All the questions in the quiz along with their answers are shown below.

Your answers are bolded. The

correct answers have a green background while the incorrect ones have a red background.
1.    Which of the following neurotransmitters is decreased in Parkinson’s disease?
 a. Adrenaline
 b. Serotonin
 c. Epinephrine
 d. Dopamine
Parkinson's disease (also known as Parkinson's, Parkinson disease, or PD) is a degenerative disorder of the
central nervous system that impairs motor skills, cognitive processes, and other functions. PD is the most
common cause of chronic progressive parkinsonism, a term which refers to the syndrome of tremor, rigidity,
bradykinesia and postural instability. Among non motor symptoms are autonomic dysfunction, cognitive and
neurobehavioral problems including dementia, and sensory and sleep difficulties. PD usually appears
around the age of 60, although there are young-onset cases. Symptoms result from insufficient formation
and action of dopamine produced in the dopaminergic neurons of the midbrain (specifically the substantia
nigra).
2.    The doctor prescribed Mr. Lorenzo with Bromocriptine (Parlodel). What classification does this drug
belong?
 a. Anticholinergic drugs
 b. Dopamine Metabolism Inhibitor
 c. Dopamine Receptor Agonist
 d. Dopamine Precursor
Medications used to treat Parkinson’s disease are those drugs that decrease the level of acethycholine
(anticholinergic drugs) and those that increase dopamine levels (dopaminergic agents). Anticholinergic
Drugs includes the ff: (1) Trihexyphenidyl (Artane) (2) Benztropine Mesylate (Cogentin) (3) Biperiden
(Akineton) (4) Dipenhydramine (Benadryl) (5) Ethoproprazine (Parsidol) (6) Procyclidine (Kemadrin) while
Dopaminergic Drugs are the ff: (1) Dopamine Precursor:LEVODOPA (Dopar, Larodopa) CARDIDOPA-
LEVODOPA (Sinemet) (2) Dopamine Receptor Agonist: BROMOCRIPTINE (Parlodel)PERGOLIDE
(Permax)(3) Dopamine Metabolism Inhibitor:SELEGILINE (Eldepryl).
3.    The primary clinical manifestations of Parkinson’s disease include the following apart from:
 a. Pill-rolling tremors
 b. Loss of intellectual capacity
 c. Slowed retarded movements
 d. Muscular rigidity
The three primary clinical manifestations of Parkinson’s Disease are 1) tremors (pill-rolling), 2) bradykinesia
(slowed retarded movements) and 3) muscular rigidity. Secondary symptoms of Parkinson’s disease
include: • Constipation • Dysphagia • Hypersalivation • Excessive sweating • Loss of bladder and bowel
control • Loss of intellectual capacity (dementia) – LATE stage • Microphagia (small cramped handwriting) •
Hypophonia (soft, whispery voice)
4.    The nurse understood that the medication therapy for Parkinson’s disease is:
 a. Curative – cures the disorder
 b. Producing unwanted side effects a week after administration.
 c. Palliative – manages the symptoms only
 d. Administered for 2-4 weeks only.
Medications given for Parkinson’s disease only manages the symptoms but do not correct or cures the
disorder, hence, it is palliative. The cause of PD is unknown, however theories were brought up that
absence or defects of dopaminergic receptors in the brain decreases dopamine levels causing the disorder.
Other explanations focused on the imbalance between the acetylcholine and dopamine. Thus, the client
needs a long-term medication regimen not short-term or 2-4 weeks only. As the disease advances, the
 continuous use of medications (not a week after) leads to a second stage in which the patient develops
motor complications called dyskinesias which make management difficult. Situation: Emma, 18 years old
has grossly inappropriate affect. She is introvert and avoids close relationships with family and friends. Her
attention is focused on reading books and she functions well when she is alone. Diagnosis: Personality
Disorder
For Question no. 5-10 Situation: Emma, 18 years old has grossly inappropriate affect. She is introvert and
avoids close relationships with family and friends. Her attention is focused on reading books and she
functions well when she is alone.  Diagnosis: Personality
Disorder____________________________________________________________________________5.  
The nurse is encouraging Emma to join the group session. Emma verbalized no desire for social
involvement. She further told the nurse that her pleasure is on reading books and not on joining the group.
Based on Emma’s history, she has no close friends or confidants and she seemed indifferent to criticism and
praise by others. What type of personality disorder does Emma has?
 a. Schizoid personality disorder
 b. Avoidant personality disorder
 c. Antisocial personality disorder
 d. Schizotypal personality disorder
Synonyms for someone with a schizoid personality disorder include introvert and loner because the
person has no desire for social involvement. The clinical symptoms include a pervasive pattern of
detachment from social relationships and a restricted range of emotional expression in interpersonal
settings. The individual avoids close relationships with family or others, chooses solitary activities, has little
interest in sexual experiences, does not take pleasure in activities, lacks close friends or confidants, appears
indifferent to praise or criticism, and exhibits emotional coldness such as detachment or flattened affect.
Attention is usually focused on objects such as books and cars rather than people. He or she may function
well in vocations where one generally works alone. FLAT AFFECT and LITTLE EMOTION. Avoidant
Personality Disorder - The client with avoidant personality disorder is highly sensitive to rejection, criticism,
humiliation, disapproval, or shame, appearing devastated by the slightest amount of disapproval. This
extreme sensitivity interferes with participation in occupational activities, development of interpersonal
relationships, and the ability to take personal risks or engage in new activities. Social withdrawal occurs
because the client views him- or herself as socially inept, personally unappealing, or inferior to others.
Antisocial Personality Disorder - Characterized by pervasive pattern of disregard for and violation of the
rights of others- and with the central characteristics of deceit and manipulation. Schizotypal Personality
Disorder - The classification of schizotypal personality disorder is used to diagnose persons whose
symptoms are similar to, but not severe enough to meet, the criteria for schizophrenia. Clients generally
exhibit a disturbance in thought processes referred to as magical thinking, superstitiousness, or telepathy (a
sixth sense). Pervasive pattern of social and interpersonal deficits marked by acute discomfort with and
reduced capacity for close relationships as well as cognitive or perceptual distortions and behavioral
eccentricities.
6.    Emma’s classified personality disorder is under which cluster?
 a. Cluster A
 b. Cluster B
 c. Cluster C
 d. Not classified
Schizoid personality disorder is under Cluster A. Cluster A : odd, eccentric (includes paranoid, schizoid and
schizotypal PD) Cluster B: dramatic, emotional or erratic (includes antisocial, borderline, histrionic and
narcissistic PD) Cluster C: anxious, fearful (includes avoidant, dependent and Obesseive-Compulsive PD)
Not classified PD: passive-aggressive PD and depressive PD
 7.    Personality disorders (PD) are listed by the DSM-IV-TR as a separate and distinct category from other
mental illnesses. The disorder falls on the Axis II of the multi-axial classification system. The following
statements are true of personality disorders except:
 a. Most patients with personality disorders are treated in acute care settings due to the inflexible
and maladaptive personality.
 b. Nurses most often encounter clients with antisocial and borderline personality disorders.
 c. There is difficulty diagnosing and treating clients with PD because of the similarities and subtle
differences between categories and types.
 d. Many people with PD have also coexisting mental illnesses.
Most patients with personality disorders are NOT treated in acute care settings due to the inflexible and
maladaptive personality but due to physical injuries or for another major mental illness.
8.    PD’s under cluster B includes which of the following?
 a. Paranoid
 b. Narcissistic
 c. Dependent
 d. Passive-aggressive
a. Paranoid – Cluster A b. Narcissistic – Cluster B c. Dependent – Cluster C d. Passive-aggressive – not
classified PD
9.    Medications given to clients with PD focus on the client’s symptoms rather than the particular subtype.
Cognitive-perceptual disturbances respond to low-dose antipsychotic medications. Symptoms under
cognitive-perceptual disturbance does not include:
 a. Depression
 b. Magical thinking
 c. Odd beliefs
 d. Ideas of references
Depression is a form of mood dysregulation. Magical thinking, odd beliefs, suspiciousness, ideas of
references and low-grade psychotic symptoms are cognitive-perceptual disturbances.
10.    During the nurse’s rounds, Emma gestured as if she is listening to someone. Then she told the nurse
that she hears voices. Initially, the nurse should respond:
 a. “What are you thinking about?”
 b. “I understand how you feel, but I don’t hear any voices.”
 c. “You must be kidding me.”
 d. “What are the voices telling you?”
KEYWORD of the question: initially. Auditory hallucinations are the most common form of hallucination. If
the client verbalizes that she hears voices, the nurse should assess what is the content of the auditory
hallucination. If the voices are telling the client to kill her or others, safety for possible violence is
implemented. Asking the client what is she thinking is inappropriate in this situation as the client already told
the nurse that she hears voices. After knowing the content of the voices it would be appropriate for the nurse
to present the reality. Situation: Nursing theories are important for nurses to know. It expected on nurses to
integrate the theories governing the field while providing care to clients.
11.    Maslow’s heirachy of needs is very helpful in prioritizing nursing interventions. Nurse Anna, is caring
for patients in the ward. In prioritizing her nursing care services she should first implement:
 a. Identifying the support system of a depressed patient
 b. Changing bed linens
 c. Initiating oxygen therapy
 d. Discussing about the love life of a teenager patient
Maslows hierarchy of needs has five levels top priority is on: 1. Physiologic needs (food, air, water) 2. Safety
needs 3. Love and belongingness 4. Self-esteem 5. Self-actualization
 12.    In the current conceptual model, the four main concepts that appears common to nursing are the
following: 1.    Psychology 2.    Medicine 3.    Person 4.    Nursing 5.    Environment 6.    Health
 a. 1,2,3,4
 b. 2,3,4,5
 c. 3,4,5,6
 d. 1,3,5,6
Concepts common in the nursing Conceptual models are the person, nursing, environment and health.
13.    Throughout Nurse Anna’s shift her topmost priority in order to create a therapeutic milieu or
environment for her patient should be on:
 a. Accepting her individuality as a person
 b. Promoting safety
 c. Orienting new nurses to the physical set-up of the hospital
 d. Explaining the disease process to the patient
Accepting her self as a unique person and self-awareness is the topmost priority in promoting a therapeutic
environment.
14.    As a nurse, Nurse Anna assumes different roles in caring for her patients. Which of the following
demonstrates the nurse’s role as an educator:
 a. Informs the client about the progress of his condition
 b. Evaluate the client’s learning needs and his/her readiness to learn
 c. Allow the client to actively participate in his/her care
 d. Communicate the needs of the client
Evaluating the client’s learning needs and his/her readiness to learn is assuming the role of an educator or
teacher. A, C, and D are demonstrating advocacy.
15.    Florence Nightingale became the “Mother of Modern Nursing” for the reason of:
 a. Providing services to the wounded soldiers during the Crimean war
 b. Establishing the red cross movement
 c. Bringing light of what a professional nursing should really be and putting up a school of
nursing
 d. Serving all patients for free
Florence Nightingale became the “Mother of Modern Nursing” because she brought light of what a
professional nursing is and put up a school of nursing.
16.    A nurse is obtaining supplies necessary to start an IV line for a client who will be undergoing blood
transfusion. Which needle size should the nurse select for the initiation of the IV?
 a. 23-gauge
 b. 18-gauge
 c. 20-gauge
 d. 25-gauge
For the administration of blood products 16-, 18- or 19- gauge is used. For peripheral fat emulsion infusions,
a 20- or 21- gauge needle is used. A 22- or 23- gauge needle is used for the standard IV solutions. 25-
gauge needles are used for subcutaneous injections.
17.    A client on clear liquid diet complained of nausea and has vomited. The doctor prescribed an anti-
emetic drug. After the administration of the drug, the client appears to be relaxed. After 4 hours the client
asked for something to eat because he is hungry. Which food is appropriate to be given to the client?
 a. Apple juice
 b. Hot tea
 c. Hot milk
 d. Dry toast
 Cold foods or room temperature foods are better tolerated by a client who is nauseated. Hot food items may
increase the nausea because of the aromas emitted. Dry toast and crackers are tolerated by nauseated
clients. However, in this case the client is on a clear liquid diet, thus, dry toast should not be given.
18.    The client who underwent a nasal surgery was brought back to the surgical unit. Which position would
the nurse anticipate for the doctor to prescribe in this client, in order to reduce swelling?
 a. Fowler’s position
 b. Lithotomy position
 c. Sim’s position
 d. Prone position
To reduce nasal swelling the client’s upper body part should be elevated (fowler’s position). Lying flat would
not provide relief of nasal swelling.
19.    A nasogastric tube is in place. Nurse Anna keeps in mind that though NGT is beneficial in some clients
its use still present possible complications. One of the common complications is aspiration pneumonia. What
causes aspiration pneumonia in NGT feeding?
 a. Streptococcus pneumonia
 b. a virus reaches the lungs when airborne droplets are inhaled through the mouth and nose
 c. Histoplasma capsulatum and blastomyces infestation
 d. Regurgitation of formula contents from the stomach into the respiratory tract
Aspiration pneumonia is a common complication of NGT feeding. It is caused by the regurgitation of formula
contents from the stomach into the respiratory tract. a. Streptococcus pneumonia – bacterial pneumonia b. a
virus reaches the lungs when airborne droplets are inhaled through the mouth and nose – viral pneumonia c.
Histoplasma capsulatum and blastomyces infestation – fungal pneumonia
20.    To prevent aspiration pneumonia, what should the nurse do?
 a. Place the client in a left-side lying position
 b. Elevating the head of bed at all times
 c. Increase fluid intake of the client
 d. Place the client in a right side-lying position
A common complication is aspiration pneumonia, which is caused by regurgitation of formula contents from
the stomach into the respiratory tract. Keeping the head of the bed elevated 30 degrees at all times assists
in preventing this complication.
21.    Formulating a patient’s discharge plan begins during:
 a. Prior to patient discharge
 b. During admission
 c. A day after the surgery
 d. When the client leaves the hospital
Discharge plan should be formulated on the day of admission.
22.    The surgeon is liable for the negligent acts of the nurses and other members of the OR team during a
surgery when he/she has the right to control and supervise. This is based on the on rule or doctrine called:
 a. Doctrine of respondent superior
 b. Borrowed servant rule
 c. Doctrine of corporate negligence
 d. Res Ipsa Liquitor
By the borrowed servant rule, the surgeon is liable for acts of team members only when he or she has the
right control and supervise the way in which the an RN or surgical technologist performs the work. Doctrine
of respondent superior – an employer is held liable for the employee’s negligent conduct (master-servant
employment relationship. Doctrine of corporate negligence – facility is held liable not because of the
negligence of the employees but for its own negligence in failing to ensure an acceptable level of care is
provided. In the common law of negligence, the doctrine of res ipsa loquitur (Latin for "the thing speaks for
 itself") states that the elements of duty of care and breach can be sometimes inferred from the very nature of
the accident, even without direct evidence of how any defendant behaved. Upon a proof of res ipsa loquitur,
the plaintiff need only establish the remaining two elements of negligence—namely, that the plaintiff suffered
damages, of which the accident was the legal cause.
23.    Any nurse practicing nursing without license is guilty of:
 a. Tort
 b. Malpractice
 c. Misdemeanor
 d. Negligence
A nurse who is practicing nursing without license is guilty of misdemeanor. A tort is a legal wrong committed
by a person involving injury of another or loss of or damage to personal property. A malpractice is any
professional misconduct, unreasonable lack of skill or judgment, or illegal or immoral act. Negligence is
defined as failure to use such care as a reasonably prudent and careful person would use under similar
circumstances.
24.    What is the main difference between assault and battery?
 a. Assault is the carrying out of physical harm while battery is a threat to harm someone physically.
 b. Assault is a legal wrong committed by a person involving injury of another or loss of or damage
to personal property while battery is failure to use such care as a reasonably prudent and careful person
would use under similar circumstances.
 c. Assault is failure to use such care as a reasonably prudent and careful person would use under
similar circumstances while battery is a legal wrong committed by a person involving injury of another or
loss of or damage to personal property.
 d. Assault is done by telling someone that you will kill or harm him physically while battery
is the performance of the actual physical harm.
Assault is an unlawful threat to harm another physically while battery is the carrying out of body harm, as by
touching the person without authorization or consent. A tort is a legal wrong committed by a person involving
injury of another or loss of or damage to personal property. Negligence is defined as failure to use such care
as a reasonably prudent and careful person would use under similar circumstances.
25.    A foreign object is left in a patient’s body which results to sustained injury by a patient. Which doctrine
applies in this situation?
 a. Doctrine of respondent superior
 b. Borrowed servant rule
 c. Doctrine of corporate negligence
 d. Res Ipsa Liquitor
In the common law of negligence, the doctrine of res ipsa loquitur (Latin for "the thing speaks for itself")
states that the elements of duty of care and breach can be sometimes inferred from the very nature of the
accident, even without direct evidence of how any defendant behaved. Upon a proof of res ipsa loquitur, the
plaintiff need only establish the remaining two elements of negligence—namely, that the plaintiff suffered
damages, of which the accident was the legal cause. By the borrowed servant rule, the surgeon is liable for
acts of team members only when he or she has the right control and supervise the way in which the an RN
or surgical technologist performs the work. Doctrine of respondent superior – an employer is held liable for
the employee’s negligent conduct (master-servant employment relationship. Doctrine of corporate
negligence – facility is held liable not because of the negligence of the employees but for its own negligence
in failing to ensure an acceptable level of care is provided.
26.    The four D’s of malpractice includes the following choices apart from:
 a. Duty to demonstrate and deliver a standard of care directly proportional to the degree of
specialty training received.
 b. Deviation of that duty by omission or commission.
 c. Damage to the nurse or nurse’s personal property.
 d. Direct cause of a personal injury or damage because of deviation of duty.
The four D’s of malpractice are: • Duty to demonstrate and deliver a standard of care directly proportional to
the degree of specialty training received. • Deviation of that duty by omission or commission. • Damage to
the PATIENT or personal property. • Direct cause of a personal injury or damage because of deviation of
duty.
27.    Liability for assault and battery may be charged if the surgeon goes beyond the limits to which the
patient consented. However, during the operation, the surgeon performed an additional surgery during the
course of an authorized surgical procedure to correct an abnormality when an unexpected condition is
encountered. Which doctrine implies that the doctor is not charged of assault and battery?
 a. Doctrine of respondent superior
 b. Extension doctrine
 c. Doctrine of informed consent
 d. Doctrine of Res Ipsa Liquitor
Extension doctrine implies that the patient’s explicit consent for surgical procedure serves as an implicit
consent for any or all surgical procedures deemed necessary to cope with unpredictable situations that
jeopardize the patient’s health. Doctrine of informed consent recognizes the physician’s duty to inform the
patient and obtain consent before treatment.
28.    The physician fails to inform the patient about the surgical operation and the nurse did not obtained an
informed consent before the surgical procedure is done. The acts of the medical team is considered as:
 a. Malpractice
 b. Assault
 c. Breach of duty
 d. Battery
Doctrine of informed consent recognizes the physician’s duty to inform the patient and obtain consent before
treatment. Failure of doing this may be considered a breach of duty.
29.    Which of the following is true of continuing education?
 a. Continuing education is a measurement of proven competence in practice.
 b. Continued education helps the practitioner keep abreast of current trends and practices.
 c. Continuing education is the only method of self-development.
 d. Continuing education is not a personal responsibility but rather should be mandated by the
institution.
Continued education helps the practitioner keep abreast of current trends and practices. It is NOT a
measurement of proven competence in practice, but it is the most widely accepted method of self-
development. Joining workshops, seminars, conferences and other educational offerings are personal
responsibility of professional nurses and surgical technologist.
30.    To safeguard the OR team from possible lawsuits, which of the following preventive strategy should be
implemented:
 a. Maintenance of good communications with each team members.
 b. Establishing a positive rapport with patients.
 c. Documentations of assessments, interventions and evaluations of patient care.
 d. All of the above.
A preventive strategy in OR the following should be done: • Maintenance of good communications with each
team members. • Establishing a positive rapport with patients. • Documentations of assessments,
interventions and evaluations of patient care. • Compliance with legal statutes and standards of accrediting
agencies, professional associations and health care facility. • Control of further insult or damage if an injury
occurs by reporting problems and taking corrective actions.
 For Questions no. 31-40 Situation: Charles, a 4-year old child, was brought to the ER who is observed to be
drooling, has a hyperextended neck and is leaning in a tripod position. The child has a fever, has difficulty
breathing and muffled cough and looks very
ill.___________________________________________________________________________31.  
Basing on the given data, the child most likely has the respiratory disorder of:
 a. Laryngotracheobronchitis
 b. Epiglottitis
 c. Croup
 d. Pneumonia
Epiglottitis is presented with a muffled cough, drooling and hyperextension of the neck (due to painful
swallowing), sits in a tripod position and looks very ill. Cough in epiglottitis is muffled while cough in
laryngotrachebronchitis or croup is a croup/barking cough.
32.    As the child’s condition is considered an emergent one, which equipment should the nurse prepare at
the bedside?
 a. Endotracheal tube
 b. Nasogastric tube
 c. Tongue depressor
 d. Catheter
In epiglottitis Endotracheal tube (ET tube) is prepared at the bedside for possible airway obstruction.
Manipulating the airway through the use of tongue depressor is contraindicated for clients with epiglottitis as
this can cause further worsening of the condition.
33.    During assessment the nurse expects that Charles' history of present illness would possibly reveal
which of the following data?
 a. Aspiration
 b. Cough becoming worst at night
 c. Tonsillitis
 d. Eating disorder
Epiglottitis is usually preceded by an upper respiratory tract infection such as tonsillitis, pharyngitis, sinusitis,
common colds, laryngitis and otitis media. In epiglotitis, the affected child suddenly becomes very ill. Cough
becoming worst at night is noted with croup or laryngotracheobronchitis. Eating disorders has not been
associated with epiglotitis.
34.    The doctor ordered diagnostic test to be performed to Charles. Basing on the patient’s condition the
nurse would expect which of the following test to be done to the client?
 a. Lateral neck radiograph
 b. Echocardiogram (ECG)
 c. Mantoux test
 d. Bronchoscopy
Lateral neck radiograph will show an enlarged epiglottis in epiglottitis. Mantoux test is used to signify the
exposure to Mycobacterium Tubercle Bacilli. A bronchoscopy is the direct observation of the larynx, trachea
and bronchi through a flexible or rigid bronchoscope. This diagnostic test is used in removing a foreign
object or to excise lesions and is not used in epiglotitis. ECG is used for cardiovascular disorders.
35.    Which of the following physician’s order should the nurse question in the case of Charles?
 a. Cefuroxime 20 mg/kg IV every 12 hours
 b. Cefuroxime 125 mg PO every 12 hours
 c. Endotracheal intubation
 d. Prophylactic tracheostomy
 Second-generation cephalosporin (e.g Cefuroxime) may be prescribed by the physician for Epigottitis.
Because children with epiglottitis can’t swallow the medication is administered through the IV line. Children
like Charles’ case need a prophylactic tracheostomy or endotracheal intubation.
36.    Charles is in what stage of cognitive development according to Jean Piaget’s theory?
 a. Sensorimotor
 b. Preoperational stage
 c. Concrete operational
 d. Formal operations
Charles is 4 years old and is under the preoperational stage of cognitive development. Sensorimotor: 0-24
months Preoperational Stage: 2-7 years old Concrete Operations: 7-11 years Formal Operations: 12-
adulthood
37.    The nurse expects that Charles is most afraid of:
 a. Unfamiliar people
 b. Strangers
 c. Being fat or having acne
 d. Being cut or wounded
Preschoolers (3-5 y.o.) is having a castration anxiety. They are afraid to be cut or wounded. Stranger anxiety
– infancy Separation anxiety – toddler Castration anxiety – preschooler
38.    Knowing Charles age, the nurse would expect these characteristics to be observed in the patient apart
from:
 a. Button buttons
 b. Lace shoes
 c. Identifies with his mother and is attached to his father
 d. Curious, creative, imaginative and imitative
By 4 years of age you expect a child to button buttons (the child learns to unbutton first before buttoning)
and lace shoes. Preschoolers are curious, creative, imaginative and imitative. Complexes are present at this
age where the child identifies with the same sex and is attached by the parent of the opposite sex. For
Charles, Oedipal complex will be noted where he will identify with his father and will be attached to his
mother.
39.    Regarding dental hygiene the nurse expects Charles (basing on his age) to do which task?
 a. Brushing teeth alone
 b. Brushing teeth with assistance
 c. Begins brushing teeth
 d. All of the above
Beginning of toothbrush: 2 ½ years Brushing teeth with little assistance: 3 years Brushing teeth alone: 6
years old
40.    Based on Erik Erickson’s psychosocial theory, Charles is in what stage?
 a. Initiative vs. Guilt
 b. Phallic
 c. Autonomy vs. Shame and Doubt
 d. Latency
Preschoolers are under the developmental task of initiative vs. guilt. Phallic is also for preschoolers but it is
under the psychosexual development of Sigmund Freud. Autonomy vs. Shame and Doubt – Toddler
Latency – (Psychosexual) Schoolage
For Questions no. 41-43 Situation: A student is brought to the school clinic because of a nose bleeding
episode._________________________________________________________________________41.  
Which of the following interventions, when done by the school nurse should be corrected?
 a. Cold compress application
 b. Instruct the student not to blow the nose for 2 days after the removal of the nasal packs.
 c. Avoid oral-temperature taking.
 d. Pressure over the soft tissue of the nose for 2-3 minutes.
Pressure over the soft tissue of the nose should be continuously done for at least 5 minutes to stop the
bleeding. Nursing interventions for epistaxis: • Sit-up, lean forward, head-tipped. • Cold compress • Nasal
pack with neosenephrine (3-5 days) Liquid diet, then soft diet Avoid oral-temperature taking Do not blow
nose for 2 days after the removal of the nasal pack • Notify physician if epistaxis is recurrent
42.    The doctor identified the student’s case to be an anterior nose bleeding which accounts for the most
common type. The following management is applicable in this case apart from:
 a. Proper positioning
 b. Application of topical vasoconstrictors
 c. Pressure over the soft tissues of the nose
 d. Nose packing with gauze impregnated with petroleum jelly or antibiotic ointment
There are two types of nose bleeding (NB), anterior NB and posterior NB. The most common type, anterior
NB is managed by proper positioning, pressure (5-10 minutes) and topical vasoconstrictors
(neosenephrine). Posterior NB, the rare form can be managed by a cotton tampon, suctioning, and if
bleeding is not identified nose packing with gauze impregnated with petroleum jelly or antibiotic ointment
may be used. However prior to insertion, a typical spray and decongestant may be used.
43.    The student asked the nurse of what are the possible causes of nose bleeding or epistaxis. The nurse
correctly identifies the cause of epistaxis by stating which of the following?
 a. “Irritation of the nasal cavity most commonly causes the rupture of tiny, distended
vessels in the mucous membrane of any area of the nose.”
 b. “All posterior nose bleeding episodes are caused by a deviated nasal septum.”
 c. “Humidity has nothing to do with nose bleeding.”
 d. “Drinking ASA most commonly cause nose bleeding.”
The most common cause of nose bleeding is the irritation of the nasal mucosa that resulted to the rupture of
tiny, distended vessels. Not all posterior nose bleeding is caused by a deviated nasal septum. Low humidity
causes epistaxis. Drinking ASA can cause bleeding tendencies but it is not the common cause of epistaxis.
For Questions no. 44-46 Leadership is a learned behavior involving influence and role modeling that
inspires people to achieve personal and group
goals._________________________________________________________________________44.    
During a meeting the head nurse allows the nursing staff to make decisions concerning the
completion of their work. She provided the members with all the materials they need to accomplish their
goals and allowed them to set their goal independently. The head nurse is using which style of leadership?
 a. Authoritarian
 b. Democratic
 c. Laissez Faire
 d. Multi critic
The Laissez Faire Leadership Style was first described Lewin, Lippitt, and White in 1938 along with the
autocratic leadership and the democratic leadership styles. The laissez faire style is sometimes described as
a "hands off" leadership style because the leader provides little or no direction to the followers. The
characteristics of the laissez faire style include: • Allows followers to have complete freedom to make
decisions concerning the completion of their work or ask questions of the leader • The leader provides the
followers with the materials they need to accomplish their goals and answers questions to the follower's
questions. Authoritarian - directive style of supervision * Low degree of participation by the people involved *
High degree of punitiveness * Pressure placed on the worker for output Democratic Leadership - conducive
to the process of exploration and discovery of the individual. MAJOR ELEMENT - MUTUAL TRUST Multi
critic - Leader utilizes varying styles depending on the situation.
 45.    In another hospital the head nurse does not consult the employees for any problems and decides on
her own. She does not allow any one during meeting to give any output and expect the members to obey the
orders without explanation. A structured set of rewards and punishments are produced to motivate everyone
to follow. This is an example of which leadership style?
 a. Authoritarian
 b. Democratic
 c. Laissez Faire
 d. Multi critic
Authoritarian - directive style of supervision * Low degree of participation by the people involved * High
degree of punitiveness * Pressure placed on the worker for output
46.    Which of the following situations does a democratic leadership style should not be used?
 a. The manager doesn’t understand his or her responsibilities and is hoping the employees can
cover for him or her.
 b. Managers are unable to thank employees for their good work.
 c. There is not enough time to get everyone’s input.
 d. All of the above
Democratic leadership should not be used when: • There is not enough time to get everyone’s input. • It’s
easier and more cost-effective for the manager to make the decision. • The business can’t afford mistakes. •
The manager feels threatened by this type of leadership. • Employee safety is a critical concern. Laissez
Faire leadership style should not be used when: • It makes employees feel insecure at the unavailability of a
manager. • The manager cannot provide regular feedback to let employees know how well they are doing. •
Managers are unable to thank employees for their good work. • The manager doesn’t understand his or her
responsibilities and is hoping the employees can cover for him or her.
47.    "The increase in the fertility rate in the United States from the years 1976 to 2006 was due to
increased levels of income and economic stability." The independent variable in this statement is:
 a. Fertility rate
 b. Income and economic stability
 c. In the United States from the years 1976-2006
 d. Increase in fertility rate
An independent variable is a variable that brings change or affects a dependent variable. Income and
economic stability causes a change in the fertility rate in the US from the years 1976-2006. If the income and
economic stability is increased the fertility rate also surges. Thus, the income and economic stability is the
independent variable as it causes change in the dependent variable (fertility rate).
48.    Danny and Jane decided to study the effects of incomplete laboratory equipments to the level of
competency of nursing students. The dependent variable in the statement is:
 a. Level of competency
 b. Laboratory equipments
 c. Nursing students
 d. Danny and Jane
A dependent variable is a variable that is changed by the interference of an independent variable. In this
case, Jane and Danny initiate the study on the effects incomplete laboratory equipments to the level of
competency in nursing students. Thus, the incomplete laboratory equipments (independent variable) can
have an EFFECT to the level of the competency (dependent variable) of nursing students.
49.    Abstract in writing up a research has the following purposes except:
 a. Re-establish the topic of the research
 b. Indicate the methodology used
 c. Present the main conclusion
 d. Introduce the research by presenting its context or background
 The main purpose of an INTRODUCTION is to introduce the research by presenting its context or
background. Introductions usually go from general to specific, introducing the research problem and how it
will be investigated). The main purpose of an ABSTRACT is to summarize the research (particularly the
objective and the main finding/conclusion), NOT to introduce the research area.
50.    IMCI strategy is very important for nurses to know. Which statement incorrectly identifies the principle
of integrated care?
 a. All sick children must be examined for “general danger signs”.
 b. Diagnosis is the topmost priority in IMCI.
 c. Counseling of caretakers about home management
 d. Use limited number of essential drugs and encourage active participation of caretakers in the
treatment of children
Classification(s) rather than a diagnosis is the topmost priority in IMCI. PRINCIPLES of integrated care:
All sick children must be examined for “general danger signs”. All sick children must be routinely
assessed for: major symptoms, nutritional, Vit A and Immunization status, feeding problems, other potential
problems  Classification(s) rather than a diagnosis Only limited number of carefully-selected clinical signs
Address most, but not all, of the major reasons a sick child is brought to a clinic Use limited number of
essential drugs and encourage active participation of caretakers in the treatment of children Counseling of
caretakers about home management