Nursing Practice III – Nursing Care of Client with Physiological and Psychosocial Alteration
Medical and Surgical Nursing
PART 1 Board Exam test questions 1 - 50
NURSING PRACTICE 3A:
DIRECTION: Choose the letter of the BEST answer by shading the corresponding letter of your choice on the answer sheet provided. STRICTLY NO ERASURE!
1. A group of nurses are studying the case of a 16-year old nursing student who was accused of frustrated homicide. Benny can determine their understanding of circumstantial evidence if they can identify which of the following in the case?
a. justifying circumstances c. exempting circumstances
b. aggravating circumstances d. mitigating circumstances
2. E.M. is a 30-year old premenopausal female who is asking the nurse the most appropriate time of the month to do her self-examination of the breast. The MOST appropriate reply by the nurse would be:
a. the 26th day of the menstrual cycle
b. 7 to 8 days after conclusion of the menstrual period
c. during her menstruation
d. the same day each month
3. Copies of certain portions of the chart maybe released at the discretion of the hospital but may be limited to:
a. x-ray result, treatment orders, and surgery technique
b. laboratory results and abstract only
c. laboratory results, OR reports and patient’s abstract
d. OR reports, laboratory results, nurse’s notes
4. Jenny is reading the progress notes of her patient and reads that the physician had documented “insensible fluid loss of approximately 800 ml daily.” She understands that this type of fluid loss can occur through:
a. urinary output c. the skin
b. the gastrointestinal part d. wound drainage
5. Communication can be verbal and non-verbal. Examples of non-verbal communication in patient-nurse relationship are the following EXCEPT:
a. signs c. symptoms
b. restlessness d. using an interpreter like a family member
6. The perioperative nurse assumes responsibility and accountability for nursing judgments and actions exemplified by the following, EXCEPT:
a. accepting on-call assignment
b. accepting committee assignment
c. selecting a.m. shift only
d. maintaining basic nursing procedure
7. What one condition besetting the nursing service prevents the use of team approach?
a. fast turn-around of nurses c. understaffing
b. no administrative support d. politics in the nursing department
8. Fe, a nurse at the PACU discovered that Luisa, 50 kilos who is 3 hours post cholecystectomy was in severe pain. Upon checking the chart, she found out that Luisa had “Demerol 100 mg I.M. prn for pain”. What should Fe do?
a. verify the order from the M.D.
b. inject 100 mg. Demerol I.M. to Luisa
c. report to the nurse supervisor for opinion
d. administer the recommended dose which is 50 mg because Luisa weighs 50 kilos
9. Postoperatively, the nurse teaches the patient with a modified radical mastectomy to prevent lymphedema by:
a. avoiding unnecessary trauma (e.g. Venipuncture, BP) to the arm on the operative side
b. using a sling to keep arm flexed at the side
c. exposing the arm to sunlight to increase circulation
d. wrapping the arm with elastic bandages during the night
10. Ms. De Leon is suffering from Bell’s palsy as indicated by a feeling of stiffness and a drawing sensation of the face. In teaching her about the disease, what would be important to tell her?
a. There may be increased sensitivity to sound
b. There is a heightened awareness of taste, so that foods must be bland
c. The eye is susceptible to injury if the eyelid does not close
d. Drooling from an increase of saliva on the affected side may occur
11. The patient is scheduled for adrenalectomy. In the preoperative period, the priority nursing action would be to monitor:
a. urine for glucose and acetone
b. vital signs
c. intake and output
d. blood urea nitrogen results
12. Virtue ethics gives us a special prospective in the parent’s role to decide for their children including decision of:
a. professional choice of children
b. spouse choice for children
c. life and death prior to conception and birth
d. gender choice for children
13. One of the reasons why behavior in the OR is so tightly controlled is:
a. it is hard to move around in a OR gown
b. the door of OR suite are closed
c. everybody is busy doing their operation
d. to prevent the cross-contamination of infection between OR staff and patient
14. One of the hidden dangers in the OR is missing instruments. What is the appropriate approach to this happening?
a. correct labeling
b. “a place for everything and everything in its place”
c. install a flush sterilizer in the OR
d. increase instrument inventory
15. Ms. W.O. is found on the floor of her room. She fell while crawling over the side rails of her bed. She is unconscious and has a large laceration to the head that is bleeding profusely. The nurse’s priority action would be:
a. apply direct pressure to the laceration to her head
b. ensure the patient has an open airway
c. notify the physician
d. check the patient’s vital signs
16. During admission of a patient with a severe head injury to the emergency department, the nurse places the highest priority on assessment for:
a. presence of a neck injury
b. neurological status with the Glasgow Coma Scale
c. cerebrospinal fluid leakage from ears or nose
d. patency of airway
17. In the hospital, the best indicator of quality is:
a. patients recover but spend more on supplies
b. patients come back with referral like their family and friends
c. patients demand more use of technology
d. patients come back of their doctor’s advice
18. A most critical strategy in nursing communication is:
a. non-verbal communication
b. giving stereotyped comments
c. verbal communication
d. active listening
19. Mr. T.O. has undergone surgery for lyses of adhesions. He is transferred from Post Anesthesia Care Unit (PACU) to the Surgical floor, the nurse should obtain blood pressure, pulse and respiration every:
a. 3 minutes c. 15 minutes
b. 30 minutes d. 20 minutes
20. Mr. K, age 13, is diagnosed with chronic bronchitis. He is very dyspneic and must sit up to breath. An abnormal condition in which there is discomfort in breathing in any bed or sitting position is:
a. Cheyne-stokes c. eupnea
b. orthopnea d. dyspnea
21. The nurse recognizes that the MOST common causative organism in pyelonephritis is:
a. E.Coli c. Candida Albicans
b. Klebsiella d. Pseudomonas
22. There is a global concern on AIDS. There are legal and ethical concerns specially:
a. duty siblings and spouse
b. need for universal testing
c. confidentiality
d. public support and understanding
23. Mr. WT is cleaning the garage and splashes a chemical to his eyes. The initial priority care following the chemical burn is to:
a. irrigate with normal saline for 1 to 15 minutes
b. transport to a physician immediately
c. irrigate with water for 15 minutes or longer
d. cover the eyes with a sterile gauze
24. Licensed nurses from foreign countries can practice nursing in the Philippines
a. employed in state colleges and universities
b. special projects with hospitals with a fixed fee
c. employees by private hospitals
d. medical mission whose services are free
25. A patient diagnosed with breast cancer has been offered the treatment choices of breast conservation surgery with radiation or a modified radical mastectomy. When questioned by the patient about these options, the nurse informs the patient that the lumpectomy with radiation:
a. reduces the fear and anxiety that accompany the diagnosis and treatment of cancer
b. has about the same 10-year survival rate as the modified radical mastectomy
c. provides a shorter treatment period with a fewer long term complications
d. preserves the normal appearance and sensitivity of the breast.
26. Following a fracture of the forearm or tibia, complaints of sharp, deep, unrelenting pain in the hand or foot unrelieved by analgesics or elevation of the extremity indicate which complication?
a. cast syndrome b. compartment syndrome c. gangrene d. fat embolism
27. Another worthy study is the compliance to the principles of aseptic technique among the sterile OR team. Who does NOT belong to the sterile OR team?
a. scrub nurse c. x-ray technician
b. assistant surgeon d. surgeon
28. Circulation must be restored within 4 minutes of cardiopulmonary arrest because:
a. the lungs fill with fluid
b. the blood begins to coagulate
c. brain cells begin to die
d. irreversible kidney failure develops
29. Benny elaborated on the concept of informed consent. He determines that the nurses need more explanation if their response is one of the following:
a. the consent should provide a description of alternative treatments or procedures
b. the consent should offer a thorough explanation of the procedures to be done and the consequences of it.
c. the consent should include the medical diagnosis and explanation of the patient’s condition
d. the consent should describe the prognosis if the recommended care is refused.
30. Which of the assessment findings would indicate a need for possible glaucoma testing?
a. intermittent loss of vision c. halos around lights
b. presence of floaters d. pruritus and erythema of the conjunctiva
31. The diabetic patient asks for a snack and something to drink. The MOST appropriate choice for this client to meet nutritional needs would be which of the following:
a. crackers with cheese and tea
b. toast with peanut butter and cocoa
c. vanilla wafers and coffee with cream
d. graham crackers and warm milk
32. The patient demonstrates knowledge of the psychological response to the operation and other invasive procedure when she asks about:
a. Who will be with me in the OR?
b. How is the post operative pain over the site like?
c. Will I be naked during the operation?
d. Is it cold inside the
33. In teaching the mother the proper administration of tetracycline eye ointment, which of the following is MOST crucial?
a. squirt a small amount on the inside of the infected eye’s lower lid
b. use clean, wet cloth to gently wipe away the pus
c. wash hands before medication administration
d. do not use other eye ointments or drops or put anything else in eyes.
34. The primary goal of nursing interventions after a craniotomy is:
a. avoiding need for secondary surgery
b. ensuring patient comfort
c. preventing increased intracranial pressure
d. prevention of infection
35. Mr. Salvo, a 35 year old male, has been admitted with the diagnosis of peptic ulcers. The nurse recognizes which drugs as those MOST commonly used in these patients to decrease acid secretions?
a. erythromycin and flagyl
b. Tagamet and zantac
c. Maalox and kayexalate
d. Dyazide and carafate
36. When reading the urinalysis report, the nurse recognizes this result as abnormal:
a. red blood cells 15-20 c. glucose negative
b. turbid d. ph 6.0
37. Mr. Hizon has had cataract surgery. Discharge teaching would include:
a. wearing eye patches for the first 72 hours
b. bending at the waist acceptable if done slowly
c. bending at the knees and keeping the head straight
d. lifting light objects is acceptable
38. Endoscopic minimally invasive surgery has evolved from diagnostic modality to a widespread surgical technique. What department should the nurse collaborate which is unusual in conventional surgery?
a. engineering department c. blood bank services
b. x-ray department d. linen section
39. When the client is discharged from the hospital and is not capable of doing the needed care services, the following can assume the role, EXCEPT:
a. family members c. significant others
b. chaplain d. responsible caregiver
40. R.N. denotes that a nurse:
a. has satisfactorily completed with the requirements to practice nursing as set by the state.
b. has a baccalaureate degree in nursing
c. is professionally ready to practice nursing
d. just a title
41. Urinary tract infection is the most common site of nosocomial infection particularly with urinary catheterization. It can be reduced significantly by through:
a. intermittent drainage c. hanging system drainage
b. open system drainage d. closed system drainage
42. The professional license of an RN is:
a. transferable c. can be revoked for reasons stipulated in RA 9173
b. lifetime d. personal
43. In medical and nursing practice, code means a call for:
a. DNR state c. clinical case
b. call to order d. cardiopulmonary resuscitation
44. A thumb mark of a comatose patient in the informed consent is considered:
a. a misrepresentation c. a not valid signature
b. “nothing” d. a valid signature
45. The OR team collaborates from the first to the last surgical procedure. Who monitors the activities of each OR suite?
a. scrub nurse c. circulating nurse
b. anesthesiologist d. surgeon
46. Organ donation to save life was initially with the first transplant done by:
a. Dr. Christian Barnard of the Union of South Africa
b. Dr. Christian of the U.S.A.
c. Dr. Christian Barnard of Soviet Union
d. Dr. Christian Barnard of U.K.
47. Ms. C.O., age 45, is being evaluated to rule out pulmonary tuberculosis. Which finding is MOST closely associated with TB?
a. green-colored sputum c. leg cramps
b. night sweats d. skin discoloration
48. Following a renal angiography, the patient assessment priority is the:
a. respiratory effort c. urinary output
b. blood pressure d. puncture site
49. In patients with acute pancreatitis, the administration of the analgesic morphine may cause:
a. addiction c. paralytic ileus
b. urinary retention d. spasms of the sphincter of Oddi
50. Who is responsible in daily monitoring the standards of safe, nursing practice in the operating suite?
a. surgeon c. OR nurse supervisor
b. perioperative nurse d. chief nurse
CLICK HERE PART 2 (51 - 100) 'NP3 Nursing Board Exam December 2006 Answer Key 'Nursing Care of Client with Physiological and Psychosocial Alteration'
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