PHILIPPINE NURSING

LICENSURE EXAM
Carpe Diem !
“Victory belongs to those who are most persevering. Ad Majorem Dei
Gloriam.”

”I solemnly pledge myself before God and in the presence of this assembly
to pass my life in purity and to practice my profession faithfully...”

NURSING PRACTICE I
1. HANDWASHING

Handwashing can help prevent illness. It involves five simple and effective steps you 1.Duration of scrubbing: ______________
can take to reduce the spread of diarrheal and respiratory illness so you can stay
healthy. Which one is not included? 2. Hum the “Happy Birthday” song from beginning to
A. Wet end _____________.
B. Lather
C. Scrub 3. Alternative if no soap and water: ______________
D. Rinse
E. Dry 4. Most Important Aspect: ______________
F. Break
2. SDGs
1.SDGs came into effect in ______________
The Sustainable Development Goals (SDGs) are a universal call to action to end
poverty, protect the planet and ensure that all people enjoy peace and prosperity. 2.Funding until ______________
The 17 SDGs are also known as:
A. International Goals 3.Lead UN development agency _______________
B. Global Goals
C. Universal Goals
D. National Goals

GOAL 1: No Poverty GOAL 10: Reduced Inequality

GOAL 2: Zero Hunger
GOAL 3: Good Health and Well-being
GOAL 4: Quality Education
GOAL 5: Gender Equality
GOAL 6: Clean Water and Sanitation
GOAL 7: Affordable and Clean Energy
GOAL 8: Decent Work and Economic Growth
GOAL 9: Industry, Innovation and Infrastructure
GOAL 11: Sustainable Cities and Communities
GOAL 12: Responsible Consumption and Production
GOAL 13: Climate Action
GOAL 14: Life Below Water
GOAL 15: Life on Land
GOAL 16: Peace and Justice Strong Institutions
GOAL 17: Partnerships to achieve the Goal

3. PULMONARY TUBERCULOSIS  caused by Mycobacterium tuberculosis

 aka: Koch’s Dse [Dr. Robert Koch] TESTS

Which anti-TB drug is given parenterally? 1.Screening: _______________

A. Rifampicin 2.Reaction to Tuberculin Test: ______________
B. Isoniazid Category 1: __RIPE __RI 3.Confirmatory: _____________
C. Pyrazinamide Category 2: __RIPES __RIPE __RIE 4.Determination of extent of lung parenchymal
D. Ethambutol Category 3: __RIP __ RI involvement: ________________
E. Streptomycin 5.Determination of antibiotic for MDR-TB: ________
4. DENGUE HEMORRHAGIC FEVER
1.Confirmatory Test: _______________
Which of the following is not expected in clients with DHF?

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 A. Falling platelet count 2.Other name for Capillary Fragility Test: _________
B. Rising hematocrit level
C. Prolonged bleeding time 3.# of petechiae: ___________
D. Thrombocytosis
E. Poor coagulation 4.Sign of Plasma Leakage: _______________

Alert: 5.Primary Intervention for DHF: ______________

 Delayed capillary refill is a sign of circulatory failure.
 IVF and BT are no longer routine managements for Dengue. 6.Contraindicated Drugs: ______________
 Give ORAL fluids as tolerated.
 IVF is given if patient is unable to drink. 7.Antibiotic to be given: _______________
 BT is administered if there is low platelet, low hematocrit and uncontrolled
bleeding. 8.Anti-mosquito Plants: _________________
 Dengue can cause Acute Encephalopathy.
9.Herbal Remedy Being Studied to Increase Platelet
Count: _____________

5. BMI
1.Other Name: __________________
Which of the following is not true about Body Mass Index (BMI)?
A. It is a person’s weight in kilograms divided by the square of height in meters. 2.Person who devised the index: ________________
B. A high BMI can be an indicator of high body fatness.
C. BMI can be used to screen for weight categories that may lead to health 3.Categories:
problems.
D. It is diagnostic of the health of an individual. 3a____________: < 18.5
3b____________: 18.5 – 24.9
BMI = weight in Kg or weight in lbs x 703 3c____________: 25 – 29.9
(height in meter)2 (height in inch )2 3d____________: > 30

6. MAD COW DISEASE

1.Other Name: ___________________
Mad Cow Disease in human is known as: 2.Agent: ________________________
A. Bird Flu 3.Source: _______________________
B. Swine Flu 4.Initial Sign: ____________________
C. Rabbit Fever 5.Late Signs: ____________________
D. CJD 6.Life Expectancy: _______________
7.Cure: _________________________

7. STD / STI
RECOMMENDED TREATMENT FOR STD’s
Which of the following STD’s can cause neurologic deficit secondary to stroke-like
syndrome? 1.Gonorrhea: _____________________
A. Gonorrhea [Neisseria gonorrhea] 2.Syphilis: ________________________
B. Syphilis [Treponema pallidum] 3.Candidiasis: ____________________
C. Candidiasis [Candida albicans] 4.Genital Warts: __________________
D. Genital Warts [Human Papilloma Virus] 5.Herpes Genitalis: ________________
E. Herpes Genitalis [Hepes Simplex Virus – II]

8. FHSIS
FHSIS provides summary data on health service delivery and selected program from
the barangay level up to the national level. FHSIS means:
A. Field Health System and Information Services
B. Field Health Station and Information System
C. Field Heath Services and Information System
D. Community Organizing and Participatory Action Research
COMPONENTS OF FHSIS
1._______________: fundamental block
2._______________: contains complaint, Dx, Tx
3._______________: secondary building block
4._______________: for monitoring and supervision
5._______________: aka Tally Form
6._______________: for transmitting data
7._______________: reflects the outcome of services
8._______________: from prov’l office to DOH

NURSING PRACTICE II
9. FAMILY PLANNING

Which of the following is correct statement about when the diaphragm needs to be 1. IM (Lunelle)  Estro + Proges: _____________
refitted? 2. IM (Depo-Provera)  Proges: ______________
A. After a weight gain or loss of 10 to 20 lb (4.5 to 9 kg ) 3. SubQ Implant (Norplant)  Proges: _________
B. After any surgical procedure 4. IUD (Mirena): ____________________________
C. Every 10 years 5. IUD (Paragard – Copper T380): _____________
D. After a change in sexual partner
10. DISCOMFORTS OF PREGNANCY Managing the Discomforts of Pregnancy
~ backache
Which of the following refers to Couvade Syndrome?  pelvic rocking exercise, tailor sitting
A. Nausea and vomiting upon waking up ~ leg cramps [due to hypocalcemia]
B. Severe nausea and vomiting extending beyond first trimester that causes F and E  knee extension + foot dorsiflexion

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 imbalance ~ ankle edema
C. Excessive craving for non-nutritional substances which is associated with IDA  elevate the legs
D. Physical symptoms experienced by men, such as nausea, vomiting, and ~ morning sickness
backache to the same degree or even more intensely than their partners during a  dry crackers, small frequent meals, limit fluid
pregnancy intake in the morning
~ constipation
 increase OFI & fiber, X laxative
11. EPISIOTOMY
Tocolytic Drugs
Episiotomy, a common procedure in obstetric care, is associated with the need for
suture and healing complications in the postpartum period. A scale is used as a tool - Terbutaline (Bricanyl, Brethine)
to assess the inflammatory process and tissue healing in the perineal trauma, through
the evaluation of five items of healing which include the following. SATA. - Isoxsuprine (Duvadilan)
A. R edness
B. E dema - Dydrogesterone (Duphaston)
C. E cchymosis
D. D ischarge - Ritodrine (Yutopar)
E. A approximation of wound edges
12. UTERINE CONTRACTION Uterotonic Drugs

The priority assessment before administration of Methergine is: Oxytocin [Syntocinon, Pitocin]
A. Respiratory rate Methylergonovine maleate [Methergine]
B. Blood pressure
C. Pulse rate ~ intra-partum: risk for tetanic contractions
D. Temperature ~ post-partum: risk for uterine atony
13. ABRUPTIO PLACENTA
Couvelaire Uterus
Which of the following would the nurse most likely expect to find when assessing a - “uteroplacental apoplexy”
pregnant client with abruptio placenta? - board-like uterus w/o apparent bleeding
A. Excessive bright red vaginal bleeding
B. Rigid, board-like abdomen DIC – complication of abruption placenta
C. Soft and boggy uterus  disseminated intravascular coagulopathy
D. Premature rupture of membranes  problem: localized coagulation & paradoxic
systemic bleeding
 Rx: IV Heparin
14. PRETERM LABOR
Steroid (IM)
A preterm labor is the delivery of conceptus after 20th week up to before the end of - if AOG is < 34 weeks
37th week. Which of the following is detected through vaginal mucus that serves as - purpose: to accelerate lung surfactant maturation
basis whether delivery is ready to occur? * Betamethasone
A. Lecithin * Dexamethasone
B. Sphingomyelin
C. Fibronectin If preterm baby is delivered with signs of
D. Rhesus factor respiratory distress, expect to administer_________
to be administered via what route? ____________
15. SUDDEN INFANT DEATH SYNDROME

SIDS is the sudden death of an infant less than 1 year of age that cannot be explained after a thorough investigation of the cause of death is
conducted. Which of the following is not true about SIDS?
A. Always place infants on their back to sleep because this position.
B. Use of a pacifier while an infant sleeps.
C. With apnea monitoring in place, an alarm sounds when the neonate experiences a period of apnea of 20 seconds or longer or a decreased
heart rate below 80 beats per minute.
D. In case the apnea monitoring alarm sounds, jiggle the baby, begin mouth-to-mouth resuscitation, call the emergency response personnel.
E. The exact cause of SIDS is well-known.
16. SICKLE CELL ANEMIA
SICKLE CELL CRISIS
Sickle-cell anemia is the presence of abnormally shaped (elongated / crescent-shape)
RBCs. Which of the following is not related to SCA? 1.____________: clumping of RBC that causes
A. SCA is an autosomal recessive inherited disorder. obstruction in blood vessels  ischemia and pain
B. It is triggered by exposure to low oxygen tension (less than 60% to 70%), a low 2.____________: pooling of RBC in organs like liver
blood pH (acidosis), or increased blood viscosity, such as occurs with and spleen  abdominal enlargement
dehydration or hypoxia. 3.____________: rapid destruction of RBC leading to
C. Hemoglobin electrophoresis is used to diagnose sickle-cell anemia. hyperbilirubinemia  jaundice
D. Therapeutic management includes pain relief, oxygenation and fluid restriction. 4.____________: decreased production of RBC leading
E. None of the above. to anemia  bone marrow will compensate by
producing more blood cells  thickening of bones

NURSING PRACTICE III

17. HIV / AIDS
1.Old Name of HIV: ___________________
The most common opportunistic infection in AIDS is pneumocystis pneumonia 2.Screening: __________________________

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[PCP]. This infection is caused by which micro-organism? 3.Confirmatory: ______________________
A. S. pneumoniae 4.Staging: ____________________________
B. P. jirovecii 5.HIV Asymptomatic: _________ [ > 500 ]
C. M. tuberculosis 6.HIV Symptomatic: __________ [ 200 – 499 ]
D. S. aureus 7.AIDS: ____________________ [ < 200 ]
8.World AIDS Day: ____________________
9.Color of Ribbon: _____________________
10.Highest Prevalence of AIDS: ___________

18. ARDS
Acute Respiratory Distress Syndrome (ARDS) is a condition that refers to non-
cardiogenic pulmonary edema. Sudden and progressive pulmonary edema will cause
a decreased lung compliance that eventually leads to impaired gas exchange and
hypoxemia. Signs and symptoms includes the following, except:
A. Arterial hypoxemia
B. Chest retractions
C. Dyspnea
D. Pleural friction rub
19. CLOSED TUBE THORACOSTOMY
While transporting the client to the ward, the client suddenly became agitated and
pulls out the tube from the chest. What is the best action of the nurse?
A. Insert one finger to the site of insertion.
B. Cover the insertion site with sterile vaselinized gauze.
C. Reconnect the tube.
D. Encourage verbalization of feelings since the patient will be agitated.
Respiratory Support
 R est (to limit oxygen consumption)
 O xygen therapy (to increase oxygenation supply)
 M echanical ventilation (iron lung machine)
 E ndotracheal intubation or tracheostomy (to assist
with mechanical ventilation)
1.Bedside Equipment: _________________________
2.Normal Bubbling: ___________________________
3.Sign of Air Leak: ___________________________
4.Sign of Obstruction: _________________________
5.Sign of Lung Re-expansion: ___________________
6.If tube is disconnected: _______________________
7.If tube is dislodged: __________________________

20. CONGESTIVE HEART FAILURE

A home care nurse is making a routine visit to a client receiving digoxin (Lanoxin) in D aily weight monitoring
the treatment of heart failure. The nurse would particularly assess the client for: D iet [low fat, low Na, high K, high fiber]
A. Thrombocytopenia and weight gain D ilator [ACE-inhibitor]
B. Anorexia, nausea and visual disturbances D igitalis
C. Diarrhea and hypotension D iuretic
D. Fatigue and muscle twitching
21. PHANTOM SENSATION
________________: analgesia that results from the
After mastectomy, some patients experience phantom sensations and report a feeling expectation that a substance will work, not from the
that the breast or nipple is still present. Which of the following is an appropriate actual substance itself
nursing diagnosis for phantom pain?
A. Ineffective coping • A placebo effect is not an indication that the person does not
B. Disturbed sensory perception have pain; rather, it is a true physiologic response.
C. Impaired skin integrity • Placebos should never be used to test the person’s
truthfulness about pain or as the first line of treatment.
D. Disturbed body image
• A positive response to a placebo should never be interpreted
as an indication that the person’s pain is not real.
• A patient should never be given a placebo as a substitute for
an analgesic medication.
22. TRACHEOSTOMY
1.Normal cuff pressure: _________________________
Which of the following is not a purpose of tracheostomy? 2.Position: ___________________________________
A. To prevent aspiration 3.Technique within first month post-creation: _______
B. To allow of passage of air by mechanical ventilator 4.Frequency of tracheostomy care: ________________
C. To separate the upper and lower airway 5.Soaking solution: ____________________________
D. To bypass lower airway obstruction 6.Rinsing solution: _____________________________
7.Locking inner cannula: ________________________
8.Unlocking inner cannula: ______________________

23. SUCTIONING
* frequency: PRN / as necessary
Which of the following an inappropriate nursing action when performing * best indicator: noisy breathing
nasopharyngeal suctioning? * technique: sterile
A. Place the client in a semi-fowler’s position. * position
B. Measure length of catheter from the tip of the nose to the earlobe. - conscious: semi Fowler’s [30-45˚]
C. Hyperoxygenate patient with 100 % oxygen before and after suctioning. - unconscious: side lying
D. Apply continuous suction upon withdrawal of the suction catheter tip. * duration of a single suction
E. Do oronasal care after the procedure. - typical [ oral/nasal ]  10 – 15 secs
- tube [ ET / trache ]  5 – 10 secs
* most dreaded complication
- vasovagal reflex
* bradyarrhythmia  arrest
24. COLOSTOMY
1.Color: __________________________
Which of the following statement about stoma in the colostomy is true? 2.Sensation: _______________________
A. Normal color of stoma is fuchsia pink 3.Bleeding: ________________________

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 B. Slight or minimal pain at the site is just normal 4.Appearance: _____________________
C. Stoma site must be dry not moist 5.When to empty pouch: ____________
D. Slight bleeding initially when the stoma is touched is normal
25. ILEOSTOMY
 drainage is constant
An ileostomy can be expected after: * liquid stool
A. Abdomino-perineal Resection - risk: F & E imbalance
B. Traumatic injury to the distal colon * contains digestive enzymes
C. Inflammatory condition of the colon - risk: skin irritation
D. Colectomy  cannot be regulated
* always wear ostomy pouch/appliance/bag
26. NASOGASTRIC TUBE
1.Single Lumen Tube: ________________
What is the indicator that the nurse must already tilt the head and neck of the 2.Double Lumen Tube: _______________
patient forward during NGT insertion? 3.Triple Lumen Tube: ________ [Balloon Tamponade]
A. Gagging or retching 4.Length: ___________________________
B. Swallowing 5.Most Accurate [Placement]: ___________________
C. Intermittent choking 6.Most Common Bedside Method: ________________
D. Calm demeanor of patient 7.Most Dreaded Complication: ___________________
27. INTRAVENOUS FLUID THERAPY
Phlebitis Infiltration
Which of the following fluid should a nurse prepare when a doctor asks for a -swelling - swelling
hypertonic fluid that contains balanced electrolytes? -painful - painful
A. NSS -red - cold
B. LR -warm - cold
C. D5W
D. D5NSS Leaking of Vesicant [Oncovin]: _____________
E. D5LR Complication: ___________________________
F. D10W Intervention: ____________________________
G. ½ NSS
28. TOTAL PARENTERAL NUTRITION
1.Route: ____________________________________
A client is receiving nutrition by means of total parenteral nutrition (TPN). A nurse 2.Primary Component: ________________________
monitors the client for complications of the therapy and assesses the client for which 3.Drugs Compatible with TPN: _________________
of the following signs of hyperglycemia? 4.Determination of TPN Component: ____________
A. Nausea, vomiting and oliguria 5.Preparation of TPN Solution: _________________
B. Sweating, chills and abdominal pain 6.Essential Equipment: _______________________
C. Fever, weak pulse and thirst 7.BSL Monitoring: ___________________________
D. Thirst and increase urine output 8.Ideal Weight Gain: _________________________
29. DECUBITUS ULCER
RYB Color Coding for Wounds
Which of the following best describes stage III pressure ulcer? Red
A. Characterized by erythema that does not resolve within minutes of pressure - formation of granulation tissue
relief. skin remains intact. *** protection!
B. Partial thickness loss of skin involving the epidermis or dermis (may involve Yellow
both). The ulcer is superficial and may present as a blister, abrasion or shallow - acute or previous infection (purulent)
crater. Free of eschar. *** cleaning!
C. Partial thickness loss which goes through the dermis to the subcutaneous tissue Black
but does not extend through the underlying fascia. Appears as a crater and may - necrosis
include undermining. *** debridement!
D. Full thickness skin loss with extensive damage through the subcutaneous tissue
to the fascia and may involve muscle layers, joints and/or bone.
______________: risk assessment scale for bed sore
30. HEPATITIS
1._____________: Hepa B Surface Antigen
Deterioration of hepatic function may lead to hepatic encephalopathy which affects (+) of HB virus
the brain function. As a nurse, you should be aware that if this complication occurs,
the patient’s diet should be: 2._____________: IgM Hepa B Core Antibody
A. High carbohydrates, high protein. acute/recent infection (< 6 months)
B. High carbohydrates, low protein.
C. Low carbohydrates, high protein. 3._____________: Hepa B Core Antibody
D. Low carbohydrates, low protein. chronic infection

4._____________: Hepa B Surface Antibody

immunity thru vaccination
31. BLOOD TRANSFUSION
1.Antibody present in plasma: ______________
A nurse is signing for a unit of PRBC at the hospital blood bank. After putting the 2.Antigen present at RBC surface: ___________
pen down, the nurse glance at the clock, which reads 1:00. The nurse calculates that 3.1 unit whole blood: ______________________
the transfusion must be started by: 4.1 unit fresh frozen plasma: _______________
A. 1:30 5.1 unit packed RBC: _____________________
B. 2:00 6.1 unit platelet: __________________________
C. 2:30 7.Blood from Patient: _____________________
D. 5:00 8.Height of Blood Product: _________________
32. PANCREATITIS 1.Priority: ______________________________

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What is the expected dietary instruction for a client with acute pancreatitis? 2.Analgesic of choice: ____________________
A. Clear liquid – water, tea, coffee, ginger ale, strained and clear juices, carbonated
beverages, bouillon (fat-free broth), plain gelatin, candy 3.Old analgesic of choice: _________________
B. Full liquid – milk and milk drinks, puddings, custards, ice cream, sherbet,
cream, butter, margarine, smooth peanut butter, yogurt 4.Hormone imbalance: ____________________
C. Soft – chopped or shredded meat, scrambled eggs, omelet, poached eggs,
cheese, mashed potatoes, sweet potatoes, or squash 5.Result of hormone imbalance: ____________
D. Regular
E. DAT 6.Signs of hemorrhagic pancreatitis: _________
F. Nil Per Os
7.Risk: ________________________________

33. CHOLECYSTITIS F emale

F air
Which of the following information is not true about extracorporeal shockwave F at
lithotripsy (ESWL) procedure? F atty diet
A. ESWL uses strong gamma rays to fragment stones into smaller pieces. F requent weight change
B. The patient will be under sedation during the procedure. F ertile  high estrogen
C. Informed consent is necessary prior to the procedure. F orty y/o and up
D. Acoustic pulse will be utilized during the procedure. F amilial tendency
F oreigner  Native Americans
34. DIET

The most ideal diet is:

A. Clear liquid B. Full liquid C. Soft D. Regular E. DAT

35. LAXATIVE

What is the laxative of choice for clients with cardiac condition and increased ICP?
A. Bisacodyl [Dulcolax]
B. Psylium Hydrophilic Mucilloid [Metamucil]Metamucil
C. Docusate Sodium [Colace]
D. Mineral Oil
E. Lactulose [Lilac, Duphalac]
36. ENEMA SOLUTIONS USED IN ENEMA
* isotonic [ 0.9 % ]
Which of the following type of enema according to purpose is used for flatulence, - PNSS [ 500 – 1000 mL ]
except? - safest (no fluid shifting)
* hypertonic [ > 0.9 % ]
A. Retention enema
- Na phosphate / Phospo-Soda / Fleet Enema
B. Carminative * hypotonic [ < 0.9 % ]
C. Return flow - tap water
D. Colonic irrigation * oils  for retention
- mineral oil, cottonseed oil, olive oil
* soap suds
- 1000 mL of PNSS or tap water + 5mL of soap
> Neutrogena, Cetaphil, Perla
37. COPD
1.Other Name: ____________________________
Low flow of oxygen is prescribed in COPD instead of high flow because the 2.Safest O2 Flow Rate [Non-COPD]: __________
administration of a high flow of oxygen to patients with this disorder can cause: 3.Safest O2 Flow Rate [COPD]: ______________
A. Explosion of the alveoli 4.Hallmark of Emphysema: _________________
B. Depression of medulla oblongata 5.Hallmark of Bronchitis: ___________________
C. Widening of the ribcage 6.Sign of chronic hypoxia: __________________
D. Loss of alveolar elasticity 7.Acid-base imbalance: _____________________
8.Used in Pulmonary Function Test: ___________
38. INCENTIVE SPIROMETRY
INCENTIVE SPIROMETRY
Arrange the following steps in order on the use of incentive spirometer.
__ S itting/upright or High Fowler’s  AKA: Sustained Maximal Inhalation (SMI)
__ P osition the device correctly
* do not tilt  device used to measure the amount of
* seal the lips tightly around mouth piece O2 inhaled via mouthpiece
__ I nhale slowly thru mouthpiece
* hold dial or ball for 2 – 6 seconds  purpose:
* exhale thru pursed lips - to promote maximum lung expansion
__ R epeat for 10x / hr whenever possible
__ O ral care after
39. EBOLA VIRUS DISEASE / EBOLA HEMORRHAGIC DISEASE
1.Agent: ______________________
Ebola is similar to Dengue in terms of manifestations, the agent or cause of this
illness attacks the body by: 2.Cause of death: _______________
A. Destruction of platelets and increasing capillary fragility leading to bleeding
B. Destruction of monocytes, vessel linings and clotting factors in the liver leading 3.Experimental Drug: ___________

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 to bleeding.
C. Destruction of RBC which in turn cause hemolysis and appearance of rashes and 4.Vaccine: _____________________
bruises
D. Destruction of bone marrow leading to myelosuppression then pancytopenia.

NURSING PRACTICE IV
40. CHEMOTHERAPY
Classification of Chemotherapeutic Drugs: _______
Which of the following statements is correct about the rate of cell growth in relation
to chemotherapy? Route:
A. Faster growing cells are less susceptible to chemotherapy. *oral
B. Non-dividing cells are more susceptible to chemotherapy *peripheral IV
C. Faster growing cells are more susceptible to chemotherapy *PICC (peripherally inserted central catheter)
D. Slower growing cells are more susceptible to chemotherapy.  insertion technique: __________
*local application thru craniotomy (Carmustine)
41. RADIATION THERAPY Brachytherapy Precaution
P rivate room [single room]
Nausea and vomiting are common adverse effects of radiation and chemotherapy. P rovide CBR s BRP
When should a nurse administer anti-emetics? - sedation / anesthesia
A. 30 minutes before the initiation of therapy - catheter
B. With the administration of therapy - anti-motility drugs & NPO status
C. Immediately after nausea begins P regnant / < 18 yrs old are not allowed
D. When therapy is completed P recaution when dislodged
- pick with long handled forceps
42. MASTECTOMY
1.Anti-estrogen: ________________________
Breast conservation surgery is also known as: 2.S/E of Nolvadex: ______________________
A. Lumpectomy 3.Screening: ___________________________
B. Total Mastectomy 4.Confirmatory: ________________________
C. Modified Radical Mastectomy 5.Drain Post-mastectomy: ________________
D. Radical Mastectomy 6.Surgery to Eliminate Estrogen: __________
43. CANCER SCREENING
Tumor Markers for Cancer
A male client has an abnormal result on a Papanicolaou test. After admitting, he
read his chart while the nurse was out of the room, the client asks what dysplasia 1._____________: colon
means. Which definition should the nurse provide? 2._____________: pancreas
A. Decrease in the size of cells 3._____________: prostate
B. Increase in the number of normal cells in a normal arrangement in a tissue or an 4._____________: cervical, ovarian
organ 5._____________: liver, testicle
C. Increase in the size of normal cells 6._____________: testicle, ovarian, choriocarcinoma
D. Alteration in the size, shape, and organization of differentiated cells
44. BREAST CANCER SVCS  Superior Vena Cava Syndrome

A nurse is teaching a group of women to perform monthly breast self-examination.  metastatic complication
The nurse should explain that the main purpose of performing the examination is to  problem:
discover: - spread of cancer cells to SVC
A. Cancerous lumps - blockage in the venous circulation
B. Areas of asymmetry  S/Sx:
C. Changes from previous self-examinations - edema (face, neck, arm, hands)
D. Fibrocystic masses * Stoke’s Sign
- dyspnea / SOB
- increased ICP
 Tx: Radiation to Sternal Area
45. PROSTATE CANCER S tony hard and fixed
T races of blood in urine and semen
For a male client newly diagnosed with radiation-induced thrombocytopenia, the R ectal discomfort
nurse should include which intervention in the plan of care? E jaculation is painful
A. Administering aspirin if the temperature exceeds 102° F (38.8° C) A bnormal urinary pattern
B. Inspecting the skin for petechiae - difficulty in starting urine
C. Providing for frequent rest periods - small stream of urine
D. Placing the client in strict isolation M etastasis
- leg / back pain
46. COLORECTAL CANCER
1.Fecal Occult Blood Test: __________
Which of the following is risk factor for colorectal cancer? 2.Screening: ______________________
A. History of IBS 3.Confirmatory: ___________________
B. History of IBD 4.Primary Intervention: ____________
C. History of impetigo 5.Bowel Diversion after APR: ______________
D. History of prolonged procainamide use 6.Bowel Diversion after Colectomy: _________
47. LARYNGEAL CANCER
V oice straining
A 35 years old client with laryngeal carcinoma has been receiving chemotherapy to O ver-exposure to:
treat cancer. Which assessment finding suggests that the client has developed - radon gas, mustard gas, asbestos

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stomatitis? - paint fumes, wood dust, cement dust
A. White, cottage cheese–like patches on the tongue - leather, rubber
B. Yellow tooth discoloration C igarette smoking & alcohol
C. Red, open sores on the oral mucosa A frican – American
D. Rust-colored sputum L olo
- men between 50 – 70 y/o
48. LEUKEMIA * Elevation of immature WBC
- infiltration to organs
ALL is a leukemia common in children. It is more prevalent among: > splenomegaly, hepatomegaly
A. Boys > abd’l pain & enlargement
B. Girls > meninges [inc. ICP] , large lymph nodes
C. Both * Decreased matured WBC [ Leukopenia ]
D. It depends. - immunosuppression
- prone to infection
* Decreased RBC [ Anemia ]
- hypoxia, fatigue, weakness, pallor
* Decreased Platelet [ Thrombocytopenia ]
- bleeding

49. MULTIPLE MYELOMA Diagnostic Sign: _______________________

A male client complains of bone pain, weight loss, and fatigue. Suspecting multiple WARNING SIGNS OF CANCER
myeloma, the physician orders a diagnostic workup, which reveals carcinoma of the C hange in bowel or bladder habit
plasma. Which nursing diagnosis may be appropriate for this client? A sore that does not heal
A. Anticipatory grieving U nusual bleeding or discharge
T hickening or lump
B. Impaired urinary excretion
I ndigestion / dysphagia
C. Disturbed body image O bvious change in wart or mole
D. Chronic low self-esteem N agging cough / hoarseness of voice

U nexplained anemia
S udden & unintentional weight loss
50. LYMPHOMA
ALARA  as low as reasonably achievable
A male client is diagnosed as having a bowel tumor and several diagnostic tests are
prescribed. The nurse understands that which test will confirm the diagnosis of S hield - lead-lined apron
malignancy?
A. Biopsy of the tumor T ime - 30 min / shift (8 hrs)
B. Abdominal ultrasound
C. Magnetic resonance imaging D istance - 6 ft
D. Computerized tomography scan
51. GLAUCOMA Rx to Decrease IOP:

The clinic nurse is preparing to test the visual acuity of a client using a Snellen chart. ~ Beta-adrenergic Blockers (-lol)
Which of the following identifies the accurate procedure for this visual acuity test? > Timolol (Tomoptic)  check BP & pulse
A. The unaffected eye is tested followed by the affected eye. ~ Carbonic Anhydrase Inhibitor
B. The client is asked to stand at a distance of 40ft. from the chart and is asked to > Acetazolamide (Diamox)
read the largest line on the chart. ~ Miotic – causes pupillary constriction
C. The right eye is tested followed by the left eye, and then both eyes are tested. > Pilocarpine (Piloptic)
D. The client is asked to stand at a distance of 40ft from the chart and to read the ~ Prostaglandin Analogue
line than can be read 200 ft away by an individual with unimpaired vision. > Latanoprost (Xalatan)
52. CATARACT What to expect post cataract extraction?
~ slight morning discharge
The client is being discharged from the ambulatory care unit following cataract ~ redness
removal. The nurse provides instructions regarding home care. Which of the ~ scratchy feeling
following, if stated by the client, indicates an understanding of the instructions? ~ blurred vision
A. “I will take Aspirin if I have any discomfort.”
B. “I will sleep on the side that I was operated on.” *** stabilization of vision is achieved 6-12 weeks after
C. “I will wear my eye shield at night and my glasses during the day.”
D. “I can carry anything after surgery.” What to report? ________________________
53. MACULAR DEGENRATION

The clinic nurse notes that the following several eye examinations, the physician has
documented a diagnosis of legal blindness in the client’s chart. The nurse reviews the Tool to assess metamorphopsia: _____________
results of the Snellen’s chart test expecting to note which of the following?
A. 20/20 vision
B. 20/200 vision
C. 20/1000 vision
D. 15/20 vision
54. RETINAL DETACHMENT
* “painless”
The client sustains a contusion of the eyeball following a traumatic injury with a
blunt object. Which intervention is initiated immediately? * curtain / shadow
A. Prepare for emergency enucleation.
B. Irrigate the eye with hot water. * cobweb
C. Apply ice to the affected eye.

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 D. Accompany the client to the operating room. * flashes of light / floater
55. MENIERE’S DISEASE TRIAD of Meniere’s
~ vertigo
When teaching the client about Meniere’s disease, which of the following instructions  accompanied w/ N/V
would a nurse give about vertigo?  risk: fall (injury)
A. Report dizziness at once but not the hearing loss. ~ tinnitus
B. Resume with usual driving activities.  “ringing” sensation
C. Get up slowly, while trying to avoid abrupt turning of head. ~ hearing loss
D. Always change your position using the logroll method.  “sensorineural”
56. PARKINSON’S DISEASE Triad Signs of PD
* tremors
A patient diagnosed with Parkinson disease (PD) is prescribed levodopa. The  “resting”, “pill rolling”
medication therapy can be considered effective when the healthcare provider assesses * rigidity
improvement in which of the following?  “stiffness” of muscles
A. Visual acuity - cogwheel rigidity
B. Appetite - mask-like facial expression
C. Urinary frequency * bradykinesia
D. Hearing  slow movement
The cause is unknown. Associated with diminished substancia nigra leading to low
dopamine level. Primary drug is Levodopa given together with Carbidopa. Levodopa can Note: Depression may be experienced by ct w/ PD.
cause nausea and hypotension. 

57. MYASTHENIA GRAVIS

1.Dx Test: ________________________
The nurse is teaching the female client with myasthenia gravis about the prevention
of myasthenic and cholinergic crises. The nurse tells the client that this is most 2.Drug for the Test: ________________
effectively done by:
A. Eating large, well-balanced meals 3.Priority in MG: __________________
B. Doing muscle-strengthening exercises
C. Doing all chores early in the day while less fatigued 4.Anti-cholinesterase: ______________
D. Taking medications on time to maintain therapeutic blood levels
5.Plasma Exchange to remove autoantibodies: _______
Autoimmune disorder causing a decreased level of acetylcholine resulting to muscle
weakness and descending paralysis. Initial sign is PTOSIS. 6.Surgery: _________________________

58. GUILLAIN BARRE SYNDROME Guillain Barre Syndrome (GBS)

Which of the following statement about GBS is fallacious?  cause: unknown

A. Respiratory paralysis could be fatal to a client with GBS.  associated with viral infection (flu virus, ZIKV)
B. Clients with GBS should receive flu vaccine shots as soon as possible.  problem:
C. GBS is a reversible condition. * acute polyneuropathy
D. Safety and ventilation should be given importance when taking care of a client - sudden degeneration of nerves
with GBS.  Rx: ____________________

59. MULTIPLE SCLEROSIS CHARCOT’s TRIAD

* tremors
Charcot’s triad is manifested by a client diagnosed with a certain degenerative - “intentional”
disease. Which of the following is the expected drug? * nystagmus
A. Levodopa - “dancing eyes”
B. Immunoglobulin - rapid & involuntary eye movement
C. Steroid * staccato speech
D. Pyridostigmine - “scanning” speech

Inflammatory disorder of nerves causing demyelination of nerves [destruction of Rx: __________________

myelin sheath]. MS may also cause mood swings.

60. AMYOTROPIC LATERAL SCLEROSIS

1.Cause: _______________________
ALS is also known as: 2.Is motor affected? _____________
A. Lou Gehrig Disease 3.Is sensory affected? ____________
B. Motor Neuron Disease 4.Is there a cure? _______________
C. Both A and B 5.Life expectancy: ______________
D. None 6.Drug: _______________________
61. CARDIOMYOPATHY

Stress cardiomyopathy is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion
of the heart. It is now a well-recognized cause of acute heart failure, lethal ventricular arrhythmias, and ventricular rupture. It is also known
as:
A. Broken Heart Syndrome
B. Takotsubo Syndrome
C. A and B
D. Neither

NURSING PRACTICE V

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62. LAYERS OF ABDOMEN

Arrange the following layers of the abdomen from the outermost to the deepest layer.
__ Peritoneum
__ Fascia
__ Muscle
__ Subcutaneous
__ Skin
63. URINARY TRACT INFECTION
1.Urinary Antiseptic: ____________________
Where is the location of the urinary meatus of a female client?
A. In the middle of the glans 2.Urinary Antibiotic: ____________________
B. Just above the anus
C. Between the clitoris and vaginal orifice 3.Urinary Analgesic: ____________________
D. In the area of the unknown
64. URINARY CATHETERIZATION

During the straight catheterization of a female client, if the catheter slips into the vagina, the nurse should:
A. Leave the catheter in place and get a new sterile catheter.
B. Leave the catheter in place and ask another nurse to attempt the procedure.
C. Remove the catheter and redirect it to the urinary meatus.
D. Remove the catheter, wipe it with a sterile gauze, and redirect to the urinary meatus.

65. CONDOM CATHETER  external catheterization

 for male clients only
 indication
A condom catheter is changed every: * urinary incontinence
A. Day.  technique
B. Two days. * clean
C. Week.  advantage
D. Two weeks. * noninvasive [ low risk for UTI ]
* can be used by ambulatory clients
 secure urine bag on thigh
66: CEREBRO-VASCULAR ACCIDENT 
1.Priority: _______________________________
Medication may be effective in the treatment of stroke related to cerebral artery
vasospasm. Based on one theory, that vasospasm is caused by an increased influx of 2.Expressive Aphasia: ______________________
calcium into the cell, medication therapy may be used to block or antagonize this
action and prevent or reverse the action of vasospasm if already present. The most 3.Receptive Aphasia: _______________________
frequently used calcium channel blocker is:
A. Nimodipine [Nimotop] 4.Homonymous Hemianopsia: ________________
B. Amlodipine [Norvasc]
C. Both A and B 5.Dysphagia: _______________________________
D. None
67: SLEEP HYGIENE 
1.Two purposes of bed: _______________________
What is the best diagnostic test for sleep?
A. Electromyogram [EMG] 2.Hormone that induces sleep: _________________
B. Electroencephalogram [EEG]
C. Electrooculogram [EOG] 3.Protein that induces sleep: ___________________
D. Polysomnography
4.Type of sleep where dreams occur: ____________

68: PARASOMNIAS – sleep disorders 

Sleep Medications  LAST option
Sleep talking is known as: - antihistamine
A. Narcolepsy - anxiolytics
B. Hypersomnia - barbiturates
C. Insomnia
D. Somnambulism *** consult MD
E. Somniluquy *** short – term period (1-2weeks)

PSYCHIATRIC FINAL RECALL 

1. Literal meaning of the prefix “PSYCHE”

2. PRIORITY in the practice of psychiatry

3. Psychotherapeutic management in psychiatric nursing

4. 6 elements of milieu therapy

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 5. Most important element in milieu therapy

6. Relationship of nurse and patient

7. Relationship of doctor and patient

8. Verbalization of feeling is healing

9. EXACT CAUSE of any mental disorders

10. Characteristic of nurse during NPI

11. Type of question that must be avoided because it will make the
client defensive
12. Norms of a nurse

13. Most important norm a nurse

14. Biologic theory: Increased serotonin and norepinephrine

15. Biologic theory: Decreased serotonin and norepinphrine

16. Biologic theory: Schizophrenia

17. Biologic theory: Anxiety

18. Biologic theory: Alzheimer’s disease

19. Biologic theory: OCD

20. Biologic theory: Eating disorders

21. Biologic theory: Substance related disorders

22. Most common route of antipsychotics and reason

23. Other names for antipsychotics

24. Types of antipsychotics

25. Route of DECANOATES

26. 3 types of antipsychotics by composition

27. Antipsychothics: fever plus sore throat

28. Antipsychothics: fever plus muscle rigidity

29. Antipsychothics: jaundice

30. 2 danger signs of antipsychotics

31. Antipsychothics: “Involuntary movements”

32. Give 5 examples of anticholinergic side effects

33. Medications to manage EPSE and examples

34. Antipsychothics: management for the teratogenic and

amenorrhea effect
35. Antipsychothics: medication commonly causing agranulocytosis

36. Antipsychothics: medication commonly causing NMS

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 37. Antipsychothics: medication commonly causing increased
prolactin
38. Antipsychothics: medication commonly causing sunburn

39. Antipsychothics: Earliest EPSE

40. Antipsychothics: Most fatal EPSE

41. Antipsychothics: Most common EPSE

42. Antipsychothics: Last to appear and permanent/irreversible EPSE

43. Antidepressants: First line of drug for depression

44. Antidepressants: Safest of all the antidepressants

45. Antidepressants: Oldest antidepressant

46. Antidepressants: Antidepressant that has the most severe

adverse effect
47. Antimanic: DOC for Mania

48. Antimanic: DOC for pregnant manic client and patient with
lithium allergy
49. Antimanic: Therapeutic blood lithium level

50. Antimanic: Relationship of Sodium and lithium

51. Antimanic: SSx of Lithium toxicity

52. Antimanic: Drugs that increase lithium level

53. Antimanic: Drugs that decrease lithium level

54. Antimanic: Lithium determination

55. Anxiolytics: Antidote for OD/toxicity

56. Anxiolytics: Most dreaded and fatal complication

57. Anxiolytics: Technique wherein a drug is gradually reduced

before stopping it to prevent rebound effect
58. Anticholinesterase: MOA of anticholinesterase

59. Anticholinesterase: Former DOC; changed because it is

teratogenic
60. Anticholinesterase: DOC for Alzheimer’s disease (dementia)
patients; Given OD PO HS
61. 2 subdivisions of biologic/medical therapy

62. Therapy: Goal is to modify negative views, thinking, cognition,

thoughts, ideas
63. “What you believe, you will achieve.”

64. “All behaviors are learned.” (Behaviors can be changed from

negative to positive)
65. “All behaviors have meaning.” (To HELP FIND MEANING IN THE
BEHAVIOR)
66. The primary focus of this therapy is the PAST (CHILDHOOD) and
the structures of personality of the patient (ID EGO SUPEREGO)
67. Best therapy for phobia

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 68. Best therapy for children

69. Best therapy for decreased self-esteem

70. Best therapy for ASD/PTSD

71. Best therapy for Alzheimer’s disease

72. Therapy: “Here and now”

73. Therapy: Standing up for your rights while respecting the rights
of others
74. Therapy: Utilization of Disulfiram (Antabuse) in alcoholism so
that the patient will refrain from drinking alcohol
75. Main indication of ECT

76. Volts/length of application/duration of seizure in ECT

77. Preparation of ECT is same with

78. Drug not used prior to ECT

79. Exact MOA of ECT

80. Is ECT contraindicated for pregnant woman?

- END OF EXAM –
CONGRATULATIONS REGISTERED NURSES!

Carpe Diem!
…Ad Majorem Dei Gloriam…

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MULTI-EDUCATIONAL REVIEW GROUP EXPERTS, INC. – Finale