FUNDAMENTALS OF NURSING

By: Lawrence C. Caranto

Situation 1
“Prevention is worth a pound of cure.”

1. To keep well individuals stay well is the aim of:

A. Health care delivery system C. Secondary prevention
B. Primary prevention D. Tertiary prevention
2. To help ill people get well is the within:
A. Primary health care services C. Secondary prevention
B. Primary prevention D. Tertiary prevention
3. To help return the affected individual to a useful place in society and make us of his remaining capacity is
the aim of:
A. Primary prevention C. Secondary prevention
B. Rehabilitation D. Tertiary prevention
4. Reducing the possibility of encounter with disease-producing agents called stressors are part of:
A. Primary health care services C. Secondary prevention
B. Primary prevention D. Tertiary prevention
5. Early case-finding and treatment of signs and symptoms are part of:
A. Primary health care services C. Secondary prevention
B. Primary prevention D. Tertiary prevention

Situation 2
Nursing as an art and a science.

6. “Putting the patient in the best condition for nature to act,” is attributed to whom?
A. ANA C. Henderson
B. Hall D. Nightingale
7. The focus of nursing care is:
A. Individual C. Community
B. Family D. Any of the above
8. The nurse performs independent and dependent actions. The latter include:
A. Application and execution of physician’s orders
B. Observation of signs and symptoms
C. Reporting and recording
D. Supervision and health education of the patient
9. The nursing action that focuses on the process of care as a method of quality control is called:
A. Nurse controlling C. Nursing reporting
B. Nursing audit D. Promotion of physical health
10. The nurse is primarily accountable to the following except:
A. For her own actions C. The chief nurse
B. Other nurses in the ward D. The individual

Situation 3
Nursing in the Philippines. In a recent election-related event, a political figure claimed on national television, “…
hindi naman kailangan magaling ang mga nurses. Gusto lang naman nilang maging room nurses, mga
tagapangalaga...”

11. Juan S. dela Cruz, BSN. RN. The RN stands for:

A. Ravishing Nurse C. Rich Nurse
B. Registered Nurse D. Room Nurse
12. Before completing the bachelor’s degree, a nurse must have completed close to how many hours of
related learning experience both in the hospital and in the community?
A. 500 B. 1, 000 C. 1, 500 D. 2, 500
13. The statement made by the political figure illustrates:
A. How nursing in the Philippines is widely accepted.
B. Many of those outside health care are misinformed.
C. Nursing is largely underrated.
D. That many political figures will say anything to get votes.
14. This politician can benefit most from:
A. Attending seminars in communication C. Consultation with nurse leaders from in and
B. Changing her looks and appearance out of the country
D. Enrolling BS Nursing in a university
15. First-level positions commonly available to the newly registered nurse in the Philippines include all, except:
A. Generalist nurse C. PHN
B. Nurse clinician D. Staff nurse

1|COMPETENCY APPRAISAL INDEPENDENT STUDY EXAM 1

Situation 4
The Filipino in health care.

16. It is said that the prevailing initial response of the common Pinoy to a discomfort or symptom is:
A. Pagkabalisa (trepidation) C. Takot (fear)
B. Pagsasawalng-bahala (denial) D. Takot sa Diyos (fear of God)
17. When a Filipino is ill and the discomfort or the symptoms persist, he shows:
A. Hilakbot (intense fear) C. Poot (intense anger)
B. Pagkamuhi (resentment) D. Tibay ng loob (stoicism)
18. The belief common to Pinoys that, “things are as they are and will be what they will be” is commonly called:
A. “Bahala na” (resignation) C. Pananalig (faith)
B. Malas (tough luck) D. Suwerte (good luck)
19. In dealing with the prevailing attitude among Filipino patients—turning to divination of the supernatural as a
means of healing when confronted with severe illness, the nurse employs the following attitudes, EXCEPT:
A. The nurse ensures safety with the religious rituals, not necessarily interfering.
B. The nurse should carefully discourage extreme attitude of leaving everything to God, at the expense of
self-reliance.
C. The nurse should discourage turning to supernatural means of healing because it goes against the
science of nursing
D. The nurse’s modification of the rituals regarding divination of the supernatural means of healing should
be well-thought and be done as far as situation allows.
20. Among the Filipino population, who most likely turn to indigenous lay consultants during illness?
A. Daryl Mendoza, a call-center agent from Puerto Prinsesa
B. Esmeralda Gutierrez, who lives in the Corinthian Gardens in Ortigas City
C. Kashkalycca Osena, Masterals student from Cebu City
D. Stephanie Piyag-et, strawberry grower from La Trinidad, Benguet.

Situation 5
Historical perspectives in the development of Nursing

21. Care of the sick was a task that belonged to women, and largely untaught.
A. Apprentice nursing C. Educated nursing
B. Contemporary nursing D. Intuitive nursing
22. Care of the sick was largely based on instinct, somewhat prehistoric.
A. Apprentice nursing C. Educated nursing
B. Contemporary nursing D. Intuitive nursing
23. Characterized by “on-the-job training” where experienced nurses directed new nurses.
A. Apprentice nursing C. Educated nursing
B. Contemporary nursing D. Intuitive nursing
24. Started on June 15, 1860 with the opening of the Florence Nightingale School of Nursing at the St. Thomas
Hospital in London.
A. Apprentice nursing C. Educated nursing
B. Contemporary nursing D. Intuitive nursing
25. Characterized by social changes, scientific and technological advancements such as nursing informatics:
A. Apprentice nursing C. Educated nursing
B. Contemporary nursing D. Intuitive nursing

Situation 6
The nurse has organized a support group that meets weekly.

26. Which statement best describes the nature of the group?

A. Groups promote the independence of individuals
B. Groups share a unity of purpose
C. Members of the group have distinctly different characteristics
D. Members of the group have varied goals
27. Which of the following best describes the nurse’s role as the group leader?
A. Provide guidance and direction to the group
B. Record and distribute minutes of the meeting
C. Set dates and times of future meetings
D. Serve as arbitrator during times of group discord
28. A young member of the group is often angry and hostile. As the group leader, the nurse’s best response to
this member would be to:
A. Allow other members of the group to confront the hostile member
B. Carefully confront the member following his outbursts
C. Carefully implement therapeutic silence during his outbursts
D. Change the group meeting times and dates without telling him

2|COMPETENCY APPRAISAL INDEPENDENT STUDY EXAM 1

29. It would be nontherapeutic for the nurse to:
A. Assist the client in speaking by using general leads
B. Finish the client’s sentences
C. Providing sufficient time to collect the member’s thoughts
D. Setting appropriate limits as to length and duration of the meeting
30. A common understanding that is shared by the members of a group—for example, support group for
cancer, is the:
A. Acceptance that they are all going to die.
B. Realization that each member isn’t alone in experiencing cancer
C. Realization that some members are coping better than the others
D. Understanding that stronger members are there to support the weaker members

Situation 7
As a client advocate, the nurse should ensure protection of the client’s rights during administration. The next set
of questions pertains to the nurse’s responsibility during admission of a client.

31. Which of the following signs taped on the door of a client in the unit violates client’s rights?
A. “DO NOT PALPATE THE ABDOMEN” - client with abdominal aneurysm.
B. “PROVIDE ASSISTANCE. CLIENT IS BLIND” - client with severe glaucoma.
C. “NPO” - client scheduled for surgery.
D. “NO VISITORS ALLOWED” - client undergoing radiation therapy.
32. When a nurse discusses her client’s illness with the client’s visitors, the nurse can be sued for:
A. Libel C. Negligence
B. Slander D. Invasion of privacy
33. A client to take his/her medication. The nurse tells the client if he/she does not take his/her medication,
his/her meals will not be served. The nurse’s statement can be used as a basis for which violation?
A. Negligence C. Battery
B. Malpractice D. Assault
34. Which principle does the nurse consider in supporting the client’s right to self determination?
A. Physician’s order C. Client’s reaction
B. Consent D. Diagnosis
35. Which of the following situations does NOT constitute malpractice?
A. The nurse administers an antibiotic to a client with allergy to the drug. The client had laryngeal edema
and was admitted to the ICU.
B. The nurse applies a heating pad on the client with appendicitis. The appendix ruptured and the client
had peritonitis.
C. The nurses did not perform CPR on a client with terminal illness whose advance directive specifies no
resuscitation measures once breathing stops.
D. The nurse administers two tablets of narcotics instead of one as prescribed. The client developed
respiratory distress and died.

Situation 8
In the management of clients with various health problems, the nurse should be equipped with the knowledge
of basic nursing procedures.

36. Which of the following is considered as the first tier of isolation precautions?
A. Standard precautions C. Contact precautions
B. Airborne precautions D. Droplet precautions
37. Which of the following is the recommended temperature for a hot sitz bath?
A. 90 °F (32.2 °C) C. 120 °F (48.9 °C)
B. 110 °F (43.3 °C) D. 125 °F (51.7 °C)
38. The recommended temperature for a warm water bath is?
A. 110 – 115 °F (43.3 – 46 °C) C. 130 -135 °F (54 – 57 °C)
B. 120 -125 °F 49 – 52 °C) D. 140 – 145 °F (60 – 63 °C)
39. What is the rationale for using a footboard in a post stroke client?
A. To promote plantar flexion of the feet. C. To prevent external rotation of the hip.
B. To promote dorsiflexion of the feet. D. To prevent internal rotation of the hip.
40. Before transferring a client from bed to a wheelchair, the initial action of the nurse is to:
A. Identify client. C. Position the wheelchair parallel to the bed.
B. Secure the wheelchair lock. D. Check the client’s room number.

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Situation 9
Nursing is a dynamic profession. As a responsible member of the health team, the nurse should be abreast with
the current trends in the advancement of the profession.

41. Globalization has created opportunities for the expansion of the nurse’s role. The acceptance of expanding
nursing roles depends on all of the following conditions, except:
A. Laws and professional regulation C. Acceptance by other members of the
B. Acceptance by clients health team
D. Acceptance by nurses themselves
42. Functional nursing is:
A. Primarily utilized in providing continuous, coordinated, and comprehensive nursing care.
B. Most appropriate in facilitating skills development in a student nurse on proper suctioning.
C. The best method of organizing client care, with a registered nurse acting as a leader to a group of
nursing personnel.
D. Also known as one-on-one nursing.
43. RA 7170, the Organ Donation Act of 1991 legalizes organ donation through the organ donor card. Which of
the following statements about organ donation is NOT true?
A. In the absence of a donor card, consent for a donation is obtained from the next kin.
B. Anyone who is at least 18 years old may become an organ donor when he/she dies.
C. A minor cannot donate any organ.
D. Declaration of brain death is done by the attending physician.
44. Self-regulation is an example of core critical thinking skill involving which of the following actions?
A. Promoting autonomy and dependency.
B. Identifying ways to improve performance.
C. Preventing analysis of a situation that derails documentation.
D. Providing full support in advocacy projects that supports the personal interests of an organization officer.
45. At what level of training should a nurse be able to engage in independent nursing practice?
A. Student C. Newly hired
B. Advanced practice D. Licensed
46. Which of the following clients can the nurse delegate to a nursing assistant?
A. A 40 year old client scheduled for catheter insertion.
B. A 50 year old client with CVA, eating his/her meal for the first time.
C. A 60 year old client who has just had tracheostomy suctioning.
D. A 35 year old client scheduled for routine urinalysis.
47. Which of the following tasks should NOT be delegated by a nurse manager to a staff nurse?
A. Evaluation of a new piece of equipment to be used by the staff in the unit.
B. Selection of a new nursing care delivery system.
C. Preparation of vacation schedule.
D. Inventory of equipment and supplies in the nursing unit.
48. Which of the following clients would qualify for hospice care?
A. A 25 year old client with leukemia undergoing chemotherapy.
B. A 75 year old client with terminal metastatic cancer.
C. A 30 year old client undergoing rehabilitation for heroin addiction.
D. A 45 year old client with post partum depression.
49. Which of the following actions should the nurse consider as the highest priority in a client with an
endotracheal tube?
A. Turn the client from side-to-side frequently.
B. Assess the lungs for bilateral breathing sounds.
C. Monitor I and O for every shift.
D. Instruct the client to cough and deep breath regularly.
50. When determining the priority needs of a client, which of the following should the nurse consider as the
highest priority?
A. Providing a safe environment. C. Ensuring growth and development.
B. Preservation of life. D. Minimizing environmental stimulation.

Situation 10
The nurse-client relationship is significant in nursing cooperation in his/her care.

51. When providing nursing care to a client, the nurses focuses on the client and tries to avoid assumption. This
process is referred to as:
A. Developing relationship C. Creating a therapeutic environment
B. Knowing the client D. Sharing personal stories
52. To enable the nurse to build a helping and caring relationship, which of the following should be established
first?
A. Trust and sympathy C. Trust and rapport
B. Trust and empathy D. Trust and friendship

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53. The person-to-person encounter that conveys a sense of caring and closeness is best described as:
A. Trust C. Empathy
B. Rapport D. Presence
54. Which of the following philosophical framework is most important in establishing a positive nurse-client
relationship?
A. The nurse must recognize that the client is a holistic being whose personality needs to be fully
understood by the nurse.
B. The nurses accepts the client as a unique human being whose ability to trust is preceded by testing
behaviors.
C. The quality of the nurse-client relationship depends on the nurse’s degree of self-awareness.
D. The nurses should view the client’s behavior non-judgmentally while assisting the client express feeling of
aggression.
55. To have an adequate base of support while standing, the nurse should keep the legs how many inches
apart?
A. 4-5 C. 12-18
B. 6-8 D. 18-24

Situation 11
Physical assessment, intravenous infusion of blood, fluids and medication.

56. When conducting a physical examination, which of the following technique should the nurse employ first?
A. Inspection
B. Palpation
C. Percussion
D. Auscultation
57. Which of the following statements about breathing sound is true?
A. Adventitious breathing sounds are normal.
B. It is best to auscultate for breathing sound using the bell of the stethoscope.
C. Bronchial sounds are normal when heard over the trachea and abnormal when heard over the lobes.
D. Bronchovesicular sounds heard over the scapula are normal sounds.
58. Which of the following statements about blood transfusion is INCORRECT?
A. Dextrose 5% in water can be used to start an IV infusion.
B. Fever is the most common sign of blood transfusion reaction.
C. Hemoglobinuria indicates hemolytic reaction in a client receiving blood transfusion.
D. Sepsis can result from auto-transfusion.
59. Which of the following combination of needles and routes of medication administration is INCORRECT?
A. 25 G, 5/8” long for insulin administration.
B. 26 G, small bore for intradermal injection.
C. 20 G, for injection of oil – based medications.
D. 25 G, angiocatheter for blood administration in an adult client.
60. Which of the following characteristics of the vein should the nurse consider when initiating an IV infusion in
the elderly?
A. Smaller size C. Fragility
B. Presence D. Prominence

Situation 12
The administration of medication is an important function of the nurse. As a clinician, it is significant for the
nurse to properly observe the patient for any adverse effects.

61. The doctor orders an enteric-coated medication for the client on gastrostomy tube. What should the nurse
do?
A. Crush the medication and administer it through the gastrostomy tube
B. Dissolve it in water before giving the medication
C. Call the pharmacy to request for a change in form
D. Administer it orally
62. A client intends to donate blood. He weighs 105 lbs. He is eligible to donate how many mL of blood?
A. 500 mL C. 450 mL
B. 250 mL D. 100 mL
63. Which type of blood can be administered to a client who needs a BT with blood type AB?
1. A 2. B 3. AB 4. O
A. 1 and 2 C. 3 and 4
B. 3 only D. 1, 2, 3 and 4
64. A vest or jacket restraint is best used for which of the following purposes?
1. Prevent a client form climbing out of bed
2. Prevent a client from falling out of a stretcher
3. Immobilize an arm
4. Prevent inflicting injury to one’s self or others

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 A. 1, 3 B. 1, 4 C. 1 only D. 1, 2
65. Which of the following interventions will NOT promote sleep?
A. Play instrumental music in the client’s room C. Massage the client’s back and legs
B. Serve hot chocolate to the client D. Turn on the TV in the client’s room

Situation 13
Tommy, 39, laborer of the dock is often readmitted to the hospital for respiratory infections.

66. The nurse teaches the client about pursed-lip breathing. She explains that the purpose of this is to
A. Promote carbon dioxide elimination C. Promote oxygen saturation
B. Decrease coughing D. Promote oxygen elimination
67. The nurse also explains, “This test allows the physician to view your airways, particularly trachea and
bronchi. He will insert an instrument with a small camera at the tip down your throat.” The nurse has partially
explained a:
A. Bronchoscopy C. CT scan
B. Bronchogram D. Pulmonary angiography
68. The complete explanation of an invasive procedure should primarily rest on the:
A. Nurse C. Watcher
B. Physician D. X-ray technician
69. After signing the informed consent, the patient asks if the procedure will be painful. The nurse expects which
of the following responses?
A. “Don’t worry about it.”
B. “It won’t be anything you can’t tolerate.”
C. “No, it doesn’t hurt. You won’t feel a thing.”
D. “There will be some discomfort, but you will be given medications.”
70. Following the procedure, the patient complains of thirst. The nurse:
A. Checks for a diet order C. Proceeds to give ice chips slowly
B. Checks for return of gag reflex D. Tells the patient to wait 6-8 hours

Situation 14
As a nurse, you are aware that your actions have ethico-legal implications. Because of this, you must always
be alert of those situations that demand an appropriate professional conduct.

71. The best definition of a tort is:

A. An illegality committed against the public and punishable by law through the courts
B. An illegality committed by one person against the property or the person of another
C. Doing something that a reasonable person under ordinary circumstances would not do
D. The application of force to the person of another by a reasonable individual
72. The nurse caring for a client fails to monitor the client during the post-op period as is the standard of care.
The nurse may be found guilty of:
A. Failure to follow the Good Samaritan C. Negligence
doctrine D. Practicing medicine without a license
B. Failure to supervise ancillary personnel
73. Negligence is defined as:
A. An act of omission by a reasonable C. Invasion of privacy
individual D. Maligning of character
B. An act outside the scope of practice
74. A nurse accidentally administers a drug to a wrong client, and the client reacts adversely to that drug. This
could lead to which of the following charges:
A. Assault C. Malpractice
B. Fraud D. Tort
75. An example of intentional tort is:
A. Breach of duty C. Malpractice
B. False imprisonment D. Negligence

Situation 15
A client is brought to the emergency department due to a fall from the construction site he works at.

76. The ED nurse initially does the following:

A. Administer cardiac thump C. Interview the relatives
B. Establish consciousness or unconsciousness D. Tag the patient
77. When the client’s name is called, only then did he open his eyes. In GCS, the nurse documents this as:
A. 4 B. 3 C. 2 D. 1
78. A decision is made to bring the client for CT Scan of the head, with no contrast medium. The nurse should:
A. Administer the ordered bowel preparation and enema
B. Ask about any apprehension in enclosed spaces
C. Inquire for allergy to seafood or shellfish
D. Secure an informed consent
6|COMPETENCY APPRAISAL INDEPENDENT STUDY EXAM 1
79. This diagnostic procedure is especially helpful because, unlike X-ray, this can:
A. Cost cheaper for the patient
B. Identify hematoma, swelling or bleeding within the brain
C. Locate fracture
D. Provide treatment of life-threatening injury at much earlier time
80. The nurse explains that the client will:
A. Be put to a brief sleep
B. Feel a sensation of warmth, headache, or salty taste
C. Lie down on a moveable table that tilts
D. Need to hold his breath for a few seconds

Situation 16
The client with a renal problem is being worked up by the nurse for CCT.

81. In order to accurately complete the test, the nurse explains to the patient:
A. “A small needle will be inserted to your C. “You will need to lie still for a few minutes.”
side.” D. “You will to collect your urine for a day.”
B. “Catch the middle stream of your urine.”
82. Additional instructions given will be:
A. Blood will be drawn at about midpoint of the collection period or time.
B. Flat on bed for 6-8 hours after the procedure
C. No food can be taken until return of gag reflex
D. X-ray will be taken

Situation 17
Physical assessment—an activity that even a novice nurse need to accomplish.

83. The client states, “My chest hurts and my left arm feels so numb.” What is the type of this data?
A. Objective data C. Secondary source
B. Primary source D. Subjective data
84. As the client describes the chief complaint, the nurse should do which of the following?
A. Ask the client to repeat the data to assure reliability
B. Document verbatim what the client has to say.
C. Paraphrase in the nurse’s own words
D. Refrain from note-taking to appear focused
85. To adequately inspect the ear canal of a 3-year-old child, the nurse should do which of the following prior
to inserting the otoscope?
A. Have the client lie down to promote comfort
B. Pull the pinna down and back
C. Pull the pinna up and back
D. Use an applicator to remove the cerumen

Situation 18
Nurses must be well-versed in the formulation of the nursing diagnosis and the descriptors associated with it. The
following items deal with descriptors.

86. Capacity to do or act:

A. Ability C. Compromised
B. Balance D. Coping
87. Inadequate:
A. Decreased C. Delayed
B. Deficient D. Depleted
88. Agitated, interrupted, or interfered with:
A. Disturbed C. Effective
B. Dysfunctional D. Excessive

Situation 19
The nurse writes the following outcome criteria for the client, “By Saturday, the client will ambulate the entire
length of the hallway three times a day with the use of the walker.”

89. “… ambulate the entire length of the hallway…”

A. Conditions C. Task statement
B. Subject D. Time frame
90. The time-frame for the above outcome criteria is:
A. By Saturday C. Three times a day
B. Entire length of the hallway D. With the use of a walker

7|COMPETENCY APPRAISAL INDEPENDENT STUDY EXAM 1

Situation 20
In the practice of the nursing profession, the nurse is faced with a diversity of situations and incidents. Through it
all, the nurse is guided by the nursing theorists then and now.

91. Nursing is a theoretical system of knowledge that prescribes a process of analysis and action related to
care for the ill person.
A. I. King
B. V. Henderson
C. C. Roy
D. M. Leininger

92. Nursing is a unique profession, concerned with all variables affecting an individual’s response to stressors,
which are intra-, inter-, and extra-personal in nature.
A. B. Neuman C. J. Watson
B. D. Johnson D. R. Parse
93. Caring is healing. It is communicated through the consciousness of the nurse to the individual being cared
for. It allows access to the higher human spirit.
A. P. Benner C. M. Leininger
B. J. Watson D. I. J. Orlando

Situation 21
The Philippine Nurses Association

94. Who is the founder of the PNA?

A. Anastacia Giron-Tupas C. Julita Sotejo
B. Eufemia Octaviano D. Rosario Montenegro
95. Who is the first President of the PNA?
A. Anastacia Giron-Tupas C. Julita Sotejo
B. Eufemia Octaviano D. Rosario Montenegro

Situation 22
Most often than not, the nurse’s knowledge of values and colors and their significance make for an excellent
and sound decision-making.

96. The client’s potassium level is 3.9 mEq/L. The nurse’s best course of action is
A. Call the laboratory for a repeat C. Educate the client on potassium-rich food
B. Document the finding D. Notify the physician
97. The client with no diet restriction complains of cool, clammy skin had blood drawn for blood sugar levels.
The result yielded is 70 mg/dL. The nurse’s next action after documenting is:
A. Administer 2 vials of D50W50, bolus C. Notifying the physician
B. Draw prescribed units of insulin D. Offering a glass of juice
98. Sodium levels (mEq/L):
A. 13.5 – 14.5 C. 3.5 - 5
B. 135 – 145 D. 35 – 45
99. An oxygen tank is green, whereas compressed air is:
A. Black C. Violet
B. Yellow D. Red
100. An IV catheter 24G is:
A. Gray C. Pink
B. Green D. Yellow

8|COMPETENCY APPRAISAL INDEPENDENT STUDY EXAM 1