Professional Documents
Culture Documents
NLE Pre-Board December 2007 Practice 4
NLE Pre-Board December 2007 Practice 4
Situation 1 - Because of the serious consequences of severe burns management requires a multi
disciplinary approach. You have important responsibilities as a nurse.
1. While Sergio was lighting a barbecue grill with a lighter fluid, his shirt burst into flames. The most
effective way to extinguish the flames with as little further damage as possible is to:
3. Sergio is brought to the Emergency Room after the barbecue grill accident. Based on the
assessment of the physician, Sergio sustained superficial partial thickness bums on his trunk, right
upper extremities ad right lower extremities. His wife asks what that means. Your most accurate
response would be:
4. During the first 24 hours after thermal injury, you should assess Sergio for
5. Teddy, who sustained deep partial thickness and full thickness burns of the face, whole anterior
chest and both upper extremities two days ago, begins to exhibit extreme restlessness. You
recognize that this most likely indicates that Teddy is developing:
a. Cerebral hypoxia
b. Hypervolemia
c. Metabolic acidosis
d. Renal failure
Situation 2 - You are now working as a staff nurse in a general hospital. You have to be prepared to handle
situations with ethico-legal and moral implications.
6. You are on night duty in the surgical ward. One of our patients Martin is prisoner who sustained
an abdominal gunshot wound. He is being guarded by policemen from the local police unit. During
your rounds you heard a commotion. You saw the policeman trying to hit Martin. You asked why he
was trying to hurt Martin. He denied the matter. Which among the following activities will you do
first?
8. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found
out that what is on record does not tally with the drugs used. Which among the following will you do
first?
a. Write an incident report and refer the matter to the nursing director
b. Keep your findings to yourself
c. Report the matter to your supervisor
d. Find out from the endorsement any patient who might have been given narcotics
9. You are on duty in the medical ward. The mother of your patient who is also a nurse came running
to the nurse station and informed you that Fiolo went into cardiopulmonary arrest. Which among the
following will you do first?
10. You are admitting Jorge to the ward and you found out that he is positive for HIV. Which among
the following will you do first?
Situation 3 - Colorectal cancer can affect old and younger people. Surgical procedures and other modes of
treatment are done to ensure quality of life. You are assigned in the Cancer institute to care of patients with
this type of cancer.
11. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the CI. After
taking the history and vital signs the physician does which test as a screening test for colorectal
cancer.
a. Barium enema
b. Carcinoembryonig antigen
c. Annual digital rectal examination
d. Proctosigmoidoscopy
12. To confirm his impression of colorectal cancer, Larry will require which diagnostic study?
a. carcinoembryonic antigen
b. proctosigmoidbscopy
c. stool hematologic test
d. abdominal computed tomography (CT) test
13. The following are risk factors for colorectal cancer, EXCEPT:
a. inflammatory bowels
b. high fat, high fiver diet
c. smoking
d. genetic factors-familial adenomatous polyposis
14. Symptoms associated with cancer of the colon include:
15. Several days prior to bowel surgery, Larry may be given sulfasuxidine and neomycin primarily to:
Situation 4 - ENTEROSTOMAL THERAPY is now considered especially in nursing. You are participating in
the OSTOMY CARE CLASS.
16. You plan to teach Fermin how to irrigate the colostomy when:
a. The perineal wound heals and Fermin can sit comfortably on the commode
b. Fermin can lie on the side comfortably, about the 3rd postoperative day
c. The abdominal incision is close and contamination is no longer a danger
d. The stool starts to become formed, around the 7th postoperative day
17. When preparing to teach Fermin how to irrigate his colostomy, you should plan to do the
procedure:
18. When observing a rectum demonstration of colostomy irrigation, you know that more teaching is
required if Fermin:
a. Lubricates the tip of the catheter prior to inserting into the stoma
b. Hands the irrigating bag on the bathroom door doth hook during fluid insertion
c. Discontinues the insertion of fluid after only 500 ml of fluid had been insertion
d. Clamps off the flow of fluid when feeling uncomfortable
19. You are aware that teaching about colostomy care is understood when Fermin states, "I will
contact my physician and report:
a. If I have any difficulty inserting the irrigating tub into the stoma.
b. If I notice a loss of sensation to touch in the stoma tissue."
c. The expulsion of flatus while the irrigating fluid is running out."
d. When mucus is passed from the stoma between irrigation."
20. You would know after teaching. Fermin that dietary instruction for him is effective when he
states, "It is important that I eat:
a. Soft foods that are easily digested and absorbed by my large intestine."
b. Bland food so that my intestines do not become irritate."
c. Food low in fiber so that there is less stool."
d. Everything that I ate before the operation, while avoiding foods that cause gas."
Situation 5 - Ensuring safety is one of your most important responsibilities. You will need to provide
instructions and information to your clients to prevent complications.
21. Randy has chest tubes attached to a pleural drainage system. When caring for him you should:
a. empty the drainage system at the end of the shift
b. clamp the chest tube when auctioning
c. palpate the surrounding areas for crepitus
d. change the dressing daily using aseptic techniques
22. Fanny came in from PACU after pelvic surgery. As Fanny's nurse you know that the sign that
would be indicative of a developing thrombophlebitis would be:
23. To prevent recurrent attacks on Terry who has acute glumerulonephritis, you should instruct her
to:
24. Herbert has a laryngectomy and he is now for discharge. Re verbalized his concern regarding his
laryngectomy tube being dislodged. What should you teach him first?
25. When caring for Larry after an exploratory chest surgery and pneumonectomy, your priority
would be to maintain:
a. supplementary oxygen
b. ventilation exchange
c. chest tube drainage
d. blood replacement
Situation 6 - Infection can cause debilitating consequences when host resistance is compromised and
virulence of microorganisms and environmental factors are favorable. Infection control is one important
responsibility of the nurse to ensure quality of care.
26. Honrad, who has been complaining of anorexia and feeling tired, develops jaundice. After a
workup he is diagnosed of having Hepatitis A. His wife asks you about gamma globulin for herself
and her household help. Your most appropriate response would be:
27. Voltaire develops a nosocomial respiratory tract infection. He asks you what that means.
a. "You acquired the infection after you have been admitted to the hospital."
b. "This is a highly contagious infection requiring complete isolation."
c. "The infection you had prior to hospitalization flared up."
d. "As a result of medical treatment, you have acquired a secondary infection.''
28. As a nurse you know that one of the complications that you have to watch out for when caring
for Omar who is receiving total parenteral nutrition is:
a. stomatitis
b. hepatitis
c. dysrhythmia
d. infection
a. Dakin's solution
b. Half-strength hydrogen peroxide
b. Acetic acid
d. Betadine
Situation 7 - As a nurse you need to anticipate the occurrence of complications of stroke so that life
threatening situations can be prevented.
31. Wendy is admitted to the hospital with signs and symptoms of stroke. Her Glasgow Coma Scale
is 6 on admission. A central venous catheter was inserted and an I.V. infusion was started. As a
nurse assigned to Wendy what will he your priority goal?
32. Knowing that for a comatose patient hearing is the best last sense to be lost, as Judy's nurse,
what should you do?
33. Which among the following interventions should you consider as the highest priority when
caring for June who has hemiparersis secondary to stroke?
34. Ivy, age 40, was admitted to the hospital with a severe headache, stiff neck and photophobia. She
was diagnosed with a subarachnoid hemorrhage secondary to ruptured aneurysm. While waiting for
surgery, you can provide a therapeutic by doing which of the following?
35. When performing a neurological assessment on Walter, you find that his pupils are fixed and
dilated. This indicated that he:
36. Hypoxia may occur in the older patients because of which of the following physiologic changer
associated with aging.
37. The older patient is at higher risk for in inconvenience because of:
a. dilated urethra
b. increased glomerular filtration rate
c. diuretic use
d. decreased bladder capacity
38. Merle, age 86, is complaining of dizziness when she stands up. This may indicate:
a. dementia
b. a visual problem
c. functional decline
d. drug toxicity
40. The most dependable sign of infection in the older patient is:
Situation 9 - A "disaster" is a large-scale emergencyeven a small emergency left unmanaged may turn into
a disaster. Disaster preparedness is crucial and is everybody's business. There are agencies that are in
charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated
approach to the management of emergency program and activities for all four emergency phases
(mitigation, preparedness, response, and recovery), for all type of emergencies and disasters (natural, man-
made, and attack) and for all levels of government and the private sector.
41. Which of the four phases of emergency management is defined as "sustained action that
reduces or eliminates long-term risk to people and properly from natural hazards and the effect"?
a. Recovery
b. Mitigation
c. Response
d. Preparedness
42. You are a community health nurse collaborating with the Red Cross and working with disaster
relief following a typhoon which flooded and devastated the whole province. Finding safe housing
for survivors, organizing support for the family, organizing counseling debriefing sessions and
securing physical care are the services you are involved with. To which type of prevention are these
activities included.
a. Tertiary prevention
b. Primary prevention
c. Aggregate care prevention
d. Secondary prevention
43. During the disaster you see a victim with a green tag, you know that the person:
a. has injuries that are significant and require medical care but can wait hours will threat to life or limb
b. has injuries that are life threatening but survival is good with minimal intervention
c. indicates injuries that are extensive and chances of survival are unlikely even with definitive care
d. has injuries that are minor and treatment can be delayed from hours to days
44. The term given to a category of triage that refers to life threatening or potentially life threatening
injury or illness requiring immediate treatment:
a. Immediate
b. Emergent
c. Non-acute
d. Urgent
45. Which of the following terms refer to a process by which the individual receives education about
recognition of stress reactions and management strategies for handling stress which may be
instituted after a disaster?
Situation 10 - As a member of the health and nursing team you have a crucial role to play in ensuring that all
the members participate actively is the various tasks agreed upon,
46. While eating his meal, Matthew accidentally dislodges his IV line and bleeds. Blood oozes on the
surface of the over-bed table. It is most appropriate that you instruct the housekeeper to clean the
table with:
a. Acetone
b. Alcohol
c. Ammonia
d. Bleach
47. You are a member of the infection control team, of the hospital. Based on a feedback during the
meeting of the committee there is an increased incidence of pseudomonas infection in the Burn Unit
(3 out of 10 patients had positive blood and wound culture). What is your priority activity?
48. Part of your responsibility as a member of the diabetes core group is to get referrals from the
various wards regarding diabetic patients needing diabetes education. Prior to discharge today 4
patients are referred to you. How would you start prioritizing your activities?
a. Bring your diabetes teaching kit and start your session taking into consideration their distance from your
office
b. Contact the nurse-in-charge and find out from her the reason for the referral
c. Determine their learning needs then prioritize
d. involve the whole family in the teaching class
49. You have been designated as a member of the task force to plan activities for the Cancer
Consciousness Week. Your committee has 4 months to plan and implement the plan. You are
assigned to contact the various cancer support groups in your hospital. What will be your priority
activity?
50. You are invited to participate in the medical mission activity of your alumni association. In the
planning stage everybody is expected to identify what they can do during the medical mission and
what resources are needed. You though it is also your chance to share what you can do for others.
What will be your most important role where you can demonstrate the impact of nursing health?
Situation 11 - One of the realities that we are confronted with is'6w mortality. It is important for us nurses to
be aware of how we view suffering, pain, illness, and even our death as well as its meaning. That way we
can help our patients cope with death and dying.
51. Irma is terminally ill she speaks to you in confidence. You now feel that Irma's family could be
helpful if they knew what Irma has told you. What should you do first?
52. Ruby who has been told she has terminal cancer turns away aha refuses to respond to you. You
can best help her by:
a. Coming back periodically and indicating your availability if she would like you to sit with her
b. Insisting that Ruby should talk with you because it is not good to Keep everything inside
c. Leaving her atone because she is uncooperative and unpleasant to be with
d. Encouraging her to be physically active as possible
53. Leo who is terminally ill and recognizes that he is in the process of losing, everything and
everybody he loves, is depressed. Which of the following would best help him during depression?
54. Which of the following statements would best indicate that Ruffy; who is dying has accepted this
impending death?
55. Maria, 90 years old has planned ahead for her-death-philosophically, socially, financially and
emotionally. This is recognized as:
Situation 12 - Brain tumor, whether malignant or benign, has serious management implications nurse, you
should be able to understand the consequences of the disease and the treatment.
56. You are caring for Conrad who has a brain tumor and increased intracranial Pressure (ICP).
Which intervention should you include in your plan to reduce ICP?
58. Which of the following activities may increase intracranial pressure (ICP)?
59. After you assessed Conrad, you suspected increased ICP! Your most appropriate respiratory
goal is to:
60. Conrad underwent craniotomy. As his nurse; you know that drainage on a craniotomy dressing
must be measured and marked. Which findings should you report immediately to the surgeon?
a. Foul-smelling drainage
b. yellowish drainage
c. Greenish drainage
d. Bloody drainage
Situation 13 -As a Nurse, you have specific responsibilities as professional. You have to demonstrate
specific competencies.
61. The essential components of professional nursing practice are all the following EXCEPT:
a. Culture
b. Care
c. Cure
d. Coordination
62. You are assigned to care for four (4) patients. Which of the following patients should you give
first priority?
63. Brenda, the Nursing Supervisor of the intensive care unit (ICU) is not on duty when a staff nurse
committed a serious medication error. Which statement accurately reflects the accountability of the
nursing supervisor?
a. Brenda should be informed when she goes back on duty
b. Although Brenda is not on duty, the nursing supervisor on duty decides to call her if time permits
c. The nursing supervisor on duty will notify Brenda at home
d. Brenda is not duty therefore it is not necessary to inform her
64. Which barrier should you avoid, to manage your time wisely?
a. Practical planning
b. Procrastination
c. Setting limits
d. Realistic personal expectation
65. You are caring for Vincent who has just been transferred to the private room. He is anxious
because he fears he won't be monitored as closely as he was in the Coronary Care Unit. How can
you allay his fear?
Situation 14 - As a nurse in the Oncology Unit, you have to be prepared to provide efficient and effective
care to your patients.
66. Which one of the following nursing interventions would be most helpful in preparing the patient
for radiation therapy?
67. What side effects are most apt to occur to patient during radiation therapy to the pelvis?
a. Urinary retention
b. Abnormal vaginal or perineal discharge
c. Paresthesia of the lower extremities
d. Nausea and vomiting and diarrhea
68. Which of the following can be used on the irradiated skin during a course of radiation therapy?
a. Adhesive tape
b. Mineral oil
c. Talcum powder
d. Zinc oxide ointment
a. desquamation
b. erythema
c. atrophy
d. pigmentation
70. What is the purpose of wearing a film badge while caring for the patient who is radioactive?
Situation 15 - In a disaster there must be a chain of command in place that defines the roles of each
member of the response team. Within the health care group there are pre-assigned roles based on
education, experience and training on disaster.
71. As a nurse to which of the following groups are you best prepared to join?
a. Treatment group
b. Triage group
c. Morgue management
d. Transport group
72. There are important principles that should guide the triage team in disaster management that you
have to know if you were to volunteer as part of the triage team. The following principles should be
observed in disaster triage, EXCEPT:
a. any disaster plan should have resource available to triage at each facility and at the disaster site if
possible
b. make the most efficient use of available resources
c. training on disaster is not important to the response in the event of a real disaster because each disaster
is unique in itself
d. do the greatest good for the greatest number of casualties
73. Which of the following categories of conditions should be considered first priority in a disaster?
74. A guideline that is utilized in determining priorities is to assess the status of the following,
EXCEPT?
a. perfusion
b. locomotion
c. respiration
d. mentation
a. pupil reactivity
b. vital sign assessment
c. cranial nerve assessment
d. level of consciousness/responsiveness
Situation 16 - You are going to participate in a Cancer Consciousness Week. You are assigned to take
charge of the women to make them aware of cervical cancer. You reviewed its manifestations and
management.
76. The following are risk factors for cervical Cancer EXCEPT:
a. immunisuppressive therapy
b. sex at an early age, multiple partners, exposure to socially transmitted diseases, male partner's sexual
habits
c. viral agents like the Human Papilloma Virus
d. smoking
77. Late signs and symptoms of cervical cancer include the following EXCEPT:
a. urinary/bowel changes
b. pain in pelvis, leg of flank
c. uterine bleeding
d. lymph edema of lower extremities
78. When a panhysterectomy is performed due to cancer of the cervix, which of the following organs
are moved?
79. The primary modalities of treatment for Stage 1 and IIA cervical cancer include the following:
Situation 17 - The body has regulatory mechanism to maintain the needed electrolytes. However there are
conditions/surgical interventions that could compromise life. You have to understand how management of
these conditions are done.
81. You are caring for Leda who is scheduled to undergo total thyroidectomy because of a diagnosis
of thyroid cancer. Prior to total thyroidectomy, you should instruct Leda to:
82. As Leda's nurse, you plan to set up an emergency equipment at her beside following
thyroidectomy. You should include:
83. Which of the following nursing interventions is appropriate after a total thyroidectomy?
84. If there is an accidental injury to the parathyroid gland during a thyroidectomy which of the
following might Leda develops postoperative?
a. Cardiac arrest
b. Dyspnea
c. Respiratory failure
d. Tetany
85. After surgery Leda develops peripheral numbness, tingling and muscle twitching and spasm.
What would you anticipate to administer?
a. Magnesium sulfate
b. Calcium gluconate
c. Potassium iodine
d. Potassium chloride
Situation 18 - NURSES are involved in maintaining a safe and health environment. This is part of quality
care management.
87. For a patient experiencing pruritus, you recommend which type of bath:
a. Water
b. colloidal (oatmeal)
c. saline
d. sodium bicarbonate
88. Induction of vomiting is indicated for the accidental poisoning patient who has ingested.
a. rust remover
b. gasoline
c. toilet bowl cleaner
d. aspirin
89. Which of the following term most precisely refer to an infection acquired in the hospital that was
not present or incubating at the time of hospital admission?
90. Which of the following guidelines is not appropriate to helping family members cope with sudden
death?
Situation 19 - As a nurse you are expected to participate in initiating or participating in the conduct of
research studies to improve nursing practice. You have to be updated on the latest trends and issues
affecting profession and the best practices arrived at by the profession
91. You are interested to study the effects of meditation and relaxation on the pain experienced by
cancer patients. What type of variable is pain?
a. Dependant
b. Correlational
c. Independent
d. Demographic
92. You would like to compare the support system of patients with chronic illness to those with acute
illness. How will you best state your problem?
a. A descriptive study to compare the support system of patients with chronic illness and those with acute
illness in terms of demographic data and knowledge about interventions
b. The effect of the Type of Support system of patients with chronic illness and those with acute illness
c. A comparative analysis of the support: system of patients with chronic illness and those with acute illness
d. A study to compare the support system of patients with chronic illness and those with acute illness
93. You would like to compare the support, system of patients with chronic illness to those with
acute illness. What type of research it this?
a. Correlational
b. Descriptive
c. Experimental
d. Quasi-experimental
94. You are shown a Likert Scale that will be used in evaluating your performance in the clinical area.
Which of the following questions will you not use in critiquing the Likert Scale?
95. In any research study where individual persons are involves, it is important that an informed
consent for the Study is obtained. The following are essential information about the consent that
you should disclose to the prospective subjects EXCEPT:
Situation 20 - Because severe burn can affect the person's totality it is important that you apply interventions
focusing on the various dimensions of man. You also have to understand the rationale of the treatment.
a. Interventional
b. Mechanical
c. Surgical
d Chemical
97. Which topical antimicrobial is most frequently used in burn wound care?
a. Neosporin
b. Silver nitrate
c. Silver sulfadiazine
d. Sulfamylon
a. exaggerated contraction
b. random layering of collagen
c. wound ischemia
d. delayed epithelialization
a. patient hypothermia
b. cross contamination of wound
c. patient discomfort
d. excessive manpower requirement
100. Oral analgecis are most frequently used to control burn injury pain:
ANSWER KEY:
1. A
2. D
3. D
4. B
5. D
6. A
7. B
8. A
9. D
10. A
11. B
12. B
13. B
14. C
15. B
16. C
17. C
18. C
19. A
20. C
21. C
22. A
23. A
24. D
25. A
26. D
27. A
28 D
29. C
30. D
31. D
32. D
33. B
34. C
35. D
36. B
37. D
38. B
39. C
40. C
41. B
42. C
43. D
44. D
45. A
46. D
47. A
48. C
49. B
50. A
51. C
52. A
53. D
54. A
55. D
56. A
57. B
58. B
59. D
60. A
61. A
62. B
63. A
64. B
65. B
66. C
67. A
68. D
69. B
70. C
71. B
72. C
73. D
74. B
75. D
76. A
77. B
78. C
79. D
80. A
81. C
82. B
83. C
84. D
85. B
86. C
87. B
88. D
89. B
90. A
91. A
92. C
93. A
94. A
95. A
96. D
97. B
98. A
99. A
100. C