth

Situation 2. Ben, age 25, recalled that his problem began around age 15 or 16. He would always count pencils in a mug with the thought that stopping it might result to something bad happening
6. There are lots of things Ben seems to think to keep himself from feeling
a. Anxious
b. Excited
c. Suspicious
d. Confused

7. He has to change clothes 20 times before work, chew each bite he eats 25 times and go up and down the stairs 5 times before he feels alright. He is demonstrating:
a. Obsession and compulsion
b. Ideas of reference
c. Denial and projection
d. Rationalization and over reaction

8.The objective of nursing care for Ben is to develop:
a. Self- worth
b. Self- mastery
c. Self- actualization
d. Self- determination

9. All of these are therapeutic interventions except:
a. Establish a routine for him
b. Assign task that can be done repetitively
c. Facilitate self- expression
d. Impose limits every time the behavior becomes repetitive

10. Ben is aware of his behavior, yet realizes that it is very disturbing to him . This is a pattern of
a. Habitual disorder
b. Neurosis
c. Personality disorder
d. Psychosis

Situation 3. The nurse visited the Ramos family to check on their 2 growing children , aged 7 and 4 years old. Upon her visit she observed an argument between Mr. and Mrs. Ramos on conflicting ways of bringing up their children. Mrs. Ramos is lax and tolerant while Mr. Ramos insists on strict ways to a point of being over protective from which he perceives community and neighbors cannot be trusted.
11. Mr. Ramos remarked " I am wary about people visiting with all the media news about kidnapping and robberies". The best response would be:
a. It must be distressing to think and feel the way you do
b. I acknowledge what you are saying but my concern is the health care of your family and information are strictly confidential.
c. I get that. Then the nurse divert the attention to talk about non-threatening topics.
d. Would you rather wish that I do not visit you and you regard me as a stranger?

12.Mrs. Ramos expressed that she cannot socialize with her neighbors because her husband thinks that she is getting overly friendly to a guy next door. Which of the following would the nurse emphasize as basic?
a. Avoid relating with neighbors to minimize conflict
b. Keeping trust in the relationship
c. Ignore the husband
d. Be assertive to express individuality

13. For the nurse to be effective in developing rapport with the family, it is essential that she keeps her appointment on time and stick to a care plan. She is applying the principle of:
a. Consistency and integrity
b. Honesty and integrity
c. Responsibility and accountability
d. Empathy and compassion

14. Which of these symptoms if demonstrated by Mrs. Ramos would necessitate referral to a doctor:
a. Submission affect
b. Hypersensitive
c. Loss of reality contact
d. Hypervigilance

15. The paranoid client utilizes which of the following defense mechanism:
a. Reaction formation
b. Projection
c. Sublimation
d. Rationalization

Situation 4. It is the nurse primary responsibility to ensure a safe environment for the patients at the psychiatry ward.
16. All of the following are true except :
a. Hostility is destructive
b. Frustration develops in response in response to needs, wants and desires
c. Aggression can be expressed in a constructive as well as in a destructive manner
d. Anger is compatible with love

17. Ian acts hostile and aggressive. He kicks the chairs in the room. The most effective way to deal with his behavior initially is to :
a. Restrain the patient and place him in the isolation room.
b. Remove the chairs in the room
c. Administer prn tranquilizer
d. Set limits on the behavior by verbal command

18. Mrs. Castro was visiting her son at the psychiatry ward. Which of the following items will the nurse not allowed to be brought inside:
a. Rubber shoes
b. String rosary bracelet
c. Box of cake
d. Bottle of softdrinks

19. Which of the following will probably be the most therapeutic for a patient on a behavioral modification ward:
a. Give client support and positive feedback for controlling the use of obscene language
b. Insist to stop obscene language by verbal reprimand
c. Provide a punching bag as an alternative to express upset emotions
d. If the client is agitated discuss the feeling of anger

20.Which of the following must be considered while planning activities for the depressed patient:
a. Reading materials to divert his thoughts
b. Activities requiring exertion of energy
c. Variety of unstructured activities
d. Challenging activities to get him out of depression

Situation 5. Mr. Moises has been diagnosed as having early chronic glaucoma. He has been admitted to the hospital for treatment.
21. The nurse identified a problem of disturbed sensory perception, visual impairment characterized by:
a. Sudden loss of eyesight
b. Loss of night vision
c. Loss of peripheral vision
d. Loss of central vision

22. In order to understand the rationale for drug therapy, it is important for the nurse to know that glaucoma is usually caused by:
a. Increased production of aqueous liquid
b. Damage to the problems in the lens
c. Gradual diminution of the retina
d. Opacity of the lens

23. Diamox is a drug used in the treatment of glaucoma. Which of these is the effect of this drug.
a. It acts as osmotic diuretics
b. It reduces the production of aqueous humor
c. It facilitates the flow of aqueous humor
d. It constricts the pupils

24. Public health nurses should identify which of these risk group for development of glaucoma has the need for annual eye examinations.
a. Patients with COPD
b. Diabetics and hypertensive patients
c. Patients with Parkinson's disease
d. Cancer patients

25. The appropriate way of using eye drops is to instill it into an open eye with the head held back and with the eyes looking
a. To the right
b. Upward
c. Downward
d. To the left

Situation 6. A vehicle hit some pedestrians while waiting for a bus ride. Some of the victims suffered injuries in the different parts of their bodies. The victims were brought to the nearby hospital. One of the victims, Meralyn was confirmed to have a fractured left arm. While waiting for the plaster cast to be applied, Meralyn appears to be anxious.
26. To reduce anxiety, the nurse teaches the procedures to the client. Which of the following topics should not be included in the teaching plan:
a. Handle hardening cast with palms of hands
b. Leave cast uncovered to promote drying
c. Trim and reshape finish cast with with knife or cutter
d. Bear weight on the plaster cast for one hour. A stocknet will be place over the left arm to be place in cast

27. Cast was applied on Meralyn's left arm. In assessing the neurovascular status of the client, which of the following assessment findings should be reported to the physician:
a. Swelling of the fingers
b. Nail bed capillary refill time of 10 seconds
c. Pain on the left arm
d. Skin abrasions on the edges of the plaster cast

28.One of the victims, a sixty year old woman sustained hip fracture. prior to surgery a Buck's extension traction is to be applied. The rationale for the application of traction is primarily based on the understanding that Buck's extension traction:
a. Secures the fracture site for rigid immoblization.
b. Secures the fracture site to prevent damage to the muscle tissues.
c. Allows reduction of the fracture site for bone healing.
d. Reduces muscle spasms and helps to immobilize the fracture

29. Mark was placed in skeletal leg traction with an overbed frame. He is not allowed to move from side to side. Which of the following nursing interventions is useful in maintaining effective traction:
a. Check the apparatus that weigh hang free and knots in the rope is tied securely
b. Assist the client by holding the trapeze and raising the hips off the bed
c. Suspend a trapeze within easy reach to the client
d. Support the affected extremity while the weights are removed

30. To prevent complications when a child is in a Buck's traction, the nurse should:
a. Assess any skin and circulatory disturbances
b. Provide high fiber small diet
c. Clean the pin sites as necessary
d. Clean the extremity and keep the skin dry

Situation 7. Del has morbid morbid fear of heights. She asks the nurse what desensitization therapy is:
31. The accurate information of the nurse of desensitization goal is:
a. To help the client cope up with their problems by learning behaviors that are more functional and to be better equipped in facing reality and making decisions.
b. To help the client relax and progressively work out a list of anxiety provoking situations through imagery
c. To help the client in a group therapy setting take specific roles and reenacts in front of an audience
d. To help the client by providing emotional experience through a one-on-one intensive relationship

32. It is essential in desensitization for the patient to:
a. Use deep breathing and other relaxation techniques
b. Assess a need for an anxiolytic drug
c. Have rapport with the therapist
d. Work through unresolved unconscious conflict

33. In this level of anxiety, cognitive capacity diminishes, focus becomes limited and client experiences tunnel vision. Physical signs of anxiety becomes more pronounced
a. Mild anxiety
b. Severe anxiety
c. Panic
d. Mild anxiety

34. Anti-anxiety medications should be use with extreme caution because long term use can lead to :
a. Hypertensive crisis
b. Risk of addiction
c. Hepatic failure
d. Hypertensive crisis

35. The nursing management of anxiety related with post traumatic stress disorder includes all of the following except:
a. Remain with the client while fear level is high
b. Encourage participation in recreation or sports activities
c. Reassure client's safety while touching him
d. Speak in a calm soothing voice

Situation 8. Sexual disorder
36. A male adolescent patient flirts and sexually provokes a female nurse. The nurse can respond most therapeutically by doing which of the following:
a. Introducing him to female clients his own age
b. Ignoring his flirtatious and provocative behaviors
c. Encouraging him to watch TV in his room
d. Telling him she is married and too old for him

37. The premorbid personality of a patient with a non psychotic maladaptive response to anxiety may most accurately be described as:
a. Dependent , pessimistic and moody
b. Unpredictable, impulsive and aggressive
c. Anxious , insensitive and self-absorbed
d. Rigid, insecure and conforming

38. An oral dependent personality is characterized by which of the following:
a. Hopelessness
b. Suspiciousness
c. Helplessness
d. Aggressiveness

39. The pedophile's choice of a sex object is primarily based on :
a. Preferred for passive sexual role
b. Fears of incestious impulses
c. Difficulty relating with adults
d. Feelings of tenderness towards children

40. A young adult male unable to stay put in one job and has no commitment in his relationship is having difficulty achieving a sense of:
a. Trust
b. Autonomy
c. Intimacy
d. Industry

Situation 9. A nurse assigned in the neurologic unit is taking care of the client with varying degrees of degenerative disorders.

41. Mr. Ang , with myasthemia gravis is having difficulty speaking. What communication strategies should the nurse avoid when interacting with Mr. Ang?
a. Encouraging the client to speak slowly.
b. Encouraging the client to speak quickly.
c. Using paper and pencil in communicating with the client.
d. Repeating what the client says for better understanding.

42. When planning a nursing care for Mr. Bo, who has Parkinson's disease which of the following goals would be most appropriate:
a. To treat the disease
b. To improve muscle tone
c. To maintain optimal body function
d. To start rehabilitation as much as possible

43. For the past 10 years, Eve, 42 years old, has had multiple sclerosis. Clients with multiple sclerosis experience different symptoms. As part of the rehabilitation planned for Eve, the nurse suggested therapy and hobbies to help her:
a. Establish routine
b. Develop perseverance and motivation
c. Establish good health habits
d. Strengthen muscle coordination

44. On the 2nd day of hospitalization, Lydia was unable to stand and is having difficulty swallowing and talking. Which of the following is the priority of the nurse in assisting Lydia:
a. To prevent contractures
b. To prevent aspiration pneumonia
c. To prevent decubitus ulcer
d. To prevent bladder distention

45. The wife of the 72 year old male with Alzheimer's disease begins to cry and tells the Nurse: "I could not understand my husband anymore. He has changed drastically." Which of the following responses of the nurse is the most appropriate?
a. "This has been a difficult time for you. Let us walk and find a place where we can talk."
b."You should not worry . We are doing everything we could."
c. "The physician and the staff will make sure that your husband will be comfortable and safe here."
d. "He will soon recover in his condition."

Situation 10. Helen is experiencing rape-trauma syndrome in an acute phase. She had been invited to a fraternity party , she had too much drink and she was raped by her date. The next day she was brought to the hospital. She has feelings of anger, humiliation, helplessness, nausea, vomiting, having nightmares and muscle tension.
46. When the nurse approached Helen , initially she was crying. She was still feeling like having a nightmare and at a great loss. The appropriate nursing diagnosis is:
a. Sexual dysfunction
b. Sexual violence
c. Situational low self-esteem
d. Ineffective coping

47. Helen told the nurse that she already douched, showered for almost half an hour and yet she still feel not clean. Helen is experiencing:
a. Frustration
b. Anger
c. Denial
d. Guilt

48. Which of these communicate unconditional acceptance of Helen's situation?
a. Why did you date a guy you hardly know?
b. Tell me when you are ready and I'll be back for you.
c. It would be alright if you will stop crying.
d. You are safe now and I am willing to listen.

49. Helen is experiencing:
a. Anticipated crisis
b. Maturational crisis
c. Situational crisis
d. Developmental crisis

50. Which of these behaviors signal Helen's readiness to proceed to the working phase of the nurse-patient relationship?
a. She wanted to know her rights.
b. She is inquiring personal information about the nurse.
c. She said that she is trusting the nurse.
d. She wanted to talk to a lawyer.

Situation 11. The purpose of the nursing care plan is to identify the care for a patient based on his problems. The nursing care plan for the patient is based on nursing care standards.
51. Problem: Anxiety due to job interview. The initial step in identifying problem is:
a. Analyze the data
b. Gather the data
c. Determine if the problem is unusual
d. Analyze the problem concisely

52. Openly verbalize anxiety about job interview. Identify how to prepare for a job interview. Which of these is not an orientation of an expected outcome:
a. Every outcome must be is measurable
b. Every outcome answers "How to know when the patient's problem has been resolved"
c. An expected outcome is stated in terms of what the nurse will do
d. An expected outcome is stated in term of what the patient will do

53. The following are reasons for setting deadlines within which to achieve outcomes of care except:
a. Set the time by which the expected outcome should be reached
b. Plan the need for a change
c. Do not allow any changes
d. Indicate specific times to review any progress

54. Which of these is not a relevant nursing order:
a. Ask the patient how he feels about the job interview.
b. Ask the patient about the side effects of medication being taken
c. Role play the interview situation
d. Discuss preparations for the job interview

55. Which of these evaluations support nursing care. Review of care plan is:
a. The sole responsibility of the primary nurse
b. A nursing team responsibility
c. The responsibility of the therapist
d. The responsibility of the patient's parents

Situation 12. Alex was discharged from the hospital. He had recovered from a manic episode of Bipolar disorder. But then, he was readmitted with an entirely different behavior. He was very depressed this time.
56. The defense mechanism utilized by manic patients to cover up their depression is:
a. Displacement
b. Denial
c. Reaction formation
d. Compensation

57. The psychodynamics of depression is:
a. Weak superego
b. Internalized hostility feelings
c. Lax superego
d. Narcisstic personality

58. Which of these drugs is likely to be indicated to Alex:
a. Valium (Diazepam)
b. Tofranil (Imipramine HCl)
c. Serenace (Haloperidol)
d. Trilafon (Pherphenazine)

59. The therapeutic use of self is essential in relating with psychiatric patients. This is best demonstrated in:
a. Suppressing her own feelings toward Alex.
b. Sympathizing with miserable feelings of Alex.
c. Engaging Alex in introspective thinking.
d. Engaging Alex in productive activity.

60. After three days of antidepressant medication, Alex still manifests depression. The nurse evaluates this as:
a. Ineffective because perhaps the dosage of the drug is inadequate.
b. Unexpected because it takes within one week for the mediation to be effective.
c. Expected because it takes about two weeks for the medication to be effective
d. Unusual because action of antidepressant drug is immediate

Situation 13.The psychiatric mental health nurse adheres to standards that ensure quality improvement. The following situations and behaviors are means to achieve this goal.
61. This is a process wherein the client's chart is reviewed to compare criteria for quality care with actual practice.
a. Algorithms
b. Interaction process analysis
c. Nursing care process
d. Psychiatric audit

62. In order to assess reliability as a behavioral characteristic, the nurse would ask herself which of the following questions regarding her recording
a. Are the nursing history and psychosocial assessment accurate ?
b. Did the history of the present problem correlate with the review of growth and development?
c. How long did it take to complete the nursing data base?
d. Is the nursing data base complete?

63. All of these are the advantages of peer review except:
a. It requires the development of standards for quality care
b. Provides an evaluation of the nurse's abilities
c. Demands accountability for nursing actions
d. Has the possibility of enhancing intra-professional respect

64. The nursing team leader wants to invoke all the nurses in participating in their own personal and professional growth through a brainstorming session. One of the most important ground rule is:
a. Ideas must be feasible
b. Follow the problem solving approach
c. Do not pass judgment on the ideas presented
d. Suggestions must be cost effective

65. "Did the nurse perform in the possible manner without waste?", aims to describe the nurse's:
a. Efficiency
b. Thoroughness
c. Analytic sense
d. Reliability

Situation 14.The supervising nurse received report that a staff nurse is displaying frequent irritation, anger, and even indifference toward the clients and co-workers.
66. The initial action of the supervisor would be to:
a. Post a guidelines on proper decorum of nurses in the bulletin board.
b. Call the nurse for a one on one conference
c. Request anecdotal report from nurse's co-workers.
d. Write a memo of warning to the nurse

67. The nurse expressed increasing feelings of dissatisfaction. The supervising nurse intervenes therapeutically by taking the role of:
a. Therapist by delving into the nurse's internal conflicts.
b. Counselor by actively listening
c. Educator by reviewing her role as a nurse
d. Administrator by relieving her of responsibilities

68. Coupled with poor work performance, mental and physical fatigue and actual withdrawal from client contact and nursing duties, the nurse can be said to be suffering from:
a. Neurotic depression
b. Personality maladjustment
c. Psychotic anxiety
d. Staff burnout

69. A priority in the nurse's personal development program would be to:
a. Boost her self-confidence
b. Address her physical well-being
c. Help her find value and meaning in her work
d. Provide social support

70. The most relevant professional program for her would be:
a. Group dynamics and team building
b. Behavior modification
c. Assertiveness training
d. Stress management

Situation 15. For personal and professional development the nursing staff decided to hold a staff development program, "Self enhancement through Assertiveness."
71. An appropriate assessment tool to maximize gathering of needs of nurses is through:
a. Survey
b. Interview of nurses
c. Observation
d. Brainstorming sessions

72. A priority objective of the program is:
a. Role play
b. Develop art and skills of therapeutic use of self
c. Develop the art of speaking
d. Project a positive image of the nursing profession

73.The most effective way to practice assertiveness skills is through:
a. Descriptive report
b. Return demonstration
c. Role play
d. Written evaluation form

74. The least satisfactory method to evaluate the effectiveness of the program is through
a. Individual interview
b. Group discussion and report
c. Attendance
d. Return demonstration

75. Which of these feedbacks from individual participants indicate maximum gain from the staff development program?
a. "I will write a plan for personal development program."
b. " I learned a lot I hope to have more seminars of its kind."
c. "I have a 'Do it now' project for myself i.e. to approach my clinical supervisor regularly to discuss nursing care of our clients."
d. "I feel very good. The program inspired me a lot."

Situation 16. A nurse was interested to study the research question: "What are the difference and similarities between aggressive and non-aggressive cognitively impaired, elderly and institutionalized people?"
76. Investigation of cognitively impaired individual presented some ethical dilemmas. Which of the following protocol would be considered unethical?
a. Interviewer is free to robe beyond a number of specific major questions.
b. Recording interaction with the elderly's permission
c. Verbal permission from the subject is unnecessary.
d. Subject is allowed to express without any suggestion from interviewer.

77. A semi-structured interview was conducted. This means that:
a. Interviewer is not held to any specific question.
b. Interviewer is free to probe beyond a number of specific major questions.
c. Interview is conducted precisely in the same manner.
d. Subject is allowed to express without any suggestion from interviewer.

78. The type of study conducted is
a. Case study
b. Qausi-experimental
c. Descriptive
d. Case study

79. The review of literature included reference to retrospective studies. Such studies have the following advantages except:
a. It is easy to get data
b. There is much material available
c. Data are inexpensive to obtain
d. Possibility of memory bias and distortion of facts

80. The average age of respondents was 86. This represents:
a. The oldest participant is 86 years old
b. The youngest participant is 86 years old
c. Most of the number of participants is 86 years old
d. The sum ages divided by total number of participants

Situation 17. Cynthia , 26 years old, is aloof in relating with other patients and members of the staff. She claims that the medications being given meant to poison her. She is also suspicious about the food being served to her.
81. Basically, Cynthia is suspicious because of her inability to develop a sense of:
a. Initiative
b. Industry
c. Intimacy
d. Trust

82. Cynthia utilizes projection by being suspicious. This means that she:
a. Involuntarily excludes wishes, impulses, memories and feelings from awareness.
b. Justifies behavior, attitudes and feelings with excuses.
c. Unconsciously refuses to accept a feeling, thought or impulse and attributes it to someone else.
d. Involuntary refuses to acknowledge reality.

83. Which of these nursing approaches is most appropriate for the nurse to begin with?
a. Invite her to socialize with other patients.
b. Refer her to activity therapy.
c. Engage Cynthia for at least one hour in a one-to-one interaction daily.
d. Make self available while maintaining distance until patient shows readiness to interact.

84. When she resists to take her medication, it is best to:
a. Have the same nurse, who she interacts with regularly, administer the drug.
b. Request the doctor to give her medication
c. Let her read the drug literature to convince her that it is therapeutic.
d. Force her to take the drug to maintain therapeutic effectiveness of the drug

85. Another reason why she refuses to take Thorazine is because she complains of robot like movement and slurred speech. The nurse's action is:
a. Avoid giving food rich in tyramine.
b. Decrease the dosage of Thorazine.
c. Withold medications until referral is made by the doctor.
d. Explain the extrapyramidal effect and administer Benadryl.

Situation 18. Mr. Madriaga was brought to the hospital due to pain radiating to the hip and leg. He is diagnosed with herniated lumbar disk. He is scheduled for myelogram.
86.After the procedure, the nurse must include which of the following nursing action in his care:
a. Place the client in the most comfortable position.
b. Lying supine with heel flexed.
c. Promote bedrest with both feet elevated at 45 degrees.
d. Assess for movement and sensation of extremity.

87. Mr. Madriaga is scheduled for lumbar laminectomy. Post operatively the nurse should:
a. Instruct the patient to move from side to side.
b. Assess for sensory loss in both legs.
c. Logroll the client with the help of another nurse.
d. Inform the client to be in a supine position.

88. Trimethobenzamide Hydrochloride (Tigan) was administered postoperatively. The action of this drug is effective when it:
a. Controls pain
b. Controls nausea
c. Controls edema
d. Controls muscle spasm

89. Mr. Madriaga is to ambulate for the first time following following surgery. What nursing action should be best when the client begins to faint:
a. Maneuver the client to a sitting position.
b. Get back to his bed and place him in a side lying position.
c. Asist the client to form a wide base of support and lean against the nurse.
d. Call another nurse for help.

90. Mr. Madriaga has to wear back brace. Which position is recommended when the brace is applied:
a. Standing position
b. Sitting position
c. Supine position on his bed
d. Sidelying on his bed

Situation 19. Ninety year old Maria is confined at the medical unit for respiratory ailment. A breathing apparatus was prescribed for her to be use while she sleeps. She refused to use it despite understanding the medical indication.
91. Which of the following ethical principles can guide the nurse:
a. Fidelity
b. Nonmaleficence
c. Autonomy
d. Beneficence

92. Maria has 6 children who are already adults. They give their opinions on weather or not to let their mother decide for herself. The nurse should encourage family conference for:
a. The eldest opinion to be given priority.
b. Consensus building
c. The medical staff to decide
d. Majority of the children to decide

93. Breathing treatments are to be given to Maria. Dino, the eldest requests that he be allowed to sign the consent on behalf of his mother. The nurse explains that Maria is rational and her right should be considered such as:
a. Right to privacy
b. Right to informed consent
c. Right to refuse treatment
d. Right to habeas consent

94. Which would be the nurse's priority following the treatment principle of least restrictive alternative:
a. Seclusion
b. Use of on site guard/watcher
c. One to one staffing
d. Physical restraint

95. Three days after an uneventful recovery from an acute myocardial infarction a client is to be moved out of cardiac unit. The most important nursing function should be to :
a. Give the prescribed sedative before the move.
b. Inform the family of the anticipated move
c. Provide a sense of security for the client.
d. Select a room adjacent to the cardiac unit.

96 The nurse is aware that characteristic behavior in the initial stage of coping with dying includes:
a. Criticizing medical care.
b. Crying uncontrollably.
c. Asking for additional medical consultations.
d. Refusing to receive visitors.

97. A husband spends most of the day with his wife, who is receiving chemotherapy for inoperable cancer, and asks the nurse how he can continue to help her. The nurse should plan to:
a. Talk with the husband alone to promote ventilation of feelings.
b. Offer the couple a detailed description of various drugs.
c. Instruct the husband about the action of various drugs.
d. Assist the couple to maintain open and honest communication.

98. A client who is scheduled to have hysterectomy starts to sob and says, "I told my husband today that after this operation I will only be half a woman. He reassured me , but I know that was just a front." The most appropriate response by the nurse would be:
a. " I think I'll call your physician who may want to postpone this operation until you and your husband have adjusted better to the outcome of a hysterectomy."
b. " You feel this operation will have an effect on how your husband feels about you as his wife."
c. "You know of course that this is silly. I wish you would not worry about such irrelevant thinking. The main thing is that you have to get well quickly."
d. " It seems like it is frightening to know that your husband rejects you as a woman."

99. Elderly people have high incidence of hip fractures because of :
a. Sedentary existence
b. Carelessness
c. Fragility of the bone
d. Rheumatoid arthritis

100. The nurse should teach a patient that Nitroglycerin tablets have lost potency when :
a. Pain is unrelieved by but facial flushing is increased.
b. Onset of relief is delayed but the duration of relief is unchanged.
c. The tablets are three or four months old.
d. Sublingual tingling is experienced.

Answer for Exam on Physiologic and Psychosocial Alterations
1. a-physiologic
2. a-body
3. a-secondary
4. a-support
5. a
6. a
7. a
8. a
9. d
10.b
11. a- feel
12. b
13. a- to build trust
14. c- psychosis
15. b
16. d
17. d
18. d
19. a
20. b
21. c
22. a
23. c
24. b
25. b
26. d
27. b
28. c
29. b
30. a
31. b
32. c
33. c
34. b
35. c
36. b
37. d - OCPD
38. d - infancy
39. c
40. d
41. b
42. c
43. d
44. b
45. a
46. d
47. d- behavioral self-blame
48. d
49. c
50. c
51. d - assessment
52. c
53. c
54. b
55. b
56. c- acting opposite
57. b- aggression turned inward
58. b- antidepressant
59. a- counter transference
60. c
61. d
62. a
63. b
64. c
65. a
66. b
67. b
68. d
69. b
70. d
71. b
72. d
73. c
74. c
75. c
76. c
77. b
78. c
79. d
80. c
81. d
82. c
83. c
84. a
85. d
86. d
87. b
88. b
89. c
90. c
91. c
92. b
93. c
94. b
95. c
96. c
97. a
98. b
99. c
100. c- tablet potent for 90 days ; 4-6 months should be replaced

Physiologic and Psychosocial Alterations Exam 2

1. To treat bladder cancer, the client will have a series of intravesical installations of Bacillus Calmette-Guerin (BCG) to be administered 1 week apart. When teaching the client about BCG, the nurse should mention that this drug commonly causes which of the following?
a. Impotence
b. Delayed ejaculation
c. Hematuria
d. Renal calculi

2. A client with lymphangitis slips, falls, and cuts her arm in the clinic. The cut is bleeding; and as the nurse assesses that the client is alert and well oriented. In performing first aid for the client, which of the following actions should the nurse undertake first?
a. Clean the cut with antiseptic
b. Cover the cut with a sterile dressing
c. Check the patient's blood pressure
d. Don a pair of gloves

3. A client seeks care for the hoarseness that has lasted for almost a month. Which of the following should the nurse ask in order to elicit the most appropriate information from the client?
a. Do you eat spicy food?
b. Have you strained your voice recently?
c. Do you eat a lot of red meat?
d. Do you smoke?

4. Mark , a 62 year old man is admitted to an intensive care unit at the acute onset of MI. As the nurse-in-charge, which of the following activities should you LEAST prioritize at this time?
a. Discussing with the client to undergo physical therapy
b. Educating the client about nature of the disease
c. Administer parenteral fluids
d. Checking the vital signs frequently

5. When caring for a client diagnosed with tumor of the parietal lobe of the brain the nurse expects to assess for which of the following?
a. Tactile agnosia
b. Short term memory impairment
c. Seizures
d. Contralateral homonymous hemianopsia

6. You are caring for a male client treated with pericarditis who is so anxious about his condition. Which of the following interventions is the most appropriate?
a. Remain with the client and explain the procedures thoroughly.
b. Keep the feet of the bed elevated 45 degrees.
c. Provide hypothermia treatment.
d. Administer enteral fluids and oxygen.

7.The nurse is caring for the bronchogenic carcinoma client. Which nursing diagnosis takes the highest priority?
a. Body image disturbance
b. Altered nutrition less than body requirement
c. Ineffective airway clearance
d. Anxiety

8. Upon admisssion, a male construction worker presents with severe headache, vertigo, diplopia, tachycardia, and distended neckveins. Blood pressure reads: 220/140 mmHg. A diagnosis of hypertensives crisis is made. In planning the care for this client, which of the following nursing interventions is INAPPROPRIATE?
a. Keeping the head of the bed elevated
b. Observing for signs of hypertension
c. Maintaining a quiet environment
d. Administering anti-hypertensive drugs and diuretics

9.

Physiologic and Psychosocial Alterations Exam 2

1. c
2. d
3. d
4. a
5. a
6. a
7. c
8. b


MCN EXAM

1. The school nurse is planning a program for a group of teenagers on skin cancer prevention. Which of the following instructions should the nurse emphasize in her talk?
a. Examine skin once per month, looking for suspicious lesions or changes in moles.
b. Sun exposure is safe, provided the client wears protective clothing
c. Stay out of the sun between 1pm and 3pm.
d. Tanning booths are safe alternative for those who wish to have darker skin.

2. Which of the following positions is most appropriate for a neonate with congenital hip dislocation?
a. Swaddled in a baby carrier
b. Prone position with hips abducted
c. Semi- fowler's with both legs flexed
d. Legs adducted with head elevated

3. A client had a severe pruritus from Hepatits B. Which of the following nursing measures would best enhance the client's comfort:
a. Avoid lotions and creams
b. Give tepid water bath
c. Use cold water to decrease itching sensation
d. Use hot water to increase vasodilation

4. The nurse is caring for a post thyroidectomy client at risk for hypocalcemia. What should the nurse do?
a. Evaluate the quality of the client's voice post operatively, noting any drastic changes
b. Monitor laboratory values daily for an elevated thyroid-stimulating hormone
c. Observe for muscle twitching and numbness or tingling of the lips, fingers and toes
d. Observe for swelling of the neck, tracheal deviation and severe pain

5. The nurse is assessing an 8 month old child for signs of neurologic deficit and increased intracranial pressure (ICP) these signs would include:
a. Tachycardia
b. An altered level of consciousness
c. Depressed fontanel
d. Slurred speech

6.The nurse is assessing a 47 years old who has come to the physician's office for his annual PE. One of the first physical signs of aging is:
a. Accepting limitations while developing assets
b. Having more frequent aches and pains
c. Increasing loss of muscle tone
d. Failing eyesight especially close vision

7. The nurse is caring for a child who has just been immunized. When teaching the child's parents about potential adverse effects, the nurse should instruct the parents to immediately report:
a. Generalized urticaria
b. Pain at the injection site
c. Mild temperature elevation
d. Local swelling at the injection site

8. The nurse administers an IM injection. Afterwards the nurse should:
a. Break the needle and discard the needle and syringe in any medical waste container
b. Discard the uncapped needle in a puncture proof container
c. Recap the needle and discard it in a puncture proof container
d. Recap the needle and discard it in any medical waste container

9. A 10 year old male with sickle cell anemia continues to wet the bed at night. He feels frustrated about this and is so embarrassed to sleep at a friend's house. Which of the following response by the nurse is most appropriate:
a. Force fluid during the day and restrict fluids after 7 pm
b. Decrease fluid intake during the day and take no liquids before bedtime
c. Perhaps your friend could sleep over at your house instead
d. We can try bladder training program

10. A 2 year old client returns from surgery after a bowel resection as a result of Hirschsprung's disease. a temporary colostomy is in place. Which immediate post operative nursing intervention takes priority?
a. Irrigating the colostomy with 100 ml of normal saline solution
b. Auscultating lung sounds
c. Changing the surgical dressing
d. Suctioning the nasopharynx frequently to remove secretion

11. A mother complains to the nurse that her 4 years old son often lies. What would be the nurse best response?
a. Ask him why he can not tell the truth
b. Acknowledge him by saying, "That's a pretend story."
c. Let the child know that he will be punished for lying
d. It is probably due to his vivid imagination and creativity




Answer for exam on MCN:
1. a
2. b- away
3. c- with emolient cream and lotion
4. c
5. c
6. d
7. a
8. b
9. d
10. b
11. b