EXAMINATION SET: A

CENTRAL PHILIPPINE UNIVERSITY

COLLEGE OF NURSING
PRELIM EXAMINATIONS IN N423- COMPETENCY APPRAISAL 2
2nd SEMESTER SY 2016-2017
INTRUCTIONS /DIRECTIONS
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THE SUBJECT PRELIM EXAMINATIONS IN N423 AND YOUR QUESTION SET BOX AND
EXAMINEE CODE. DO NOT WRITE ANYTHING IN THE QUESTIONNAIRES.
EXAMINATION PROPER FOR

SET A

SITUATION: The following question pertain to alterations in endocrine and metabolism.

1. The nurse has to assess a clients mental and emotional status before he can begin therapy for
treatment of an endocrine disorder. Which of the following can be tested to assess the clients
mental and emotional status?
a. Ability to respond to questions
b. Motor function
c. Sleep-wake cycles
d. Facial expression
2. A nurse is collecting data about the diet history of a client who has low blood sugar. Which of
the following would be an important consideration in the diet history?
a. Consumption of health foods
b. Conumption of sea salt and kelp
c. Consumption of seafood
d. Consumption of carbohydrates
3. Which of the following postoperative nursing actions should the nurse perform when a client
with acromegaly has nasal packing?
a. Detect the signs of increased intracranial pressure and meningitis
b. Detect the presence of cerebrospinal fluid
c. Detect the signs of hypoglycaemia
d. Detect the presence of striae
4. Which of the following is the most common adverse reaction during initial therapy with a thyroid
replacement?
a. Allergy
b. Signs of hyperthyroidism
c. Weight gain
d. Bones becoming demineralised
5. Which of the following group of clients should be assessed for pheochromocytoma?
a) Clients with hypertension that is difficult to control
b) Clients with high blood glucose levels
c) Clients who take more than four medicines to control their blood pressure
d) Client with either primary or secondary adrenal insufficiency
e) Clients who develop hypertension before age 35
a. a, c, e
b. a, b, c

c. c, d, e
d. all of the above
SITUATION: Please continue answering the following questions with your knowledge on alteration ins
endocrine and metabolism.
6. A client with type 1 diabetes is advised to undergo pancreas and islet cell transplantation.
Which of the following is the goal of this transplantation?
a. Cholesterol reduction
b. Muscle tone improvement
c. Blood circulation improvement
d. Administer insulin through IV route
7. Which of the following nursing actions helps the nurse to detect evidence of albuminuria when
caring for a client with diabetic neuropathy?
a. Check the urine with a test strip
b. Monitor blood glucose and haemoglobin A1c results
c. Check the postprandial glucose test results
d. Check the fasting blood glucose test results
8. A nurse is caring for a client whose blood glucose is 49 mg/dL. The client is lethargic but
arousable. Which of the following is the priority nursing action?
a. Re-check blood glucose in 15 min.
b. Give 7 g of protein.
c. Give 15 to 20 g of carbohydrates.
d. Report findings to the clients health care provider.
9. A clients blood glucose level is 257 mg/dL at 0800, and the health care providers prescription
for sliding scale insulin for this blood glucose result is 6 units of Regular insulin (Humulin R)
subcutaneously. This client also receives 12 units of insulin glargine (Lantus) subcutaneously
every morning. Which of the following methods should the nurse use to draw up and
administer the insulin?
a. In one insulin syringe, draw up 6 units of Regular insulin. In a separate insulin
syringe, draw up 12 units of insulin glargine and give two separate injections.
b. Draw up the Regular insulin first, and then draw up the insulin glargine in the same
syringe. Administer one injection that contains both insulins.
c. Draw up the insulin glargine first, and then draw up the Regular insulin in the same
syringe. Administer one injection that contains both insulins.
d. Give only the 6 units of Regular insulin as indicated on the sliding scale prescription.
10. When assessing the laboratory values of a client with type 2 diabetes, the nurse should
expect the results to reveal:
a. Ketones in the blood but not the urine
b. Glucose in the urine but not in the blood
c. Urine negative for ketones and glucose in the blood
d. Urine and blood positive for both glucose and ketones
SITUATION: The human body needs nourishment. Once it is obstructed, alteration in the bodys
normal function will crash and cause disability. The following questions will test your knowledge
related to alteration in nutrition and metabolic function.
11. What instruction should be given to a client scheduled for a gallbladder series test?
a. To remain on a low residue diet 1 to 2 days before the test
b. To take a laxative the evening before the test
c. Not to eat or drink until the test is complete
d. To take cleansing enemas the morning of the test
12. Which of the following diagnostic tests can be given to a client who cannot retain dye tablets
given to test his gallbladder?
a. Oral cholecystography
b. Cholangiography
c. Barium enema
d. Barium swallow
13. The nurse needs to promote easy passage of food to the stomach in an obese elderly client
with hiatal hernia. Which of the following nursing actions in the care plan would help the
client?
a. Encouraging frequent, small, well-balanced meals

b. Suggesting avoidance of foods that cause discomfort

c. Instructing the client to eat slowly and chew the food thoroughly
d. Instructing the client to avoid alcohol and tobacco product
14. The nurse is monitoring a client diagnosed with peptic ulcer disease. She is observing this
nonsurgical client for any sign of medicl complications. Which of the following assessment
measures is the most useful?
a. Assessing the clients bowel patterns and stool characteristics
b. Evaluating the clients skin for signs of infections
c. Evaluating the emotional status
d. Assessing the vital signs and fluid status
15. When monitoring the food intake of a client with Crohns disease, the nurse observes that the
client does not eat most of the food served. The nurse learns that the client finds the food
unappetizing. Which of the following steps should the nurse take to address this issue?
a. Explain to the client the benefits of eating the prescribed food.
b. Request the dietitian to suggest more acceptable food.
c. Provide the client total parenteral nutrition and lipid infusions
d. Provide the client elemental diet formula and 5-ASA medications
SITUATION: Please continue answering the following questions related to nutrition and metabolic
function.
16. Which of the following instructions should the nurse provide to a client who is asymptomatic of
colonic cancer but whose stool test results are positive for blood?
a. Add fiber to the diet
b. Undergo a colonoscopy
c. Use warm soaks
d. Use a stool softener
17. When assessing clients for chronic hepatitis, in which group of clients will the nurse observe
the pain to be mild or absent?
a. Women nearing menopause
b. Children
c. Young adults
d. Older adults
18. When assessing a client for acute pancreatitis, which of the following symptoms will the nurse
observe?
a. Increased thirst and urination
b. Ypertension and nausea
c. Rapid breathing and pulse rate
d. Frothy, foul-smelling stools
19. The nurse has performed nasogastric decompression for a client who has undergone
colostomy surgery. Which of thef ollowing related interventions should a nurse consider for
this client?
a. Inspect the swelling of joints
b. Inspect the bleeding wound
c. Monitor pulse pressure and rate
d. Measure the amount of fluids lost
20. Why should a nurse instruct a client with an ileostomy to avoid enteric-coated products?
a. The coating prevents the absorption of the product
b. The coating adversely affects ileostomy
c. The coating affects the absorption of vitamins
d. The coating causes particularly strong odors
SITUATION: HEALTH EDUCATION is necessary in order to enhance the lifestyle and health of every
individual.
21. The nurse teaches a client with type 2 diabetes how to provide self care to prevent
infections of the feet. The nurse recognizes thaty the teaching was effective when the client
says, I should:
a. Massage my feet and legs with oil or lotion
b. Apply heat intermittently to my feet and legs
c. Eat food high in protein and carbohydrate kilocalories
d. Control my blood glucose level through diet, exercise and medication

22. Postoperatively, a client asks, Could i have a pillow under my knees? My legs feel stretched.
The nurse can best reinforce the preoperative teaching by responding:
a. Ill get pillows for you. I want you to be as rested as possible.
b. Its not a good idea, but you do look uncomfortable. Ill get one.
c. We dont allow pillows under the legs because you will get too warm.
d. A pillow under the knees can result in clot formation because it slows blood
flow.
23. The nurse teaches a client with exophthalmos how to reduce discomfort and prevent corneal
laceration. The nurse recognizes that the teaching is understood when the client states, I
should:
a. Eliminate excessive blinking.
b. Not move my extraocular muscles.
c. Elevate the head of my bed at night.
d. Avoid using a sleeping mask at night.
24. When teaching a client how to prevent constipation, the nurse identifies that the dietary
teaching is understood when the client states that the preferred breakfast cereal is:
a. Froot loops
b. Corn flakes
c. Capn crunch
d. Shredded wheat
25. A client has decided to become a vegan (total vegetarian) and wishes to plan a diet to ensure
adequate protein quality. To provide guidance, the nurse should instruct this client to:
a. Add milk to grains to provide complete proteins
b. Use eggs and plant foods o provide essential amino acids
c. Plan a careful mixture of plant proteins to provide a balance of amino acids
d. Add cheese to grains and beans to increase the quality of the protein consumed
SITUATION:Nurse Martha is aware of her ethical and legal responsibilities as a professional nurse.
She sees to it that she complies with the ethical principles in the care of her patients.
26. Which of the following principles apply to the action of the Martha to refrain from discussing
the disease condition of the patient with those who are not involved in his care?
a. Beneficence
b. Non-maleficencE
c. Justice
d. Autonomy
27. Mr. Garcia is diagnosed to have acute myocardial infarction and is recommended for
admission. He refuses to be admitted and asks to be transferred to a tertiary hospital instead.
Which of thE following principles should Martha use as guide for her action?
a. Autonomy
b. Justice
c. Non-maleficence
d. Beneficence
28. The present Code of Ethics Nurses in the Philippines was approved by the Board of Nursing
through:
a. BON Resolution No. 1955
b. BON Resolution No. 633
c. Bon Resolution No. 110
d. BON Resolution No. 220
29. When conflict arises regarding management of patient care, which of the following should be
upheld?
a. Physicians orders
b. Preference of the family
c. Patients rights
d. Institutional policy
30. Mr. Gibson, a British national, who is terminally ill, instructed the Martha to refrain from giving
him resuscitation in the event that he goes into cardiac arrest. Which of the following actions
of Martha is NOT within legal norms?
a. Prepare the form for advanced directives and ask Mr. Gibson to sign
b. Ask two other persons who are qualified to be witnesses of the signed directive

c. Explain to Mr. Gibson that this is not allowed

d. Attached the advance directives to the patients charts
SITUATION: Ms. Sheena Perez is the Health Education Program Officer of the Municipal Health
Office. She plans to develop programs based on the various laws and directives from the DOH.
31. She knows that all prescriptions of the municipal health officer should be in generics. What
law provides for this mandate?
a. R.A 9173
b. R.A. 6675
c. R.A. 1080
d. R.A. 7160
32. Sheena has to consider managing the resources of the MHO. She knows that the delivery of
basic services and facilities of the national government was transferred to the local
government units. Which of the following laws mandated this?
a. R.A 7305
b. R.A. 7160
c. R.A. 4226
d. R.A. 9173
33. Which of the following provisions does NOT apply to R.A 7305?
a. Promotes and improves the socio-economic well being of health workers
b. Develop their skills and capabilities
c. Encourage those qualified and with abilities to remain in government service.
d. Standardizes the salaries of nurses working in the government
34. She deems it necessary for her to undergo continuing professional education. Which of the
following supports this objective?
a. PRC Resolution No. 2004 -179
b. BON Resolution No. 220 s.2004
c. EO No. 220
d. BON Resolution No. 425 s. 2003
35. She emphasized to her team that they should be careful in the practice of their profession to
avoid legal entanglements. Which of the following could be a cause for revocation/suspension
of license?
1.Unprofessional or unethical conduct
2.Gross incompetence or serious ignorance
3.Malpractice or negligence
4.Use of fraud, deceit, or false statements in obtaining a certificate of
registration/professional license or a temporary/special permit
a. 1, 2, & 3
b. 2, 3, & 4
c. 1, 3, & 4
d. 1, 2, 3, & 4
SITUATION: Kamille successfully passed the PNLE. She has just received her professional
identification card as a registered nurse.
36. As a nurse, she should be guided by the nursing law in the country. Which is NOT a provision
of this law?
a. Increases the composition of the Board from five to seven representing nursing
education, service and community health nursing
b. b. Requires those nurses who have been away from practice to undergo one
month of didactic training and five months of practicum before returning to the
workforce.
c. Recognition of nursing specialty organizations in coordination with the accredited
professional organization
d. Provides for incentives and benefits system for nurses and their dependents.
37. Which TWO of the following statements are NOT TRUE about the new nursing law?
1.It guarantees the delivery of quality basic health services through an
adequate nursing personnel system throughout the country.
2.Requires the member of the Board to resign from any employment both in the
government and private institutions
3.Requires the Chairman of the Board to be a holder of a doctorate degree

4.Amends the Philippine Nursing Act of 1991

a. 1 & 2
b. 2 &3
c. 3 & 4
d. 1 & 4
38. Which of the following is the correct provision of the law regarding IV therapy?
a. IV therapy training according to protocol established is mandated.
b. A nurse who has not been trained in IV therapy is prohibited to perform IV therapy
c. The present law is silent on the provision for mandatory training for IV therapy
d. The nurse can perform IV administration in the presence and supervision of a
physician
39. Which of the following actions will shield her from possible lawsuits?
1.Knowledge and implementation of standards/protocol of care
2.Documentation of actions accurately and concisely
3.Document outcomes of care
4.Following all doctors orders that are legal and in writing
a. 1, 2, 4
b. 2, & 3
c. 1, 2, & 3
d. 2, 3, & 4
40. She assessed a three- year old boy for fever, but the boy would not want to go near her.
Which of the following remarks of Kamille would constitute an assault?
a. You dont want to have your temperature taken? I will call the guard to hold
you and give you an injection instead!
b. Alright, just tell me when you are ready to have your temperature taken.
c. This will not hurt you; just put it under your tongue.
d. If you will let me take your temperature your fever will be gone.
SITUATION: The following questions will test your knowledge on management of resources, as a
nurse manager.
41. 19. When Harry uses team nursing as a care delivery system, he and his team need to
assess the priority of care for a group of patients, which of the following should be a priority?
a. Each patient as listed on the worksheet
b. Patients who needs least care
c. Medications and treatments required for all patients
d. Patients who need the most care
42. She is hopeful that her unit will make a big turnaround in the succeeding months. Which of
the following actions of Harry demonstrates that he has reached the third stage of change?
a. Wonders why things are not what it used to be
b. Finds solutions to the problems
c. Integrate the solutions to his day-to-day activities
d. Selects the best change strategy
43. Julius is a newly-appointed nurse manager of The Good Shepherd Medical Center, a tertiary
hospital located within the heart of the metropolis. He thinks of scheduling planning workshop
with his staff in order to ensure an effective and efficient management of the department.
Should he decide to conduct a strategic planning workshop, which of the following is NOT a
characteristic of this activity?
a. Long-term goal-setting
b. Extends to 3-5 years in the future
c. Focuses on routine tasks
d. Determines directions of the organization
44. Which of the following statements refer to the vision of the hospital?
a. The Good Shepherd Medical Center is a trendsetter in tertiary health care in the
Philippines in the next five years
b. The officers and staff of The Good Shepherd Medical Center believe in the unique
nature of the human person
c. All the nurses shall undergo continuing competency training program.
d. The Good Shepherd Medical Center aims to provide a patient-centered care in a total
healing environment.

45. Julius orients his staff on the patterns of reporting relationship throughout the organization.
Which of the following principles refer to this?
a. Span of control
b. Hierarchy
c. Esprit d corps
d. Unity of direction
SITUATION: Documentation and reporting are just as important as providing patient care, As such,
the nurse must be factual and accurate to ensure quality documentation and reporting.
46. Health care reports have different purposes. The availability of patients record to all health
team members demonstrates which of the following purposes:
a. Legal documentation
b. Research
c. Education
d. Vehicle for communication
47. When a nurse commits medication error, she should accurately document clients response
and her corresponding action. This is very important for which of the following purposes:
a. Research
b. Legal documentation
c. Nursing Audit
d. Vehicle for communication
48. POMR has been widely used in many teaching hospitals. One of its unique features is
SOAPIE charting. The P in SOAPIE charting should include:
a. Prescription of the doctor to the patients illness
b. Plan of care for patient
c. Patients perception of ones illness
d. Nursing problem and Nursing diagnosis
49. The medical records that are organized into separate section from doctors or nurses has more
disadvantages than advantages. This is classified as what type of recording?
a. POMR
b. Modified POMR
c. SOAPIE
d. SOMR
50. Which of the following is the advantage of SOMR or Traditional recording?
a. Increases efficiency in data gathering
b. Reinforces the use of the nursing process
c. The caregiver can easily locate proper section for making charting entries
d. Enhances effective communication among health care team members
SITUATION Survey and Statistics are important part of research that is necessary to explain the
characteristics of the population.
51. According to the WHO statistics on the Homeless population around the world, which of the
following groups of people in the world disproportionately represents the homeless
population?
a. Hispanics
b. Asians
c. African Americans
d. Caucasians
52. Which of the following is not true about a Pure Experimental research?
a. There is a control group
b. There is an experimental group
c. Selection of subjects in the control group is randomized
d. There is a careful selection of subjects in the experimental group
53. The researcher implemented a medication regimen using a new type of combination drugs to
manic patients while another group of manic patient receives the routine drugs. The
researcher however handpicked the experimental group for they are the clients with multiple
episodes of bipolar disorder. The researcher utilized which research design?
a. Quasi-experimental
b. Phenomenological
c. Pure experimental

d. Longitudinal
54. You would like to compare the support system of patient with chronic illness to those with
acute illness. How will you best state your problem?
a. A descriptive study to compare the support system of patients with chronic illness and
those with acute illness in terms of demographic data and knowledge about
intervention.
b. The effects of the types of support system of patients with chronic illness and those
with acute illness.
c. A comparative analysis of the support system of patients with chronic illness and
those with acute illness.
d. What are the differences of the support system being received by patient with
chronic illness and patients with acute illness?
55. In the Hypothesis: The utilization of technology in teaching improves the retention and
attention of the nursing students. Which is the dependent variable?
a. Utilization of technology
b. Improvement in the retention and attention
c. Nursing students
d. Teaching
SITUATION: Joint Commission on Accreditation of Hospital Organization (JCAHP) patient safety
goals and requirements include the care and efficient use of technology in the OR arid elsewhere in
the healthcare facility.
56. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm
systems?
a. limit suppliers to a few so that quality is maintained
b. implement a regular inventory of supplies and equipment
c. Adherence to manufacturer's recommendation
d. Implement a regular maintenance and testing of alarm systems
57. Over dosage of medication or anesthetic can happen even with the aid of technology like
infusion pump, sphymomanometer, and similar devices/machines. As a staff, how can you
improve the safety of using infusion pumps?
a. Check the functionality of the pump before use
b. Select your brand of infusion pump like you do with your cellphone
c. Allow the technician to set the; infusion pump before use
d. Verify the flow rate against your computation
58. JCAHOs universal protocol for surgical and invasive procedures to prevent wrong site, wrong
person, and wrong procedures/surgery includes the following EXCEPT:
a. Mark the operative site if possible
b. Conduct pre-procedure verification process
c. Take a video of the entire intra-operative procedure
d. Conduct time out immediately before starting the procedure
59. You identified a potential risk of pre and post operative clients. To reduce the risk of patient
harm resulting from fall, you can implement the following EXCEPT:
a. Assess potential risk of fail associated with the patient's medication regimen
b. Take action to address any identified risks through Incident Report (IR)
c. Allow client to walk with relative to the OR
d. Assess and periodically reassess individual client's risk for falling
60. As a nurse you know you can improve on accuracy of patient's identification by 2 patient
identifiers, EXCEPT:
a. identify the client by his/her wrist tag and verify with family members
b. identify client by his/her wrist tag and call his/her by name
c. call the client by his/her case and bed number
d. call the patient by his/her name and bed number

SITUATION: Communication is vital to provide knowledge to the patient and relay information to other
health care team.

1. 61.A client is on a ventilator. One of the nurses asks what should be done when condensation
resulting from humidity collects in the ventilator tubing. The best response to this question
would be:
a. Notify the respiratory therapist.
b. Empty the fluid from the tubing.
c. Decrease the amount of humidity.
d. Record the amount of fluid removed from the tubing.
2. 62.The nurse performs preoperative teaching related to subtotal thyroidectomy. The nurse
identifies that the client understands the teaching about the local effects of the administration
of a general anesthetic when the client states. Immediately after surgery I may experience:
a. Transient headaches.
b. Feelings of chilliness.
c. Paroxysmal hiccoughs.
d. Discomfort swallowing.
3. 63.During a health symposium, a nurse teaches the group how to prevent food poisoning. The
nurse evaluates that the teaching has been understood when one of the participants states:
a. Meats and cream based food need to be refrigerated.
b. Once most food is cooked it does not need to be refrigerated.
c. Poultry should be stuffed and then refrigerated before cooking.
d. Cooked food should be cooled before being put into the refrigerator.
4. 64.A client, who had hiatal hernia, is 5 feet 3 inches tall and weighs 140 pounds, asks the nurse
how to prevent esophageal reflux. The nurses best response would be:
a. Increase your intake of fat with each meal.
b. Lie down after eating to help your digestion.
c. Reduce your caloric intake to foster weight reduction.
d. Drink several glasses of fluid during each of your meals.
5. 65.A client with type 2 diabetes travels frequently and asks how to plan meals during trips. The
nurses most appropriate response would be to:
a. You can order diabetic foods on most airlines and in restaurants.
b. You should plan your food ahead and carry it with you from home.
c. Make regular food choices, wherever you are, following your food plan.
d. You can monitor your blood glucose level frequently and can eat accordingly.

SITUATION: Alexa Mika Lisa is taking care of clients with gastrointestinal, hepatobiliary and
endocrine problems..
1. 66.Ray was admitted to the ER 3 hours of vomiting after having been suspected of liver
cirrhosis . His respiratory rate is 4 and the ABG result shows the following: pH = 7.16; PCO2 =
70; HCO3= 22. You know that his ABG interpretation would be:
a. Fully compensatory metabolic acidosis
b. Uncompensated respiratory acidosis
c. Partially compensatory metabolic acidosis
d. Fully compensated respiratory acidosis
2. 67.Another patient was admitted to the hospital diarrhea due to ulcerative colitis with the
following ABG reading: pH = 7.35; PaO2 = 88; PaCO2 = 33 and HCO3 = 18. The ABG result
would be interpreted as:
a. Fully compensated Metabolic acidosis
b. Fully compensated Respiratory acidosis
c. Partially compensated Metabolic acidosis
d. Partially compensated Respiratory acidosis
3. 68.The nurse Lisa is aware that total parenteral nutrition is a more desirable therapy than
just intravenous fluids for clients with gastrointestinal problems. She understands that the
clients receiving only IV fluids lose weight because:
a. Lack of bulk in the diet
b. Deficient carbohydrate intake
c. Insufficient intake of water soluble vitamins

d. Increasing concentrations of electrolytes

4. 69.For clients with liver cirrhosis and pancreatitis, the nurse should assess for:
a. Hypokalemia and hyponatremia
b. Hyperkalemia and hyponatremia
c. Hypokalemia and hypernatremia
d. Hyperkalemia and hypernatremia
5. 70.The nurse is reviewing the arterial blood gas report for a client with type I diabetes. The
nurse understands that the result that would reflects diabetic ketoacidosis would be:
a. pH: 7.28, PCO2: 28, HCO3: 18
b. pH: 7.30, PCO2: 54, HCO3: 28
c. pH: 7.50, PCO2: 49, HCO3: 32
d. pH: 7.52, PCO2: 26, HCO3: 20

SITUATION: Alyssa, a newly graduate nurse is taking care of patients at the Oncology department.
Her knowledge on principles and care of patients with cancer is vital in this scenario.
1. 71.A male client with pancreatic cancer is aware of the terminal nature of the illness.
Behaviors that would indicate that he is accepting the fact of his impending death are:
a. Alternately crying and talking openly about death
b. Getting second, third, and fourth medical opinions
c. Making out his will and planning a visit to a good friend
d. Refusing to follow treatments and stating, Im going to die anyway.
2. 72.An older adult develops severe bone marrow depression from chemotherapy for cancer of
the colon. The nurse should:
a. Monitor for signs of alopecia
b. Increase daily intake of fluids
c. Monitor intake and output of fluids
d. Use a soft toothbrush for oral hygiene
3. 73.The laboratory results of a client following chemotherapy for cancer of the colon indicate
bone marrow depression. The nurse should encourage the client to:
a. Use an electric razor when shaving
b. Drink citrus juices frequently for nourishment
c. Increase activity levels and ambulate frequently
d. Sleep with the head of the bed slightly elevated
4. 74.A client has an abdomino-perineal resection to remove a cancerous lesion. After this
surgery the nurse should expect the client to have:
a. Temporary colostomy
b. Ileostomy
c. Permanent colostomy with rectal packing
d. Permanent colostomy only
5. 75.After a surgical procedure for Whipples procedure that included the removal of the
stomach, the head of the pancreas, the distal end of the duodenum, and the spleen, the
postoperative manifestation by the client that requires immediate attention by the nurse
should be:
a. Jaundice
b. Indigestion
c. Weight loss
d. Hyperglycemia

SITUATION: Situation: Nursing ethics is an important part of the nursing

profession. As the ethical situation arises, so is the need to have an accurate and
ethical decision making.
1. 76.The purpose of having a nurses code of ethics is:
a. Delineate the scope and areas of nursing practice
b. identify nursing action recommended for specific health care
situations

c. To help the public understand professional conduct

expected of nurses
d. To define the roles and functions of the health care givers, nurses,
clients
2. 77.The principles that govern right and proper conduct of a person
regarding life, biology and the health professionals is referred to as:
a. Morality
b. Religion
c. Values
d. Bioethics
3. 78.The most important nursing responsibility where ethical situations
emerge in patient care is to:
a. Act only when advised that the action is ethically sound
b. Not takes sides, remain neutral and fair
c. Assume that ethical questions are the responsibility of the health
team
d. Be accountable for his or her own actions
4. 79.According to the code of ethics, which of the following is the primary
responsibility of the nurse?
a. Assist towards peaceful death
b. Health is a fundamental right
c. Promotion of health, prevention of illness, alleviation of suffering
and restoration of health
d. Preservation of health at all cost
5. 80.Why is there an ethical dilemma?
a. the choices involved do not appear to be clearly right or wrong
b. a clients legal right co-exist with the nurses professional
obligation
c. decisions has to be made based on societal norms.
d. decisions has to be mad quickly, often under stressful conditions
SITUATION: Knowledge on nursing law can help the nurse protect herself from
law suites and create harmonious relationship with the clientele.
6. 81.Which of the following is a medical example of invasion of privacy?
a. Orally uttering a character attack in the presence of others
b. Writing damaging statement that is read by others
c. Allowing unauthorized persons to observe the client during
care
d. Offering exaggerated negative oopinions about the clients
7. 82.Which of the following is the primary tool of risk management?
a. Incident report
b. Advance directives
c. Living will
d. Medical durable power of attorney
8. 83.Which of the following must the client be informed of when an informed
consent is obtained?
a. The scope of nursing practice
b. The grounds of disciplinary action
c. The identification of legal titles for the nurse
d. The description of the treatment proposed
9. 84.Which of the following is a type of advance directive?
a. Living will
b. Do not resuscitate orders
c. Informed consent
d. Liability insurance

10.85.Which of the following is an argument of deontology, a theory of

ethics?
a. Consequences are the only important consideration
b. Consequences are good if they bring pleasure
c. Duty is equally important
d. The greatest good for the greatest number
SITUATION: The following questions pertain to professional growth and
development of the nurse.
11.86.When a nurse causes an injury to the patient and the injury caused
becomes the proof of the negligent act, the presence of the injury is said
to exemplify the principle of:
a. Force majeure
b. Respondeat superior
c. Res ipsa loquitur
d. Holdover doctrine
12.87.Ensuring that there is an informed consent on the part of the patient
before a surgery is done, illustrates the bioethical principle of:
a. Beneficence
b. Autonomy
c. Truth telling/veracity
d. Non-maleficence
13. 88.When there is a conflict in the care of patients, which of the following must Genevieve
use to guide her action?
a. Patients rights
b. Decision of the relatives
c. Judgment of the attending physician
d. Court ruling
14. 89.One of her patients is terminally-ill with colon cancer. The patients relatives signified
their intention to stop the nasogastric tube feeding of the patient. Which of the following
responses of Genevieve is ethical?
a. You have to sign a waiver of responsibility
b. The patient needs nasogastric tube feeding even if he is dying
c. I suggest that you consult first your physician on this matter
d. I agree with you that will just prolong the agony of the patient
15. 90. She works with a senior staff that is perceived to be bad-tempered and dislikes
teaching newcomers. Which of the following actions of Genevieve is inappropriate?
a. Refrain from making comments on the conduct of the senior staff
b. Discuss the behavior of the staff with the other staff of the unit.
c. Safeguard the reputation and dignity of the senior staff.
d. Refrain from doing anything that will discredit the senior staff
GENERAL QUESTIONS:
91. After Billroth operation for peptic ulcer disease, gastric emptying is a problem to be
addressed. The nurse should be mindful of what common complications?
a. Dumping syndrome
b. Disequilibrium syndrome
c. Hypocalcemic tetany
d. Dawn and somogyi syndrome
92. After thyroidectomy, there might be incidental removal of parathyroid gland, the nurse
should prepare to counteract what complications?
a. Thyrotoxicosis
b. Diabetes insipidus
c. Hypocalcemic tetany
d. Hypertensive crisis
93. In liver cirrhosis, bleeding esophageal varices is expected by the nurse, she should be
mindful to prepare a tamponade with the availability of what tube?
a. Levine tubing
b. Salem Sump

c. Sengstaken Blakemore tube

d. Jackson Pratt drain

94. If hypocalcemic tetany is evident by Chvosteks sign and Trousseaus

sign, the nurse should prepare what emergency set at the bedside?
1. Cut down set
2. Tracheostomy set
3. Tourniquet
4. Epinephrine
5. Calcium gluconate
a. all except 3

c. all except 1 and 2

b. all except 4

d.

2 and 5 only

95. The first line of therapy for juvenile onset diabetes mellitus will be?
a. Insulin

b. OHA

c. Diet

d. All of the

above

96. In mixing insulin in one syringe, which of the following is correct?

a. withdraw from long acting first then withdraw from short acting vial
b. inject air to short acting vial, then inject air to long acting vial and
withdraw, then withdraw from short acting vial
c. inject air to long acting vial, then inject air to short acting
and withdraw then withdraw from long acting vial
d. any order, it does not matter

97. Which of the following drug classifications and actions matches

correctly?
a. Omeprazole - H2blockers
b. Misoprostol ( Cytotec) - Antacids
c. Neomycin Sulfate- Oral Hypoglycemic drug
d. Propylthiuracil- Anti- thyroid drug

98. Which of the following diagnostic tests is incorrectly paired?

a. ERCP- for pancreatitis and choledocholithiasis
b. T3, T4, TSH- for thyroid problems
c. Colonoscopy- for peptic ulcer disease
d. FBS- for diabetes mellitus

99. Which of the following clinical marker is correctly paired?

a. serum acid phosphatase- pancreatitis
b. Glycosylated haemoglobin- Liver cirrhosis
c. Carcino embryonic antigen (CEA)- colon cancer
d. T3,T4, TSH- diabetes mellitus

100. Which of the following clinical manifestations is/are correctly indicated?

1. jaundice- cholecystitis
2. ascites- liver cirrhosis
3. polydipsia- diabetes mellitus
4. ribbon like stool- colon cancer
5. tremors- ulcerative colitis
6. weight gain- hyperthyroidism
a. 1, 2, 3, 4
b. 1,2, 3, 4, 5

c. 1, 2, 3, 4, 6
d. 1,2,3,5,6

X-----------------------------------------------END of
EXAMINATIONS-------------------------------------------X

Life is a destiny, however, it is not a matter

of chance but a matter of choice............
( Anonymous)