31.

NP3 RECALL_PRE-INTENSIVE and quality improvement (QI) among health

personnel in the workplace. One day, Dr. lopez
SITUATION 1 while conducting her rounds observed a charge
Chacha, a 6 month old baby is admitted in the nurse (CN) facilitating a team on reducing post-
Pediatric unit for acute diarrhea and dehydration. operative complications in her unit of
assignment. The nurse was emphasizing the
1. You are in charge of this patient. In your four (4) essential steps of the QI process.
assessment you expect to find which of the
following? 6. The FIRST phase of this activity is
__________.
a. Moderately lethargic
b. Bulging fontanelle a. Review cause/s of the problems
c. loosening of the skin b. List of problems & prioritize
d. High grade fever
c. Conduct root cause analysis
2. Further clinical findings of the child that you d. Analyze the problems carefully
have observed include which ONE of the
following? 7. While undergoing the QI process, three (3)
members of the team were having conflict in
a. Metabolic alkalosis what management to do. Which of the following
b. Metabolic acidosis can be an EFFECTIVE strategy to resolve this
c. Respiratory acidosis conflict?
d. respiratory alkalosis
a. Reprimand the three members of the team of
3. The child was ordered Oresol (ORS). As a their behavior
nurse, how would you prepare Oresol treatment b. Assign the three members of the team in the
for this child? different shifts
c. Assign an Administration to solve the conflict
a. Mix 2 sachet of ORS in 1 liter of water d. Have the three members confront with
b. Mix 1 sachet of ORS in 2 liters of water each other
c. Mix 2 sachet of ORS in 2 liters of water
d. Mix 1 sachet of ORS in 1 liter of water 8. Dr. Lopez was initiating some innovative
activities in the medical center for a continuous
4. The BEST practice for the nursing staff to quality improvement (CQI) in patient care
prevent spread of infection when patient has services. A policy has been adopted for nursing
infectious diarrhea is _________. staff every shift to conduct hourly rounds for
patients with PRIORITY health problems and
attached policy was being complied with by the
a. Autoclave linens
nurses however, she found out in the
b. Strict handwashing
succeeding dates, it was no longer followed.
c. isolate the patient
What is the PRIORITY action of Dr. Lopez in this
d. wear latex gloves
situation?
5. After the Oresol Treatment which of the
following is an indication that Oresol is effective? a. Assign one Nurse per shift to conduct the
hourly rounds
b. Conduct a general meeting with the staff
a. Patient is well hydrated
and determine why such policy is NOT
b. Refuse to play with other children
complied with
c. Socialization with other children
c. Conduct a general meeting with the staff and
d. Temperature is 36.8°C
explain the benefits of the hourly rounds
d. Call to the office nurses who fail to comply the
SITUATION 2
hourly rounds
Dr. Lopez, a Ph.D graduate in Nursing, has been
appointed as a consultant in a tertiary hospital to
9. The CQI team have observed that the
help administration of coming up to strategies
incidence of FALL among older persons have
that will further enhance culture of team work
increased by 50%. This data has reached Dr. d. Alteration in Comfort
Lopez and she instructed the team to conduct
which one of the following PRIORITY 14. Due to excessive vomiting in Pyloric
measures? Stenosis, you should assess the child for which
of the following imbalances?
a. Provide a cash incentive for units with 0
incidence of Fall. a. Respiratory Acidosis
b. Intensify the in-service program for the unit b. Metabolic Acidosis
with the highest incidence of Fall. c. Metabolic Alkalosis
c. Identification of the root cause of Fall. d. Respiratory
d. Decrease the benefits of those personnel who
are involved in the Fall incidence. 15. Before scheduling the infant for surgery, the
doctor ordered the administration of parenteral
10. A part of the CQI that Dr. Cynthia wanted to fluid and electrolytes. Which of the following
implement is the partnership safe and quality incorporated solutions should be administered
patient model, the collaboration process as a through IV?
strategy is an example of _________.
a. Potassium Chloride
a. Feedback mechanism b. Magnesium Chloride
b. Through – put C. Bicarbonate Chloride
C. output D. Calcium Chloride
D. Input
SITUATION 4
SITUATION 3 Abby is a BSN graduate and have to take the
Sanji, 4-week-old infant is admitted to the nurses licensure examination to be able to
hospital with a history of vomiting. The mother Practice her chosen profession. In order to
explains that her daughter has an initial problem qualify for the licensure examination, she has to
with the regurgitation which progressed to a comply with the basic requirements from the
projectile vomiting which becomes more forceful. PRC-Board of Nursing.

11. Upon admission, the FIRST nursing action 16. Which one of the following is NOT
you should perform is ________. considered an admission criterion for BSN
graduates seeking admission to the Licensure
a. Switch the child feedings to electrolyte examination?
solution
b. Call the pediatric ward doctor for the a. 20 years old upon registration
admission b. Citizen of the Philippines
c. Assess and weigh the infant c. Completed related learning experiences
d. Begin an IV fluid as ordered d. Good moral character

12. Which of the following serum electrolyte 17. Taking an Oath of profession is a
imbalances occur in an infant with persistent requirement for you to practice nursing in the
vomiting? Philippines. Which of the following is the legally
designated officer to conduct the oathtaking?
A. Potassium
B. Sodium a. Professional Regulatory Board of Nursing
C. Chloride b. President, Association of Nursing Service
D. Calcium Administrators
c. President, Phil. Nurses Association
13. What is the MOST APPROPRIATE nursing d. President, Association of Dens, Philippine
diagnosis for this patient? College of Nursing

a. Altered Bowel Elimination 18. In RA 9173, which of the following is NOT

b. Altered Nutrition among the provisions?
c. Fluid volume deficit
a. Functions of the Board of Nursing
b. Scholarship
c. Nurse to patient ratio
d. Salary and benefits
19. In health facilities, like tertiary hospitals,
nurses are able to enhance their competence by
rotating in different shifts. When a nurse is
assigned to do wound dressings to all patients
for the entire shift, this is an example of what
type of nursing service delivery?
a. Case management
b. Team nursing
c. Functional nursing
d. Primary nursing
20. A framework that is adopted recently is the
use SBAR for nurse-Health Care provider
communication. SBAR is an acronym for
Situation, Background, Information, Assessment
while R is recommendation. Which of the
following statements fall under the category of
assessment?
a. “Sally is 21 years old, single and college
graduate.”
b. “She had a relief of abdominal distention after
an intake of antacid.”
c. “Can you give pain medications for her
abdominal pain.”
d. She is having discomforts and crying
because of abdominal distention”
SITUATION 5
Juaning, 58 year old is admitted for a suspected
heart failure. He has shortness of breath, mild
chest pain, tachypea and presence of crackles
on the bases of both lungs. Your head nurse
(HN) instructed you to prepare nitroglycerin to be
administered by Intravenous route. You validated
from your head nurse why such medication is
going to be given to patient Juaning.
21. The HN as part of her teaching function
provided you this APPROPRIATE response.
This is to _______.
a. “reduce after load”
b. “increase after load”
c. “increase preload”
d. “reduce preload”
22. When doing a health teaching to a patient,
the FIRST step is to determine ____________.
a. readiness to learn
b. adaptation to learning styles
c. learning needs
d. capacity to learn
23. You are assigned to do a health education
class on Thursday morning with several patients
for possible discharge. You have a diabetic
patient for discharge. He is taking a medication
Carvedilol. Which one of the following
instructions must be EMPHASIZED during your
discharge teaching?
a. Observe skin care because the drug can
decrease tissue perfusion
b. Monitor blood sugar level because the drug
can cause hyperglycemia
c. Monitor pulse rate, sugar levels because
the drug may mask hypoglycemia
d. Check pulse rate every 6 hours because the
drug can cause palpitation
24. You are teaching a group of patients who are
undergoing hemodialysis regarding their dietary
plan. You should explain to them that intake of
protein is necessary because it __________.
a. reduces demand for liver functioning
b. increases nitrogenous waste products
c. maintains osmotic pressure
d. induces frequent urination
25. There is a doctor’s order for your patient with
heart failure to be discharged after two days.
The diet order is for him to limit his sodium
intake to only 2 g. Identify which of the following
breakfast selection should be included in your
plan.
a. Orange juice, bacon, fried egg, and steamed
rice.
b. Orange juice, fried salted fish, and steamed
rice.
c. Orange juice, toast bread, poached egg
and jam.
d. Orange juice, pouched egg, brown rice and
ham.
SITUATION 6
Patient Marites, a 60 year-old was brought to the
Emergency Room due to severe pain caused by
burns on her arms and legs after her house
caught fire. She was crying and moaning. She 3. demonstrate and practice the relaxation
was diagnosed by the doctor to have 3rd degree intervention
burns. Nurse Even started to conduct her health 4. consider Dolores’s willingness to participate,
assessment and patient was subsequently past experiences and contraindications
admitted. 5. individualize the content of the relaxation
interventions
26. Nurse Even formulated and documented in a. 4, 1, 5, 3, 2
the chart her nursing diagnosis on Patient b. 2, 1, 4, 3, 5
Marites. A PRIORITY nursing diagnosis she C. 3, 2, 4, 1, 5
wrote is, PAIN R/T _________. D. 4, 2, 5, 3, 1

a. Exposed nerve endings SITUATION 7

b. Burn injury Ms. Charlotte is the Nurse Director in a Level 3
c. anxiety private hospital in Metro Manila. In the past
d. inflammation months she has been encountering staffing
problems so she is worried that she cannot
27. Nurse Even gives pain reliever to Patient comply with the expectations of her stakeholders
Marites before a procedure is done. Which of the as a Premiere health institution in the country
following route should be avoided? that can deliver Safe and Quality care.

31. In the Strategic plan process, which of the

a. Intramuscular injections
b. Inhalations
C. Topical medications
D. Oral medications
28. Nurse Even evaluates Patient Marites a day
after incurring the burn. Which of the following
nursing interventions is APPROPRIATE at this
time?
a. Apply topical anesthesia on the site of burn
b. Administer oxygen via nasal mask
c. Evaluate the intensity of pain
d. Administer pain reliever through injection
29. Nurse Even provides bio-behavioral
interventions to minimize pain and anxiety of
Patient Marites. Which one of the following is
NOT appropriate to be done?
a. Music therapy
b. Guided imagery
C. Distraction
D. Stretching
30. A simple relaxation therapy was applied to
Patient Dolores. The following steps of
relaxation therapy done by Nurse Tala is
_________.
1. evaluate and document Ms. Dolores’s
response to therapy
2. create a quiet, non-disruptive environment
with dim lights and comfortable temperature
following questions is addressed to be able to
arrive at a specific vision-mission in a nursing
business plan?
1. What business are we in now?
2. What business do we want to be?
3. What do our customers expect of us now?
4. What will be the expectations of our
customers in the future?
5. Who are our customers?
a. 2, 3 & 4
b. 1,2,3,4 & 5
c. 1 & 2
d. 1, 3 & 4
32. The hallmark of Nursing shortage is BEST
described as ___________.
a. Predetermined standards of group of patients
with the available nursing staff
b. Situation related to recruitment and retention
of nursing personnel
c. Use of nursing models to forecast availability
of nursing personnel
d. Discrepancy between the supply and
demand of nursing graduates
33. In the light of the brainstorming session of
the team leaders, the issue of managing
performance of personnel was raised into the
discussion. Which of the following is the
sequence in the performance appraisal?
1. Assess the institutional and personal goals
2. Assess progress of the staff
3. Evaluate progress
4. Establish objectives and time frame
a. 4, 1, 2, & 3
b. 1, 3, 4 & 2
C. 2, 3, 1 & 4
D. 1, 4, 2 & 3
34. Prioritization and delegation of personnel
can also be of help to the professional nurses in
staffing problem. Cases have been raised by the
team members such as; if you have a plan of
care for a diabetic patient which of the following
interventions can be delegated to the
experienced nursing attendant?
a. Discuss with the patient and family on insulin
therapy
b. Perform wound care for a diabetic foot
c. Administer metformin for his diabetes
d. Teach the patient to perform daily foot care
35. Likewise a clinical situation in the ward is
when a patient is attached to a Naso-gastric
tube (NGT), which of the following nursing
measure can be delegated to a nursing
attendant?
a. Removing the nasogastric tube as ordered
b. Performing oral care every 4 hours and PRN
c. Securing the safety of the nasogastric tube
with a tape
d. Disconnect the suction to accompany patient
to the toilet
SITUATION 8
Sherlock, 32 years old, single, who is an
electrical engineer is scheduled to undergo left
leg amputation because of an abscess from a
non-healing wound. He is a Juvenile Diabetic.
36. On admission the nurse started to gather his
health history, but the client appears uneasy and
uncomfortable to share information about his
condition. What is the BEST approach of the
nurse in this situation?
a. Assure him that the information he is
going to share will be treated confidentially.
b. Tell him, you have encouraged similar
problems in the past
c. Continue getting his data in a professional
manner
d. Ask him if he wants to be interviewed at a
later time
37. The parents of Sherlock came to visit him.
They feel very anxious about their son’s
condition. You were asked by the parents what
they can do to help their son. Your BEST
response is __________.
a. “Don’t show him that you are anxious, it will
just aggravate his condition.”
b. “I am sure anything you will do for him will be
appreciated.”
c. “Allow him to do activities that interest
him for the meantime.”
d. “Don’t worry, he will be able to adapt to his
condition in due time.”
38. After surgery, Sherlock was transferred to
the Post Anesthesia unit (PACU). His vital signs
were stable and he was responsive. After two
hours, he was transferred to his room. The Ward
Nurse received the patient. The BEST nursing
approach to do REALITY orientation to Mr.
Sherlock is _______.
a. “Good afternoon, Mr. Sherlock. Do you know
where you are?”
b. “Mr. Sherlock, you just had your surgery,
and you are back to your room.”
c. “Thanks God, you had a successful operation.
Your parents are here.”
d. “Good afternoon, Mr. sherlock, did you have a
good sleep during the operation.”
39. On the 3rd day, after the operation, you
observed that Mr. Sherlock was very quiet, and
when approached, he said to the nurse. “I am
really concerned with my future!” The nurse’s
BEST response is __________.
a. “You’re upset, what are you thinking about
your future?”
b. “We have our hospital chaplain, do you want
to see him?”
c. “Do you want to discuss your concerns to your
parents?”
d. “Tell me more about your concerns about
your future.”
40. As the nurse of Mr. Sherlock, what is your
PRIORITY goal for him?
a. Plan for early rehabilitation.
b. Arrange for his counselor to spend time with
him.
c. Create options for his future.
d. Self-acceptance of his leg amputation.
SITUATION 9
Robin, 71 years old, a former car dealer has
been chronically-ill due to Emphysema. He was
in and out of the hospital for the past 2 years. He
decided to have a living will so he asked his
eldest daughter to contact their lawyer.
41. Which of the following conditions is
APPROPRIATE to have a living will? When a
patient is __________.
a. on a stage of drowsiness and receiving
sedatives
b. incapacitated but conscious and in a
terminal condition
c. with family members who are around and can
make decisions for him
d. in a critical condition and receiving lifesaving
drugs
42. Which of the following actions of the Nurse
can be classified as intentional tort?
a. Refusing a patient to sign a waiver so he
can go home.
b. Failure to instruct the nursing aid to put up the
side rails of an older patient resulting to fall.
c. Administering a blood transfusion to a wrong
patient.
d. Failure to report to the physicial the untoward
reaction of a drug.
43. A Nurse is assigned in the ICU unit for
almost 3 years and has attended several
patients who have died under her shift. She was
emotionally affected with this situation but
remains to be silent every time she reports for
duty. The BEST way for the Nurse to cope with
this feeling is to ________.
a. consult a psychologist regarding this
feeling
b. discuss this feeling with the other members of
the staff
c. neglect this behavior and go out with friends
d. request the supervisor to transfer her to
another unit
44. A patient is admitted in your unit because of
rectal bleeding and need a blood transfusion.
Being a Jehovah’s witness, he refused the order
of the physician. The wife secretly talked with
the Nurse and the physician to administer the
blood transfusion after taking his sleeping pills.
What is the BEST action of the health care
professionals in this situation.
a. Refer the case to the minister so he can
convince the patient
b. Proceed with giving of blood transfusion as
this is highly needed
c. Refuse the suggestion of the wife for the
husband might be awake
d. Talk with the wife that she is violating the
husband’s request
45. A waitress in a nearby bar was admitted
because she was suspected to be suffering from
HIV. The waitress is single, but with a boyfriend
working in the Middle East. During the shift
report of the nurses, the outgoing morning shift
was discussing the case in a very loud voice and
being heard by some patients in the ward. The
Nurse, can be charged for_________.
a. Breach of confidentiality
b. Oral defamation
c. Injustice
d. Non-maleficence
SITUATION 10
Nurse Hinata is assigned in the Female Medical
ward, caring for patients with varying health
conditions. She believes that documentation is
an essential aspect of the nursing process and
vital for the role as a Nurse especially on record
keeping and reporting.
46. When Nurse Hinata indicates basic care
information, skills and referral services that the
patients may need before being released from
the health facility is an entry of what
documentation in the chart?
a. Multidisciplinary notes
b. Physician orders
c. Discharge Plan
d. Nurses notes
47. In coming up with her formulated nursing
diagnosis for her patient Ms. Ino, who is
suffering from hemolytic anemia, you will expect
Nurse Hinata to write in the Nursing care plan
which one of the following PRIORITIES?
a. Ineffective airway clearance R/T poor gas
exchange.
b. Activity Intolerance R/T to fatigue.
c. Poor tolerance to heat R/T increased
metabolism.
d. Imbalanced Nutrition: less body weight.
48. The physician on duty (POD) ordered a
specific diet for patient Ino. Which of the
following diet prescriptions will Nurse Hinata
transmit to dietary department?
a. High protein, high caloric diet.
b. High fiber, less fat, high protein diet.
c. High fats, high protein diet.
d. High carbohydrate, less fiber, low protein diet.
49. Kushina, 55 yr old is another patient of
Nurse Hinata who is having an asthmatic attack,
with extreme dyspnea and presence of sternal
retraction. The physician who was making his
rounds examined the patient and ordered the
drug of choice that will relieve patient’s
problems. Which of the following will be likely be
written by the physician, carried out and
recorded by the Nurse in the Medication chart?
a. Nor-epinephrine
b. Epinephrine
c. Prednisone
d. Albuterol
50. Nurse Hinata is preparing for her shift report
with the members of her team in the ward, when
she was approached by her junior nurse who
raised this concern regarding a physician order.
Which of the following orders should I question if
this has been written by a doctor?
a. twenty four hour ambulatory EKG for a
hypertensive patient
b. stress test monitoring for an obese adult
c. a high dose of insulin for a diabetic
adolescent
d. blood transfusion for an anemic elderly
SITUATION 11
Dr. Cynthia, a Ph.D graduate in Nursing, has
been appointed as a consultant in a tertiary
hospital to help administration of coming up to
strategies that will further enhance culture of
team work and quality improvement (QI) among
health personnel in the workplace. One day, Dr.
Cynthia while conducting her rounds observed a
charge nurse (CN) facilitating a team on
reducing post-operative complications in her unit
of assignment. The nurse was emphasizing the
four (4) essential steps of the QI process.
51. The FIRST phase of this activity is
__________.
a. Review cause/s of the problems
b. List of problems & prioritize
c. Conduct root cause analysis
d. Analyze the problems carefully
52. While undergoing the QI process, three (3)
members of the team were having conflict in
what management to do. Which of the following
can be an EFFECTIVE strategy to resolve this
conflict?
a. Reprimand the three members of the team of
their behavior
b. Assign the three members of the team in the
different shifts
c. Assign an Administration to solve the conflict
d. Have the three members confront with
each other
53. Dr. Cynthia was initiating some innovative
activities in the medical center for a continuous
quality improvement (CQI) in patient care
services.
A policy has been adopted for nursing staff every
shift to conduct hourly rounds for patients with
PRIORITY health problems and attached policy
was being complied with by the nurses however,
she found out in the succeeding dates, it was no
longer followed. What is the PRIORITY action of
Dr. Cynthia in this situation?
a. Assign one Nurse per shift to conduct the
hourly rounds
b. Conduct a general meeting with the staff
and determine why such policy is NOT
complied with
c. Conduct a general meeting with the staff and
explain the benefits of the hourly rounds
d. Call to the office nurses who fail to comply the
hourly rounds
54. The CQI team have observed that the
incidence of FALL among older persons have
increased by 50%. This data has reached Dr.
Cynthia and she instructed the team to conduct
which one of the following PRIORITY
measures?
a. Provide a cash incentive for units with 0
incidence of Fall.
b. Intensify the in-service program for the unit
with the highest incidence of Fall.
c. Identification of the root cause of Fall.
d. Decrease the benefits of those personnel who
are involved in the Fall incidence.
55. A part of the CQI that Dr. Cynthia wanted to
implement is the partnership safe and quality
patient model, the collaboration process as a
strategy is an example of _________.
a. Feedback mechanism
b. Through – put
c. output
d. input
SITUATION 12
Abby is a BSN graduate and have to take the
nurses licensure examination to be able
to Practice her chosen profession. In order to
qualify for the licensure examination, she has
to comply with the basic requirements from the
PRC-Board of Nursing.
56. Which one of the following is NOT
considered an admission criterion for BSN
graduates seeking admission to the Licensure
examination?
a. 20 years old upon registration
b. Citizen of the Philippines
c. Completed related learning experiences
d. Good moral character
57. Taking an Oath of profession is a
requirement for you to practice nursing in the
Philippines. Which of the following is the legally
designated officer to conduct the oathtaking?
a. Professional Regulatory Board of Nursing
b. President, Association of Nursing Service
Administrators
c. President, Phil. Nurses Association
d. President, Association of Dens, Philippine
College of Nursing
58. In RA 9173, which of the following is NOT
among the provisions?
a. Functions of the Board of Nursing
b. Scholarship
c. Nurse to patient ratio
d. Salary and benefits
59. In health facilities, like tertiary hospitals,
nurses are able to enhance their competence by
rotating in different shifts. When a nurse is
assigned to do wound dressings to all patients
for the entire shift, this is an example of what
type of nursing service delivery?
a. Case management
b. Team nursing
c. Functional nursing
d. Primary nursing
60. A framework that is adopted recently is the
use SBAR for nurse-Health Care provider
communication. SBAR is an acronym for
Situation, Background, Information, Assessment
while R is recommendation. Which of the
following statements fall under the category of
assessment?
a. “Sally is 21 years old, single and college
graduate.”
b. “She had a relief of abdominal distention after
an intake of antacid.”
c. “Can you give pain medications for her
abdominal pain.”
d. She is having discomforts and crying
because of abdominal distention”
SITUATION 13
Juaning, 58 year old is admitted for a suspected
heart failure. He has shortness of breath, mild
chest pain, tachypea and presence of crackles
on the bases of both lungs. Your head nurse
(HN) instructed you to prepare nitroglycerin to be
administered by Intravenous route. You validated
from your head nurse why such medication is
going to be given to patient Juaning.
61. The HN as part of her teaching function
provided you this APPROPRIATE response.
This is to _______.
A. “reduce after load”
B. “increase after load”
C. “increase preload”
D. “reduce preload”
62. When doing a health teaching to a patient,
the FIRST step is to determine ____________.
A. readiness to learn
B. adaptation to learning styles
C. learning needs
D. capacity to learn
63. You are assigned to do a health education
class on Thursday morning with several patients
for possible discharge.
You have a diabetic patient for discharge. He is
taking a medication Carvedilol. Which one of the
following instructions must be EMPHASIZED
during your discharge teaching?
A. Observe skin care because the drug can
decrease tissue perfusion
B. Monitor blood sugar level because the drug
can cause hyperglycemia
C. Monitor pulse rate, sugar levels because
the drug may mask hypoglycemia
D. Check pulse rate every 6 hours because the
drug can cause palpitation
64. You are teaching a group of patients who are
undergoing hemodialysis regarding their dietary
plan. You should explain to them that intake of
protein is necessary because it __________.
a. reduces demand for liver functioning
b. increases nitrogenous waste products
c. maintains osmotic pressure
d. induces frequent urination
65. There is a doctor’s order for your patient with
heart failure to be discharged after two days.
The diet order is for him to limit his sodium
intake to only 2 g. Identify which of the following
breakfast selection should be included in your
plan.
a. Orange juice, bacon, fried egg, and steamed
rice.
b. Orange juice, fried salted fish, and steamed
rice.
c. Orange juice, toast bread, poached egg
and jam.
d. Orange juice, pouched egg, brown rice and
ham.
SITUATION 14
Ms. Maribel is the Nurse director in a Level 3
private hospital in Metro Manila. In the past
months she has been encountering staffing
problems so she is worried that she cannot
comply with the expectations of her stakeholders
as a Premiere health institution in the country
that can deliver Safe and Quality care.
66. In the Strategic plan process, which of the
following questions is addressed to be able to
arrive at a specific vision-mission in a nursing
business plan?
1. What business are we in now?
2. What business do we want to be?
3. What do our customers expect of us now?
4. What will be the expectations of our
customers in the future?
5. Who are our customers?
A. 2, 3 & 4
B. 1,2,3,4 & 5
C. 1 & 2
D. 1, 3 & 4
67. The hallmark of Nursing shortage is BEST
described as ___________.
a. Predetermined standards of group of patients
with the available nursing staff
b. Situation related to recruitment and retention
of nursing personnel
c. Use of nursing models to forecast availability
of nursing personnel
d. Discrepancy between the supply and
demand of nursing graduates
68. In the light of the brainstorming session of
the team leaders, the issue of managing
performance of personnel was raised into the
discussion. Which of the following is the
sequence in the performance appraisal?
1. Assess the institutional and personal goals
2. Assess progress of the staff
3. Evaluate progress
4. Establish objectives and time frame
A. 4, 1, 2, & 3
B. 1, 3, 4 & 2
C. 2, 3, 1 & 4
D. 1, 4, 2 & 3
69. Prioritization and delegation of personnel
can also be of help to the professional nurses in
staffing problem. Cases have been raised by the
team members such as; if you have a plan of
care for a diabetic patient which of the following
interventions can be delegated to the
experienced nursing attendant?
a. Discuss with the patient and family on insulin
therapy
b. Perform wound care for a diabetic foot
c. Administer metformin for his diabetes
d. Teach the patient to perform daily foot
care

70. Likewise a clinical situation in the ward is
when a patient is attached to a Naso-gastric
tube (NGT), which of the following nursing
measure can be delegated to a nursing
attendant?
a. Removing the nasogastric tube as ordered
b. Performing oral care every 4 hours and PRN
c. Securing the safety of the nasogastric tube
with a tape
d. Disconnect the suction to accompany patient
to the toilet
SITUATION 15
Eddie Wao, 71 years old, a former car dealer
has been chronically-ill due to Emphysema. He
was in and out of the hospital for the past 2
years. He decided to have a living will so he
asked his eldest daughter to contact their lawyer.
71. Which of the following conditions is
APPROPRIATE to have a living will?
When a patient is __________.
A. on a stage of drowsiness and receiving
sedatives
B. incapacitated but conscious and in a
terminal condition
C. with family members who are around and can
make decisions for him
D. in a critical condition and receiving lifesaving
drugs
72. Which of the following actions of the Nurse
can be classified as intentional tort?
a. Refusing a patient to sign a waiver so he
can go home.
b. Failure to instruct the nursing aid to put up the
side rails of an older patient resulting to fall.
c. Administering a blood transfusion to a wrong
patient.
d. Failure to report to the physicial the untoward
reaction of a drug.
73. A Nurse is assigned in the ICU unit for
almost 3 years and has attended several
patients who have died under her shift. She was
emotionally affected with this situation but
remains to be silent every time she reports for
duty. The BEST way for the Nurse to cope with
this feeling is to ________.
a. consult a psychologist regarding this
feeling
b. discuss this feeling with the other members of
the staff
c. neglect this behavior and go out with friends
d. request the supervisor to transfer her to
another unit
74. A patient is admitted in your unit because of
rectal bleeding and need a blood transfusion.
Being a Jehovah’s witness, he refused the order
of the physician. The wife secretly talked with
the Nurse and the physician to administer the
blood transfusion after taking his sleeping pills.
What is the BEST action of the health care
professionals in this situation.
a. Refer the case to the minister so he can
convince the patient
b. Proceed with giving of blood transfusion as
this is highly needed
c. Refuse the suggestion of the wife for the
husband might be awake
d. Talk with the wife that she is violating the
husband’s request
75. A waitress in a nearby bar was admitted
because she was suspected to be suffering from
HIV. The waitress is single, but with a boyfriend
working in the Middle East. During the shift
report of the nurses, the outgoing morning shift
was discussing the case in a very loud voice and
being heard by some patients in the ward. The
Nurse, can be charged for_________.
a. Breach of confidentiality
b. Oral defamation
c. Injustice
d. Non-maleficence
SITUATION 16
Nurse Joy is assigned in the Female Medical
ward, caring for patients with varying health
conditions. She believes that documentation is
an essential aspect of the nursing process and
vital for the role as a Nurse especially on record
keeping and reporting.
76. When Nurse Joy indicates basic care
information, skills and referral services that the
patients may need before being released from
the health facility is an entry of what
documentation in the chart?
a. Multidisciplinary notes
b. Physician orders
c. Discharge Plan
d. Nurses notes

77. In coming up with her formulated nursing
diagnosis for her patient Ms. Dina, who is
suffering from hemolytic anemia, you will expect
Nurse Joy to write in the Nursing care plan
which one of the following PRIORITIES?
a. Ineffective airway clearance R/T poor gas
exchange.
b. Activity Intolerance R/T to fatigue.
c. Poor tolerance to heat R/T increased
metabolism.
d. Imbalanced Nutrition: less body weight.
78. The physician on duty (POD) ordered a
specific diet for patient Dina. Which of the
following diet prescriptions will Nurse Joy
transmit to dietary department?
a. High protein, high caloric diet.
b. High fiber, less fat, high protein diet.
c. High fats, high protein diet.
d. High carbohydrate, less fiber, low protein diet.
79. Marimar, 55 yr old is another patient of
Nurse Joy who is having an asthmatic attack,
with extreme dyspnea and presence of sternal
retraction. The physician who was making his
rounds examined the patient and ordered the
drug of choice that will relieve patient’s
problems. Which of the following will be likely be
written by the physician, carried out and
recorded by the Nurse in the Medication chart?
a. Nor-epinephrine
b. Epinephrine
c. Prednisone
d. Albuterol
80. Nurse Joy is preparing for her shift report
with the members of her team in the ward, when
she was approached by her junior nurse who
raised this concern regarding a physician order.
Which of the following orders should I question if
this has been written by a doctor?
a. twenty four hour ambulatory EKG for a
hypertensive patient
b. stress test monitoring for an obese adult
c. a high dose of insulin for a diabetic
adolescent
d. blood transfusion for an anemic elderly
SITUATION 17
Nicolo, 32 years old, single, who is an electrical
engineer is scheduled to undergo left leg
amputation because of an abscess from a non-
healing wound. He is a Juvenile Diabetic.
81. On admission the nurse started to gather his
health history, but the client appears uneasy and
uncomfortable to share information about his
condition. What is the BEST approach of the
nurse in this situation?
a. Assure him that the information he is
going to share will be treated confidentially.
b. Tell him, you have encouraged similar
problems in the past
c. Continue getting his data in a professional
manner
d. Ask him if he wants to be interviewed at a
later time
82. The parents of Nicolo came to visit him.
They feel very anxious about their son’s
condition. You were asked by the parents what
they can do to help their son. Your BEST
response is __________.
a. “Don’t show him that you are anxious, it will
just aggravate his condition.”
b. “I am sure anything you will do for him will be
appreciated.”
c. “Allow him to do activities that interest
him for the meantime.”
d. “Don’t worry, he will be able to adapt to his
condition in due time.”
83. After surgery, Nicolo was transferred to the
Post Anesthesia unit (PACU). His vital signs
were stable and he was responsive. After two
hours, he was transferred to his room. The Ward
Nurse received the patient. The BEST nursing
approach to do REALITY orientation to Mr.
Timmy is _______.
a. “Good afternoon, Mr. Nicolo. Do you know
where you are?”
b. “Mr. Nicolo, you just had your surgery, and
you are back to your room.”
c. “Thanks God, you had a successful operation.
Your parents are here.”
d. “Good afternoon, Mr. Nicolo, did you have a
good sleep during the operation.”
84. On the 3rd day, after the operation, you
observed that Mr. Nicolo was very quiet, and
when approached, he said to the nurse. “I am
really concerned with my future!” The nurse’s a. Apply topical anesthesia on the site of burn
BEST response is __________. b. Administer oxygen via nasal mask
c. Evaluate the intensity of pain
a. “You’re upset, what are you thinking about
your future?” d. Administer pain reliever through injection
b. “We have our hospital chaplain, do you want
to see him?” 89. Nurse Tala provides bio-behavioral
c. “Do you want to discuss your concerns to your interventions to minimize pain and anxiety of
parents?” Patient Dolores. Which one of the following is
d. “Tell me more about your concerns about NOT appropriate to be done?
your future.”
a. Music therapy
85. As the nurse of Mr. Nicolo, what is your b. Guided imagery
PRIORITY goal for him? c. Distraction
d. Stretching
a. Plan for early rehabilitation.
b. Arrange for his counselor to spend time with 90. A simple relaxation therapy was applied to
him. Patient Dolores. The following steps of
c. Create options for his future. relaxation therapy done by Nurse Tala is
d. Self-acceptance of his leg amputation. _________.
1. evaluate and document Ms. Dolores’s
SITUATION 18 response to therapy
Patient Dolores, a 60 year-old was brought to 2. create a quiet, non-disruptive environment
the Emergency Room due to severe pain with dim lights and comfortable temperature
caused by burns on her arms and legs after her 3. demonstrate and practice the relaxation
house caught fire. She was crying and moaning. intervention
She was diagnosed by the doctor to have 3rd 4. consider Dolores’s willingness to participate,
degree burns. Nurse Tala started to conduct her past experiences and contraindications
health assessment and patient was 5. individualize the content of the relaxation
subsequently admitted. interventions
A. 4, 1, 5, 3, 2
86. Nurse Tala formulated and documented in B. 2, 1, 4, 3, 5
the chart her nursing diagnosis on Patient C. 3, 2, 4, 1, 5
Dolores. A PRIORITY nursing diagnosis she D. 4, 2, 5, 3, 1
wrote is, PAIN R/T _________.
SITUATION 19
a. Exposed nerve endings Mia Thermopolis, 4-week-old infant is admitted
b. Burn injury to the hospital with a history of vomiting. The
c. anxiety mother explains that her daughter has an initial
d. inflammation problem with the regurgitation which progressed
to a projectile vomiting which becomes more
87. Nurse Tala gives pain reliever to Patient forceful.
Dolores before a procedure is done. Which of
the following route should be avoided? 91. Upon admission, the FIRST nursing action
you should perform is ________.
a. Intramuscular injections
b. Inhalations a. Switch the child feedings to electrolyte
c. Topical medications solution
d. Oral medications b. Call the pediatric ward doctor for the
admission
88. Nurse Tala evaluates Patient Dolores a day c. Assess and weigh the infant
after incurring the burn. Which of the following d. Begin an IV fluid as ordered
nursing interventions is APPROPRIATE at this
time? 92. Which of the following serum electrolyte
imbalances occur in an infant with persistent
vomiting? d. respiratory alkalosis

a. Potassium 98. The child was ordered Oresol (ORS). As a

b. Sodium nurse, how would you prepare Oresol treatment
c. Chloride for this child?
d. Calcium
a. Mix 2 sachet of ORS in 1 liter of water
93. What is the MOST APPROPRIATE nursing b. Mix 1 sachet of ORS in 2 liters of water
diagnosis for this patient? c. Mix 2 sachet of ORS in 2 liters of water
d. Mix 1 sachet of ORS in 1 liter of water
a. Altered Bowel Elimination
b. Altered Nutrition 99. The BEST practice for the nursing staff to
c. Fluid volume deficit prevent spread of infection when patient has
d. Alteration in Comfort infectious diarrhea is _________.

94. Due to excessive vomiting in Pyloric a. Autoclave linens

Stenosis, you should assess the child for which b. Strict handwashing
of the following imbalances? c. isolate the patient
d. wear latex gloves
a. Respiratory Acidosis
b. Metabolic Acidosis 100. After the Oresol Treatment which of the
c. Metabolic Alkalosis following is an indication that Oresol is effective?
d. Respiratory Alkalosis
a. Patient is well hydrated
95. Before scheduling the infant for surgery, the b. Refuse to play with other children
doctor ordered the administration of parenteral c. Socialization with other children
fluid and electrolytes. Which of the following d. Temperature is 36.8°C
incorporated solutions should be administered
through IV?

a. Potassium Chloride
b. Magnesium Chloride
c. Bicarbonate Chloride
d. Calcium Chloride

SITUATION 20
Chacha, a 6 month old baby is admitted in the
Pediatric unit for acute diarrhea and dehydration.

96. You are in charge of this patient. In your

assessment you expect to find which of the
following?

a. Moderately lethargic
b. Bulging fontanelle
c. loosening of the skin
d. High grade fever

97. Further clinical findings of the child that you

have observed include which ONE of the
following?

a. Metabolic alkalosis
b. Metabolic acidosis
c. Respiratory acidosis