REFRESHER COURSE: PREBOARD EXAMINATION
Nursing Practice III: Care of Clients with Physiologic and
Psychosocial Alterations (Part A)
GENERAL INSTRUCTIONS:
1. This test questionnaire contains 100 test questions
2. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalid your answer.
3. AVOID ERASURES.
4. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set.
5. Write the subject title “NURSING PRACTICE III” on the box provided.
Situation: Florenda, 52 years old, was transported to
the Operating Room for Total Abdominal Hysterectomy
1. The scrub nurse ensures that aseptic technique is
maintained throughout the procedure. When she serves the
right gloves to the surgeon, which of the following is the
correct technique to be followed by the scrub nurse?
A. Keep thumbs away from the cuff
B. Pick up the gloves and place the palm towards you
C. Maintain fingers of the gloves facing you
D. Slide the gloves by holding under the glove cuff and spread
to create wide opening
2. The surgeon uses electrosurgical equipment to cauterize
blood vessels. Which of the following nursing activity should
have been done by the circulating nurse to ensure safety?
A. Correctly drape electro cautery cable and cord
B. Electro cautery equipment is placed appropriately at the
back of the surgeon
C. Grounding pad is connected to grounding cable properly
placed under the patent’s buttocks
D. Electro cautery pencil is made easily available each time the
surgeon uses it
3. The surgeon passed the specimen to the scrub nurse. Which
of the following is the correct action of the scrub nurse?
A. Place specimen in a basin moistened with saline solution
B. Wipe specimen with sponge
C. Wipe specimen with surgical sponge (OS)
D. Pass the specimen to the circulating nurse
4. The surgeon asked a suture to close the peritoneum. Which
of the following should have been done by the scrub nurse
before suture is handed to the surgeon?
A. Specimen passed to the circulating nurse
B. Needle holder passed to the surgeon
C. Needle mounted on the needle holder
D. “Surgical count” completed
5. The surgeon tells the scrub nurse that the procedure done
was total abdominal hysterectomy with bilateral sphingo-
oophorectomy. The scrub nurse understands that the
specimen she received would consist of which of the following
organs?
A. Right and left ovaries, uterus, a fallopian tube
B. Uterus, fallopian tube, ovary, and urinary bladder
C. Uterus, right and left fallopian tubes, and ovaries
D. Uterus, urinary bladder, two ovaries, right and left fallopian
tubes
NURSING PRACTICE III: Care of Clients with Physiologic and Psychosocial Alterations (Part A)
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Situation: Jasmine is working in the cardiac unit with a
nurse floater. Together, they made their rounds while
Kristine assessed the nurse’s knowledge on the
commonly used cardiac drugs.
6. Jasmine asked the floater why nitroglycerin is given to a
client with angina. The correct response of the nurse is that
nitroglycerine:
A. increases preload
B. increases afterload
C. dilates the veins
D. constricts the arteries
7. Being new in the cardiac unit, Jasmine emphasized to the
floater that the long standing hallmark in nursing intervention
for clients taking Digoxin (Lanoxin) is:
A. Take the apical pulse for one full minute stethoscope
B. Monitor intake and output hourly
C. Check the blood pressure reading with the same BP
apparatus
D. Palpate the radial pulse for one full minute
8. Jasmine tests the floater’s readiness for the assignment by
asking this question “When you find a client in cardiac arrest,
which of the following drugs would you be ready to
administer?” The correct answer of the nurse floater is:
A. Atropine sulfate
B. Lidocaine 2% anti - arrhytmic
C. Morphine sulfate
D. Epinephrine
9. One of the hypertensive clients assigned to the nurse floater
is on Captopril (Capoten), an Angiotensin Converting Enzyme
(ACE) Inhibitor. Which of the following nursing interventions
should be included in the plan of care?
A. Monitor sugar level
B. Observe complete bed rest
C. Measure intake and output carefully
D. Monitor for bruising, petechiae, or bleeding
10. The nurse floater is instructing one of her clients on
Clopidogrel bisulfate (Plavix). Which of the following indicates
that her client understands the effect of the drug?
A. “I should slow down on my carbohydrate intake.”
B. “I should take liberal amount of fluid while on this drug.”
C. “I should use caution in taking over the counter drugs that
might cause bleeding.”
D. “I may gain weight while on this drug.”
Situation: Virgilio, 40 years old, was admitted for
check- up. He was diagnosed with essential
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hypertension a year ago. Upon admission, his blood
pressure is 170/90, slightly dysneic, dizzy and with
blurred vision.
11. The admitting nurse understands that increased diastolic
pressure indicates which of the following? systolic - at work
A. Generalized vasoldilation diastolic - at rest
B. Loss of elasticity of the aorta and arteries
C. Increased peripheral resistance and increased workload of
the left ventricle
D. Widening of the lumen of the arteries
12. Virgilio has been taking Atenolol (Tenormin) 50 mg. orally
once daily. The nurse understands that the specific action is to
block:
A. Beta receptor stimulation of the heart
B. Effects of the angiotensin II on receptors
C. Calcium entry into the myocardium cells
D. Alpha receptors in vascular smooth muscle
13. Hydrochlorothiazide (Hytaz) 12.5mg 1 tablet orally once
daily has been prescribed for the client. The specific action of
this thiazide diuretic is to:
A. Promote excretion of sodium and chloride be decreasing
absorption in the distal tubule
B. Increase osmotic draw of the urine inhibiting water re-
absorption
C. Inhibit sodium and chloride re-absorption in the ascending
loop of Henle
D. Inhibit sodium- potassium exchange in the distal tubule
14. From the results of the laboratory test prescribed by the
physician, which of the following will the nurse consider as an
indication of impaired renal function? Elevated levels of;
A. Creatinine
B. Hematocrit
C. Potassium
D. Total Cholesterol
15. “Risk for excess fluid volume” is a nursing diagnosis
identified by the nurse. The following are acceptable indicators
of excess fluid volume, EXCEPT:
A. Intake and output record
B. Compliance to sodium restriction
C. Vital signs reading
D. Weight changes
Situation: Conrado sought admission for acute gout of
the right foot. Nurse Karmela was in-charge of the
client.
16. Nurse Karmela performs initial assessment. Which of the
following types of joint pain supports the physician’s diagnosis?
A. Bilateral
B. Symmetrical
C. Polyarticular
D. Monoarticular
17. Which of the following examinations would the nurse
expect to be ordered?
A. Bone marrow aspiration
B. Knee-jerk examination
C. Synovial fluid analysis
D. Bone density
18. The client is for 24- hour urine collection for uric acid
determination. To have a reliable result, the nurse anticipates
which diet prescription prior to the examination?
A. Low fat diet
B. Low protein diet
C. Purine free diet
D. Low purine diet
19. During the acute attack, the pain of the affected foot can
be so intense that even the weight of the linen can be
unbearable. The MOST appropriate nursing intervention is to:
A. Apply splint on the affected
B. Place a foot cradle on the bed
NURSING PRACTICE II: Care of Clients with Physiologic and Psychosocial Alterations (Part A)
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C. Elevate the affected foot
D. Apply bandage around the affected foot
20. Colchicine is prescribed during the acute attack phase.
Nurse Karmela is aware that the action of the drug is to:
A. Provide fast symptomatic relief
B. Lower serum uric acid allupurinol
C. Block the conduction of pain sensation
D. Interfere with the inflammation response of uric acid
crystals in the joints NSAID
Situation: Henry, 65 year old underwent Transurethral
Prostatectomy (TURP). He was admitted to the Post
Anesthesia Care Unit (PACU). The following questions
apply.
21. The Operating Room (OR) nurse endorsed the ongoing
intravenous infusion of Dextrose 5% Ringer’s Lactate, 500ml,
running at 40ml per hour at the level of 300ml. The nurse who
received the client in PACU at 1500H,would expect the present
infusion to be consumed at:
A. 2400H
B. 0100H
C. 2200H
D. 0300H
22. The client has an indwelling triple catheter to continuous
bladder irrigation (CBI) with Normal Saline Solution (NSS)
infusing at 200ml per hour. After four hours, the nurse
emptied the drainage bag and obtained and output of 1,080
ml. Which of the following will the nurse record as the client’s
urinary output?
200 times 4 hours = 800 Normal saline solution
A. 180ml
B. 1,080 ml 1080-800= 280
C. 800ml
D. 280ml
23. The surgeon’s order reads: “Maintain traction on the
indwelling triple lumen catheter.” Which of the following is the
MOST appropriate action of the nurse?
A. Tape the catheter to the abdomen and keep client in supine
position
B. Pull the catheter taut and tape to the thigh alternately every
6 hours
C. Instruct the client to keep both legs together and extended
all the time
D. Pull the catheter taut, tape to one thigh and keep the leg
extended all the time
24. The nurse understands that Normal Saline Solution (NSS)
is used for CBI to prevent which of the following?
A. Later intoxication
B. Elevation of specific urine gravity
C. Dehydration
D. Formation of stones
25. The nurse assigned to the client monitored and maintained
the CBI rate of NSS at 200 ml per hour. This intervention is
critical because it:
A. Washes out remaining fragments of stones
B. Avoids postoperative infection
C. Decreases bleeding and keep the bladder free from blood
clot
D. Maintains adequate hydration.
Situation: The nurse is assigned to admit a 27 year old
female patient with protruding eyeballs and an
enlarged neck. Physician’s diagnosis is Grave’s disease.
26. The nurse performs initial assessment and confers with the
medical resident. Which of the following will the nurse consider
as the correct description of Grave’s disease?
A. Antibodies bind to TSH receptors causing increased thyroid
hormone
B. Multiple thyroid nodules resulting in thyroid hyper function
C. Increased in thyroid secretion of T3 cause unknown
D. Uncontrolled secretion of T3 and T4 form benign thyroid
tumor
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 for hyperthyroidism levothyroxin for hypothyroidism
27. During the interview, nurse found out that the client takes
Prophylthiouracil (Prophyl-Thracil) daily. Which of the following
is the specific action of this drug?
A. Beta-adreneric blocking drug
B. Decreases blood flow to the thyroid gland
C. Destroys thyroid cells
D. Blocks thyroid hormone production
28. The nurse identified the nursing diagnosis “Disturbed
sensory perception related to exophthalmus.” Which of the
following nursing interventions is intended to promote
decrease in periorbital fluid?
A. Cover eyes
B. Administer artificial tears as prescribed
C. Elevate head at 45 degrees
D. Use cool moist eye compress
Lugol’s solution
29. The client is scheduled for subtotal thyroidectomy. Strong
iodine solution is prescribed. The nurse prepares to administer
the medication knowing that therapeutic effect of the
medication is to:
A. increase thyroid hormone
B. replace the thyroid hormone
C. suppress thyroid hormone production
D. prevent oxidation of iodide
30. Following thyroidectomy, the nurse notes the very weak
and hoarse voice of the client. Which nursing intervention is
most appropriate at this time?
A. Caution the client not to force herself to talk
B. Notify the surgeon immediately Laryngeal nerve damage laryngeal edema
C. Reassure the client this is usually a temporary condition
D. Offer the client warm NSS gargle
Situation: Nurse Remy is assigned in the pediatric
ward. She was in charge of a 20 month-old child,
Jayson, diagnosed with intussusception
31. Nurse Remy is reviewing the chart of Jayson. What will she
expect to read as symptoms of her client?
A. Foul-smelling, watery stool
B. Nausea and vomiting
C. Projectile vomiting
D. Crampy and intermittent severe abdominal pain
32. A nursing student was with Nurse Remy. She wants to fully
understand the case and so she asks the nurse to describe the
case. The appropriate definition of intussusception is the:
A. herniation of the small intestine into the abdominal opening
B. telescoping of bowel into the adjacent segment
C. Mechanical obstruction from the inadequate motility of the
small intestine
D. protrusion of the bowel through an abdominal opening
33. Nurse Remy prepares for the insertion of nasogastric tube
(NGT). She understands that the primary indication of NGT in
Jayson’s case is for:
A. irrigation
B. feeding
C. medication administration
D. decompression
34. While making her rounds, Jayson’s mother showed nurse
Remy the child’s brown stool. What is the appropriate action of
the nurse?
A. bring the stool to the laboratory
B. instruct the mother to dispose the stool properly
C. document the characteristics of the stool
D. reports the passage of stool to the physician
35. Nurse Remy reviewed a certain literature where the
classical triad of pain, palpable sausage-shaped abdominal
mass and currant jelly-like stool occurred only in 15% of
children when they are seen initially. Which of the following is
nurse Remy’s correct interpretation of this finding, if there are
60 sick children as the population?
NURSING PRACTICE II: Care of Clients with Physiologic and Psychosocial Alterations (Part A)
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A. The classic triad of symptoms was observed in 9 out of 60
sick children
B. Approximately 15 sick children experienced the classic triad
of symptoms
C. When seen initially, 30 sick children did not show any of the
symptoms
D. Among the 60 children, there were 25 who showed the
classic triad of symptoms
Situation: The primary goal of nursing research is to
develop a scientific knowledge base for nursing
practice. Nursing research includes all students
concerning nursing practice, nursing education, and
nursing administration.
36. Researcher Bea conducted a research of the effect of using
an agent in giving oral hygiene in the nursing care of the
acutely ill surgical patients. In this type of study, it necessary
to:
A. conduct a pilot study
B. administer treatment
C. conduct interview
D. develop a questionnaire
37. Of the following listed designs below, which one would
allow the researcher to have the most confidence that the oral
care with agent is effective in helping acutely ill surgical client
attain health outcome?
A. One-shot case study
B. Non-equivalent control group design
C. Post-test only control group design
D. One-group pre-test post-test group design
38. A team of researchers conducted a study on the
relationship of the completed surgical cases and the extent of
performance of standard competencies among level 3 nursing
students assigned in the Operating Room, in correlational
study, the researcher examines the:
A. questionnaire used to collect data from large samples
B. difference between two correlated groups
C. relationship between or among two or more variables
D. cause and effect relationship
39. The statistical tool that is used in determining the
magnitude and direction of the relationship between two
variables is: analyzing for
A. Test of relationship two groups
B. Analysis of variance 3 or more group
C. Pearson r coefficient of correlation correlational
D. Spearman rho coefficient of correlation ordinal scale
40. A researcher conducted a study on assessment of the
psychosocial problems of cancer patients in Metro Manila.
Which of the following instruments was used to collect data
from large samples?
A. Descriptive statistics
B. Inferential statistics
C. Questionnaire and interview
D. Controlled laboratory setting
Situation: Statistics from nursing research show that
structured health teaching programs have resulted in
modified client behavior and improved health status.
41. Nurses are aware that normal aging affects the changes in
client’s cognition. Therefore, when teaching a 72 year old
diabetic client how to administer insulin, the nurse should:
A. demonstrate faster because the client tires easily
B. present all information at one time
C. demonstrate by using audio visual technology
D. frequently repeat information for reinforcement
42. Considering the sensory changes in the elderly, which of
the following techniques would be most helpful to enhance
client’s recall?
A. use of colors to emphasize data and dose
B. use properly labeled individual containers
C. highlight date and dose
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D. label all medications with number in bold ink
43. When teaching a client drug self-administration, which of
the following behaviors reflect that the client is not ready to
learn?
A. Arranges the medication in the container provided for
B. Hears without reaction
C. Agrees to schedule of teaching
D. Notes medication, dose and time
44. Modifying the teaching program because the learner has
difficulty in comprehending involves which appropriate nursing
action?
A. postponing the teaching until client’s condition improves
B. contacting family members to assist in the goal
development to learn
C. changing the terms in the teaching pamphlet so that the
learner can understand it
D. altering the content of the program
45. Nursing actions that can be used to motivate clients learn
the health programs include all of the following except:
A. negative criticism is emphasized at once
B. the establishment of realistic goals based on individual client
needs
C. creation of a conducive atmosphere for client’s privacy
D. feedback when a client has been unsuccessful
Situation: Integral to quality management in the
Operating Room is the observance of the basic
principles and practices to establish and maintain a
sterile field by the sterile team involved in the surgical
intervention.
46. Once a scrubbed personnel dons a sterile gown and
gloves, he/she is considered “sterile”. This connotes that
he/she can:
A. assist in positioning the client for surgery
B. touch sterile instrument on the sterile field
C. hand suture as needed to the scrub
D. “prep” the surgical site
47. The assistant surgeon accidentally contaminated his gloves
while adjusting the retractor. As a perioperative nurse you
know that there are two methods that the surgeon can choose
from. What are these methods?
1. Change the contaminated gloves by the closed glove
technique
2. Change the contaminated gloves using the open glove
technique
3. One member of the surgical sterile team is to glove the
assistant surgeon
4. The circulating nurse the sterile gloves to the assistant
surgeon
A. 3 and 4
B. 1 and 2
C. 1 and 3
D. 2 and 3
48. The scrub nurse aids the assistant surgeon apply the sterile
drape. The scrub nurse understands that once the drapes are
positioned over the prepped incision site, the drapes must not
be:
A. marked
B. folded
C. aligned
D. moved
49. You are circulating in an Exploratory Laparotomy for a
ruptured appendicitis. The scrub nurse asks for “normal saline
solution (NSS) wash”. You immediately opened one liter of NSS
and began to pour to the sterile basin of the scrub nurse.
Before you can empty the NSS container, the scrub nurse
signal you “enough”. What is your appropriate action with the
remaining NSS?
A. Discard the remaining NSS
B. Pour the remaining NSS to another sterile basin in the back
table
NURSING PRACTICE II: Care of Clients with Physiologic and Psychosocial Alterations (Part A)
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C. Cover the remaining NSS bottle aseptically right away
D. Transfer the remaining NSS to smaller sterile container
50. Immediately before opening and presenting any sterile
item to the sterile field, the circulating nurse should inspect for
which of the following indicators?
1. Package integrity
2. Date when manufactures
3. Sterilization indicator
4. Expiration date
5. Purchase price
6. Device specification
A. 1,2,3,5
B. All of these
C. 1,3,4 only
D. 1,2,3,6
Situation: Zyra, a 32 year old woman was rushed to the
nearest community hospital after obtaining burns in
the anterior chest, both upper extremities and half of
her face. Nurse Lulu was assigned to her.
51. Nurse Lulu reads the chart and finds out that NGT
placement was ordered for her patient. Nurse Lulu performs
the procedure correctly if she does the following except: (-)
A. Tilts the patient’s nose upward before inserting the tube.
B. Asks the patient to swallow when the tube is in the
nasopharynx.
C. Prepare the patient NPO 6-8 hours prior to the insertion.
D. Apply water soluble lubricant at the tip of the tube.
52. After the procedure, the nurse checks if the tube is
properly placed. She is correct of she states that the most
accurate method of checking tube placement is:
A. pH measurement of the aspirate
B. Air auscultation
C. Visual assessment of the aspirate
D. X-ray visualization
53. Patient Zyra was about to take her lunch. Before the
administration of osteorized food, the tube must be irrigated.
Nurse Lulu has an accurate understanding of the situation if
she uses this fluid in tube irrigation:
A. Bottled water AKA WATER “ PURIFIED WATER” = 30 min before and after
B. Tap water
C. Normal saline solution
D. D5LRs
54. Enteral feeding poses patients receiving it to various
complications. Appropriate interventions must done for the
following except: NGT = Insertion , Position ( HIGH FOWLERS)
A. Diarrhea NGT = FEEDING 30 degrees , semi fowler for maintain 30 minutes
B. Pasty, unformed stool
C. Constipation
D. Hyperglycemia
55. Zyra who was in NGT was prescribed a timed-release
tablet. What action of the nurse indicates the she had an
accurate understanding of the situation upon giving the drug?
A. Powderized the tablet and dissolve in water.
B. Give it as prescribed.
C. Call the physician to change the medication
D. Consult the pharmacist for an alternative form of the drug.
Situation: Mr. John Skarner, a 57 year-old lawyer was
confined after complaining persistent and productive
cough accompanied by shortness of breath. History
was taken and it revealed that he started smoking at
the age of 15 and was able to consume 10 cigarettes in
a day.
56. Based on the situation, how many pack years does Mr.
Skarner have?
A. 42 years 57- 15 - 42 years
B. 28years
C. 21 years 10 Divide 20 times 42 = 21 years
D. 36 years
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57. The patient was diagnosed of Chronic Bronchitis has a
correct understanding of the situation if she states that Chronic
bronchitis is the presence of cough and sputum production for
how long?
A. at least 2 months in each 3 consecutive years
B. at least 3 months in each 2 consecutive years
C. more or less 3 months in each 3 consecutive year
D. more than 3 months in a year
58. One night, the patient prompted the nurse because of
difficulty in breathing. The patient requested the nurse to raise
the oxygen level from what is being prescribed. The nurse has
an accurate understanding of the situation if she does what
action? COPD, KNOWLEDGE DEFICIT
A. Follow the client’s wish to facilitate breathing.
B. Discontinue the oxygen therapy because the patient is no
longer responsive to it.
C. Give the client expectorant immediately to expel retained
secretions.
D. Maintain the regulation and assess for other potential
problems.
59. Mr. Skarner was ordered for a postural drainage. The
patient asked the nurse when it will be done. The nurse is
correct if she stated that CPT is best performed:
A. Early in the morning before breakfast.
B. In the morning after eating merienda.
C. In the afternoon before dinner.
D. Thirty minutes after the patient took his lunch.
NEVER AFTER MEALS, RISK FOR ASPIRATION, VOMITING
60. You noticed that the patient still have productive cough.
Which method is best used for assessing breath sounds?
A. Palpation
B. Auscultation
C. Percussion
D. Inspection
Situation: Cancer is one of the leading causes of
disability and death worldwide. Various treatments and
medical regimen have been discovered to halt or
minimize the progression of the said disease.
61. A patient who was admitted in the oncology ward had his
chart placed in the station. As the nurse browses the chart,
she notices TIS, N0, and M0 written on the patient’s diagnosis.
She correctly interprets the data if she states that TIS, N0, M0
means :
A. No evidence of primary tumor, Regional lymph node can’t
be assessed and distant metastasis
B. Primary Tumor can’t be assessed, No regional lymph node
metastasis and distant metastasis can’t be assessed
C. Carcinoma in situ, No regional lymph node metastasis and
no distant metastasis
D. Tumor less than 2 cm, One regional node involvement and
distant metastasis can’t be assessed
62. Tristana, a 38 year old woman was also admitted in the
ward. She was diagnosed of having stage 2 cervical cancer and
was scheduled a radiation therapy specifically cervical
implants. Which of the following room locations is best for
patient Tristana? BRACHYTHERAPY - INTERNAL
A. Near the nurses’ station TELETHERARNAL ; FREE FROM RADIATION
B. Away from the hallway
C. Somewhere near the ward exit
D. In front of the ward’s common rest room
63. As you make your rounds, you noticed that there are
implants in the patient’s bed. Initially, what should the nurse
do? 3 radiation safety principles DISTANCE - MAX 1 - 2 meters
A. Pick up the implants using a gloved hand and place it in the
trash bin. Time - 30 mins within 8 hr shift
B. Call the attention of the maintenance and let him dispose of
the implants. SHIELD - LEAD APRONS
C. Pick up the implants using long forceps and place it in a
lead container.
D. Have the patient pick the implants and insert it back.
NURSING PRACTICE II: Care of Clients with Physiologic and Psychosocial Alterations (Part A)
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64. Another patient was also admitted in the same ward and
diagnosed of stage 3 lung cancer. He was advised to undergo
chemotherapy. The following statements indicate that the
patient has an accurate understanding regarding the effects of
chemotherapy except: (-)
A. I will use soft-bristled toothbrush for my oral care.
B. Imgonna eat nutritious foods like fresh fruits and
vegetables.
C. I prefer artificial rather than fresh flowers in my room.
D. I should avoid engaging in contact sports.
65. The patient started to worry why his hair had started to fall
off. You came off with a diagnosis of body image disturbance.
The patient asked if his hair would grow back. The nurse has a
correct understanding of the situation if she stated that:
A. “Hair loss is temporary and it will grow back right after the
treatment.”
B. “Your hair will never grow back and wearing of wigs is
recommended for life.”
C. “Your hair will grow back some time after the therapy but it
is not the same as before.”
D. “Worrying is the cause of hair loss and not the treatment so
stop worrying.”
Situation: Diabetes Mellitus is one of the leading
debilitating diseases in the world. It is related to
sedentary lifestyle, improper diet and genetics.
66. Nurse Annie was assigned in the Diabetes enter. She is
aware that insulin is mainly responsible for controlling the
levels of glucose in the blood. Insulin is produced by what cell?
A. Alpha-cells
B. Beta-cells
C. Delta-cells
D. Goblet cells
67. A type I DM client experiences Diabetic Ketoacidosis. Based
on your knowledge, the acid-base balance most likely seen in
the patient is:
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
HYPERGYLCEMIS - BREAKDOWN FATS - ( KETONES cause kausmall respiration)
68. A type II DM client is asking the nurse what is the best
time to buy shoes. The nurse is correct if she replied:
A. Morning
B. Anytime of the day will do
C. Time is not a relevant factor
D. Late in the afternoon
69. The nurse is instructing a diabetic client about foot care.
The patient needs no further instruction if he states the
following except:
A. “I will walk barefooted in the house to promote circulation”.
B. “ I’m gonna avoid soaking my feet in the water for long
time”.
C. “I will cut my toe nails straight”.
D. “I will eat nutritious food recommended by my dietician”.
DM PATIENTS ARE RISK FOR PERIPHERAL NEUROPATHY
70. A client is taking Glyburide (Micronase) for her type II DM.
Which statement from the patient would alert the nurse?
A. The client stays up late when he overtimes at work.
B. I limit my alcohol intake up to 2 glasses everytime we have
a night out. increase risk for hyperglycemia
C. I do not recommend this drug to my pregnant diabetic
friends.
D. I usually experience headache after taking this medication.
Situation: In the OR, there are safety protocols that
should be followed. The OR nurse should be well
versed with all these to safeguard the safety and
quality of patient delivery outcome.
71. Which of the following should be given highest priority
when receiving patient in the OR?
A. Assess level of consciousness
B. Verify patient identification and informed consent
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C. Assess vital signs B. Autoclaving
D. Check for jewelry, gown, manicure and dentures C. Flash sterilizer
D. Alcohol immersion
72. Surgeries like I and D (Incision and Drainage) and
debridement are relatively short procedures but considered Situation: Nurses hold a variety of roles when
“dirty cases.” When are these procedures best scheduled? providing care to a peri-operative patient.
A. Last case
B. In between cases 81. Which of the following role would be the responsibility of
C. According to the availability of the anesthesiologist the scrub nurse?
D. According to the surgeon’s preference A. Assess the readiness of the client prior to the surgery
B. Ensure that the airway is adequate
73. Katarina, an active cheerleader complains flashes of lights C. Account for the number of sponges, needles, supplies used
appearing and a shadow covering the upper vision of her left during the surgical procedure
eye. You suspect that Katarina sustained a: D. Evaluate the type of anesthesia appropriate for the surgical
Text
A. Retinal Detachment client
Text
B. Glaucoma LOSS OF VISION ; TUNNEL VISION
C. Cataract CLOUDY OR BLURRING VISION 82. As a peri-operative nurse, how can you best meet the
D. Macular degeneration LOSS OF CENTRAL VISION safety need of the client after administering pre-operative
narcotic?
74. Based on the situation, you plan to position the client on: A. Put side rails up and ask the client not to get out of bed
A. Side-lying on the affected eye B. Send the client to OR with the family
B. Lateral on the affected eye C. Assist client to get up to go to the comfort room
C. Dependent position on the area affected D. Obtain consent form
D. Independent position on the side affected
83. It is the responsibility of the pre-op nurse to do skin prep
75. As you prepare the patient for surgery, you noticed that for patients undergoing surgery. If hair at the operative site is
the patient is fidgeting, going in and out of his bed and not shaved, what should be done to make suturing easy and
frequently asks about the procedure. These behaviors of the lessen the chance of incision infection?
patient most likely suggest? A. Draped
A. The patient does not have enough sleep last night. B. Pulled
B. Client is pressed between financial burden and family C. Clipped
responsibilities. D. Shampooed
C. She drank too much coffee during breakfast
D. She is anxious about the surgery. 84. It is also the nurse’s function to determine when infection
has developed in the surgical incision. The perioperative nurse
Situation: Sterilization is the process of removing all should observe for what signs of impending infection?
living microorganisms. To be free of all living A. Localized heat and redness
microorganisms is sterility. B. Serosanguinous exudates and skin blanching
C. Separation of the incision
76. There are three general types of sterilization used in the D. Blood clots and scar tissue are visible
hospital. Which is not included? ( CALOR , RUBOR, TUMOR , DOLOR AND FUNCTIO LASSE)
A. Steam sterilization 85. Which of the following nursing interventions is done when
B. Chemical sterilization examining the incision wound and changing dressing?
cC Dry heat sterilization A. Observe the dressing, and type and odor of drainage if any
D. Sterilization by boiling B. Get patient’s consent
C. Wash hands
77. Autoclave on steam under pressure is the most common D. Request the client to expose the incision wound
method of sterilization in the hospital. The nurse knows that
the temperature and time is set to the optimum level to Situation: Enrolling as nursing students taught you
destroy not only the microorganism, but also the spores. what the nursing profession has in store for you and to
Which of the following is the ideal setting of the autoclave recognize that each one came from different environs,
machine? different influences, different past and present. As you
A. 10,0000C for 1 hour journey through nursing, you saw yourselves transform
B. 5,0000C for 30 minutes “from the person you were” to the “aspiring nurse” you
C. 370C for 15 minutes have become. Now that you have graduated and now
D. 1210C for 15 minutes taking your Nurse Licensure Examination (NLE) there is
only the “YOU, who is the nurse.”
78. It is important that before a nurse prepares the material to
be sterilized a chemical indicator strip, preferably a Muslin 86. As an aspirant, a beginning nurse practitioner after your
Sheet, should be placed above the package. What is the color basic nursing education, the “YOU, who is a professional
of the stripe produced after autoclaving? nurse” means:
A. Black A. I have simply fine tuned myself, my needs, my wants,
B. Blue my idiosyncrasies, to fit in the profession of nursing.
C. Gray B. The I in me and the nurse in me are two distinct
D. Purple identities that even my patients have to learn to
respect.
79. Chemical indicators communicate that: C. I have simply retained my former self but acquired
A. The items are sterile. the knowledge, skills, attitudes, and values expected
B. The items have undergone sterilization process but not of a nurse.
necessarily sterile. D. The person I am and the professional nurse I aspire
C. The items are disinfected. to be have now developed into one Filipino Nurse. We
D. The items have undergone disinfection process but not are one and the same identity.
necessarily disinfected
87. As you progress in developing your nursing competencies,
80. If a nurse will sterilize a heat and moisture label you have to thread a career-path according to the culture and
instruments, it is according to AORN recommendation to use design of Philippine Nursing. This means:
which of the methods of sterilization?
A. Ethylene oxide gas

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 a. Serving in other countries and learning new and
modern ways of doing nursing and sharing these back in
the Philippines.
b. Progressing as nurse-generalist in a multitude of
choice-practice settings to that of expert nurse-
practitioner also in choice-practice-settings
c. Avoiding personal and professional stagnation by
updating and upgrading one’s self
d. Constantly upgrading one’s self through advanced
technological means and strategies
88. It is important to remember that while RNs value “job
tenure” because the years in service spell variety of
experiences in nursing practice, it is far more valuable to
consider that tenure-years are nothing if these are not parallel
with one’s personal-professional growth and maturity. This
implies:
a. Simply earning years of job-related service until we
retire from service.
b. Extending assistance to our less-fortunate fellow
nurses.
c. Progressive upgrading of competencies in terms of
knowledge, skills, attitudes, and values as
professional nurse.
d. Volunteering our services wherever needed.
89. We often give our best in caring but despite all efforts, the
reality of facing death is inevitable. Our brand and core values
of nursing will always extend beyond the ordinary levels of
promotive, preventive, curative, and rehabilitative care. This
culturally-bound, Filipino values of nursing likewise needs to be
nurtured:
A. Psychological care
B. Emotional care
C. Spiritual care
D. Relational care
90. It is important to not only enrich one’s mind with
progressive technical upgrades but equip one’s self with
holistic personal and professional development believing that:
A. we are also God’s angels of mercy on earth
B. we may also find real holism in the service we render
C. we and the beneficiaries of our care are made up of
body, soul, and spirit and each component do have
health needs intertwined
D. should we encounter terminal patients, we may
understand how to support them to their dying stage
Situation: Nurse Jade is in charge of a client who was
admitted for management of acute episodes of
cholecystitis.
INFLAMMATION OF GALLBLADDER
91. Nurse Jade did her admission assessment. She
understands that the pain is characterized as:
A. Tenderness that is generalized in the upper
epigastric area
B. Tenderness and rigidity at the left epigastric area
radiating to the back
C. Tenderness and rigidity of the upper right abdomen
radiating to the midsternal area
D. Pain of the left upper quadrant radiating to the left
shoulder
92. To confirm the diagnosis of cholecystitis, the attending
physician ordered the procedure that can detect gallstones as
small as 1 to 2 cm and inflammation. Nurse Jade would
prepare the client for which specific diagnostic procedure?
A. cholangiography
B. gall bladder series
C. oral cholecystogram
D. ultrasonography
93. The diagnosis was confirmed as cholecystitis with
gallstones. The doctor prepared the client for the removal of
his gallbladder. The client asks the nurse: “How will this
procedure affect my digestion?” The nurse’s most correct
response would be: GALL BLADDER- STORES BILE FOR DIGESTION FAT
A. c. “Your body system will adjust in due time.”
NURSING PRACTICE II: Care of Clients with Physiologic and Psychosocial Alterations (Part A)
TOPRANK REVIEW ACADEMY, Inc.
B. “The removal of the gallbladder usually interferes with
digestion but can be remedied by dietary
modifications.”
C. “The removal of the gallbladder would significantly
interfere only with the digestion of fatty food.”
D. “The removal of gallbladder does not usually interfere
with digestion.”
94. While reviewing the laboratory findings of the client, Nurse
Jade found out that which findings are elevated?
1. white blood cell count
2. total serum bilirubin
3. alkaline phosphate
4. red blood cell count
5. cholesterol
6. serum amylase
A. 3,5,6
B. 1,2,6
C. 1,2,3
D. 2,3,4
95. A T-tube was inserted and the doctor ordered: “Monitor
the amount, color, consistency and odor of drainage.” Which of
the following procedures can the nurse perform without the
doctor’s order?
A. clamping
B. emptying
C. aspirating
D. irrigating
Situation: Alfonsus sought hospital confinement for
pleuritic pain, fever, and cough. The attending
physician had a chest x-ray taken STAT. Result
revealed presence of lung infiltrates. The client was
assigned to Kianne the staff nurse.
96. When Kikay performed chest auscultation, she observed
short discreet bubbling sounds over the lower region of the
right lung. Which of the following abnormal findings will Kikay
consider?
A. Friction rub
B. Murmur
C. Wheezes
D. Crackles
97. Kikay put her priority nursing diagnosis as “Ineffective
airway clearance related to increased secretions and ineffective
coughing.” Which nursing intervention would be considered to
facilitate coughing with the LEAST discomfort?
A. Splinting chest wall with pillow when coughing
B. Putting the client in semi-Fowler’s position all the time
C. Taking cough med q4 hours round the clock
D. Utilizing the purse-lip technique of breathing
INEFFECTIVE AIRWAY CLEARANCE , IMPAIRED GAS
EXHANGE AND IMPAIRED BREATHING PATTERN
98. The physician prescribes oral penicillin 500 mg every six
hours for seven days. On the fifth day, before Kikay
administers the first dose for the day, she computed for the
total amount in the milligrams of the oral penicillin that has
been received by the client. Which of the following is the
correct amount?
A. 2,500 mg 500MG Q6 HRS FOR 7 DAYS
B. 15,000 mg
C. 10,000 mg 4 DOSES X 500MG = 2000MG IN A DAY
D. 8,000 mg 2000MG TIMES 4 DAYS = 8000
99. Standard precaution dictates that the nurse observes which
of the following when caring for a client with streptococcal
pneumonia?
A. Use of face mask
B. Use of sterile gloves
C. Observe two-feet distance when giving care
D. Use clean gloves
100. Sputum cultures are to be obtained to establish the
client’s specific antibiotic treatment. Kikay would BEST collect
the specimen:
A. Early in the morning CONCENTRATED YUN SECRETION
B. Early morning after an antiseptic gargle
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 C. After brushing the client’s teeth
D. Anytime of the day after a warm salt solution gargle

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