Nursing Practice III – Nursing Care of Client with Physiological and Psychosocial Alteration
Medical and Surgical Nursing / Psychology
PART 1 Board Exam test questions 1 - 50
Situation 1: Leo lives in the squatter area. He goes to nearby school. He helps his mother gather molasses after school. One day, he was absent because of fever, malaise, anorexia and abdominal discomfort.
1. Upon assessment, Leo was diagnosed to have hepatitis A. Which mode of transmission has the infection agent taken?
A. Fecal oral
B. Droplet
C. Airborne
D. Sexual contact
2. Which of the following is concurrent disinfection in the case of Leo?
A. In
B. Sanitary disposal of feces, urine and blood
C. Quarantine of the sick individual
D.
3. Which of the following must be emphasized during mother’s class to Leo’s mother?
A. Administration of immunoglobulin to families
B. Thorough hand washing before and after eating and toileting
C. Use of attenuated vaccines
D. Boiling of food especially meat
4. Disaster control should be undertaken when there are 3 or more hepatitis A cases. Which of these measures is a priority?
A. Eliminate fecal contamination from foods
B. Mass vaccination of uninfected individuals
C. Health promotion and education to families and communities about the disease it’s cause and transmission.
D. Mass administration of immunoglobulin
5. What is the average incubation period of Hepatitis A?
A. 30 days
B. 60 days
C. 50 days
D. 14 days
Situation 2: As a nurse researcher you must have a very good understanding of the common terms of concept used in research.
6. The information that an investigator collects from the subjects or participants in a research study is usually called:
A. Hypothesis
B. Data
C. Variable
D. Concept
7. Which of the following usually refers to the independent variables in doing research?
A. Result
B. Cause
C. Output
D. Effect
8. The recipients of experimental treatment is an experimental design or the individuals to be observed in a non experimental design are called;
A. Setting
B. Subjects
C. Treatment
D. Sample
9. The device or techniques an investigator employs to collect data is called?
A. Sample
B. Instrument
C. Hypothesis
D. Concept
10. The use of another persons ideas or wordings giving appropriate credit results from inaccurate attribution of materials to its sources. Which of the following is referred to when another persons idea is inappropriate credited as one’s own?
A. Plagiarism
B. Quotation
C. Assumption
D. Paraphrase
Situation 3: Mrs. Pichay is admitted to your ward. The MD ordered “Prepare for thoracentesis this pm to remove excess air from the pleural cavity.”
11. Which of the following nursing responsibilities is essential in Mrs. Pichay who will undergo thoracentesis?
A. Support and reassure client during the procedure
B. Ensure that informed consent has been signed
C. Determine if client has allergic reaction to local anesthesia
D. Ascertain if chest x-rays and other tests have been prescribed and completed
12. Mrs. Pichay who is for thoracentesis is assigned by the nurse to which of the following positions?
A. Trendelenburg position
B. Supine position
C. Dorsal Recumbent position
D. Orthopneic position
13. During thoracentesis, which of the following nursing intervention will be most crucial?
a. Place patient in a quiet and cool room
b. Maintain strict aseptic technique
c. Advice patient to sit perfectly still during needle insertion until it has been withdrawn from the chest
d. Apply pressure over the puncture site as soon as the needle is withdrawn
14. To prevent leakage of fluid in the thoracic cavity, how will you position the client after thoracentesis?
A. Place flat in bed
B. Turn on the unaffected side
C. Turn on the affected side
D. On bed rest
15. Chest x-ray was ordered after thoracentesis. When your client asks what is the reason for another chest x-ray, you will explain:
A. to rule out pneumothorax
B. to rule out any possible perforation
C. to decongest
D. to rule out any foreign body
Situation 4: A computer analyst, Mr. Ricardo J. Santos, 25 was brought to the hospital for diagnostic workup after he had experienced seizure in his office.
16.Just as nurse was entering the room, the patient who was sitting on his chair begins to have a seizure. Which of the following must the nurse do first?
A. Ease the patient to the floor
B. Lift the patient and put him on the bed
C. Insert a padded tongue depressor between his jaws
D. Restrain patient’s body movement
17. Mr. Santos is scheduled for CT SCAN for the next day, noon time. Which of the following is the correct preparation as instructed by the nurse?
A. Shampoo hair thoroughly to remove oil and dirt
B. No special preparation is needed. Instruct the patient to keep his head still and stead.
C. Give a cleansing enema and give until 8 AM
D. Shave scalp and securely attach electrodes to it
18. Mr. Santos is placed on seizure precaution. Which of the following would be contraindicated?
A. Obtain his oral temperature
B. Encourage to perform his own personal hygiene
C. Allow him to wear his own clothing
D. Encourage him to be out of bed.
19. Usually, how does the patient behave after his seizure has subsided?
A. Most comfortable walking and moving about.
B. Becomes restless and agitated.
C. Sleeps for a period of time
D. Say he is thirsty and hungry.
20. Before, during and after seizure. The nurse knows that the patient is ALWAYS placed in what position?
A. Low fowler’s
B. Modified trendelenburg
C. Side Lying
D. Supine
Situation 5: Mrs. Damian an immediate post op cholecystectomy and choledocholithotomy patient, complained of severe pain at the wound site.
21. Choledocholithotomy is:
A. The removal of the gallbladder
B. The removal of the stones in the gallbladder
C. The removal of the stones in the common bile duct
D. The removal of the stones in the kidney
22. The simplest pain relieving technique is:
A. Distraction
B. Taking aspirin
C. Deep breathing exercise
D. Positioning
23. Which of the following statement on pain is true?
A. Culture and pain are not associated
B. Pain accomplished acute illness
C. Patient’s reaction to pain varies
D. Pain produces the same reaction such as groaning and moaning
24. In a pain assessment, which of the following condition is a more reliable indicator?
A. Pain rating scale of 1 – 10
B. Facial expression and gestures
C. Physiological responses
D. Patients description of the pain sensation
25. When a client complains of pain, your initial response is:
A. Record the description of pain
B. Verbally acknowledge the pain
C. Refer the complaint to the doctor
D. Change to a more comfortable position
Situation 6: You are assigned at the surgical ward and clients have been complaining of post pain at varying degrees. Pain as you know is very subjective.
26. A one-day post operative abdominal surgery client has been complaining of severe throbbing abdominal pain described as 9 in 1 – 10 pain rating. Your assessment reveals bowel sounds on all quadrants and the dressing is dry and intact. What nursing intervention would you take?
A. Medicate client as prescribed
B. Encourage client to do-imagery
C. Encourage deep breathing exercise
D. Call surgeon stat
27. Pentoxidone 5 mg IV every 8 hours was prescribed for post abdominal pain, which will be your priority nursing action?
A. Check abdominal dressing for possible swelling
B. Explain the proper use of PCA to alleviate anxiety
C. Avoid overdosing to prevent dependence/tolerance
D. Monitor VS, more importantly RR
28. The client complained of abdominal distention and pain. Your nursing intervention that can alleviate pain is:
A. Instruct client to go to sleep and relax
B. Advice the client to close the lips and avoid deep breathing and talking
C. Offer hot and clear soup
D. Turn to sides frequently and avoid too much talking
29. Surgical pain might be minimized b which nursing action in the O.R.
A. Skill of surgical team and lesser manipulation
B. Appropriate preparation for the scheduled procedure
C. Use of modern technology in closing the wound
D. Proper positioning and draping of client.
30. Inadequate anesthesia is said to be one of the common cause of pain both in intra and post-op patients. If general anesthesia is desired, it will involve loss of consciousness. Which of the following are the 2 general types of GA?
A. Epidural and Spinal
B. Subarachnoid block and intravenous
C. Inhalation and Regional
D. Intravenous and inhalation
Situation 7: Nurse’s attitudes toward the pain influence the way they perceive and interact with clients in pain.
31. Nurses should be aware of that older adults are at risk of underrated pain. Nursing assessment and management of pain should address the following beliefs EXCEPT:
A. Older patients seldom tend to report pain than the younger ones
B. Pain is a sign of weakness
C. Older patients do not believe in analgesics, they are tolerant.
D. Complaining of pain will lead to being labelled a bad patient
32. Nurses should understand that when a client responds favourably to a placebo, it is known as the placebo effect. Placebos do not indicate whether or not a client has:
A. Conscience
B. Real pain
C. Disease
D. Drug tolerance
33. You are the nurse in the pain clinic where you have client who has difficulty specify the location of pain. How can you assist such client?
A. The pain is vague
B. By charting-it hurts all over
C. Identifying the absence and presence of pain
D. Ask the client to point to the painful are by just one finger.
34. What symptom more distressing than pain, should the nurse monitor when giving opioids especially among elderly clients who are in pain?
A. Forgetfulness
B. Constipation
C. Drowsiness
D. Allergic reactions like pruritus
35. Physical dependence occurs in anyone who takes opiods over a period of time. What do you tell a mother of a ‘dependent’ when asked for advice?
A. Start another drug and slowly lessen the opioid dosage
B. Indulge in recreational outdoor activities
C. Isolate opioid dependent to a restful resort
D. Instruct slow tapering of the drug dosage and alleviate physical withdrawal symptoms.
Situation 8: The nurse is performing health education activities for Janevi Segovia, a 30 years old Dentist with Insulin dependent diabetes Mellitus.
36. Janevi is preparing a mixed dose of insulin. The nurse is satisfied with her performance when she:
A. Draw insulin from the vial of clear insulin first
B. Draw insulin from the vial of the intermediate acting insulin first
C. Fill both syringes with the prescribed insulin dosage then shake the bottle vigorously
D. Withdraw the intermediate acting insulin first before withdrawing the short acting insulin first.
37. Janevi complains of nausea, vomiting, diaphoresis and headache. Which of the following nursing intervention are you going to carry first?
A. Withhold the client’s next insulin injection
B. Test the client’s blood glucose level
C. Administer Tylenol as ordered
D. Offer fruit juice, gelatine and chicken bouillon
38. Janevi administered regular insulin at 7 A.M. and the nurse should instruct Jane to avoid exercising at around:
A. 9 to 11 A.M.
B. After 8 hours
C. Between 8 A.M. to 9 A.M.
D. In the afternoon, after taking lunch.
39. Janevi was brought at the emergency room after four month because she fainted in her clinic. The nurse should monitor which of the following test to evaluate the overall therapeutic compliance of a diabetic patient?
A. Glycosylated Hemoglobin
B. Fasting blood glucose
C. Ketone levels
D. Uirne glucose level
40. Upon the assessment of HbA1C of Mrs. Segovia. The nurse has been informed of a 9 % HbA1C result. In this case, she will teach the patient to:
A. Avoid infection
B. Take adequate food and nutrition
C. Prevent and recognize hypoglycaemia
D. Prevent and recognize hypoglycaemia
41. The nurse is teaching plan of care for Jane with regards to proper foot care. Which of the following should be included in the plan?
A. Soak feet in hot water
B. Avoid using mild soap on the feet
C. Apply a moisturizing lotion to dry feet but not between the toes
D. Always have a podiatrist to cut your toe nails; never cut them yourself
42. Another patient was brought to the emergency room in an unresponsive state and a diagnosis of hyperglycaemic hyperosmolar nonketotic syndrome is made. The nurse immediately prepare to initiate which of the following anticipated physician’s order?
A. Endotracheal intubation
B. 100 units of insulin
C. Intravenous infusion of normal saline
D. Intravenous infusion of sodium bicarbonate
43. Jane eventually developed DKA and is being treated in the emergency room. Which finding would the nurse expect to note as confirming this diagnosis?
A. Comatose state
B. Decreased urine output
C. Increased respiration and increase in pH
D. Elevated blood glucose level and plasma bicarbonate level
44. The nurse teaches Jane to know the difference between hypoglycaemia and ketoacidosis. Jane demonstrates understanding of the teaching by stating that glucose will be taken of which of the following symptoms develops?
A.
B. Shakiness
C. Blurred vision
D. Foul breath odor
45. Jane has been scheduled to have a FBS taken in the morning. The nurse tells Jane to eat or drink after midnight. Prior to taking the blood specimen, the nurse noticed that Jane is holding a bottle of distilled water. The nurse asked Jane if she drink any, and she said yes. Which of the following is the best nursing action?
A. Administer syrup of ipecac to remove the distilled water from the stomach.
B. Suction the stomach content using NGT prior to specimen collection
C. Advice to physician to reschedule to diagnostic examination next day
D. Continue as usual and have the FBS analysis performed and specimen be taken.
Situation 9: Elderly clients usually produce unusual signs when it comes to different diseases. The ageing process is a complicated process and the nurse should understand that it is an inevitable fact and she must be prepared to care for the growing elderly population.
46. Hypoxia may occur in the older patients because of which of the following
physiologic changes associated with aging.
A. Ineffective airway clearance
B. Decreased alveolar surfaced area
C. Decreased anterior-posterior chest diameter
D. Hyperventilation
47. The older patient is at higher risk for incontinence because of:
A. dilated urethra
B. increased glomerular filtration rate
C. diuretic use
D. decreased bladder capacity
48. Merle, age 86, is complaining of dizziness when she stands up. This may
indicate:
A. dementia
B. a visual problem
C. functional decline
D. drug toxicity
49. Cardiac ischemia in an older patient usually produces:
A. ST-T wave changes
B. Very high creatinine kinase level
C. Chest pain radiating to the left arm
D. Acute confusion
50. The most dependable sign of infection in the older patient is:
A. change in mental status
B. fever
C. pain
D. decreased breath sounds with crackles
CLICK HERE PART 2 (51 - 100)'NP3 Nursing Board Exam November 2008 Answer Key Nursing Care of Client with Physiological and Psychosocial Alteration'
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