Jun 23, 2010

NP1 Nursing Board Exam June 2008 Answer Key 'Foundation of Professional Nursing Practice'

100 Nursing Board Exam test questions of June 2008 Nurse Licensure Examination (NLE)
Nursing Practice 1 – Foundation of Professional Nursing Practice
Fundamentals of Nursing

PART 1 Board Exam test questions 1 - 50


June 2008
 Situation – Accurate computation prior to drug administration is a basic skill all nurses must have.


1. Rudolf is diagnosed with amoebiasis and is to received Metronidazole (Flagyl) tablets 1.5 gm daily in 3 divided doses for 7 consecutive days. Which of the following is the correct dose of the drug that the client will received per oral administration?
A. 1,000 mg tid
B. 500 mg tid
C. 1,500 mg tid
D. 50 mg tid

2. Rhona, a 2 year old female was prescribed to receive 62.5 mg suspension three times a day. The available dose is 125 mg/ml. which of the following should Nurse Paolo prepare for each oral dose?
A. 0.5 ml
B. 1.5 ml
C. 2.5 ml
D. 10 ml

3. The physician ordered Potassium Chloride (KCL) in D5W 1 liter to be infused in 24 hours for Mrs. Gomez. Since Potassium Chloride is a high risk drug, Nurse Robert used an intravenous pump. Which of the following should Nurse Robert do to safely administer this drug?
A. Check the pump setting every 2 hours
B. Teach the client how the infusion pump operates
C. Have another nurse check the infusion pump setting
D. Set the alarm of the pump loud enough to be heard

4. Baby Liza, 3 months old, with a congenital heart deformity, has an order from her physician: “give 3.00 cc of Lanoxin today for 1 dose only”. Which of the following is the most appropriate action by the nurse?
A. Clarify order with the attending physician
B. Discuss the order with the pediatric heart specialist in the unit
C. Administer Lanoxin intravenously as it is the usual route of administration
D. Refer to the medication administration record for previous administration of Lanoxin

5. When Nurse Norma was about to administer the medications of client Lennie, the relative of Lennie told the nurse that they buy her medicines and showed the container of medications of the client. Which of the following is the most appropriate action by the nurse?
A. Hold the nurse administration of the client’s medication and refer to the head nurse
B. Put aside the medications she prepared and instead administer the client’s
medications
C. Tell the client that she will inform the physician about this
D. Bring the medications of the client to the nurse’s station and prepare accordingly


Situation – You are a newly hired nurse in a tertiary hospital. You have finished your orientation program recently and you are beginning to assimilate the culture of the profession.

6. Using Benner’s stages of nursing expertise, you are a beginning nurse practitioner. You will rank yourself as a/an:
A. competent nurse
B. novice nurse
C. proficient nurse
D. advanced beginner

7. Benner’s “Proficient” nurse level is different from the other levels in nursing expertise in the context of having:
A. the ability to organize and plan activities
B. having attained an advanced level of education
C. a holistic understanding and perception of the client
D. intuitive and analytic ability in new situations

8. As you become socialized into the nursing “culture” you become a patient advocate. Advocacy is explained by the following EXCEPT:
A. respecting a person’s right to be autonomous
B. demonstrating loyalty to the institution’s rights
C. shared respect, trust and collaboration in meeting health needs
D. protecting and supporting another person’s rights

9. Modern day nursing has led to the led development of the expanded role of the nurse as seen in the function of a:
A. Clinical nurse specialist
B. Critical care nurse
C. community health nurse
D. staff nurse

10. You join a continuing education program to help you:
A. Earn credits for license renewal
B. Get in touch with colleagues in nursing
C. Enhance your basic knowledge
D. Update your knowledge and skills related to field of interest

Situation – Mr. Jose’s chart is the permanent legal recording of all information that relates to his health care management. As such, the entries in the chart must have accurate data.

11. Mr. Jose’s chart contains all information about his health care. The functions of records include all except:
A. means of communication that health team members use to communicate their
contributions to the client’s health care
B. the client’s record also shows a document of how much health care agencies will
be reimbursed for their services
C. educational resource for student of nursing and medicine
D. recording of actions in advance to save time

12. An advantage of automated or computerized client care system is:
A. The nursing diagnoses for a client’s data can be accurately determined
B. Cost of confinement will be reduced
C. Information concerning the client can b easily updated
D. The number of people to take care of the client will be reduced

13. Information in the patient’s chart is inadmissible in court as evidence when:
A. The client’s family refuses to have it used
B. The client objects to its use
C. The handwriting is not legible
D. It has too many abbreviations that are “unofficial”

14. Nursing audit aims to:
A. provide research data to hospital personnel
B. study client’s illness and treatment regimen closely
C. compare actual nursing done to established standards
D. provide information to health-care providers

15. A telephone order is given for a client in your ward. What is your most appropriate action?
A. Copy the order on to the chart and sign the physician’s name as close to his
original signature as possible
B. Repeat the order back to the physician, copy onto the order sheet and
indicate that it is a telephone order
C. Write the order in the client’s chart and have the head nurse co-sign it
D. Tell the physician that you can not take the order but you will call the nurse
supervisor

Situation – Errors while providing nursing care to patients must be avoided and minimized at all time. Effective management of available resources enables the nurse to provide safe, quality patient care.

16. In the hospital where you work, increased incidence of medication error was identified as the number one problem in the unit. During the brainstorming session of the nursing service department, probable causes were identified. Which of the following is process related?
A. interruptions
B. use of unofficial abbreviations
C. lack of knowledge
D. failure to identify client

17. Miscommunication of drug orders was identified as a probable cause of medication errors. Which of the following is safe medication practice related to this?
A. Maintain medication in its unit dose package until point of actual administration
B. Note both generic and brand name of the medication in the Medication
Administration Method
C. Only officially approved abbreviations maybe used in prescription orders
D. Encourage clients to ask question about their medications.

18. The hospital has an ongoing quality assurance program. Which of the following indicates implementation of process standards?
A. The nurses check client’s identification band before giving medications
B. The nurse reports adverse reaction to drugs
C. Average waiting time for medication administration is measured
D. The unit has well ventilated medication room

19. Which of the following actions indicate that Nurse Jerome is performing outcome evaluation of quality care?
A. Interviews nurses for comments regarding staffing
B. Measures waiting time for client’s per nurse’s call
C. Checks equipment for its calibration schedule
D. Determines whether nurses perform skin assessment every shift

20. An order for a client was given and the nurse in charge of the client reports that she has no experience of doing the procedure before. Which of the following is the most appropriate action of the nurse supervisor?
A. Assign another nurse to perform the procedure
B. Ask the nurse to find way to learn the procedure
C. Tell the nurse to read the procedure manual
D. Do the procedure with the nurse

Situation – Oral care is an important part of hygienic practices and promoting client
comfort.

21. An elderly client, 84 years old, is unconscious. Assessment of the mouth reveals excessive dryness and presence of sores. Which of the following is BEST to use for oral care?
A. lemon glycerine
B. hydrogen peroxide
C. Mineral oil
D. Normal saline solution

22. When performing oral care to an unconscious client, which of the following is a special consideration to prevent aspiration of fluids into the lungs?
A. Put the client on a sidelying position with head of bed lowered
B. Keep the client dry by placing towel under the chin
C. Wash hands and observe appropriate infection control
D. Clean mouth with oral swabs in a careful and an orderly progression

23. The advantages of oral care for a client include all of the following, EXCEPT:
A. decreases bacteria in the mouth and teeth
B. reduces need to use commercial mouthwash which irritate the buccal
mucosa
C. improves client’s appearance and self-confidence
D. improves appetite and taste of food

24. A possible problem while providing oral care to unconscious clients is the risk of fluid aspiration to lungs. This can be avoided by:
A. Cleaning teeth and mouth with cotton swabs soaked with mouthwash to avoid
rinsing the buccal cavity
B. swabbing the inside of the cheeks and lips, tongue and gums with dry cotton swabs
C. use fingers wrapped with wet cotton washcloth to rub inside the cheeks, tongue,
lips and ums
D. suctioning as needed while cleaning the buccal cavity

25. Your client has difficulty of breathing and is mouth breathing most of the time. This causes dryness of the mouth with unpleasant odor. Oral hygiene is recommended for the client and in addition, you will keep the mouth moistened by using:
A. salt solution
B. water
C. petroleum jelly
D. mentholated ointment

Situation - Mr. Martin, 71 years old was suddenly rushed to the hospital because of severe chest pain. On admission, he was diagnosed to have acute myocardial infarction and was placed in the ICU.

26. While in the ICU, he executes the document tat list the medical treatment he chooses to refuse in case his condition becomes severe to a point that he will be unable to make decisions for himself. This document is:
A. living will                                         
B. informed consent                                
C. last will and testament
D. power of attorney

27. After one day, the patient’s condition worsened and feeling hopeless. He requested the nurse to remove the oxygen. The nurse should:
A. follow the patient because it is his right to die gracefully
B. follow the patient as it is his right to determine the medical regimen he needs 
            C. refuse the patient and encourage him to verbalize hid feelings
            D. refuse the patient since euthanasia is not accepted in the Philippines

28.  Euthanasia is an ethical dilemma which confronts nurses in the ICU because:
            A. the choices involved do not appear to be clearly right or wrong
            B. a clients legal right co-exist with the nurse’s professional obligation
            C. decisions has to be made based on societal norms.
            D. decisions has to be mad quickly, often under stressful conditions

29. A nurse who supports a patient and family’s need to make decisions that is right for them is practicing which of the following ethical principles?
            A. Autonomy              
B. confidentiality                       
C. privacy                    
D. truthfulness

30. Mr. Martin felt better after 5 days but recognizing the severity of his illness, he executes a document authorizing the wife to transact any form of business in his behalf in addition to all decisions relative to his confinement his document is referred to as:
            A. power f attorney                              
            B. living will
C. informed consent                                          
D. medical records

Situation - Miss Castro was recently appointed chief nurse of a 50-bed government hospital in Valenzuela. On her first day of duty, she tried to remember the elements of administration she learned from her basic nursing education.

31.  One of the first things Ms. Castro did was to engage her until in objective writing, formulating goals and philosophy of nursing service. Which activities are MOST appropriately described to which elements of administration?
            A. planning                 
B. controlling                
C. directing                   
d. organizing

32. In recognizing the Department of Nursing, she comes up with the organizational structure defining the role and function of the different nursing positions and line-up the position with qualified people.  This is included in which element of administration:
            A. monitoring                
B. evaluation                
C. organizing              
D. planning

33. After one month, she and her management committee assess the regulatory measures taken and correct whatever discrepancies are found. This is part of which element of administration:
            A. monitoring                
B. organizing                
C. evaluation              
D. planning

34. Revaluation and administrative process is BEST described as:
A. a continuing process of seeing that performance meets goals and targets 
            B. obtaining commitment of members to do better
            C. informing personnel how well and how much improvement has been made
            D. follow-up of activities that have been studied

35. In all of the various administrative functions, which of the following management skill is demanded efficiently and effectively of Ms. Castro?
            1. Decision making skills                                     2. Forecasting skills
            3. Auditing skills                                                 4. Communications skills

            A. 2 & 3                                    
B. 1 & 4                                   
C. 1 & 2                       
D. 2 & 4   

Situation - Health is wealth specifically in this time of the century. The nurse is trained to promote well being of the people.

36. How does a nurse promote one’s well being?
            A. periodic travels for rest and recreation
            B. faithful and observance of healthy simple lifestyle
            C. run away from polluted, stressful areas              
            D. avoid sleepless, over fatigue nights

 37. The nurse can be involved with health promotion as a significant person in helping the family:   


A. become a better family
            B. prevent disease
            C. control their symptoms
            D. modify health promotive behaviors

38. The nurse should NOT leave medication at the bedside because:
            a. the bedside table is not sterile
            b. it is convenient for the nurse
            c. the nurse will not be able to accurately document that the patient actually took the medication
            d. the patient may forget to take it.

39. Non-pharmacologic pain management includes all the following EXCEPT:
            a. relaxation techniques                                                  
            b. massage                                                     
c. use of herbal medicines
d. body movement

40. When assessing a client’s blood pressure, the nurse finds it necessary to recheck the reading. How many seconds after deflating the cuff should the nurse wait before rechecking the pressure?
            a. 10                                                                             
            b. 30                          
            c. 45                        
            d. 60

Situation  – The use of massage and meditation to help decrease stress and pain have
been strongly recommended based on documented testimonials.

41. Martha wants to do a study on this topic: “Effects of massage and meditation on stress
and pain”. The type of research that best suits this topic is:
A. Applied research
B. Qualitative research
C. Basic research
D. Quantitative research

42. The type of research design that does not manipulate independent variable is:
A. Experimental design
B. Quasi-experimental design
C. Non-experimental design
D. Quantitative design
43. This research topic has the potential to contribute to nursing because it seeks to
A. include new modalities of care
B. resolve a clinical problem
C. clarify an ambiguous modality of care
D. enhance client care

44. Martha does review of related literature for the purpose of
A. determine statistical treatment of data research
B. gathering data about what is already known or unknown about the
problem
C. to identify if problem can be replicated
D. answering the research question

45. Client’s rights should be protected when doing research using human subjects. Martha identifies these rights as follows EXCEPT:
A. right of self-determination
B. right to compensation
C. right of privacy
D. right not to be harmed

Situation – Richard has a nursing diagnosis of ineffective airway clearance related to
excessive secretions and is at risk for infection because of retained secretions. Part of Nurse Mario’s nursing care plan is to loosen and remove excessive secretions in the airway.

46. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:
A. Client lying on his back then flat on his abdomen on Trendelenburg position
B. Client seated upright in bed or on a chair then leaning forward in sitting
position then flat on his back and on his abdomen
C. Client lying flat on his back and then flat on his abdomen
D. Client lying on his right then left side on Trendelenburg position

47. When documenting outcome of Richard’s treatment Mario should include the following in his recording EXCEPT:
A. Color, amount and consistency of sputum
B. Character of breath sounds and respiratory rate before and after procedure
C. Amount of fluid intake of client before and after the procedure
D. Significant changes in vital signs

48. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:
A. Amount of food and fluid taken during the last meal before treatment
B. Respiratory rate, breath sounds and location of congestion
C. Teaching the client’s relatives to perform the procedure
D. Doctor’s order regarding position restrictions and client’s tolerance for lying flat

49. Mario prepares Richard for postural drainage and percussion. Which of the following is a special consideration when doing the procedure?
A. Respiratory rate of 16 to 20 per minute
B. Client can tolerate sitting and lying positions
C. Client has no signs of infection
D. Time of last food and fluid intake of the client

50. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:
A. Percussion uses only one hand while vibration uses both hands
B. Percussion delivers cushioned blows to the chest with cupped palms
while vibration gently shakes secretion loose on the exhalation cycle
C. In both percussion and vibration the hands are on top of each other and hand
action is in tune with client’s breath rhythm
D. Percussion slaps the chest to loosen secretions while vibration shakes the
secretions along with the inhalation of air.

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