MS 1 PERIOPERATIVE

1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there
is a need for sterile supply which is not in the sterile field, who hands out these items by
opening its outer cover?

a. Circulating nurse
b. Anesthesiologist
c. Surgeon
d. Nursing aide

2. The OR team performs distinct roles for one surgical procedure to be accomplished within a
prescribed time frame and deliver a standard patient outcome. While the surgeon performs the
surgical procedure, who monitors the status of the client like urine output, blood loss?

a. Scrub nurse
b. Surgeon
c. Anesthesiologist
d. Circulating nurse

3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the
nurse of the floor or ward where the patient is confined. For orthopedic cases, what
department is usually informed to be present in the OR?

a. Rehabilitation department
b. Laboratory department
c. Maintenance department
d. Radiology department

4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team
who else to be present when a client undergoes laparoscopic surgery?

a. Information technician
b. Biomedical technician
c. Electrician
d. Laboratory technician

5. In massive blood loss, prompt replacement of compatible blood is crucial. What department
needs to be alerted to coordinate closely with the patient’s family for immediate blood
component therapy?
a. Security Division
b. Chaplaincy
c. Social Service Section
d. Pathology department

Situation 2 – You are assigned in the Orthopedic Ward where clients are complaining of pain in
varying degrees upon movement of body parts.

6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is
in pain. Which of the following observation would prompt you to call the doctor?

a. Dressing is intact but partially soiled

b. Left foot is cold to touch and pedal pulse is absent
c. Left leg in limited functional anatomic position
d. BP 114/78, pulse of 82 beats/minute

7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You

injected Demerol at 5 pm. The next dose of Demerol 50 mg I.M. is given:

a. When the client asks for the next dose

b. When the patient is in severe pain
c. At 11pm
d. At 12pm

8. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors-
indicate appropriate adaptation?

a. The client reports pain reduction and decreased activity

b. The client denies existence of pain
c. The client can distract himself during pain episodes
d. The client reports independence from watchers

9. Pain in Ortho cases may not be mainly due to the surgery. There might be other factors such
as cultural or psychological that influence pain. How can you alter these factors as the nurse?

a. Explain all the possible interventions that may cause the client to worry.
b. Establish trusting relationship by giving his medication on time
c. Stay with the client during pain episodes
d. Promote client’s sense of control and participation in pain control by listening to his
concerns
10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is
your nursing priority care in such a case?

a. Instruct client to observe strict bed rest

b. Check for epidural catheter drainage
c. Administer analgesia through epidural catheter as prescribed
d. Assess respiratory rate carefully

Situation 3 – Records are vital tools in any institution and should be properly maintained for
specific use and time.

11. The patient’s medical record can work as a double-edged swords. When can the medical
record become the doctor’s/nurse worst enemy?

a. When the record is voluminous

b. When a medical record is subpoenaed in court
c. When it is missing
d. When the medical record is inaccurate, incomplete, and inadequate

12. Disposal of medical records in government hospitals/institutions must be done in close

coordination with what agency?

a. Department of Interior and Local Government (DILG)

b. Metro Manila Development Authority (MMDA)
c. Records Management Archives Office (RMAO)
d. Depart of Health (DOH)

13. In the hospital, when you need-the medical record of a discharged patient for research, you
will request permission through:

a. Doctor in charge
b. The hospital director
c. The nursing Service
d. Medical records section

14. You readmitted a client who was in another department a month ago. Since you will need
the previous chart, from whom do you request the old chart?

a. Central supply section

b. Previous doctor’s clinic
c. Department where the patient was previously admitted
d. Medical records section

15. Records Management and Archives Offices of the DOH is responsible for implementing its
policies on record, disposal. You know that your institution is covered by this policy it;

a. Your hospital is considered tertiary

b. Your hospital is in Metro Manila
c. It obtained permit to operate from DOH
d. Your hospital is Philhealth accredited

Situation 4 – In the OR, there are safety protocols that should be followed. The OR nurse should
be well versed with all these to safeguard the safety and quality to patient deliveryoutcome.

16. Which of the following should be given highest priority when receiving patient in the OR?

a. Assess level of consciousness

b. Verify patient identification and informed consent
c. Assess vital signs
d. Check for jewelry, gown, manicure and dentures

17. Surgeries like I and D (incision and drainage) and debridement are relatively short
procedures but considered ‘dirty cases’. When are these; procedures best scheduled?

a. Last case
b. In between cases
c. According to availability of anesthesiologist
d. According to the surgeon’s preference

18. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing
care during the intraoperative phase. As the circulating nurse, you make certain that
throughout the procedure…

a. the surgeon greets his client before induction of anesthesia

b. the surgeon and anesthesiologist are in tandem
c. strap made of strong non-abrasive material are fastened securely around the joints of the
knees and ankles and around the 2 hands around an arm board
d. client is monitored throughout the surgery by the assistant anesthesiologist
19. Another nursing check that should not be missed before the induction of general anesthesia
is:

a. check for presence underwear

b. check for presence dentures
c. check patient’s blood studies
d. check baseline vital signs

20. Some different habits and hobbies affect postoperative respiratory function. If your client
smokes 3 packs of cigarettes a day for the part 10 years, you will anticipate increased risk for:

a. perioperative anxiety and stress

b. delayed coagulation time
c. delayed wound healing
d. postoperative respiratory dysfunction

Situation 5 – Nurses hold a variety of roles when providing care to a perioperative patient.

21. Which of the following role would be the responsibility of the scrub nurse?

a. Assess the readiness of the client prior to surgery

b. Ensure that the airway is adequate
c. Account for the number of sponges, needles, supplies, Used during the surgical procedure
d. Evaluate the type of anesthesia appropriate for the surgical client

22. As a perioperative nurse, how can you best meet the safety need of the client after
administering preoperative narcotic?

a. Put side rails up and ask client not to get out of bed
b. Send the client to ORD with the family
c. Allow client to get up to go to the comfort room
d. Obtain consent form

23. It is the responsibility of the pre-op, nurse to do skin prep for patients undergoing surgery.
If hair at the operative site is not shaved, what should be done to make suturing easy and
lessen chance of incision infection?

a. Draped
b. Pulled
c. Clipped
d. Shampooed

24. It is also the nurse’s function to determine when infection is developing in the surgical
incision. The perioperative nurse should observe for what signs of impending infection?

a. Localized heat and redness

b. Serosanguinous exudates and skin blanching
c. Separation of the incision
d. Blood clots and scar tissue are visible

25. Which of the following nursing intervention is done when examining the incision wound and
changing the dressing?

a. Observe the dressing and type and odor of drainage if any

b. Get patient’s consent
c. Wash hands
d. Request the client to expose the incision wound

Situation 6 – Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min and
he appears to be in acute respiratory distress.

26. Which of the following nursing actions should be initiated first?

a. Promote emotional support

b. Administer oxygen at 6L/min
c. Suction the client every 30 min
d. Administer bronchodilator by nebulizer

27. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse, what
its indication the nurse will say is:

a. Relax smooth muscles of the bronchial airway

b. Promote expectoration
c. Prevent thickening of secretions
d. Suppress cough

28. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction
will include the following EXCEPT:
a. Avoid emotional stress and extreme temperature
b. Avoid pollution like smoking
c. Avoid pollens, dust seafood
d. Practice respiratory isolation

29. The asthmatic client asked you what breathing technique he can best practice when
asthmatic attack starts. What will be the best position?

a. Sit in high-Fowler’s position with extended legs

b. Sit-up with shoulders back
c. Push on abdomen during exhalation
d. Lean forward 30-40 degrees with each exhalation

30. As a nurse you are always alerted to monitor status asthmaticus who will likely and initially
manifest symptoms of:

a. metabolic alkalosis
b. respiratory acidosis
c. respiratory alkalosis
d. metabolic acidosis

Situation 7 – Joint Commission on Accreditation of Hospital Organization (JCAHO) patient safety

goals and requirements include the care and efficient use of technology in the OR arid
elsewhere in the healthcare facility.

31. 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

32. Over dosage of medication or anesthetic can happen even with the aid of technology like
infusion pump, sphygmomanometer, 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
33. JCAHO’s 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

34. You identified a potential risk of pre and postoperative 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 the following EXCEPT: medication
regimen
b. Take action to address any identified risks through Incident Report (IR)
c. Allow client to walk with relative to the OF?
d. Assess and periodically reassess individual client’s risk for falling

35. 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 8 – Team efforts is best demonstrated in the OR

36. If you are the nurse in charge for scheduling surgical cases, what important information do
you need to ask the surgeon?

a. Who is your internist

b. Who is your assistant and anesthesiologist, and what is your preferred time and type of
surgery?
c. Who are your anesthesiologist, internist, and assistant
d. Who is your anesthesiologist.

37. In the OR, the nursing tandem for every surgery is:

a. Instrument technician and circulating nurse

b. Nurse anesthetist, nurse assistant, and instrument technician
c. Scrub nurse and nurse anesthetist
d. Scrub and circulating nurses

38. While team effort is needed in the OR for efficient and quality patient care delivery, we
should limit the number of people in the room for infection control. Who comprise this team?

a. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly

b. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
c. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
d. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

39. When surgery is on-going, who coordinates the activities outside, including the family?

a. Orderly/clerk
b. Nurse supervisor
c. Circulating nurse
d. Anesthesiologist

40. The breakdown in teamwork is often times a failure in:

a. Electricity
b. Inadequate supply
c. Leg work
d. Communication

Situation 9 – Colostomy is a surgically created anus- It can be temporary or permanent,

depending on the disease condition.

41. Skin care around the stoma is critical. Which of the following is not indicated as a skin care
barriers?
a. Apply liberal amount of mineral oil to the area
b. Use karaya paste and rings around the stoma
c. Clean the area daily with soap and water before applying bag
d. Apply talcum powder twice a day

42. What health instruction will enhance regulation of a colostomy (defecation) of clients?

a. Irrigate after lunch everyday

b. Eat fruits and vegetables in all three meals
c. Eat balanced meals at regular intervals
d. Restrict exercise to walking only

43. After ileostomy, which of the following condition is NOT expected?

a. increased weight
b. Irritation of skin around the stoma
c. Liquid stool
d. Establishment of regular bowel movement

44. The following are appropriate nursing interventions during colostomy irrigation EXCEPT:

a. Increase the irrigating solution flow rate when abdominal cramps is felt
b. Insert 2-4 inches of an adequately lubricated catheter to the stoma
c. Position client in semi-Fowler
d. Hand the solution 18 inches above the stoma

45. What sensation is used as a gauge so that patients with ileostomy can determine how often
their pouch should be drained?

a. Sensation of taste
b. Sensation of pressure
c. Sensation of smell
d. Urge to defecate

Situation 11 -After an abdominal surgery, the circulating and scrub nurses have critical
responsibility about sponge and Instrument count.

51. When is the first sponge/instrument count reported?

a. Before closing the subcutaneous layer

b. Before peritoneum is closed
c. Before dosing the skin
d. Before the fascia is sutured

52. What major supportive layer of the abdominal wall must be sutured with long tensile
strength such as cotton or nylon or silk suture?

a. Fascia
b. Muscle
c. Peritoneum
d. Skin

53. Like sutures, needles also vary in shape and uses. If you are the scrub nurse for a patient
who is prone to keloid formation and has a low threshold of pain, what needle would you
prepare?

a. Round needle
b. A traumatic needle
c. Reverse cutting needle
d. Tapered needle

54. Another alternative “suture” for skin closure is the use of:

a. Staple
b. Therapeutic glue
c. Absorbent dressing
d. invisible suture

55. Like any nursing interventions, counts should be documented. To whom does the scrub
nurse report any discrepancy of country so that immediate ‘and appropriate action in
instituted?

a. Anesthesiologist
b. Surgeon
c. Or nurse supervisor
d. Circulating nurse

Situation 12 – As a nurse, you should be aware and prepared of the different roles you play.

56. What role do you play, when you hold all clients’ information entrusted to you in the
strictest confidence?

a. Patient’s advocate
b. Educator
c. Patient’s Liaison
d. Patient’s arbiter

57. As a nurse, you can help improve the effectiveness of communication among healthcare
givers
a. Use of reminders of what to do
b. Using standardized list of abbreviations, acronyms, and symbols
c. One-on-one oral endorsement
d. Text messaging and e-mail

58. As a nurse, your primary focus in the workplace is the client’s safety. However, personal
safety is also a concern. You can communicate hazards to your co-workers through the use of
the following EXCEPT:

a. Formal training
b. Posters
c. Posting IR in the bulletin board
d. Use of labels and signs

59. As a nurse, what is one of the best way to reconcile medications across the continuum of
care?

a. Endorse on a case-to-case basis

b. Communication a complete list of the patient’s medication to the next provider of service
c. Endorse in writing
d. Endorse the routine and ‘stat’ medications every shift

60. As a nurse, you protect yourself and co-workers from misinformation and
misrepresentations through the following EXCEPT:

a. Provide information to clients about a variety of services that can help alleviate the client’s
pain and other conditions
b. Advising the client, by virtue of your expertise, that which can contribute to the client’s well-
being
c. Health education among clients and significant others regarding the use of chemical
disinfectant
d. Endorsement thru trimedia to advertise your favorite disinfectant solution

61. A one-day postoperative abdominal surgery client has been complaining of severe
throbbing abdominal pain described as 9 in a 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 and turning
d. Call surgeon stat

62. Pentoxicodone 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 .

63. The client complained of abdominal and pain. Your nursing intervention that can alleviate
pain is:

a. Instruct client to go to sleep and relax

b. Advise 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

64. Surgical pain might be minimized by which nursing action in the OR:

a. Skill of surgical team and lesser manipulation

b. Appropriate preparation For the scheduled procedure
c. Use of modem technology in closing the wound
d. Proper positioning and draping of clients

65. One very common cause of postoperative pain is:

a. Forceful traction during surgery

b. Prolonged surgery
c. Break in aseptic technique
d. Inadequate anesthetic

Situation 14 – You were on duty at the medical ward when Zeny came in for admission for
tiredness, cold intolerance, constipation, and weight gain. Upon examination, the doctor’s
diagnosis was hypothyroidism.

66. Your independent nursing care for hypothyroidism includes:

a. administer sedative round the clock
b. administer thyroid hormone replacement
c. providing a cool, quiet, and comfortable environment
d. encourage to drink 6-8 glasses of water

67. As the nurse, you should anticipate to administer which of the following medications to
Zeny who is diagnosed to be suffering from hypothyroidism?

a. Levothyroxine
b. Lidocaine
c. Lipitor
d. Levophed

68. Your appropriate nursing diagnosis for Zeny who is suffering from hypothyroidism would
probably include which of the following?

a. Activity intolerance related to tiredness associated with disorder

b. Risk to injury related to incomplete eyelid closure
c. Imbalance nutrition related to hypermetabolism
d. Deficient fluid volume related to diarrhea

69. Myxedema coma is a life threatening complication of long standing and

untreated hypothyroidism with one of the following characteristics.

a. Hyperglycemia
b. hypothermia
c. hyperthermia
d. hypoglycemia

70. As a nurse, you know that the most common type of goiter is related to a deficiency

a. thyroxine
b. thyrotropin
c. iron
d. iodine

Situation 15 – Mrs. Pichay is admitted to your ward. The MD ordered “Prepared for
thoracentesis this pm to remove excess air from the pleural cavity.”
71. Which of the following nursing responsibility 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

72. Mrs. Pichay, who is for thoracentesis, is assisted by the nurse to any of the following
positions, EXCEPT:

a. straddling a chair with arms and head resting on the back of the chair
b. lying on the unaffected side with the bed elevated 30-40 degrees
c. lying prone with the head of the bed lowered 15-30 degrees
d. sitting on the edge of the bed with her feet supported and arms and head on a padded
overhead table

73. 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. Advise 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

74. To prevent leakage of fluid in the thoracic cavity, how wilt 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

75. Chest x-ray was ordered after thoracentesis. When you 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 16 – In the hospital, you are aware that we are helped by the .use of a variety of
equipment/devices to enhance quality patient care delivery;

76. You are initiate an IV line to your patient, Kyle, 5, who is febrile. What IV administration set
will you prepare?

a. Blood transfusion set

b. Macroset
c. Volumetric chamber
d. Microset

77. Kyle is diagnosed to have measles. What will your protective personal attire include?

a. Gown
b. Eyewear
c. Face mask
d. Gloves

78. What will you do to ensure that Kyle, who is febrile, will have a liberal oral fluid intake?

a. Provide a glass of fruit every meal

b. Regulate his IV to 30 drops per minute
c. Provide a calibrated pitcher of drinking water and juice at the bedside and monitor intake
and output
d. Provide a writing pad to record his intake

79. Before bedtime, you want to ensure Kyle’s safety in ‘bed. You will do which of the following:

a. Put the lights on

b. Put the side rails up
c. Test the call system
d. Lock the doors

80. Kyle’s room is fully mechanized. What do you teach the watcher and Kyle to alert the nurse
for help?

a. How to lock side rails

b. Number of the telephone operator
c. Call system
d. Remote control
Situation 17 – Tony, 11 years old, has ‘kissing tonsils’ and is scheduled for tonsillectomy and
adenoidectomy or T and A.

81. You are the nurse of Tony who will undergo T and A in the morning. His mother asked you if
Tony will be put to sleep. Your teaching will focus on:

a. spinal anesthesia
b. anesthesiologist’s preference
c. local anesthesia
d. general anesthesia

82. Mothers of children undergoing tonsillectomy and adenoidectomy usually ask what food
prepared and give their children after surgery. You as the nurse will say:

a. balanced diet when fully awake

b. hot soup when awake
c. ice cream when fully awake
d. soft diet when fully awake

83. The RR nurse should monitor for the most common postoperative complication of:

a. hemorrhage
b. endotracheal tube perforation
c. esopharyngeal edema
d. epiglottis

84. The PACU nurse will maintain postoperative T and A client in what position?

a. Supine with neck hyperextended and supported with pillow

b. Prone with the head on pillow and tuned to the side
c. Semi-Fowler’s with neck flexed
d. Reverse trendelenburg with extended neck

85. Tony is to be discharged in the afternoon of the same day after tonsillectomy and
adenoidectomy. You as the RN will make sure that the family knows to:

a. offer osterized feeding

b. offer soft foods for a week to minimize discomfort while swallowing
c. supplement his diet with vitamin C rich juices to enhance heating
d. offer clear liquid for 3 days to prevent irritation
Situation 18 – Rudy was diagnosed to have chronic renal failure. Hemodialysis is ordered that
an A-V shunt was surgically created.

86. Which of the following action would be of highest priority with regards to the external
shunt?

a. Avoid taking BP or blood sample from the arm with shunt

b. Instruct the client not to exercise the arm with the shunt
c. Heparinize the shunt daily
d. Change dressing of the shunt daily

87. Diet therapy for Rudy, who has acute renal failure, is tow-protein,
low potassium and sodium. The nutrition instruction should include:

a. Recommend protein of high biologic value like eggs, poultry and lean meat
b. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
c. Allowing the client cheese, canned foods, and other processed food
d. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet

88. Rudy undergoes hemodialysis for the first time and was scared of disequilibrium
syndrome. He asked you how this can be prevented. Your response is:

a. maintain a conducive comfortable and cool environment

b. maintain fluid and electrolyte balance
c. initial hemodialysis shall be done for 30 minutes only so as not to rapidly remove
the waste from the blood than from the brain
d. maintain aseptic technique throughout the hemodialysis

89. You are assisted by a nursing aide with the care of the client with renal failure. Which
delegated function to the aide would you particularly check?

a. Monitoring and recording I and O

b. Checking bowel movement
c. Obtaining vital signs
d. Monitoring diet

90. A renal failure patient was ordered for creatinine clearance. As the nurse you will
collect

a. 48 hour urine specimen

b. first morning urine
c. 24 hour urine specimen
d. random urine specimen

Situation 19 – Fe is experiencing left sharp pain and occasional hematuria. She was advised
to undergo IVP by her physician.

91. Fe was so anxious about the procedure and particularly expressed her low pain
threshold. Nursing health instruction will include:

a. assure the client that the pain is associated with the warm sensation during the
administration of the Hypaque by IV
b. assure the client that the procedure painless
c. assure the client that contrast medium will be given orally
d. assure the client that x-ray procedure like IVP is only done by experts

92. What will the nurse monitor and instruct the client and significant others, post IVP?

a. Report signs and symptoms for delayed allergic reactions

b. Observe NPO for 6 hours
c. Increase fluid intake
d. Monitor intake and output

93. Post IVP, Fe should excrete the contrast medium. You instructed the family to include
more vegetables in the diet and

a. increase fluid intake

b. barium enema
c. cleansing enema
d. gastric lavage

94. The IVP reveals that Fe has small renal calculus that can be passed out spontaneously.
To increase the chance of passing the stones, you instructed her to force fluids and do
which of the following?

a. Balanced diet
b. Ambulance more
c. Strain all urine
d. Bed rest

95. The presence of calculi in the urinary tract is called:

a. Colelithiasis
b. Nephrolithiasis
c. Ureterolithiasis
d. Urolithiasis

Situation 20 – At the medical-surgical ward, the nurse must also be concerned about drug
interactions.

96. You have a client with TPN. You know that in TPN, like blood transfusion, there should
be no drug incorporation. However, the MD’s order read; incorporate insulin to present
TPN. Will you follow the order?

a. No, because insulin will induce hyperglycemia in patients with TPN

b. Yes, because insulin is chemically stable with TPN and can enhance
blood glucose level
c. No, because insulin is not compatible with TPN
d. Yes, because it was ordered by the MD

97. The RN should also know that some drugs have increased absorption when infused in
PVC container. How will you administer drugs such as insulin, nitroglycerine hydralazine to
promote better therapeutic drug effects?

a. Administer by fast drip

b. Inject the drugs as close to the IV injection site
c. Incorporate to the IV solution
d. Use volumetric chamber

98. One patient has a ‘runaway’ IV of 50% dextrose. To prevent temporary excess of insulin
transient hyperinsulin reaction, what solution should you prepare in anticipation of the
doctors order?

a. Any IV solution available to KVO

b. Isotonic solution
c. Hypertonic solution
d. Hypotonic solution

99. How can nurse prevent drug interaction including absorption?

a. Always flush with NSS after IV administration

b. Administering drugs with more diluents
c. Improving on preparation techniques
d. Referring to manufacturer’s guidelines
100. In insulin administration, it should be understood that our body normally releases
insulin according to our blood glucose level. When is insulin and glucoselevel highest?

a. After excitement
b. After a good night’s rest
c. After an exercise
d. After ingestion of food

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. Investigation of contact
B. Sanitary disposal of feces, urine and blood
C. Quarantine of the sick individual
D. Remove all detachable objects in the room.

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 Acases. 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

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 postoperative 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. Pentoxide 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 by 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 Jane Segovia, a 30 years
old Dentist with Insulin dependent diabetes Mellitus.

36. Jane 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. Jane 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. Jane 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. Jane 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. Heavy breathing
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

Situation 10 – In the OR, there are safety protocols that should be followed. The OR nurse
should be well versed with all these to safeguard the safety and quality of
patient deliveryoutcome.

51. Which of the following should be given highest priority when receiving patient in the
OR?

A. Assess level of consciousness

B. Verify patient identification and informed consent
C. Assess vital signs
D. Check for jewelry, gown, manicure, and dentures

52. Surgeries like I and D (incision and drainage) and debridement are relatively short
procedures but considered ‘dirty cases’. When are these procedures best scheduled?
A. Last case
B. In between cases
C. According to availability of anaesthesiologist
D. According to the surgeon’s preference

53. OR nurses should be aware that maintaining the client’s safety is the overall goal of
nursing care during the intraoperative phase. As the circulating nurse, you make certain
that throughout the procedure:

A. the surgeon greets his client before induction of anesthesia

B. the surgeon and anesthesiologist are in tandem
C. strap made of strong non-abrasive materials are fastened securely around the joints of
the knees and ankles and around the 2 hands around an arm board.
D. Client is monitored throughout the surgery by the assistant anaesthesiologist

54. Another nursing check that should not be missed before the induction of
general anesthesia is:

A. check for presence underwear

B. check for presence dentures
C. check patient’s ID
D. check baseline vital signs

55. Some lifetime habits and hobbies affect postoperative respiratory function. If your
client smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate increased
risk for:

A. perioperative anxiety and stress

B. delayed coagulation time
C. delayed wound healing
D. postoperative respiratory function

Situation 11: Sterilization is the process of removing ALL living microorganism. To be free
of ALL living microorganism is sterility.

56. There are 3 general types of sterilization use in the hospital which one is not included?

A. Steam sterilization
B. Chemical sterilization
C. Autoclaving
D. Sterilization by boiling
57. Autoclave or steam steam under pressure is the most common method of sterilization
in the hospital. The nurse knows that the temperature and time is set to the optimum level
to destroy not only the microorganism, but also the spores. Which of the following is the
ideal setting of the autoclave machine?

A. 10,000 degree Celsius for 1 hour

B. 5,000 degree Celsius for 30 minutes
C. 37 degree Celsius for 15 minutes
D. 121 degree Celsius for 15 minutes

58. It is important that before a nurse prepares the material to be sterilized. A chemical
indicator strip should be placed above the package, preferably, Muslin sheet. What is the
color of the striped produced after autoclaving?

A. Black
B. Blue
C. Gray
D. Purple

59. Chemical indicators communicate that:

A. The items are sterile

B. That the items had undergone sterilization process but not necessarily sterile
C. The items are disinfected
D. That the items had undergone disinfection process but not necessarily disinfected

60. If a nurse will sterilize a heat and moisture labile instruments, it is according to AORN
recommendation to use which of the following method of sterilization?

A. Ethylene oxide gas

B. Autoclaving
C. Flash sterilizer
D. Alcohol immersion

Situation 12 – Nurses hold a variety of roles when providing care to a perioperative patient.

61. Which of the following role would be the responsibility of the scrub nurse?

A. Assess the readiness of the client prior to surgery

B. Ensure that the airway is adequate
C. Account for the number of sponges, needles, supplies, used during the surgical
procedure.
D. Evaluate the type of anesthesia appropriate for the surgical client

62. As a perioperative nurse, how can you best meet the safety need of the client after
administering preoperative narcotic?

A. Put side rails up and ask the client not to get out of bed
B. Send the client to OR with the family
C. Allow client to get up to go to the comfort room
D. Obtain consent form

63. It is the responsibility of the pre-op nurse to do skin prep for patients
undergoing surgery. If hair at the operative site is not shaved, what should be done to make
suturing easy and lessen chance of incision infection?

A. Draped
B. Pulled
C. Clipped
D. Shampooed

64. It is also the nurse’s function to determine when infection is developing in the surgical
incision. The perioperative nurse should observe for what signs of impending infection?

A. Localized heat and redness

B. Serosanguinous exudates and skin blanching
C. Separation of the incision
D. Blood clots and scar tissue are visible

65. Which of the following nursing interventions is done when examining the incision
wound and changing the dressing?

A. Observe the dressing and type and odor of drainage if any

B. Get patient’s consent
C. Wash hands
D. Request the client to expose the incision wound

Situation 13: The preoperative nurse collaborates with the client significant others, and
healthcare providers.

66. To control environmental hazards in the OR, the nurse collaborates with the following
departments EXCEPT:
A. Biomedical division
B. Chaplaincy services
C. Infection control committee
D. Pathology department

67. An air crash occurred near the hospital leading to a surge of trauma patient. One of the
last patients will need surgical amputation but there are no sterile surgical equipments. In
this case, which of the following will the nurse expect?

A. Equipments needed for surgery need not be sterilized if this is an emergency

necessitating life saving measures
B. Forwarding the trauma client to the nearest hospital that has available sterile equipment
is appropriate
C. The nurse will need to sterilize the item before using it to the client using the regular
sterilization setting at 121 degree Celsius in 15 minutes.
D. In such cases, flash sterilizer will be use at 132 degree Celsius in 3 minutes.

68. Tess, the PACU nurse discovered that Malou, who weighs 110 lbs prior to surgery, is in
severe pain 8 hours after cholecystectomy. Upon checking the chart, Malou found out that
she has an order of Demerol 100 mg I.M. prn for pain. Tess should verify the order with:

A. Nurse supervisor
B. Anesthesiologist
C. Surgeon
D. Intern on duty

69. Rosie, 57, who is diabetic is for debridement if incision wound. When the circulating
nurse checked the present IV fluid, she found out that there is no insulin incorporated as
ordered. What should the circulating nurse do?

A. Double check the doctor’s order and call the attending MD

B. Communicate with the ward nurse to verify if insulin was incorporated or not
C. Communicate with the client to verify if insulin was incorporated
D. Incorporate insulin as ordered

70. The documentation of all nursing activities performed is legally and professionally vital.
Which of the following should NOT be included in the patients chart?

A. Presence of prosthetic devices such as dentures, artificial limbs hearing aid, etc.
B. Baseline physical, emotional, and psychosocial data
C. Arguments between nurses and residents regarding treatment
D. Observed untoward signs and symptoms and interventions including contaminant
intervening factors.

Situation 14 – Team efforts is best demonstrated in the OR.

71. If you are the nurse in charge for scheduling surgical cases, what important information
do you need to ask the surgeon?

A. Who is your internist?

B. Who is your assistant and anesthesiologist, and what is your preferred time and type
of surgery?
C. Who are your anesthesiologist, internist, and assistant?
D. Who is your anesthesiologist?

72. In the OR, the nursing tandem for every surgery is:

A. Instrument technician and circulating nurse

B. Nurse anesthetist, nurse assistant, and instrument technician
C. Scrub nurse and nurse anesthetist
D. Scrub and circulating nurses

73. While team effort is needed in the OR for efficient and quality patient care delivery, we
should limit the number of people in the room for infection control. Who comprise this
team?

A. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly

B. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
C. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
D. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

74. Who usually act as an important part of the OR personnel by getting the wheelchair or
stretcher, and pushing/pulling them towards the operating room?

A. Orderly/clerk
B. Nurse Supervisor
C. Circulating Nurse
D. Anesthesiologist

75. The breakdown in teamwork is often times a failure in:

A. Electricity
B. Inadequate supply
C. Leg work
D. Communication

Situation 15: Basic knowledge on Intravenous solutions is necessary for care of clients with
problems with fluids and electrolytes.

76. A client involved in a motor vehicle crash presents to the emergency department with
severe internal bleeding. The client is severely hypotensive and unresponsive. The nurse
anticipates which of the following intravenous solutions will most likely be prescribed to
increase intravascular volume, replace immediate blood loss and increase blood pressure?

A. 0.45 % sodium chloride

B. Normal saline solution
C. o.33% sodium chloride
D. Lactated ringer’s solution

77. The physician orders the nurse to prepare an isotonic solution. Which of the following
IV solution would the nurse expect the intern to prescribe?

A. 5 % dextrose in water
B. 10 % dextrose in water
C. 0.45 % sodium chloride
D. 0.5 % dextrose in 0.9% sodium chloride

78. The nurse is making initial rounds on the nursing unit to assess the condition or
assigned clients. The nurse notes that the client’s IV site is cool, pale and swollen and the
solution is not infusing. The nurse concludes that which of the following complications has
been experienced by the client?

A. Infection
B. Phlebitis
C. Infiltration
D. Thrombophlebitis

79. A nurse reviews the client’s electrolytes laboratory report and notes that
the potassium level is 3.2 mEq/L. Which of the following would the nurse note on the
electrocardiogram as a result of the laboratory value?

A. U waves
B. P waves
C. Elevated T waves
D. Elevated ST segment

80. One patient has a runaway IV of 50 % dextrose. To prevent temporary excess of insulin
or transient hyperinsulin reaction what solution you prepare in anticipation of the doctor’s
order?

A. Any IV solution available to KVO

B. Isotonic solution
C. Hypertonic solution
D. Hypotonic solution

81. An informed consent is required for:

A. Closed reduction of a fracture

B. Insertion of intravenous catheter
C. Irrigation of the external ear canal
D. Urethral catheterization

82. Which of the following is not true with regards to the informed consent?

A. It should describe different treatment alternatives

B. It should contain a thorough and detailed explanation of the procedure to be done
C. It should describe the client’s diagnosis
D. It should given an explanation of the client’s prognosis

83. You know that the hallmark of nursing accountability is the:

A. Accurate documentation and reporting

B. Admitting your mistakes
C. Filing an incidence report
D. Reporting a medication error

84. A nurse is assigned to care for a group of clients. On review of the client’s medical
records the nurse determines that which client is at risk for excess fluid volume?

A. The client taking diuretics

B. The client with renal failure
C. The client with an ileostomy
D. The client who requires gastrointestinal suctioning
85. A nurse is assigned to care for a group of clients. On review of the client’s medical
records, the nurse determines that which client is at risk for deficient fluid volume?

A. A client with colostomy

B. A client with congestive heart failure
C. A client with decreased kidney function
D. A client receiving frequent wound irrigation

Situation 16: As a perioperative nurse, you are aware of the correct processing methods for
preparing instruments and other devices for patient use to prevent infection.

86. As an OR nurse, what are your foremost considerations for selecting chemical agents
for disinfection?

A. Material compatibility and efficiency

B. Odor and availability/
C. Cost and duration of disinfection process
D. Duration of disinfection and efficiency

87. Before you used disinfected instrument it is essential that you:

A. Rinse with tap water followed by alcohol

B. Wipe the instrument with sterile water
C. Dry the instrument thoroughly
D. Rinse with sterile water

88. You have a critical heat labile instrument to sterilize and are considering to use high
level of disinfectant. What should you do?

A. Cover the soaking vessel to contain the vapour

B. Double the amount of high level of disinfectant
C. Test the potency of the high level of disinfectant
D. Prolong the exposure time according to manufacturer’s direction

89. To achieve sterilization using disinfectants, which of the following is used?

A. Low level disinfectants immersion in 24 hours

B. Intermediate level disinfectants immersion in 12 hours
C. High level disinfectants immersion in 1 hour
D. High level disinfectants immersion in 10 hours
90. Bronchoscope, Thermometer, Endoscope, ET tube, Cystoscope are all BEST sterilized
using which of the following?

A. Autoclaving at 121 degree Celsius in 15 minutes

B. Flash sterilizer at 132 degree Celsius in 3 minutes
C. Ethylene Oxide gas aeration for 20 hours
D. 2% Glutaraldehyde immersion for 10 hours

Situation 17: The OR is divided in three zones to control traffic flow and contamination.

91. What OR attires are worn in the restricted area?

A. Scrub suit, OR shoes, head cap

B. Head cap scrub suit, mask, OR shoes
C. Mask, OR shoes, scrub suit
D. Cap, Mask, gloves, shoes

92. Nursing intervention for a patient on low dose IV insulin therapy includes the following
EXCEPT:

A. Elevation of serum ketones to monitor ketosis

B. Vital signs including BP
C. Estimate serum potassium
D. Elevation of blood glucose levels

93. The doctor ordered to incorporate 1000 “u” insulin to the remaining ongoing IV. The
strength is 500/ml. How much should you incorporate into the IV solution?

A. 10 ml
B. 2 ml
C. 0.5 ml
D. 5 ml

94. Multiple vial-dose-insulin when in use should be:

A. Kept at room temperature

B. Kept in the refrigerator
C. Kept in narcotic cabinet
D. Store in the freezer

95. Insulin using insulin syringe are given using how many degrees of needle insertion?
A. 45
B. 180
C. 90
D. 15

Situation 18: Maintenance of sterility is an important function a nurse should perform in

any OR setting.

96. Which of the following is true with regards to sterility?

A. Sterility is time related items are not considered sterile after a period of 30 days of being
not in use.
B. for 9 months sterile items are considered sterile as long as they are covered with sterile
muslin cover and stored in a dust proof covers.
C. Sterility is event related, not time related.
D. For 3 weeks, items double covered with muslin are considered sterile as long as they
have undergone the sterilization process

97. Two (2) organizations endorsed that sterility are affected by factors other that the time
itself, these are:

A. The PNA and the PRC

B. AORN and JCAHO
C. ORNAP and MCNAP
D. MMDA and DILG

98. All of these factors affect the sterility of the OR equipment, these are the following
except:

A. The material used for packaging

B. The handling of the materials as well as its transport
C. Storage
D. The chemical or process used in sterilizing the material

99. When you say sterile, it means:

A. The material is clean.

B. The material as well as the equipments are sterilized and had undergone a rigorous
sterilization process
C. There is a black stripe on the paper indicator
D. The material has no microorganism nor spores present that might cause an infection
100. In using liquid sterilizer or autoclave machine, which of the following is true?

A. Autoclave is better in sterilizing OR supplies versus liquid sterilizer

B. They are both capable of sterilizing the equipments, however, it is necessary to soak
supplies in the liquid sterilizer for a longer period of time.
C. Sharps are sterilized using autoclave and not cidex.
D. If liquid sterilizer sterilization process is used, rinsing it before using is not necessary.