Session # 1

1. Which of the following facets of health is demonstrated if the patient feels very much optimistic about the
results of her pregnancy?
a. Spiritual influences c. Cultural influences
b. Physical health d. Emotional health
RATIO: Emotional health is known as a positive outlook and emotions channeled in a healthy manner like in the following
statement the patient feels very much optimistic about the results of her pregnancy.

2. When the patient is communicative with her friends with regard to his marital problems which facet of health is
being applied here?
a. Spiritual influences c. Cultural influences
b. Environmental influences d. Social well-being
RATIO: Social well-being is known as supportive relationships with family and friends since the patients the patient is
communicative with her friends with regard to his marital problems.

3. When the patient is identifying a solution to financial problems in order to be rid of her financial stresses the
patient is demonstrating which of the following facets of health?
a. Emotional health c. Physical health
b. Developmental level d. Social well-being
RATIO: Developmental level is how it thinks, solves problems, and makes decisions since the patient is identifying a
solution to financial problems.

4. This is the ability of the nurse to extrapolate the findings, prioritize them, and finally formulate and implement
the plan of care is the overall goal
a. Health history c. Physical examination
b. Health assessment d. Nursing process
RATIO: In the nursing process it’s a problem-solving problem that identify patient problems; set a goal and develop an
action plan; implement the plan; and evaluate the outcome since it's the overall goal of the nurse.

5. Which of the following is NOT true about the assessment phase of the nursing process?
a. Subjective and objective data are gathered c. It is the first step of the nursing process
b. It ends when doing the nursing diagnosis d. It continues throughout the entire patient encounter
RATIO: It does not end with the nursing diagnosis. The final step would be evaluation and the nursing process can start
over if there are goals that are not met.

6. This is the phase of the nursing process where the nurse determines whether the goals made for the patient
have been attained
a. Nursing diagnosis c. Implementation
b. Planning d. Evaluation
RATIO: Evaluation is where to patient reassess the condition of the patient and whether the short or long-term goals she
has made for the patient has been achieved with the nursing interventions.

7. The phase of the nursing process where the nurse establishes both the short-term and the long-term goals for
the patient
a. Assessment c. Planning
b. Diagnosis d. Diagnosis
RATIO: This is where the nurse identifies 2 types of goals for the patient: short-term-goal and the long-term-goal.

8. Which of the following is NOT true about the nursing diagnosis?

a. It has a nursing focus c. It determines the medical diagnosis of the patient
b. It is based on real or potential health problems d. It sets the stage for the remainder of the care plan
RATIO: It determines the medical diagnosis of the patient

9. Which of the following best describes problem-oriented assessment?

a. The nurse focuses on gathering information about c. The nurse here gathers data to evaluate the outcomes
the patient’s problem. of the plan of care
b. This allows the nurse to obtain a full picture of the d. The data collection is focused on the patient’s
patient’s health status and current problems. emergent problem

RATIO: This is where the nurse must learn more about the patient’s chief complaint by using the OLDCART method.

10. Which of the following best describes follow-up history?

a. The nurse focuses on gathering information about the c. The nurse here gathers data to evaluate the
patient’s problem. outcomes of the plan of care
b. This allows the nurse to obtain a full picture of the d. The data collection is focused on the patient’s
patient’s health status and current problems. emergent problem
RATIO: An emergency history is the data collection which focused on the patient’s emergent problem with a systematic
prioritization of need beginning with the ABCs of airway, breathing, and circulation.
 Session # 2

1. Which of the following is an example of a subjective data?

a. Cyanosis c. Blurred vision
b. A blood pressure of 140/90 mmHg d. Heart rate of 89 beats per minute
RATIO: Blurred vision is an example of a subjective data.

2. This phase of the interview is where the nurse invites the patient’s story, identify and respond to emotional
cues, and expand and clarify the patient’s story
a. Pre-interview c. Working
b. Introduction d. Termination
RATIO: The working phase is where the nurse is going to explore more about the patient’s problems and seek some
clarification about it.

3. The primary goal in the introduction phase of the interview is for the nurse to
a. Obtain subjective data c. Greet the patient
b. Make the patient comfortable d. Establish rapport
RATIO: To establish a rapport

4. The primary source of health history would be from which of the following?
a. Parents c. Spouse
b. Patient d. Siblings
RATIO: a conversation with a purpose within three folds using health history format:

5. Which of the following is an example of an objective information?

a. Dizziness c. Skin warm to touch
b. Headache d. Itchiness
RATIO Skin warm to touchis an example of an objective information.

6. Which of the following component of the adult health history lists childhood illnesses?
a. Family history c. History of present illness
b. Past history d. Review of systems
RATIO: In the past history the components of childhood illness is included such as asthma.

7. This is a component of the adult health history that documents personal/social history
a. Health patterns c. Identifying data
b. Chief complaint(s) d. History of present illness
RATIO: In Health Patterns provides a guide for gathering personal/social history from the patient
.
8. Which of the following is NOT an identifying data in the adult health history?
a. Age c. Gender
b. Date of birth d. Immunization status
RATIO: Immunization status does not belongs to identifying data rather its for patients that received vaccines.

9. This helps amplify the patient’s chief complaint and describes how each symptom developed
a. Identifying data c. Health patterns
b. History of present illness d. Past history
RATIO: History of present illness helps amplify the patient’s chief complaint and describes how each symptom developed.

10. This outlines or diagrams age and health, or age and cause of death, of siblings, parents, grandparents
a. History of present illness c. Family history
b. Past history d. Health patterns
RATIO: Since in the Family history this outlines or diagrams age and health, or age and cause of death, of siblings,
parents, grandparents
 Session # 3

1. The patient information in the health history format should have which of the following EXCEPT
a. Written form c. Interview form
b. Electronic form d. Verbal form
RATIO: In the health history format is a structured framework for organizing patient information in written, electronic, and
verbal form to communicate effectively with other health care providers.

2. Which of the following is NOT true with regard to the working phase of interview?
a. Identify and respond to emotional cues c. Expand and clarify the patient’s story
b. Review patient record d. Generate and test diagnostic hypotheses
RATIO: Review patient record belongs to Self-Reflection not regard to the working phase of interview.

3. The nurse tells the patient, “So you will take the drugs according to the schedule that we have discussed,
monitor your blood pressure daily and you will have a follow-up appointment with your doctor after a week.” This
is done during which phase of the interview
a. Pre-interview phase c. Orientation phase
b. Working phase d. Termination phase
RATIO: Termination phase is to summarize important points and to discuss plan of care since the statement is regards to
the schedule, monitor blood pressure daily and a follow-up appointment.

4. When providing guided questioning the nurse must

a. Move from open-ended to focused questions c. Ask a series of questions, one at a time
b. Use questioning that elicits a graded response d. All of the above
RATIO: All the following options above are guided questionnaire for the nurse.

5. Which of the following is NOT providing an empathic response from the nurse to the patient?
a. “That must really be upsetting.” c. “That happened to me to when I was younger.”
b. Offering a tissue to a crying patient d. Gently placing your hand on the patient’s arm.
RATIO: The statement is not an empathic response from the nurse to the patient since it doesn't identify the patient’s
feelings.

6. When dealing with silent patients the nurse must ask questions such as
a. “Do you want me to stay with you for a while?” c. “You seem very quiet. Have I done something to
b. “Is something troubling you?” upset you?”
d. “Do you feel sad?”
RATIO: The statement is direct to the point when asking the patient.

7. This tool would be very helpful in dealing with a confused patient

a. Mental status examination c. Interview form
b. PQRST d. Glasgow-Coma Scale
RATIO: Mental status examination is focuses on level of consciousness, orientation, memory, and capacity to understand.

8. When the nurse is dealing with a talkative patient the nurse must employ which of the following therapeutic
communication techniques?
a. Focusing c. Providing general leads
b. Listening d. Clarifying
RATIO: Dealing with a talkative patient the nurse must employ by listening closely to the conversation and must show
interest by asking questions.

9. Which of the following therapeutic communication techniques is most appropriate for a patient who is crying?
a. “Please stop crying, it will only further upset you.” c. “I am glad you were able to express your
b. “I have suffered the same thing you have experienced feelings.”
and it is traumatizing.” d. “Don’t cry, all of these things that has happened to
you is part of life.”
RATIO: Usually for the patients who feel distress or pain this communication techniques is most appropriate.

10. When dealing with an angry or disruptive patient in the ward the nurse must do the following EXCEPT
a. Allow them to express their angry without getting c. Stay calm, appear accepting, and avoid being
angry in return confrontational in return.
b. Alert the security staff d. Try to pat the patient’s back
RATIO: Try to pat the patient’s back is not the way of dealing with an angry or disruptive patient in the ward the nurse.
 Session # 4

1. ANSWER: Visual Acuity Chart

RATIO: To test near and far vision.

2. ANSWER: Stadiometer
RATIO: Used to measure patient height, a stadiometer is an essential piece of equipment at any medical practice.

3. ANSWER: Otoscope
RATIO: Inspect the tympanic membrane and external ear canal

4. ANSWER: Ophthalmoscope
RATIO: Instrument used to examine the eyes.

5. ANSWER: Sphygmomanometer
RATIO: Measure systolic and diastolic blood pressure

6. ANSWER: Acoustic Stethoscope

RATIO: Instrument used to examine and listen to the heart, chest, and lungs.

7. ANSWER: Reflex Hammer

RATIO: Instrument used to tap areas of the body to test the animal's reflex response.

8. ANSWER: Pulse oximeter

RATIO: Pulse oximetry is a noninvasive and painless test that measures your oxygen saturation level, or the
oxygen levels in your blood.

9. ANSWER: Medical scales

RATIO: Medical scales are essential for tracking the progress of patients while they are being monitored in a
hospital or at the physician's office.

10. ANSWER: Tuning Fork

RATIO: Test auditory function and vibratory sensation
 Session # 5

1. Obtaining information about the child’s illness is necessary for physical examination. The parent or a guardian
will be a great source of information for which of the following pediatric clients?
a. Adolescent c. School-age child
b. Infant d. None of the above
RATIO: For clients like infants or child’s illness this great source of information for pediatric.

2. Which of the following is important for the nurse to do when interviewing the preschool and the older children
EXCEPT?
a. Be age appropriate c. Interview the parent instead
b. Establish rapport d. Listen to the child’s comments
RATIO: Parents are guiding their children.

3. The best way to measure the height of an infant patient is by

a. Letting the infant sit c. Allow the infant to stand and be held by the guardian
b. Place the infant flat on an examination table d. Any of the above
RATIO: All the options above are the best way to measure the height of an infant patient.

4. The head circumference is measured routinely especially for children aged

a. 2 to 3 years old c. 4 to 8 years old
b. 9 to 12 years old d. 13 to 18 years old
RATIO: The head circumference us measured routinely in children to the age 2 or 3 years or in any child with a neurologic
concern.

5. The normal pulse rate for a neonate is at

a. 50-60 beats per minute c. 80-100 beats per minute
b. 60-80 beats per minute d. 100 to 180 beats per minute
RATIO: Pulse rates vary with age: from 100 to 180 beats per minute for a neonate to 50 to 95 beats per minute for the 14-
to 18-year-old adolescent.

6. In order to allay the fears of a younger pediatric patient in the measurement of their blood pressure the nurse
must do which of the following?
a. Explain the procedure to the client c. Taking the blood pressure on a stuffed animal or
b. Tell the mother to hold the child while BP doll will show the child that the procedure is not to
measurement will be done be feared.
d. Inform the child that blood pressure measurement is
not painful.
RATIO: This will distract the younger pediatric patient while measuring their blood pressure by the nurse.

7. When measuring the pediatric client’s chest circumference with a tape measure, the nurse must do which of
the following?
a. Measure at the nipple line c. Measure above the nipple line
b. Measure below the nipple line d. Any of the above
RATIO: Take the measurement at the nipple level with a tape measure; observe for chest size, shape, movement of the
chest with breathing, and any retractions.

8. Which of the following is true with regard to the infant or younger children’s abdomen?
a. The abdomen is flat c. The abdomen appears globular
b. The abdomen may protrude slightly d. The abdomen is retracted
RATIO: The abdomen may protrude slightly in infants and small children.

9. Which of the following is assessed on the infant’s head in order to assess for further dehydration?
a. Scalp c. Fontanels
b. Cheeks d. Temples
RATIO: The nurse feels the skull to determine if the fontanels are open or closed and to check for any swelling or
depression.

10. Which of the following is the characteristic of the infant’s spine?

a. Rounded and flexible c. Rounded and rigid
b. Straight and rigid d. Straight and flexible
RATIO: In infants the spine is rounded and flexible
 Session # 6

1. This device is used to measure the patient’s blood pressure

a. Goniometer c. Pulse oximeter
b. Stadiometer d. Sphygmomanometer
RATIO: An instrument for measuring blood pressure, particularly in arteries.

2. When the patient has a blood pressure of more than 160/110, the patient is categorized as having
a. Prehypertension c. Stage 2 hypertension
b. Stage 1 hypertension d. Stage 3 hypertension
RATIO: Hypertension Stage 2 is when blood pressure consistently ranges at 140/90 mm Hg or higher.

3. This type of breathing which has gradual increases and decreases of breathing with periods of apnea
a. Ataxic breathing c. Hypopnea
b. Obstructive breathing d. Cheyne-Stokes breathing
RATIO: Cheyne Stokes breathing is a type of abnormal breathing which characterized by a gradual increase in breathing,
and then a decrease.

4. Deep breathing due to metabolic acidosis is known as

a. Ataxic breathing c. Kussmaul breathing
b. Cheyne-stokes breathing d. Tachypnea
RATIO: Kussmaul breathing is known for deep and labored breathing pattern often associated with severe metabolic
acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure.

5. Pain resulting to direct injury to the peripheral or central nervous system is known as
a. nociceptive pain c. psychogenic pain
b. neuropathic pain d. idiopathic pain
RATIO: Neuropathic pain is known as nerve pain––is pain that results from injury to the somatosensory nervous system.

6. The apex of the heart is found at the

a. 2nd intercostal space, mid-clavicular line c. 5th intercostal space, mid-clavicular line
b. 3rd intercostal space, mid-clavicular line d. 7th intercostal space, mid-clavicular line
RATIO: The apex of the heart is located on the midclavicular line, in the fifth intercostal space. It is formed by the left
ventricle.

7. Which of the following is observed when detecting the respirations of the patient EXCEPT?
a. Rate c. Sigh
b. Rhythm d. Depth
RATIO: In detecting the respirations the nurse observe the rate, rhythm, depth, and effort of breathing.

8. Which of the following is NOT true regarding the measurement of the body temperature?
a. Oral temperature is usually quoted at 37oC c. Oral temperatures are higher than rectal
b. Temperature may rise in the late afternoon or evening temperatures
d. Axillary temperatures are lower than oral
temperatures
RATIO: It should be a rectal temperature higher than an oral temperature.

9. If a nurse has detected a fruity odor in the breath of the patient, the nurse must suspect for
a. Stroke c. Diabetes mellitus
b. Hypertension d. Pneumonia
RATIO: Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin,
causing blood sugar (glucose) levels to be abnormally high.

10. When the nurse observes for pallor and cyanosis on the patient’s appearance, she should note this under
a. Facial expression c. Dress, grooming, and personal hygiene
b. Skin color and obvious lesions d. Level of consciousness
RATIO: Skin color and obvious lesions is regarded such as Pallor, cyanosis, jaundice, rashes, bruises.
 Session # 7

1. Which of the following statements is true about global migration in relation to health care?
a. Patient care has been easier since most nurses can c. There is an increased challenge of providing
adapt to the different needs of patients. health care to patients with health care beliefs,
b. There is globalization of health care therefore creating practices and needs different from the health care
more ease of work for health care workers. provider.
d. Health care workers nowadays are comfortable with
the different cultures around the world
RATIO: In the global migration is that there is an increased challenge of providing health care to patients with health care
beliefs, practices and needs different from the health care provider

2. A patient is taking about the shared values that they have in the Middle East such as strictly conforming to
their religious practices. The patient here is exhibiting which of the following?
a. Culture c. Race
b. Ethnicity d. Beliefs
RATIO: thnicity is an ethnic group composed of individuals who self-identify membership with or belong to a group
with shared, values, ancestry, and experiences.

3. The nurse has noted the skin color of the patient on the patient’s chart as part of the assessment. The nurse
here is documenting the patient’s
a. Culture c. Race
b. Ethnicity d. Values
RATIO: socially constructed concept of dividing people into populations or groups on the basis of various sets physical
characteristics

4. In order for a nurse to acquire certain skills in order to provide the appropriate nursing care for people of
different cultures, the nurse must first develop
a. Cultural competence c. Cultural desire
b. Cultural awareness d. Cultural humility
RATIO: Cultural Competence is known as to recognizes the need for a set of skills necessary to care for people of
different cultures

5. Which of the following self-reflection answers by the nurse would pose a problem later on in rendering health
care to a patient who has a different culture than hers?
a. “I am aware of my biases, prejudices, stereotypes to c. “I learn who to seek experiences with other cultures.”
other people.” d. “I sometimes have issues with the cultural beliefs
b. “I feel comfortable interacting with people from of some patients.”
different cultures.”
RATIO: The statement follows a self-reflection has a patient who has a different culture.

6. Nurses should learn about their own strengths and weaknesses by doing which of the following?
a. Self-awareness c. Collaborative partnerships
b. Respectful communication d. Counter transference
RATIO: A Self-awareness learns about your own biases such as our own strengths and weaknesses.

7. Which of the following is NOT true about respectful communication?

a. Let your patients be the experts on their own unique c. Try to change the patient’s unconventional
cultural perspectives cultural practice
b. Maintain an open, respectful, and inquiring attitude. d. Always be ready to acknowledge your areas of
ignorance or bias.
RATIO: The statement in option C is not true about respectful communication.

8. When the patient diagnosed with stage 4 cancer cries out, “Why? Why is God punishing me like this?!” The
patient here is demonstrating
a. Emotional distress c. Spiritual distress
b. Physiological distress d. Psychological distress
RATIO: The patient here is demonstrating a Spiritual distress since it diagnosed with stage 4 cancer.

9. When the patient is suffering from spiritual distress the role of the nurse is to
a. Listen and let the patient do the talking c. Advise the patient that his/her condition is God’s will
b. Offer valid solutions d. Refer the patient to their family
RATIO: The role of nurse is to let the patient do the talking since the patient is suffering from spiritual distress

10. Which of the following questions is not under sources of hope and strength in Stoll’s guidelines for spiritual
assessment?
a. “Who is the most important person to you?” c. “What is your source of strength and hope?”
b. “To whom do you turn when you need help? Are they d. “Is religion or God significant to you? If yes, can
available? you describe how?”
RATIO: Option A,B,C is under to the source of Hope and strength in Stoll’s guidelines for spiritual assessment while
Option D is under the Concept of God or Deity.
 Session # 8

1. The patient has told you, “I want to play basketball. Do you know that my brother loves to play it? However, my
brother is in Europe right now. One place in Europe I want to visit would be Greece. The beaches there are nice. I
have read things about Greek mythology as well…” This is an example of
a. Looseness of association c. Clang association
b. Flight of ideas d. Word salad
RATIO: Flight of ideas is jumping from one topic to another. However, the topics seem to have a connection between
them.

2. When the patient has no variation in his or her affect the nurse must note this as
a. Labile affect c. Blunted affect
b. Inappropriate affect d. Flat affect
RATIO: Flat affect shows no facial expressions is a condition that causes people to not express emotions.

3. The patient talking to you says, “I want to go to Baguio, because it’s hot here in the plains yo! There is always
one thing I am always missing from there. That why I want to my friends there and hangout everywhere.” This
type of though processing must be noted by the nurse

a. Neologism c. Verbigeration
b. Clang association d. Perseveration
RATIO: Clang association regards as words in the speech that sound similar but have no connection or meaning and
words with similar sounds or that rhyme are grouped together.

4. When the patient says that he is the current president of the Philippines and vows to get rid of China from the
Spratlys, he is demonstrating which of the following types of delusions?
a. Religious delusion c. Delusion of grandeur
b. Delusion of persecution d. Thought insertion
RATIO: A delusion of grandeur is the false belief in one's own superiority, greatness, or intelligence.

5. The patient saw two nurses who were quietly talking to each other at the nurses’ station. The patient then said,
“You two! I know that you are talking about me.” This type of delusion is known as
a. Jealous delusion c. Thought insertion
b. Delusion of persecution d. Ideas of reference
RATIO: Ideas of is regards as a person having a belief or perception that irrelevant, unrelated or innocuous things in the
world are referring to them directly or have special personal significance.

6. The most common type of hallucination seen in schizophrenic patients is

a. Auditory c. Visual
b. Tactile d. Olfactory
RATIO: This may confuse their own actual thoughts for auditory hallucinations.

7. When the nurse is asking, “What would you do if you are on the 4th floor of a building and suddenly a fire
broke out?” The nurse here is testing the patient’s
a. Insight c. Judgment
b. Reliability d. Impulsivity
RATIO: Judgment is regards to the patient's judgment based on the history or on an imaginary scenario.

8. The nurse is asking the patient, “Do you have anything that extremely frightens you whenever you see that
thing?” The nurse here is determining the patient’s
a. Orientation c. Insight
b. Anxiety d. Phobia
RATIO: Phobias is known as fears that cause them to avoid certain situations.

9. A patient has told the nurse, “Nurse my krizzits are dirty. You need to wash them.” The nurse asked the patient
what krizzits are and the patient was pointing at his soiled clothes. This is an example of
a. Clang association c. Neologism
b. Tangentiality d. Verbigeration
RATIO: Neologism is coining of new words known only to the patient.

10. The nurse has asked the patient, “What do you recall about your 10th birthday?” The nurse here is testing
the patient’s
a. Memory c. Comprehension
b. Orientation d. Consciousness
RATIO: Memory is regarded as to evaluate a patient's memory, have them respond to the following prompts.
 Session # 9

1. What type of sweat glands are present in the armpits and groin area?
a. Eccrine c. Sebaceous
b. Apocrine d. None of the above
RATIO: Apocrine glands are found in the armpits and genital region that they produce a thick fluid.

2. These cells are responsible for the skin color of a person

a. Epithelial cells c. Dermatocytes
b. Melanocytes d. Eponychium
RATIO: Functions of melanocyte are actively phagocytic, dendritic cells derived from the neural crest, and generate
pigment in membrane-bound melanosomes.

3. Which of the following is NOT a function of the integumentary system?

a. It regulates the body temperature c. Excrete waste materials
b. It serves as a protection for the internal organs d. Provide posture and structure to the body
RATIO: Integumentary system is an organ system consisting of the skin, hair, nails, and exocrine glands.

4. The layer of the skin that consists of adipose tissue would be the
a. Epidermis c. Subcutaneous
b. Dermis d. Any of the above
RATIO: The subcutaneous tissue or also known as the hypodermis contains adipose tissue which functions as an
insulation for the body.

5. Which of the following mechanisms that the skin does in order to regulate the body temperature? Select all
that apply
a. Release of catecholamines c. Release of pyrogens
b. Vasodilation d. Vasoconstriction
RATIO: In the following mechanisms that the skin does in order to regulate the body temperature it does sweating,
shivering, vasodilatation, and vasoconstriction.

6. Excessive intake of yellow or orange colored fruits and vegetables can lead to which of the following?
a. Pallor c. Jaundice
b. Carotenemia d. Redness
RATIO: Carotenemia characterized by yellow pigmentation of the skin (xanthoderma) and increased beta-carotene levels
in the blood.

7. Loss of oxygen from the skin can lead to which of the following skin colors?
a. Carotenemia c. Flushing
b. Jaundice d. Cyanosis
RATIO: Loss of oxygen the blood may still be flowing, but it changes color it caused by low oxygen levels in the red blood
cells or problems getting oxygenated blood to your body.

8. Which of the following organs will the nurse suspect to have a disorder if she has observed the patient with a
jaundiced skin?
a. Kidneys c. Liver
b. Stomach d. Pancreas
RATIO: Jaundice is a liver disease or excessive hemolysis of red blood cells that there’s many red blood cells dying or
breaking down and going to the liver.

9. Tinea versicolor is caused by an infection of which of the following microorganisms?

a. Fungi c. Bacteria
b. Protozoan d. Virus
RATIO: It's caused by different types of fungi like tinea infection can affect any part of the body such as feet, nails, and
genital area are not often called ringworm.

10. The nurse is tasked to assess the degree of dehydration of a patient who is suffering from acute
gastroenteritis. She is going to assess the patient’s skin turgor. The best site for the assessment of skin turgor
would be at the
a. Elbow c. Abdomen
b. Forearm d. Thigh
RATIO: Normally the skin promptly returns into place, the best area to assess for skin turgor would be on the abdomen.
 Session # 10

1. A nurse is assessing a patient and has observed that the patient has skin elevations that are fluid-filled all over
his body. The patient later on was diagnosed to have chicken pox. The type of skin lesion seen in chicken pox is
a. Bulla c. Pustules
b. Vesicle d. Burrow
RATIO: Small fluid-filled blisters (vesicles) which form in about one day and then break and leak.

2. These are highly pigmented brown and flat lesions on the skin of a person. They are more commonly known as
birth marks.
a. Spider angiomas c. Hemangioma
b. Vitiligo d. Café-au-lait spots
RATIO: Café au lait spots, or café au lait macules, are flat, hyperpigmented birthmarks they’re often pale brown in color.
The darker your skin is naturally, the darker your café au lait spot will be. This type of birthmark may occur at any time
from birth through early childhood.

3. A person who has atopic dermatitis constantly scratches the affected skin leading to the formation of a thick
and leathery skin called
a. Scale c. Lichenification
b. Crust d. Scars
RATIO: Lichenification is when your skin becomes thick and leathery it usually a result of constant scratching or rubbing.

4. This stage of pressure ulcer has full-thickness skin loss, with damage to or necrosis of subcutaneous tissue
that may extend to, but not through, underlying muscle
a. Stage I c. Stage III
b. Stage II d. Stage IV
RATIO: Stage 3 pressure ulcers involve full-thickness skin loss potentially extending into the subcutaneous tissue layer

5. In the ABCDEs of melanomas, the nurse must know that D – diameter of the melanoma should be
a. < 6 mm c. > 6 mm
b. < 3 mm d. > 10 mm
RATIO: Most melanomas are greater than 6 mm in diameter.

6. The nurse is assessing a patient and saw that the skin of the patient has grouped lesions of herpes simplex.
The patient is diagnosed to have shingles. The nurse should note this on her chart as which of the following
according to patterns and shapes?
a. Linear c. Clustered
b. Geographic d. Serpiginous
RATIO: The clustered of blisters that form with shingles fill with fluid, pop, then start to ooze.

7. Which of the following skin conditions can cause the patient to have burrows on the skin?
a. Ringworm c. Athlete’s foot
b. Jock itch d. Scabies
RATIO: Scabies is caused by tiny mites that burrow into your skin it’s an itchy skin condition caused by a tiny burrowing
mite called Sarcoptes scabiei.

8. Animal scratches such as that from cats or dogs can cause which of the following on the skin of patients?
a. Erosion c. Fissure
b. Excoriation d. Ulcers
RATIONALE: Excoriations are linear or punctate erosions caused by scratching mostly caused by animals.

9. This is the type of fingernails seen in patients with Raynaud’s disease?

a. Beau lines c. White spots
b. Mees lines d. Clubbing of the fingers
RATIO: Beau's lines is known as transverse depressions in the nail that result from trauma, exposure to cold, Raynaud's
disease, or any episodic disease serious enough to disrupt normal nail growth.

10. A nurse is assessing the fingers of a patient and she notes that the patient has clubbing of the fingers. This
condition is associated to chronic
a. Alcoholism c. Dehydration
b. Smoking d. Hypoxia
RATIO: Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the
tissue level.
 Session # 11

1. What would be the cause of primary headaches?

a. Stroke c. No identifiable underlying cause
b. Meningitis d. Seizures
RATIO: The cause of Primary headaches has no identifiable underlying cause.

2. Which of the following types of headache has an aura and is accompanied by seizures?
a. Tension-type headache c. Metabolic headache
b. Cluster headache d. Migraine headache
RATIO: Seizures is a paroxysmal, uncontrolled electrical discharge of neurons in brain interrupting normal function and
are often symptoms of underlying cause. Hemiplegic migraine is considered a type of migraine with aura.

3. When palpating for the lymph nodes on the neck of a patient, the nurse must use which of the following?
a. Thumb and index fingers c. Thumbs only
b. Index and middle fingers d. Index fingers only
RATIO: Using the pads of your index and middle fingers, move the skin over the underlying tissues in each area in a
circular motion.

4. Which of the following is the characteristic of the face of a patient who has hypothyroidism?
a. Swelling of the face c. Mask-like face
b. Emaciated face d. Moon face
RATIO: Swelling of face is a characteristic of the face of a patient who has hypothyroidism.

5. The nurse assessing the neck of the patient has observed for an enlargement of the thyroid gland. The nurse
must suspect for which of the following conditions?
a. Goiter c. Cushing syndrome
b. Hyperparathyroidism d. Addison’s disease
RATIO: Assess thyroid function and ask about any evidence of an enlarged thyroid gland or goiter. Goiter is a
general term for an enlarged thyroid gland

6. Which of the following signs is not seen in a patient who has hyperthyroidism?
a. Palpitations c. Periorbital puffiness
b. Frequent bowel movements d. Exophthalmos
RATIO: Periorbital puffiness is a sign for Hypothyroidism

7. Which of the following must be included in the teaching to prevent motor vehicular head injuries?
a. Always use the seatbelt c. Small children should sit in the back seat especially if
b. Wear a helmet when riding motorcycles, all-terrain the car has a passenger airbag
vehicles, motorized scooters, bicycles, horses or d. All of the above
snowmobiles.
RATIO: To prevent head injuries in motor vehicle accidents, recommend the following

8. In order to decrease the likelihood of falls, the nurse must teach the following precautions EXCEPT
a. Install safety features in the home such as grab bars c. Allow babies to use walkers.
in the bathroom and nonslip mats in the bathtub. d. Install window guard
b. Wear nonslip, well-fitting shoes.
RATIO: We do not allow babies to use walkers unsupervised

9. When assessing for the lymph nodes of the head, the very last lymph node that the nurse must palpate would
be the
a. Supraclavicular lymph nodes c. Submental lymph nodes
b. Preauricular lymph nodes d. Occipital lymph nodes
RATIO: The superficial lymph nodes of the head and neck receive lymph from the scalp, face and neck. The last lymph
nodes in the neck to be palpated are the superficial cervical and the deep cervical chains, located anterior and superficial
to the sternomastoid.

10. The characteristic face of a patient who has Cushing syndrome would be
a. Emaciated c. Puffy and reddish cheeks
b. Moon face d. Reddish cheeks and cyanotic face all over
RATIO: The increased adrenal cortisol production of Cushing syndrome produces a round or “moon” face with red
cheeks. Excessive hair growth may be present in the mustache and sideburn areas and on the chin.
 Session # 12

1. Which of the following structures of the eye regulates the amount of light entering the eye?
a. Pupil c. Cornea
b. Iris d. Lens
RATIO: The iris opens and closes to control the amount of light entering the eye through the pupil.

2. Which of the following vitamins is deficient in a patient who is experiencing xerophthalmia?

a. Vitamin C c. Vitamin D
b. Vitamin K d. Vitamin A
RATIO: Xerophthalmia is a progressive eye disease caused by vitamin A deficiency that can dry out your tear ducts and
eyes.

3. A patient who can see objects that are near but is not able to see objects from afar has which of the following
conditions?
a. Hyperopia c. Myopia
b. Presbycusis d. Astigmatism
RATIO: A nearsighted person sees near objects clearly, while objects in the distance are blurred.

4. The patient can be declared legally blind if the patient has a visual acuity of
a. 20/150 c. 20/180
b. 20/100 d. 20/200
RATIO: considered legally blind when vision in the better eye, corrected by glasses, is 20/200 or less. Legal blindness
also results from a constricted field of vision: 20° or less in the better eye.

5. Excessive tearing of the eyes can be commonly caused by which of the following?
a. Nasolacrimal duct obstruction c. Cataract
b. Retinal detachment d. Presbyopia
RATIO: Excessive clear tearing is the most common symptom of nasolacrimal duct obstruction.

6. A nurse is assessing a patient who has Bell’s Palsy has observed for the drooping of the eyelid of the affected
side. The nurse must note this as
a. Ectropion c. Ptosis
b. Entropion d. Pterygium
RATIO: Ptosis is a drooping upper eyelid that narrows the palpebral fissure from a muscle or nerve disorder.

7. When the nurse is assessing a 4-year old child, she has noticed that the child has an eye misalignment. She
should note this as
a. Strabismus c. Presbyopia
b. Amblyopia d. Exophthalmos
RATIO: Strabismus is eye misalignment found most frequently in infants and children up to 5 years old.

8. When teaching a patient who is going to use contact lenses for the first time, the nurse must teach the patient
that prior to the application of the contact lenses the patient must
a. Look at a bright light c. Clean the contact lenses
b. Do handwashing d. Ask assistance from a family member in the
application of the contact lenses
RATIO: Patients should remember to wash their hands when inserting or removing lenses, to wear and remove them as
prescribed by the health care provider, and to keep them clean and not share contacts.

9. This is the fine rhythmic oscillations of the eyes

a. Amblyopia c. Nystagmus
b. Presbyopia d. Exophthalmos
RATIO: Nystagmus is a fine rhythmic oscillation of the eyes.

10. A patient who has hyperthyroidism can have which of the following eye conditions?
a. Ptosis c. Ectropion
b. Exophthalmos d. Entropion
RATIO: A wide-eyed stare suggests retracted eyelids often due to hyperthyroidism. Wide eyed stare suggests
hyperthyroidism.
 Session # 13

1. The labyrinth within the inner ear is responsible for which of the following?
a. Air conduction c. Equilibrium
b. Bone conduction d. Hearing
RATIO: The labyrinth within the inner ear senses the position and movements of the head and helps to maintain balance
(the malleus, incus, and stapes).

2. In conductive hearing loss the patient will most likely have problems in which of the following ear structures?
a. Auricle c. Ossicles
b. Tympanic membrane d. All of the above
RATIO: Conductive hearing loss can be produced by any defect in the pinna, external auditory canal, tympanic
membrane, and ossicles, up to the foot of the stapes.

3. Otitis media is common among children below 5 years old since

a. Their immune system is not yet mature c. Children often insert objects into their ears
b. The auditory canal is too short d. The eustachian tube is short and more horizontal
RATIO: Children often poke things like small toys or beads into their ears to see how far they will go, or to try to scratch
an itch.

4. When tinnitus is present together with hearing loss and vertigo, this may suggest
a. Conductive hearing loss c. Meniere’s disease
b. Sensorineural hearing loss d. Otosclerosis
RATIO: When associated with hearing loss and vertigo, tinnitus suggests Ménière’s disease.

5. Which of the following causes of worsen symptoms of rhinorrhea due to excessive use of decongestants?
a. Vasomotor rhinitis c. Allergic rhinitis
b. Rhinitis medicamentosa d. Hay fever
RATIO: Excessive use of decongestants can worsen symptoms, causing rhinitis medicamentosa.

6. Which of the following beverages can cause nasal congestion in a patient if taken in excess?
a. Alcohol c. Milk
b. Coffee d. Carbonated drinks
RATIO: Alcohol can dehydrate the body and can make congestion worse.

7. Fever, pharyngeal exudates, and anterior lymphadenopathy, especially when cough is not present can suggest
an infection of which of the following microorganisms?
a. Corynebacterium diphtheriae c. Haemophilus influenzae
b. Filterable virus d. Streptococcus pyogenes
RATIO: Fever, pharyngeal exudates, and anterior cervical lymphadenopathy, especially without cough, suggest
streptococcal pharyngitis, or “strep throat”

8. Which of the following conditions does NOT cause hoarseness?

a. Smoking c. Increased intake of high-sodium foods
b. Voice abuse d. Tuberculosis
RATIO: Hoarseness may arise from overuse of the voice, allergies, smoking, or inhaled irritants.

9. The nurse has observed for a sore smooth tongue in a patient while doing a physical examination. The nurse
must suspect for
a. Streptococcal infection c. Gingivitis
b. Nutritional deficiencies d. Hypothyroidism
RATIO: The most common cause of a smooth tongue is Nutritional deficiencies that include iron, folate and vitamin B12
deficiency.

10. The patient with tumor growing on their larynx has stated to the nurse that she has difficulty in swallowing.
The nurse must note this on her chart as
a. Polydipsia c. Dysphagia
b. Polyphagia d. Odynophagia
RATIO: People with dysphagia have difficulty swallowing.
 Session # 14

1. Nurse Megumi is taking care of a patient who has pulmonary tuberculosis. During the inspection of the
patient’s sputum, she has noticed some blood streaks on it. This is termed as
a. Rhinitis c. Hematemesis
b. Rhinorrhea d. Hemoptysis
RATIO: Hemoptysis is coughing up of blood from the lungs; it may vary from blood-streaked phlegm to frank blood.

2. During the history of present illness, a patient named Subaru is complaining of a dry cough for less than 3
weeks. He is currently suspected for COVID-19. His cough can be categorized as
a. Acute cough c. Chronic cough
b. Subacute cough d. None of the above
RATIO: A cough lasting less than 3 weeks is termed acute and one lasting longer than 8 weeks is defined as chronic.

3. Nurse Alice is currently auscultating a 4-year old patient who is suffering from pneumonia. Upon auscultation
through her stethoscope she has heard a high-pitched inspiratory sound. She must document this as
a. Wheezing c. Crackles
b. Stridor d. Rhonchi
RATIO: Stridor is a high-pitched sound that is usually heard best when a child breathes in (inspiration).

4. Nurse Ikumi is currently admitting a patient who is complaining of shortness of breath and cough. The nurse
has noticed that the patient’s chest is barrel-shaped. According to the patient’s health history, he has been a
chronic smoker for the past 20 years and has been smoking 2-3 packs of cigarettes per day. The nurse must
suspect for which of the following diseases?
a. Asthma c. Cystic fibrosis
b. Chronic obstructive pulmonary disease (COPD) d. COVID-1
RATIO: COPD is a disease that is caused by long-term cigarette smoking.

5. Which of the following would best describe tactile fremitus?

a. These are popping sounds heard from the patient’s c. These are palpable vibrations transmitted through
chest wall the bronchopulmonary tree to the chest wall as the
b. It is a harsh and high-pitched inspiratory sound patient is speaking
d. It is a high-pitched musical sound usually heard during
expiration
RATIO: These are palpable vibrations transmitted through the bronchopulmonary tree to the chest wall as the patient is
speaking

6. Nurse Hisako is assessing a patient with asthma. Which of the following breath sounds will she expect to hear
from this patient?
a. Stridor c. Rhonchi
b. Wheezing d. Vesicular
RATIO: Audible wheezing indicates severe asthma.

7. What type of cardiac disease does the patient have if the patient has the presence of crackles in the lung area
upon auscultation of the nurse?
a. Atherosclerosis c. Aneurysm
b. Right-sided heart failure d. Left-sided heart failure
RATIO: Left-sided heart failure has pulmonary clinical manifestations

8. This type of deformity of the thorax shows that the sternum is displaced anteriorly, increasing the
anteroposterior diameter. The costal cartilages adjacent to the protruding sternum are depressed.
a. Funnel chest c. Pigeon chest
b. Flail chest d. Barrel chest
RATIO: Pectus carinatum, also called pigeon chest,

9. When Nurse Ryoko is percussing the patient’s lungs. A normal percussion note that the nurse must percuss
must be
a. Dull c. Flat
b. Hyperresonant d. Resonant
RATIO: normal percussion note that the nurse must percuss must be Resonant

10. Nurse Satoshi has read on the patient’s chart that the patient has pleural effusion. Which of the following is
true with regard to this condition?
a. This is the inflammation of the pleurae c. This is fluid accumulating in the pleural space
b. This is the air-trapping at the alveoli d. This is also known as pulmonary edema
RATIO: Pleural effusion, sometimes referred to as “water on the lungs,”
 Session # 15

1. Which of the following is NOT a main function of the cardiovascular system?

a. Delivering oxygen and nutrients to cells c. Maintaining perfusion to the organs and tissues
b. Removing waste products d. Regulate the blood glucose levels
RATIO: Regulate the blood glucose levels

2. This is the area found on the exterior chest where the health worker examines in order to detect the underlying
structures of the heart
a. Precordium c. Endocardium
b. Myocardium d. Pericardium
RATIO: The area of the exterior chest that overlays the heart and great vessels is called the precordium.

3. Which of the following statements is true about the point of maximal impulse (PMI)?
a. It is found behind the right ventricle and to the left, c. Located at the right and left 2nd intercostal space next
outlined below in black, forms the left margin of the to the sternum.
heart. d. It is found between the 2nd intercostal space and the
b. This is located at the left border of the heart and is 5th intercostal space.
found in the 4th intercostal space 7-9 cm lateral to
the midsternal line.
RATIO: This impulse locates the left border of the heart and is normally found in the 5th intercostal space 7 cm to 9 cm
lateral to the midsternal line, at or just medial to the left midclavicular line.

4. Which of the following layers of the heart contains cardiac muscle?

a. Pericardium c. Myocardium
b. Precordium d. Endocardium
RATIO: The muscle layer of the heart is termed the myocardium and is made up of cardiomyocytes.

5. How much is the normal peak pressure of systole?

a. 70 mmHg c. 100 mmHg
b. 80 mmHg d. 120 mmHg
RATIO: 120 mmHg is the normal peak pressure of systole

6. A nursing student is asking her instructor about the definition of the stroke volume. The nursing instructor is
correct when she says which of the following definitions?
a. It is the amount of blood ejected by the ventricle c. The amount of blood pumped by the heart in a minute.
with each heartbeat. d. The total number of heart beats in a minute.
b. This is the difference between the systolic and
diastolic blood pressure.
RATIO: Stroke volume is the amount of blood ejected by the ventricle with each heartbeat.

7. Where can you find the sinoatrial node on the heart?

a. At the atrial septum c. At the ventricular septum
b. At the ventricles d. At the right atrium
RATIO: The sinoatrial node is a group of cells located in the wall of the right atrium of the heart.

8. Cardiac output is the product of (Select all that apply)

a. Heart rate c. Myocardial contractions
b. Pulse pressure d. Stroke volume
RATIO: Blood volume, Heart rate, Stroke volume, Blood viscosity, Peripheral resistance

9. What best describes a preload?

a. This is the degree of vascular resistance to ventricular c. Refers to the load that stretches the cardiac
contraction muscle before contraction.
b. Sources of resistance to left ventricular contraction d. The ability of the cardiac muscle, when given a load,
include the tone in the walls of the aorta and the to contract or shorten.
peripheral vascular tree.
RATIO: Preload refers to the load that stretches the cardiac muscle before contraction.

10. Which of the following equipment are used in measuring the blood pressure? (Select all that apply)
a. Sphygmomanometer c. Watch
b. Stethoscope d. Ruler
RATIO: You will need a sphygmomanometer and a stethoscope.