Situation: Pulmonary tuberculosis remains to be a public health problem in the

Philippines.

1. Patient Leslie went to the emergency room for he has been complaining of a cough
that won’t go away for the past weeks. Further assessment is needed. Which of the
following manifestations should Leslie manifest that may indicate her having
tuberculosis?

a. Low-grade fever, night sweats, hemoptysis

b. Night sweats, chest pain, weight loss

c. Hemoptysis, restlessness, and crackles

d. Diminished breath sound, pleural friction, and dry, nonproductive cough. Hemoptysis also
may occur.

2. Upon admission, which room should Nurse Tokyo placed the client?

a. private room with positive air pressure with minimum of 6 air exchanges per hour

b. semi-private room with cohort patients

c. private room with negative air pressure with minimum of 6 air exchanges per hour

d. semi-private room with bathroom privileges

3. Which medications would be used in four-drug treatment for the initial phase of TB
(select all that apply)?​

1. Isoniazid

2. Pyrazinamide

3. Rifampin (Rifadin)

4. Rifabutin (Mycobutin)
5. Levofloxacin (Levaquin)

6. Ethambutol (Myambutol)

1 point

a. 1236

b. 1345

c. 1356

d. 2346

4. Leslie has been on medication therapy for 2 weeks now. She asked Nurse Tokyo if
she still infectious. What should be the appropriate response of Nurse Tokyo?

1 point

a. “yes, you are still infectious and must continue the medication for more weeks”

b. “yes, and you need to be isolated for 2 months to avoid infecting family members”

c. “since you are medicating for 2 weeks now, you unlikely to infect anyone”

d. “you are now considered non-infectious and can return for employment immediately

5. After 6 months of treatment, Leslie continues to have positive sputum cultures and
admits difficulty remembering to take the medication consistently. What is the nurse's
best course of action?

1 point
 a. Arrange for directly observed therapy (DOT) with a public health nurse.

b. Require the patient to visit the clinic daily to take the medication.

c. Introduce the patient to someone who has recovered from TB to share their success story.

d. Provide additional teaching sessions to help the patient understand the risks of
noncompliance.

Situation: Nurse Lou is caring for multiple clients with respiratory problems

6. Mat, patient with asthma, is prescribed two different inhaled medication, Salmeterol
and Beclomethasone. Nurse Lou assessed the understanding of the patient on the
proper use of the equipment. Which of the following statements reflect proper
understanding of the patient?

1 point

a. “I should wait 1 to 2 minutes between using the two inhalers.”

b. “I should use the corticosteroid first and then the bronchodilator immediately after.”

c. “I should wait 5 minutes after using the first inhaler before using the second one.”

d. “If I need a second dose of the same inhaler, I should wait at least 5 minutes before taking
it.”

7. The nurse determines that additional teaching is necessary when the asthma patient
states:

1 point

a. "I should exercise daily, if my symptoms are controlled."

b. "I can occasionally use over-the-counter bronchodilators if I experience chest tightness."

 c. "I should inform my husband about my medications and how to seek help during a severe
asthma attack."

d. "Keeping a diary to track my medication use, symptoms, peak expiratory flow rates, and
activity levels will assist in adjusting my therapy."

8. After undergoing a left lower lobectomy, a client returns to their room with a chest
tube in place. Nurse Lou develops a care plan with the primary nursing diagnosis of
Impaired gas exchange related to lung surgery. Which of the following is the most
appropriate expected outcome for this diagnosis?

1 point

a. The client will sit upright, leaning slightly forward.

b. The client will request pain medication as needed.

c. The client will maintain a pulse oximetry level above 93%.

d. The client will remain pain-free.

9. Nurse Lou is caring for Mr. Salazar, a 60-year-old man with history of chronic
obstructive pulmonary disease, admitted due to shortness of breath and confusion. His
ABG analysis reveals a pH of 7.20, PaCO2 of 73 mmHg, PaO2 of 77mmHg and HCO3
of 24 mEq/L. What do these values indicates?

1 point

a. Respiratory acidosis

b. Metabolic acidosis

c. Respiratory alkalosis

d. Metabolic alkalosis
10. The patient has had COPD for years, and his ABGs usually show hypoxia (PaO2 45
mm Hg). Which ABG results show movement toward respiratory acidosis and further
hypoxia indicating respiratory failure?

1 point

a. pH 7.35, PaO2 62 mm Hg, PaCO2 45 mm Hg

b. pH 7.34, PaO2 45 mm Hg, PaCO2 65 mm Hg

c. pH 7.42, PaO2 90 mm Hg, PaCO2 43 mm Hg

d. pH 7.33, PaO2 92 mm Hg, PaCO2 32 mm Hg

Situation: A 28-year-old male is brought to the emergency department due to

motorcycle accident. He complains difficulty of breathing, pain on the left side
and use of accessory muscle was noted. Upon assessment, the nurse noticed
decreased breath sound and hyperresonance on the side affected. Pneumothorax
is the diagnosis.

11. What instruction should the nurse initially instruct the patient to do?

1 point

a. Inhale and exhale deeply

b. Inhale and strain against a closed glottis

c. Hold their breath and remain still to prevent air from entering

d. Partially cover the wound with the heel of his hand

12. The immediate goal for this diagnosis is to?

*

1 point

a. To stabilize breathing and relieve pain

b. Normalize breath sounds

c. Prevent infection

d. Evacuate air from the pleural space and promote lung re-expansion

13. To remove air from the pleural space, a chest tube is to be inserted in what area?

1 point

a. 2nd intercostal pace

b. 3rd-4th intercostal space

c. 4th-5th intercostal space

d. 6th intercostal space

14. To assess whether a tension pneumothorax is developing, what should the nurse
evaluate?

1 point

a. Dull percussion sounds on the injured side

b. Severe respiratory distress and tracheal deviation

c. Muffled and distant heart sounds accompanied by decreasing blood pressure

d. Reduced chest movement and diminished breath sounds on the affected side
15. When pneumothorax is confirmed, what should the nurse do immediately?

1 point

a. Insert a large-bore needle to relieve pressure

b. Provide a high concentration of supplemental oxygen

c. Insert a chest tube and connect to suction

d. Call the primary healthcare provider to take the patient for surgery

Situation: COPD

16. A patient is long-term smoker complaining of sputum production and frequent

infection. what is likely the reason for their symptoms based on the effect of smoking?

1 point

a. Constant irritation from smoking causes inflammation and increases the number of
mucus-secreting and goblet cells causing hypersecretion of mucus

b. Due to abnormal distention of the airspaces beyond the terminal bronchioles and
destruction of the walls of the alveoli

c. Smoking depresses the activity of scavenger cells and affects the respiratory tract’s
ciliary cleansing mechanism

d. carbon monoxide combines with hemoglobin to form carboxyhemoglobin

17. COPD patients are prone to infection and may worsen hypoxemia. What should the
nurse encourage to prevent infection?

*
 1 point

a. Avoid going outdoors if there is significant air pollution

b. Avoid exposure to high temperatures with low humidity

c. Avoid extremes of heat and cold

d. Get immunized against influenza and pneumonia

18. When assessing a patient with history of emphysema, which characteristic change
in the patient’s chest should the nurse identify to assess the progression of the disease?

1 point

a. Anteroposterior and transverse diameter ratio of 2:1

b. Depression in the lower portion of the sternum.

c. Anteroposterior and transverse diameter ratio of 1:2

d. Displacement of the sternum and an increase in the anteroposterior diameter

19. The breathing pattern of most people with COPD is shallow, rapid, and inefficient.
Which breathing exercise should the nurse recommend to improve breathing efficiency?

1 point

a. Perform upper chest breathing to expand lung capacity.

b. Perform diaphragmatic breathing to decrease respiratory rate and increase alveolar

ventilation.

c. Hold breath for 10 seconds and exhale forcefully.

d. Exhale and inhale normally.

20. Which dietary adjustment helps fulfill the nutritional requirements of patients with
COPD?

1 point

a. Consuming a diet high in carbohydrates and low in fat

b. Eating soft, small, frequent meals

c. Eating mostly hot-prepared meals

d. Drinking fluids during meals to aid digestion

Situation: Chest tube drainage system is used to remove abnormal

accumulations of air and fluid from the pleural space.

21. In wet suction system, what determines the level of suction applied?

1 point

a. Amount of bubbling observed in the suction chamber.

b. Diameter of suction chamber.

c. Height of chest drainage system.

d. Amount of water instilled in the suction chamber.

22. Dr. Zach asked you to assist him with the removal of chest tube. You would instruct
the client to;

1 point
 a. Take a deep breath, exhale, and do valsalva maneuver.

b. Breathe normally during the removal.

c. Inhale three times and exhale as the tube is pulled out.

d. Take shallow breath to minimize discomfort.

23. Chest tube diameter is measured in:

1 point

a. Gauge

b. French

c. Inches

d. cm H2O

24. ​ When transporting a patient with chest tube, how should the chest drainage
system be managed?

1 point

a. At the same level as the chest.

b. Positioned lower than the chest level.

c. Clamped at all times.

d. Above the level of chest to allow for easier monitoring.

25.A patient with a chest tube is being managed with wall suction to help drain air and
fluid from the pleural space. The physician orders to discontinue suction therapy. As a
nurse, what should you do next to ensure proper management of the chest drainage
system?
*

1 point

a. Keep the suction port attached to maintain the pressure and avoid air from entering the
system.

b. Detach the tubing from the suction port to allow air to escape from the pleural space into
the atmosphere.

c. Clamp the chest tube to prevent any air from escaping and monitor the patient for signs of
tension pneumothorax.

d. Seal the drainage system completely to prevent any airflow and secure the tube.

Situation: Cases of Filipinos with acute and chronic kidney disease has been
increasing necessitating the need for dialysis.

26. Which of the following part of the body is the most common site for creating AV
fistula?

1 point

a. Arm

b. Forearm

c. Hand

d. Fingers

27. Patient Roan has just had her fistula surgically created by anastomosis of artery and
vein on the right arm. She was advised to take care of her fistula. Which of the following
statements by Roan would not indicate proper understanding of care of fistula?

*
 1 point

a. I will do hand-flexing exercises such as ball squeezing to mature the fistula

b. I will take my BP on the right arm only

c. I must touch the shunt several times a day to feel for a thrill

d. I will avoid carrying bags and heavy stuff on my right arm

28. Roan is scheduled to have her hemodialysis session today and is also under
antihypertensive medications. She asked the nurse if she should take her morning dose
of lisinopril. What should the nurse reply?

1 point

a. “anti-hypertensive medications should be withheld and must continue following dialysis”

b. “it is okay to take your antihypertensive medication while undergoing dialysis”

c. “I’ll ask your physician about this and will get back to you”

d. “you must not skip your maintenance medication as it may cause some problems”

29. Yuki, a 30-year-old woman, is involved in a vehicular accident sustaining significant

trauma to her lower back and abdomen. Upon assessment, she is found to have
bruising around her flanks. Imaging studies reveal damage to her kidneys. Over the
next 24 hours, her urine output decreases significantly, has elevated BUN and
creatinine. What type of renal failure is she experiencing?

1 point

a. Prerenal

b. Intrarenal
 c. Postrenal

d. Acute renal failure

30. Acute renal failure (ARF) is characterized by a rapid loss of renal function caused
by damage to the kidneys. This condition often impacts urine output, which can vary
from normal levels to significant changes. During a patient assessment, the nurse
observes that the patient's urine output has decreased to less than 500 mL in 24 hours.
How should this condition be classified?

1 point

a. Oliguria

b. Non-oliguria

c. Anuria

d. Polyuria

31. Soyo, a patient with chronic kidney disease is undergoing peritoneal dialysis and is
the middle of an exchange. The nurse notices that the peritoneal fluid is draining more
slowly than usual and his abdomen is increasing in girth. What is the most appropriate
intervention?

1 point

a. Advance the catheter 2 to 4 cm further into the peritoneal cavity to promote drainage

b. Reposition the patient to facilitate drainage for possible obstruction

c. Clamp the catheter and notify the physician

d. Apply gentle pressure to the abdomen to promote drainage

32. The nurse is caring for a patient who has recently returned from surgery after a
nephrectomy. During an hourly assessment, the nurse notices the patient is less alert,
has a low blood pressure, and is producing very little urine. What should the nurse do
next?

1 point

a. Assess the patient for signs of bleeding and notify the physician immediately

b. Reassess the vital signs for the next hour to monitor for changes

c. Increase the patient’s oral fluid intake to improve blood pressure and urine output

d. Reposition the patient

33. The dialysis solution is pre-warmed before peritoneal dialysis mainly to:

1 point

a. Facilitate elimination of serum urea.

b. Promote vasoconstriction and reduce clearance.

c. Provide additional warmth to the body.

d. Encourage relaxation of the abdominal muscles.

34. The nurse is educating a client with chronic renal failure on maintaining proper
nutrition. Which of the following dietary choices would be most suitable?

1 point
 a. High in carbohydrates and protein.

b. High in calcium, potassium, and protein.

c. Low in protein, sodium, and potassium.

d. Low in protein but high in potassium.

35. The client with acute renal failure has an elevated serum potassium level, and the
nurse administers sodium polystyrene sulfonate (Kayexalate). This medication works
by:

1 point

a. Enhancing potassium excretion through the colon.

b. Promoting calcium absorption in the colon.

c. Releasing hydrogen ions in exchange for sodium ions.

d. Exchange sodium for potassium ions in the colon.

Situation: Dex, 10-years old, comes to the emergency department accompanied

by his mother. He states that he experiences periorbital and facial edema and
decreased urine output. He also notices cola-like color in his urine. The nurse
suspects glomerulonephritis.

36. Which question should the nurse ask to help confirm the diagnosis of
glomerulonephritis?

1 point

a. “Do any of your family members have this problem?

b. “Has the child had any history of infection involving the skin or throat?”
 c. “Do the child frequently pee or feel pain on urination?

d. “Do you consume an excessive amount of sodium in your diet?”

37. Which of the following findings requires the most urgent intervention?

1 point

a. Significant generalized swelling throughout the body

b. Urine specific gravity reading of 1.035

c. High levels of albumin detected in the urine

d. A 24-hour urine output of 1,500 mL

38. Dex is found to have elevated BUN and hypertension in addition to the initial
assessment. Which selection of foods should the nurse anticipate?

1 point

a. Fries, apple juice, and cookies

b. Grilled salmon, donuts, and fruits

c. Wheat bread, fruit juice box, and hotdogs

d. Baked chicken, steamed broccoli, and milk

39. Dex is started on treatment focused on preserving kidney function, corticosteroid

therapy and managing hypertension and proteinuria. Which of the following outcomes
indicate that the treatment is not effective?

1 point
 a. Increasing urine output and decreased edema

b. Decreased blood pressure and reduced proteinuria

c. Increasing blood pressure and persistent proteinuria

d. urine specific gravity of 1.009

40. Dex is about to be discharged, which statement indicates that the mother
understood the discharge instruction?

1 point

a. “I’ll make sure that my son will not get any respiratory problems”

b. “I will make sure that my son will get enough rest and I’ll limit his fluid intake”

c. “I will ensure that my son will take the full course of antibiotics as prescribed if he again
contracts infection”

d. “Foods high in potassium should be restricted from now on to protect his kidneys”

Situation: Joy, a 77-year-old woman is admitted for the management of her

chronic health condition and has urinary catheter in place. Over the past 24
hours, the nurse has noticed some changes and suspects a urinary tract
infection.

41. The nurse is monitoring Joy for urinary tract infection. Which initial symptoms is Joy
likely to manifest that would indicate UTI?

1 point

a. Generalized fatigue and change in cognitive functioning

b. Suprapubic or pelvic pain

 c. Burning on urination, frequency and urgency

d. Hematuria and back pain

42. What factors contribute to urinary tract infection in people like Joy? Select all that
apply.

1. ​ Chronic health condition

2. ​ Proper hygiene

3. ​ Instrumentation of the urinary tract

4. ​ Excessive water intake

5. ​ immobility

1 point

a. 1,2,3

b. 2,3,5

c. 1,3,5

d. 3,4,5

43. Upon discharge, Joy asks the nurse how to prevent recurrence of UTI?

1 point

a. Bathe in tub rather than shower to prevent the bacteria from entering the urethra.
 b. Void every 2 to 3 hours and completely empty the bladder.

c. Avoid urinary tract irritants and limit fluid intake to flush out bacteria.

d. Take cranberry juice every day to completely eliminate bacteria.

44. The nurse also discussed the significance of increasing fluid intake. Which of the
following factors may contribute to the patient’s risk of not obtaining sufficient fluids?

1 point

a. Reduced liver function.

b. Elevated secretion of antidiuretic hormone.

c. Lower production of aldosterone.

d. Decreased ability to recognize thirst.

45. When instructing a patient with a urinary tract infection about taking
phenazopyridine hydrochloride (Pyridium), the nurse should explain that they may
notice:

1 point

a. Bright orange-red urine

b. Diarrhea

c. Constipation

d. Slight drowsiness

Situation: Nurse Chelle is assigned to care for patients with coronary vascular
disease
46. A patient present to the emergency department with complaints of intermittent chest
pain on exertion, which is later diagnosed as angina. The nurse should inform the
patient that angina is most often attributable to what cause?

1 point

a. Coronary atherosclerosis

b. Decreased cardiac output

c. Infarction of the myocardium

d. Decreased cardiac contractility

47. Nurse Chelle is preparing to assist with a coronary bypass graft. She knows that
the vessel most commonly used as source for CABG is what?

1 point

a. Brachial vein

b. Greater saphenous vein

c. Femoral artery

d. Brachial artery

48. She is also caring for a patient admitted with an occluded coronary artery and has
an emergency PTCA. After the procedure, the patient is admitted to the critical care
unit. For what complication should the nurse closely monitor the patient?

1 point
 a. Congestive heart failure

b. Hyperlipidemia

c. Myocardial ischemia

d. Bleeding at the insertion site

49. Zach, a patient with angina, has been prescribed nitroglycerin. Before administering
the drug, Nurse Chelle should inform the patient about what potential adverse effects?

1 point

a. Diplopia and blurred vision

b. Throbbing headache and dizziness

c. Tinnitus and vertigo

d. Nervousness and paresthesia

50. A 58-year-old man presents to the emergency department complaining of severe

substernal chest pain radiating to his left arm. He is diagnosed with myocardial
infarction. What nursing assessment should the nurse prioritize on admission to the
coronary care unit?

1 point

a. Obtain family history of heart disease

b. Begin ECG monitoring

c. Auscultate heart sounds

d. Conduct a comprehensive assessment of the patient’s condition

Situation: Nurses play an essential role in promoting public health and
encouraging disease prevention; thus, they should be knowledgeable about the
common terms used in infection control.

51. It is an individual who harbors the organism and is capable of transmitting it to a

susceptible host and is often asymptomatic.

1 point

a. Contact

b. Carrier

c. Suspect

d. Host

52. The limitation of the freedom of movement imposed on people or animals previously
exposed to communicable disease/s for a period of time.

1 point

a. Quarantine

b. Isolation

c. False imprisonment

d. Surveillance

53. The ability of the organism to produce disease is called.

*
 1 point

a. Pathogenicity

b. Infectivity

c. Virulence

d. Viral load

54. The COVID-19 was an epidemic that affected several countries including the
Philippines in 2019. Covid is an example of:

1 point

a. Endemic

b. Sporadic

c. Pandemic

d. Epidemic

55. According to the Centers for Disease Prevention (CDC), this is the simplest
approach to preventing the spread of infections and must be incorporated into the
culture of any organization.

1 point

a. Environmental hygiene

b. Hand hygiene

c. Vaccination

d. Institutional culture
Situation: The community health nurse is teaching a class on HIV prevention. The
following questions apply.

56. The microorganism that causes HIV is called?

1 point

a. Picornavirus

b. Retrovirus

c. Coronavirus

d. Rhabdovirus

Option 5

57. Which of the following T4/CD4 levels would indicate that a patient is in advanced
HIV disease or AIDS according to the classification of CDC?

1 point

a. 1000 cells/μL

b. 500 cells/μL

c. Less than 200 cells/μL

d. 200 to 499 cells/μL

58. Which of the following is the most common mode of HIV transmission?

1 point
 a. Airborne

b. Sexual contact/intercourse

c. Blood transfusion

d. Casual contact (e.g., handshakes)

59. What is the primary purpose of antiretroviral therapy (ART) in patients with HIV?

1 point

a. Cure the disease

b. Prevent the spread of HIV to others

c. Reduce viral load to undetectable levels

d. Eliminate opportunistic infections

60. Which of the following practices should be emphasized as increasing risk?

1 point

a. Donating blood

b. Using a public restroom

c. Unprotected sex

d. Touching a person infected with HIV

Situation: A sudden increase in cases of Polio in Barangay Alak-alakan has urged

the PHN to conduct a house-to-house survey. The following questions apply.

61. The following statements regarding the disease are true, except.

*
 1 point

a. Males are more prone to the disease than females

b. Male to Female ratio is 3:2

c. Males and Females have the same susceptibility to the disease

d. Death is higher in males than females

62. All but one of the following are identified immunological types of poliomyelitis that
affect people.

1 point

a. Brunhilde

b. Bulbar

c. Lansing

d. Leon

63. Vaccination is an integral part of the prevention and control of the disease. OPV is
given at what age?

1 point

a. Birth

b. 4 weeks

c. 6 weeks

d. 2 weeks

64. Which of the following is the correct management for polio patients?
*

1 point

a. Apply cold packs to the affected limb to relieve pain and muscle shortening

b. Administration of Morphine SO4 for pain

c. Apply hot/warm packs to the affected limb to relieve pain and muscle shortening

d. Do not bathe the patient and remove sources or indications of running water within hearing
distance of the patient.

65. Poliomyelitis is also known as:

1 point

a. Lyssa

b. Heine-Medin Disease

c. El Tor

d. La Grippe

Situation: In early 2024, whooping cough outbreaks were reported across the
Philippines. Nurses should be knowledgeable of this disease. The following
questions apply.

66. Which of the following age groups are more susceptible to Pertussis?

1 point

a. Elderly
 b. Infants

c. Teenagers

d. Toddler

67. The nurse is caring for a 3-year-old who has been diagnosed with whooping cough.
The nurse knows that which of the following organisms is the cause of this disease?

1 point

a. H. pertussis

b. M. pertussis

c. P. pertussis

d. B. pertussis

68. The mother of an 8-week-old has come in for their child’s immunizations and asks
the nurse which diseases are covered in the DTaP vaccine. The nurse explains that
which of the following diseases are covered with the DTaP immunization?

1 point

a. Diphtheria, Tetanus, Pneumococcal

b. Diphtheria, Tetanus and Poliomyelitis

c. Diphtheria, Tetanus and Pertussis

d. Diphtheria, Tetanus and Parvovirus 19

69. A nurse is providing care to a child who has been diagnosed with pertussis. The
nurse expects which of the following medications to be ordered?
*

1 point

a. Erythromycin

b. Atropine

c. Albuterol

d. Acyclovir

70. The nurse is admitting a new client who has been diagnosed with pertussis. The
nurse knows which of the following symptoms are associated with this diagnosis?

1 point

a. Chronic, productive coughing

b. A barking cough that sounds like a seal

c. A dry cough and wheeze

d. Paroxysmal coughing followed by a “whooping” sound

Situation: Nurse Thilly is taking care of a patient diagnosed with PTB. The
following questions apply.

71. The causative agent of Tuberculosis is?

1 point

a. Hansen’s bacilli

b. Mycobacterium tuberculosis
 c. GABHS

d. Bacillus anthracis

72. The nurse obtains a sputum specimen from the client as ordered. Which of the
following laboratory techniques is most commonly used to identify tubercle bacilli in
sputum?

1 point

a. Acid-fast staining

b. Sensitivity testing

c. Agglutination testing

d. Dark-field illumination

73. When is the best time to collect specimens for the patient ordered for acid-fast
bacillus (AFB) testing?

1 point

a. At bedtime

b. Early morning

c. As soon as possible

d. After breakfast

74. Which of the following symptoms is common in clients with TB?

1 point
 a. Weight loss

b. Increased appetite

c. Dyspnea on exertion

d. Mental status changes

75. Which of the following family members exposed to TB would be at highest risk for
contracting the disease?

1 point

a. 45-year-old mother

b. 17-year-old daughter

c. 8-year-old son

d. 76-year-old grandmother

76. All of the following are first line drugs for short course chemotheraphy (SCC) for TB,
except

1 point

a. INH

b. Streptomycin

c. Rifadin

d. Ethambutol

77. INH treatment is associated with the development of peripheral neuropathies. Which
of the following interventions would the nurse teach the client to help prevent this
complication?
*

1 point

a. Adhere to a low cholesterol diet

b. Supplement the diet with pyridoxine (vitamin B6)

c. Get extra rest

d. Avoid excessive sun exposure.

78. The patient taking Ethambutol complained of a sudden visual change. What is the
priority nursing action?

1 point

a. Notify MD

b. Withhold medication

c. Do nothing, this is expected

d. Perform visual acuity test

79. The patient, who is receiving Pyrazinamide, reports stiffness and extreme pain in
the right big toe. The site is extremely red, swollen, and warm. You notify the physician
and as the nurse, you anticipated the doctor will order?

1 point

a. Calcium level

b. Vitamin B6 level
 c. Uric acid level

d. Amylase level

80. You note your patient’s sweat and urine is orange. You reassure the patient and
educate him that which medication below is causing this finding?

1 point

a. Ethambutol

b. Streptomycin

c. Isoniazid

d. Rifampin

Situation: Vector-borne diseases are common in tropical countries like the

Philippines. These diseases are spread by vectors, like mosquitoes or ticks, that
thrive in warm, wet environments.

81. Nurse Andy is caring for a patient with suspected dengue fever. The patient
complains of severe joint and muscle pain. Which statement by the nurse would be
appropriate in this situation?

1 point

a. "It's common to experience joint and muscle pain with dengue fever.”

b. "You may be suffering from influenza, not dengue fever.”

c. “Dengue fever doesn't cause any pain; it's a mild infection.”

d. "Your pain may be due to malaria, not dengue fever.”

Option 5
82. The most serious complication of Dengue fever is:

1 point

a. Rashes

b. Hypovolemic shock

c. Pneumonia

d. Otitis media

83. You noticed that your patient diagnosed with Dengue is having epistaxis. Which of
the following should you avoid?

1 point

a. Apply pressure to one or both nostrils if both are bleeding

b. Apply cold compress over the bridge of the nose and forehead

c. Place the patient in Fowler’s or semi-Fowler’s position

d. Hyperextend the neck to lessen pressure on the nose

84. Herman’s rash is the pathognomonic sign of dengue fever. Generally, they appear
on the lower extremities and usually start:

1 point

a. toward the end of the febrile period

b. before the febrile state

 c. during the height of fever

d. after the fever has subsided

85. All but one are correct statements about Aedes aegypti.

1 point

a. day-biting mosquito

b. breeds on stagnant water

c. low-flying mosquito

d. breeds on running water

86. Malaria is caused by what species?

1 point

a. bacteria

b. virus

c. protozoan

d. fungi

87. Among the following agents, which one is responsible for most deaths from malaria
and is predominantly found in the Philippines?

1 point
 a. P. vivax

b. P. falciparum

c. P. malariae

d. P. ovale

88. All of the following are vector-borne diseases, except.

1 point

a. Zika

b. Ague

c. Elephantiasis

d. El Tor

89. All of the following are other names for dengue, except.

1 point

a. Dandy fever

b. Ague

c. Breakbone fever

d. Infectious thrombocytopenic purpura

90. An organism, typically an arthropod such as a biting insect or an arachnid, that

transmits a disease or parasite from one animal or animal or plant to another is called.

*
 1 point

a. causative agent

b. vector

c. arthropods

d. microorganism

Situation: Rayman was scratched by a stray dog while on his way home from
school.

91. You asked Rayman what he immediately did after the incident. Which response
indicates that Rayman doesn’t need further instructions?

1 point

a. I reported the incident to the barangay Captain

b. I washed my wound immediately with soap and water

c. I sucked the blood out of my wound

d. I filed a complaint at the police station

92. The rabies virus is passed on by contact with what part of an infected animal?

1 point

a. Skin

b. Saliva

c. Blood

d. Claws
 e. B and C

93. Upon assessment, you noticed that Rayman has sustained a minor scratch without
bleeding. The case is considered?

1 point

a. Category I

b. Category II

c. Category III

d. Category IV

94. Based on the response to the previous number what would be the recommended
post-prophylactic measures?

1 point

a. None

b. Immediate vaccination and local treatment

c. Local treatment of wound only

d. Administration of rabies immunoglobulin (RIG)

95. It is also known as the “Anti-Rabies Act of 2007”

1 point

a. RA 9482
 b. RA 9842

c. RA 8485

d. RA 8584

Situation: Infection prevention and control (IPC) is a scientific approach and a

practical solution designed to prevent harm caused by infections to patients and
health workers. It is not always possible to identify individuals who may spread
infection to others; therefore, nurses must be knowledgeable about standard and
other necessary precautions.

96. The first step in hand washing is.

1 point

a. Rinse hand with water

b. Rub hand palm to palm

c. Wet hands with water

d. Use a towel to turn on the faucet

97. You are a school nurse. Which action will you take to have the most impact on the
incidence of infectious disease in the school?

1 point

a. Provide written information about infection control to all patients.

b. Ensure that students are immunized according to national guidelines.

c. Make soap and water readily available in the classrooms.

d. Teach students how to cover their mouths when coughing.

98. The following are the preventive aspects of nursing care for a patient suffering from
a communicable disease, except:

1 point

a. Proper supervision of food handlers

b. Immunization

c. Isolation and quarantine of suspected and infected individuals

d. Health education

99. Andy sustained a vehicular accident and had a big cut on his arm. He was given
6,000 ‘u’ anti-serum ATS. What type of immunity will the drug provide?

1 point

a. Artificial passive

b. Natural passive

c. Artificial active

d. Natural active

100. What is the single most effective means of preventing health care-associated
infections in the hospital?

1 point

a. Periodic fumigation
 b. Use of PPE

c. Prophylactic antibiotics

d. Hand hygiene

Situation: Nurse Chotola has recently embarked on his journey as a perioperative

nurse at a bustling hospital. This position represents his first foray into a surgical
setting, and he is filled with determination to make a positive impact. On his first
day on the job, Nurse Chotola is inspired to handle his responsibilities with
excellence and dedication.

101. Nurse Chotola is going over a surgeon's prescription for a preoperative patient,
which indicates that the patient should not eat or drink anything after midnight. Nurse
Chotola should contact the surgeon to confirm which medication should be administered
to the patient rather than being withheld?

1 point

A. Ferrous sulfate

B. Prednisone

C. Alprazolam

D. Conjugated estrogen

102. Nurse Chotola is instructing a patient on coughing and deep-breathing methods to

help avoid complications after surgery. What would be the most suitable statement for
Nurse Chotola to convey to the patient regarding these techniques?

1 point

A. "Careful observation of your oxygen levels will detect the presence of hypoxemia."
 B. "The utilization of an incentive spirometer can reduce the risk of pneumonia."

C. "Giving intravenous fluids will help prevent or address fluid imbalance."

D. "Practicing early ambulation and providing blood thinners will help prevent the development
of pulmonary embolism."

103. When creating a plan of care for a client scheduled for surgery, Nurse Chotola
should include which of the following activities on the day of surgery?

1 point

A. Encouraging the client to void before going into surgery

B. Avoiding oral hygiene and mouthwash use

C. Ensuring the client has not eaten for the last 24 hours to prevent aspiration

D. Close monitoring and reporting of slight changes in vital signs, such as the blood pressure
or pulse

104. Nurse Chotola demonstrates correct understanding when he says that all but one
of the postoperative nursing management tasks in the clinical unit are being performed.

1 point

A. Reviewing the postoperative orders, admit patient to the unit, and performing an initial
assessment are essential parts of the postoperative nursing management tasks

B. In the hours immediately post-surgery, nursing interventions focus on aiding the patient's
recovery from anesthesia, conducting regular assessments, watching for complications,
managing pain, and implementing strategies to encourage self-care, successful adherence to
the treatment plan, home discharge, and complete recovery.

C. During the first few hours after being admitted to the clinical unit, primary concerns include
ensuring adequate ventilation, maintaining hemodynamic stability, addressing incisional pain,
 preserving surgical site integrity, managing nausea and vomiting, evaluating neurological
status, and ensuring spontaneous voiding.

D. Unless otherwise specified, vital signs, including pulse, blood pressure, and respirations,
should be recorded every 15 minutes during the first 2 hours, followed by every 30 minutes for
the subsequent two hours. Thereafter, they are measured less frequently if they remain stable.
Monitoring of the patient's temperature is done every 2 hours for the first 24 hours
postoperatively.

105. Nurse Chotola is providing preoperative education to a patient regarding the use of
an incentive spirometer. Which information should he include during his discussion with
the patient?

1 point

A. Inhale as rapidly as possible.

B. Keep a loose seal between the lips and the mouthpiece.

C. After maximum inspiration, hold the breath for 15 seconds and exhale.

D. The best results are achieved when sitting up or with the head of the bed elevated 45 to 90
degrees

106. Jun Pooh is a newly hired nurse assigned to care for a patient who underwent
posterior fossa decompression. Which of the following actions by Jun Pooh would
require follow-up by the observing nurse preceptor?

1 point

A. Monitor vital signs, and perform neurologic checks

B. Spacing nursing interventions and assisting the patient with self-care

C. Checking the patient’s motor function and sensory disturbances at intervals

 D. Encouraging the patient to perform deep breathing exercises and coughing frequently to
facilitate respiratory function

107. Which of the following is not true about informed consent?

1 point

A. The nurse reinforces information provided by the surgeon and provides information
regarding the step by step surgical procedure to help alleviate the patient's anxiety.

B. The nurse should notify the physician if the patient needs additional information to make
his or her decision.

C. The nurse should ensure that the consent form has been signed before giving the patient
any psychoactive premedication.

D. Ensures that the patient has received and comprehended the procedure, including its risks,
benefits, and alternatives, and, most importantly, confirm that the patient was competent and
consented voluntarily.

108. Nurse Jun Pooh receives a phone call from the postanesthesia care unit informing
her that a patient is being moved to the surgical unit. What should Nurse Jun Pooh
prioritize doing first upon the patient's arrival?

1 point

A. Check the patient’s dressing to assess for bleeding.

B. Assess the patency of the airway.

C. Check tubes or drains for patency.

D. Assess the vital signs to compare with preoperative measurements.

109. Nurse Jun Pooh is preparing the preoperative client for surgery. After giving his
preoperative client teachings, Nurse Jun Pooh approached a student nurse and asked
her about the important considerations upon the arrival of patients in the operating
room. The following statements indicate the student nurse is knowledgeable about his
impending surgery, except:

1 point

A. The surgeon meets with the client in the preoperative area and uses a surgical marking pen
to indicate the surgical site, while both the nurse and surgeon ensure that the site has been
marked correctly.

B. Prior to initiating the surgical procedure, a time-in is conducted with all members of the
surgical team present to confirm the correct patient and surgical site once more.

C. Upon the client's arrival in the operating room, the operating room nurse will verify the
identification bracelet with the client's verbal response and will review the client's chart.

D. The client's records will be examined for completeness, including informed consent forms,
medical history and physical examination, and information regarding any allergies.

110. During surgery, a patient exhibits masseter muscle contractions, tachycardia, and a
temperature of 103F. What medication should the nurse anticipate to be administered to
the patient?

1 point

A. Amiodarone

B. Epinephrine

C. Morphine

D. Dantrolene

111. Which antibody is primarily involved in allergies and parasitic infestations?

*

1 point

A. Immunoglobulin G

B. Immunoglobulin E

C. Immunoglobulin A

D. Immunoglobulin M

112. Princess Sah, a 17-year-old girl has been diagnosed with early systemic lupus
erythematosus (SLE) affecting her joints. While educating Princess Sah about the
condition, the nurse explains that SLE is a(n):

1 point

A. Mild hereditary disorder of women that causes fever, fatigue, weight loss, and usually
resolves on its own

B. Febrile generalized vasculitis of unknown etiology

C. Chronic, inflammatory disease resulting from disturbed immune regulation that causes an
exaggerated production of autoantibodies

D. Autoimmune disorder in which granulocytes and agranulocytes are instrumental in

promoting the onset and flares of the disease, contributing to the immune response in SLE

113. Nurse San Shai is a newly hired nurse, who was assigned to care for a patient who
complains of fatigue, weakness, malaise, muscle pain, joint pain at multiple sites,
anorexia, and photosensitivity. Systemic lupus erythematosus (SLE) is suspected. San
Shai further checks for which of the following that is also indicative of the presence of
SLE?

*
 1 point

A. Angioedema

B. Ascites

C. Two hemoglobin S genes

D. Erythema of the face

114. The nurse is getting ready to bathe a client who has cutaneous Kaposi's sarcoma
lesions. The patient’s lesions are open and are exuding a small amount of clear fluid.
What personal protective equipment should the nurse consider using in the bathing plan
for this client?

1 point

A. Gloves

B. A gown and gloves

C. A gown, gloves, and a mask

D. A gown and gloves to change the bed linens, and gloves only for the bath

115. Nurse Arshie is providing home care instructions to Ms. Kate Go, a 22 year-old
client with systemic lupus erythematosus. Nurse Arshie is teaching Ms. Kate Go about
methods to manage fatigue. Which statement by the client indicates a need for further
instruction?

1 point

A. "I should engage in light exercises, like walking, when I am not fatigued."

B. "I should take hot baths since they help me relax and unwind."
 C. "I should rest whenever I can to save my energy."

D. "I need to limit extended rest periods as they lead to stiffness in my joints."

116. Which nursing intervention should a nurse anticipate to be given for a client
diagnosed with scleroderma?

1 point

A. Advise the client to remain supine for 1 to 2 hours after meals.

B. Maintain bed rest as much as possible to prevent fatigue.

C. Regulate the room temperature, keeping it warm during the day and cooler at night for
optimal comfort.

D. Administer corticosteroids as prescribed for inflammation.

117. The client with acquired immunodeficiency syndrome (AIDS) is diagnosed with
cutaneous Kaposi's sarcoma. The nurse knows that this diagnosis is confirmed by the
presence of:

1 point

A. Swelling in the genital area

B. Positive punch biopsy of the cutaneous lesions

C. A rash that occurs in a single stripe around the left or right side of the body

D. Appearance of reddish-blue lesions noted on the skin

118. The nurse is conducting an assessment on a patient diagnosed with a latex allergy.
To assess the client's risk factors, the nurse should inquire about an allergy to which
specific food item?
*

1 point

A. Milk

B. Eggs

C. Gluten

D. Bananas

119. Nurse Ma Louie is assigned to care for a client who is scheduled for a patch skin
test. What essential instruction should Nurse Ma Louie provide to the client?

1 point

A. Specific foods will be introduced into your diet at a time.

B. A substance will be injected under your skin.

C. The skin will be examined under ultraviolet light through a special glass.

D. Discontinue systemic corticosteroid or antihistamine therapy for 48 hours prior to the test.

120. A 45-year-old male patient has been diagnosed with a severe bacterial infection
and is prescribed amikacin as part of his treatment regimen. The nurse provides
detailed instructions on the use of the medication and educates the patient about
potential side effects. The nurse specifically advises the patient to contact the physician
immediately if which occurs?

1 point

A. Nausea
 B. Hearing loss

C. Lethargy

D. Muscle aches

121. A nurse provides care for a patient undergoing brachytherapy as a treatment for
uterine cancer. It is essential for the nurse to ensure that the patient comprehends the
specific interventions that will be administered during this process. The following are
important considerations for the nurse to be aware of when caring for this patient,
except:

1 point

A. Assign the patient to a private room

B. Prohibit visits by children or pregnant women, and instruct visitors to maintain a distance of
at least 6 feet from the radiation source.

C. Ensure all staff members wear dosimeter badges and limit visitor access to 30 minutes per
day.

D. Educate the patient on the importance of performing light exercises, such as walking and
Kegel exercises daily

122. Tumor Lysis Syndrome (TLS) is an oncological emergency, which occurs when
there is a destruction of a large number of malignant cells, which can lead to electrolyte
imbalances and acute renal failure. The following conditions can be observed in TLS,
except:

1 point

A. Hyperkalemia

B. Hypercalcemia
 C. Hyperuricemia

D. Hyperphosphatemia

123. The following signs and symptoms can be observed in patients experiencing
Tumor Lysis Syndrome (TLS), except:

1 point

A. ECG changes

B. Altered mental status

C. Polyuria

D. Flaccid paralysis

124. Which of the following interventions is not related to the management of patients
experiencing Tumor Lysis Syndrome (TLS)?

1 point

A. IV hydration

B. Administration of allopurinol

C. Administration of Na bicarbonate

D. Potassium replacement

125. Nurse Lee Suh understands that which of the following medications is indicated for
breast cancer among postmenopausal women who are estrogen receptor (ER)
positive?

*
 1 point

A. Tamoxifen

B. Leuprolide

C. Ondansetron

D. Doxorubicin

126. Nurse Nina is reinforcing teaching with a client who has cancer and is receiving
external radiation therapy. Which of the following statements made by the client
indicates a need for further teaching?

1 point

A. “I’m glad that the procedure is painless and lasts only for a few minutes.

B. “I will be alone in the treatment room.”

C. “Activities of daily living may be resumed immediately after the treatment.”

D. “I have to be isolated to protect others from radiation.

127. A nurse is providing care for a patient diagnosed with advanced breast cancer,
who is experiencing anorexia and cachexia. To address the patient's loss of appetite
and malnutrition, the nurse anticipates that which medication will be prescribed as part
of the patient's treatment plan?

1 point

A. Tamoxifen

B. Megestrol

C. Leuprolide
 D. Ondansetron

128. A 58-year-old male patient diagnosed with squamous cell carcinoma of the larynx
is receiving intravenous bleomycin as part of his chemotherapy regimen. The nurse
caring for the patient expects that which diagnostic test will be ordered?

1 point

A. Echocardiography

B. Pulmonary function studies

C. Cervical radiography

D. Electrocardiography

129. A female patient is undergoing treatment with methotrexate, administered

intravenously at a dosage of 12 g/m², for osteogenic carcinoma. During the course of
methotrexate therapy, the nurse anticipates that the patient will receive which of the
following additional agents to safeguard normal cells from the adverse effects of the
treatment?

1 point

A. Leucovorin Calcium

B. Mesna

C. Zofran

D. Phentolamine

130. Pedro is a 57-year-old patient currently undergoing chemotherapy with Cytoxan

(Cyclophosphamide). The nurse would tell the client to take which action?
*

1 point

A. Take the medication with food.

B. Increase fluid intake to 2000 to 3000 mL daily.

C. Decrease sodium intake while taking the medication.

D. Increase potassium intake while taking the medi- cation.

131. A nurse is preparing a care plan for a 38-year-old female client with metastatic
breast cancer who is receiving tamoxifen. The nurse specifically monitors which
laboratory value while the client is taking this medication?

1 point

A. Glucose level

B. Calcium level

C. Potassium level

D. Prothrombin time

132. A nurse is preparing a care plan for a 38-year-old female client who is scheduled to
receive Cytoxan (Cyclophosphamide) as part of her chemotherapy regimen. The nurse
is aware that which of the following medications is the antidote for cyclophosphamide
toxicity? *

1 point

A. Mesna

B. Leucovorin Calcium (folinic acid)

 C. Naloxone (Narcan)

D. Neostigmine

133. A 47-year old client has a radiation implant located in the endocervical area. The
nurse has observed that the radiation source has become dislodged and is lying on the
bed. Which of the following nursing actions should the nurse undertake as the most
appropriate initial response? *

1 point

A. Reassure the client that you will be back as soon as you can after notifying the physician

B. Don sterile gloves and proceed to remove the radiation source from the room.

C. Immediately put on lead-lined gloves and reinsert the implant.

D. Utilize long-handled forceps to transfer the implant into a sealed lead-lined container
situated within the room.

134. Mr. Berto, a 39-year old patient is scheduled to undergo external radiation therapy
for thyroid cancer. The nurse will provide education regarding the procedure. Which of
the following statements should not be included in the teaching? *

1 point

A. "You will be alone in the room; however, observation is ongoing, and communication is
possible."

B. "The procedure is painless."

C. "The patient may immediately resume normal activities following the treatment."

D. "The duration of the procedure is one hour, during which the patient must remain still."

135. The most common site of cancer of the breast is the: *

1 point

A. Upper outer quadrant of the breast

 B. Upper inner quadrant of the breast

C. Lower outer quadrant of the breast

D. Lower inner quadrant of the breast

136. Nurse Gu Rang has been assigned to provide care for a patient diagnosed with
multiple myeloma. In preparation for this responsibility, Nurse Gu Rang is reviewing the
laboratory results associated with this condition and would anticipate observing which
specific significant findings typical of this disorder? *

1 point

A. Decreased blood urea nitrogen level

B. Increased calcium level

C. Increased white blood cells

D. Decreased number of plasma cells in the bone marrow

137. Nurse Gu Rang is developing a care plan for a client diagnosed with multiple
myeloma. The plan will prioritize which of the following interventions? *

1 point

A. Promoting fluid intake

B. Facilitating coughing and deep breathing exercises

C. Monitoring the red blood cell count.

D. Ensuring regular oral hygiene

138. A patient has been admitted for evaluation with a suspected diagnosis of Hodgkin's
lymphoma. What specific assessment findings should the nurse expect to observe in
this individual? *

1 point
 A. Fatigue

B. Slapped cheek appearance

C. Weight gain

D. Enlarged lymph nodes

139. A nurse is reviewing the medical history of a patient diagnosed with bladder cancer
in preparation for an upcoming assessment. As part of this process, the nurse carefully
examines the patient's records for any relevant clinical findings. Given the nature of the
diagnosis, the nurse anticipates finding documentation indicating which most prevalent
sign or symptom associated with this type of cancer? *

1 point

A. Urgency during urination

B. Increased frequency of urination.

C. Dysuria

D. Hematuria

140. Superior vena cava (SVC) syndrome represents a medical emergency in oncology,
arising when the superior vena cava is compromised due to compression or obstruction
caused by tumor proliferation. Nurse Ni Wang is currently monitoring a patient for
indications associated with this condition. In this context, which of the following is
considered an early sign of this oncological emergency? *

1 point

A. Cyanosis

B. Arm edema

C. Periorbital edema

D. Mental status changes

141. The nurse manager is leading an educational session for the nursing staff on
recognizing the signs and symptoms of hypercalcemia in patients with metastatic
prostate cancer. The nurse manager stresses that which specific symptom is regarded
as a late indication of this oncological emergency? *

1 point

A. Constipation

B. Electrocardiographic changes

C. Headache

D. Dysphagia

142. Nurse Letty is conducting a health teaching to a group of young female clients in
the community regarding the procedure for breast self-examination. Nurse Letty should
advise the clients to conduct the examination at which of the following times? *

1 point

A. At the onset of menstruation

B. One week after the start of menstruation

C. Every month during ovulation

D. Weekly at the same time of day

143. As a nurse in a medical-surgical unit, you are caring for Mr. Lin, a 65-year-old male
patient recently diagnosed with bladder cancer. He has a history of smoking and has
presented with symptoms that prompted further investigation leading to his diagnosis.
During your assessment, Mr. Lin expresses concern about his condition and asks what
symptoms he might expect moving forward. You recall that certain clinical findings are
more commonly associated with bladder cancer. What is the most common clinical
finding associated with bladder cancer? *

1 point
 A. Painless hematuria

B. Persistent abdominal pain

C. Unexplained weight loss

D. Frequent urinary tract infections

144. The nurse is conducting an assessment of the casted extremity of a client. Which
of the following signs is indicative of an infection? *

1 point

A. Presence of dependent edema

B. Presence of a “hot spot” on the cast

C. Coolness and pallor of the extremity

D. Diminished distal pulse

145. Nurse Karen is admitting a client with multiple traumatic injuries to the nursing unit.
The client has sustained a leg fracture and has had a plaster cast applied. Which
position would be optimal for the casted leg? *

1 point

A. Flat for three hours, then elevated for one hour

B. Flat for twelve hours, then elevated for twelve hours

C. Elevated for three hours, then flat for one hour

D. Elevated on pillows continuously for twenty-four to forty-eight hours

146. The nurse has provided education to a client in an arm cast regarding the signs
and symptoms of compartment syndrome. The nurse assesses that the client
understands the information if the client states that they will report which early symptom
of compartment syndrome? *

1 point
 A. Pain that increases when the arm is positioned below the level of the heart

B. Cold, bluish-colored fingers

C. Numbness and tingling in the fingers

D. Pain that is disproportionate to the severity of the fracture

147. Nurse Elmer Lou is providing care for a client who underwent an above-knee
amputation two days prior. The elastic compression bandage that was wrapped around
the residual limb has come off. The nurse's immediate course of action should be to: *

1 point

A. Apply ice to the site.

B. Call the physician.

C. Rewrap the elastic compression bandage to the residual limb.

D. Apply a dry, sterile dressing and elevate the residual limb using one pillow.

148. A client with a hip fracture inquires about the nature of Buck's (extension) traction,
which is being utilized prior to surgery. The nurse should provide which of the following
information to the client? *

1 point

A. It allows bony healing to begin before surgery and involves the use of pins and screws.

B. It provides rigid immobilization of the fracture site and employs pulleys and wheels.

C. It lengthens the fractured leg to prevent severing blood vessels and involves pins and
screws.

D. It offers comfort by alleviating muscle spasms, ensures fracture immobilization, and

involves the use of pulleys and wheels.

149. Nurse Sarah is preparing a teaching plan for a client about crutch walking using a
three-point gait pattern. Which of the following should nurse Sarah include? *

1 point
 A. The crutch on the affected side and the unaffected foot are advanced simultaneously.

B. Both crutches and the foot of the affected extremity are advanced together, followed by the
foot of the unaffected extremity.

C. Both crutches are advanced simultaneously, then both legs are lifted and placed down on a
spot behind the crutches. The feet and crutches form a tripod.

D. Both crutches are moved together, and then both legs are lifted through and beyond the
crutches and placed down at a point ahead of the crutches.

150. Nurse Sarah is preparing a teaching plan for a client about crutch walking using a
swing-to gait pattern. Which of the following should nurse Sarah include? *

1 point

A. The crutch on the affected side and the unaffected foot are advanced simultaneously.

B. Both crutches and the foot of the affected extremity are advanced together, followed by the
foot of the unaffected extremity.

C. Both crutches are advanced simultaneously, then both legs are lifted and placed down on a
spot behind the crutches. The feet and crutches form a tripod.

D. Both crutches are moved together, and then both legs are lifted through and beyond the
crutches and placed down at a point ahead of the crutches.

Situation – Gerald, a 26-year old construction worker, arrives in the Ear Clinic
riding a Honda Motorcycle. He is wearing a headset with Mp3 player hooked to
his belt. Nelson is for hearing assessment.

151. Pure Tone Audiometry is ordered for Gerald. Which of the following does this
procedure measure? *

1 point

A. Vestibular portion of the auditory nerve

B. Ear canal volume

C. Structure of the cars

 D. Hearing acuity

152. Gerald was found to have Mastoiditis. Which of the following ear structure is
affected ?*

1 point

A. Tympanic membrane

B. Pinna

C. Eustachian tube

D. Mastoid air cells

153. Which of the following is the most common cause of Mastoiditis? *

1 point

A. Bone tumor

B. Untreated Otitis Media

C. Meningitis

D. Mastoid diseases

154. Antibiotics have limited use in the actual treatment of Mastoiditis

because________. *

1 point

A. Tissue destruction is extensive

B. It is a long-term treatment

C. Antibiotics do not easily penetrate the infected bony structure of the mastoid

D. Culture has to be done to identify which antibiotic is most effective for the treatment of
Mastoiditis

155. Which of the following is the most common treatment for Mastoiditis? *
 1 point

A. Mastoidectomy only

B. Mastoidectomy with tympanoplasty

C. Antibiotics with tympanoplasty

D. Antibiotics

Situation – As a professional nurse you take into consideration the ethico-moral

principles in providing nursing care.

156. You released information over the phone to a caller who identified himself as the
brother of your patient. You found out later that the brother was out of town. Which of
the following rights did you violate? *

1 point

A. Right to privacy

B. Right to continuity of care

C. Right to confidentiality

D. Right to respectful care

157. Your patient is having difficulty making decision to undergo hip surgery. Which of
the following nursing actions BEST describes your advocacy roles as a nurse? *

1 point

A. Protect patient’s autonomy and independence

B. Communicate patient’s needs to the interdisciplinary team

C. Advise the client to undergo surgery because it is best for her

D. Actively support patient’s decision

158. Mrs Go needs to undergo a hip surgery. She refused to have it done even after the
attending surgeon has explained the procedure thoroughly. Which ethical principle
applies in this situation? *

1 point

A. Autonomy – the right to make one’s own decisions (Kozier&Erb, p.85).

B. Justice – often referred to as fairness (Kozier&Erb, p.85).

C. Non-maleficence – duty to do no harm (Kozier&Erb, p.85).

D. Beneficence – means doing good (Kozier&Erb, p.85).

159. Informed consent is one of the patient’s bill of rights. One of its requirements is the
capacity of the patient to give it. Which of the following elements is/are related to this
capacity? (SELECT ALL THAT APPLY).

1. Patient is an adult – a competent client older than 18 years of age must sign the
consent (Saunders, p.223)

2. He is competent to make a choice – the client must be mentally and emotionally

competent to give the consent (Saunders, p.223)

3. He has the freedom to make a choice

4. He can understand the consequences – the client must be mentally and emotionally
competent to give the consent (Saunders, p.223)

1 point
 A. 1, 2, 3

B. 1, 2, 4

C. 1, 2, 3, 4

D. 1, 3, 4

160. Another requirement of informed consent is voluntariness. It means, freedom of

choice without the following conditions, EXCEPT__________. *

1 point

A. Force

B. Fraud

C. consequences

D. deceit

SITUATION: Like death and taxes, change is inevitable. Change can result into
both success and failure of an organization. Therefore, nurse managers must be
knowledgeable in dealing with change.

161. When people in control enforce changes in an organization and others in the
organization have no input into these changes, what change strategy is being
implemented? *

1 point

A. Normative-Reeducative strategy

B. Power-Coercive strategy

C. Change-Stabilization strategy

D. Rational-Empirical strategy

162. The change strategy which assumes that people act more in accordance with
social values and less likely to change based on information or rational arguments: *
 1 point

A. Stabilization-Evaluation strategy

B. Power-Coercive strategy

C. Normative-Reeducative strategy

D. Rational-Empirical strategy

163. Martyr Nieverra, hospital X’s medical director, is lobbying for majority rule within the
group to decide on what new equipment will be purchased for every department. This
decision making model is called: *

1 point

A. Collegial

B. Political

C. Garbage can

D. Swallow hard

164. A nurse manager is planning to implement a change in the method of the

documentation system for the nursing unit. Many problems have occurred as a result of
the present documentation system, and the nurse manager determines that a change is
required. The initial steps in the process of change for the nurse manager is which of
the following? *

1 point

A. Plan strategies to implement the change

B. Set goals and priorities regarding the change process

C. Identify the inefficiency that needs improvement or correction

D. Identify potential solutions and strategies for the change process

165. According to Kurt Lewin, the final step needed to complete the change process
successfully is called: *

1 point

A. Moving

B. Unfreezing

C. Changing

D. Refreezing

SITUATION: The stages of grief and mourning are universal and are experienced
by people from all walks of life, across many cultures. Mourning occurs in
response to an individual’s own terminal illness, the loss of a close relationship,
or to the death of a valued being, human or animal. There are five stages of grief
that were first proposed by Elisabeth Kübler-Ross in her 1969 book On Death and
Dying.

166. Which of the following statements is true in the perception of a 5y/o child on death?
*

1 point

A. Associates death with violence

B. Believes death is reversible

C. Understands own mortality

D. May fantasize that death can be defied

167. When terminally-ill client named Kate assumes artificial cheerfulness and opts to
visit another doctor for second opinion about her medical diagnosis, what stage of
grieving is she in? *

1 point
 A. Bargaining

B. Acceptance

C. Denial

D. Depression

168. The most important consideration when caring for dying patient like Kate is: *

1 point

A. Promotion of physiologic and psychologic comfort

B. Provision of adequate rest and sleep

C. Provision of adequate nutrition

D. Provision of personal hygiene measures

169. Kate requested for a DNR order. Days after, she went into cardiopulmonary arrest.
Which of the following is appropriate nursing intervention for Kate’s husband who is
grieving over her death *

1 point

A. Advise him not to cry because he’s a man and it would do no good for him

B. Encourage him to accept a new lover/object to replace lost person

C. Provide opportunity to the person to "tell their story"

D. Discourage expression of difficult feelings such as anger and sadness

170. Kate’s husband expresses a feeling of numbness, anxiety, preoccupation,

confusion and sadness. The nurse knows that these feelings are characteristics of
which phase of bereavement: *

1 point

A. Shock and disbelief

 B. Yearning and protest

C. Anguish and despair

D. Reorganization and restitutio

Situation – A 60-year old developed shock after a severe myocardial infarction.

He now has acute renal failure

171. The client’s family asks the nurse why the client developed acute renal failure. The
nurse should base the respond on the knowledge that there is *

1 point

A. An obstruction of flow from the kidneys

B. A surge of the blood flow into the kidneys

C. A prolonged episode of inadequate cardiac output

D. Histologic damage to the kidney resulting in acute tubular necrosis

172. The most significant sign of acute renal failure is *

1 point

A. Decreased urine output

B. Increased blood pressure

C. Increased urine specific gravity

D. Elevated body temperatur

173. The client’s blood urea nitrogen(BUN) level is elevated. This most likely resulted
from: *

1 point

A. Hemolysis of RBC

B. Reduced renal blood flow

 C. Below normal metabolic rate

D. Destruction of kidney cell

174. The client’s serum potassium is elevated, and the nurse administers sodium
polystyrene sulfonate (Kayexalate). The drug is administered because of its ability to *

1 point

A. Exchange sodium and potassium ions in the colon

B. Increase potassium excretion from the colo

C. Increase calcium absorption in the colon

D. Release hydrogen ions for sodium ions

175. If the client’s potassium level continues to rise, the nurse should be prepared for
which of the following emergency situations: *

1 point

A. Hemorrhage

B. Pulmonary edema

C. Cardiac arrest

D. Circulatory collapse

176. A high carbohydrate, low protein diet is prescribed for the client. The rationale for
high carbohydrate diet is that carbohydrates will: *

1 point

A. Act as a diuretic

B. Help maintain urine acidity

C. Prevent the development of ketosis

D. To prevent accumulation of toxic substances

177. The client has an external cannula inserted in her forearm for hemodialysis. Which
of the following measures should the nurse avoid when caring for the client? *

1 point

A. Using the unaffected arm for blood pressure measurements.

B. Performing venipuncture on the arm with fistula.

C. Auscultating the cannula for bruits every 4 hours.

D. Checking of bleeding at the needle insertion site.

178. As the client undergoes her first hemodialysis treatment, the nurse should assess
her carefully for signs and symptoms of disequilibrium syndrome including: *

1 point

A. Fever, chills and chest pain

B. Headache, confusion and nausea

C. Fever, rales, and shortness of breath

D. Hypotension, tachycardia, and shortness of breath

179. If disequilibrium syndrome occurs during dialysis, the priority nursing action would
be to: *

1 point

A. Slow down the rate of dialysis

B. Reassure the client that it will dissipate eventually

C. Start nasal oxygen administration

D. Place the client in high Fowler’s position

180. Which of the following abnormal blood values would not be improved by dialysis
treatment: *
 1 point

A. Low hemoglobin

B. Hyperkalemia

C. Elevated serum creatinine

D. Hypernatremia

181. Which of the following is the hallmark manifestation of nephritic syndrome? *

1 point

A. Anasarca

B. Infection

C. Periorbital edema

D. Hematuria

Situation – Mrs Wesselmie, a 58-yearold female was brought in the Emergency

Room with the chief complaint of sudden severe headache, numbness of the right
side of her body and difficulty in speaking. Oxygen was administered at once to
Mrs H.

182. The rationale for administering oxygen to suspected stroke patient is __________.
*

1 point

A. To prevent further respiratory deficit

B. To prevent hypoxia and hypercapnia

C. To prevent further neurologic deficits

D. To increase the respiratory function

183. Which of the following risk of complications is lessened through oxygen

administration to patient suspected of having a stroke? *
 1 point

A. Increased intracranial pressure

B. Rebleeding

C. Fluid accumulation in the lungs

D. Pulmonary emboli

184. A non-contrast computed tomography (CT) scan was ordered for Mrs Wesselmie.
The purpose of this diagnostic test is to determine___________. *

1 point

A. The patency of Mrs Wesselmie airway

B. The treatment for Mrs Wesselmie

C. The extent of damage to Mrs Wesselmie motor function

D. If the event is ischemic or hemorrhagic

185. Which of the following is the focus of INITIAL assessment for Mrs Wesselmie.? *

1 point

A. Visual acuity

B. Emotional status

C. motor functions

D. airway patency

186. You read in the physician’s notes that Mrs Wesselmie. has contralateral deficits.
This means ___________. *

1 point

A. Both sides of the body are involved

 B. A right cerebral vessel is involved

C. A left cerebral vessel is involved

D. Deficits will be present below the level of the stroke

Situation: Fernan is a 30 year-old father who currently works as a construction

worker in Laguna. He has been complaining of difficulty in hearing for several
weeks already. In relation to this, he went for a hearing assessment at the nearest
ear clinic.

187. The physician ordered that a pure tone audiometry be performed for Fernan. The
nurse explains to the client that this test is used to measure: *

1 point

A. Hearing acuity

B. Ear canal volume

C. Vestibular portion of the auditory nerve

D. Abnormality in the ear structure

188. Fernan was eventually diagnosed with Mastoiditis. The doctor explains to Fernan
that in this condition, which part of the ear is affected? *

1 point

A. Eustachian tube

B. Tympanic membrane

C. Pinna

D. Mastoid air cells

189. He further explains that the most common cause of this illness is: *

1 point
 A. Meningitis

C. Bone tumor

B. Mastoid diseases

D. Otitis media

190. The nurse understands that antibiotics are not the preferred treatment for
mastoiditis because of its limited use. She knows that this is because: *

1 point

A. It requires long-term treatment

B. Tissue destruction in mastoiditis is extensive

C. Antibiotics do not easily penetrate the infected bony structure of the mastoid

D. Culture has to be done before treatment

191. The physician follows-up the nurse's statement and mentions that the
recommended management for mastoiditis is: *

1 point

A. Mastoidectomy only

B. Antibiotics

C. Mastoidectomy with tympanoplasty

D. Antibiotics with tympanoplasty

PSYCHOTIC DISORDERS: Inna Sembrano is a 45 years old client diagnosed with

Delusional Schizophrenia. She is currently on pharmacotherapy of
psychotropics. The questions below pertains to the case.

192. As part of the client’s medical management, she was ordered with Chlorpromazine
300mg QID. It is the responsibility of the nurse to review the documentation notes of the
patient’s response to the drug. Which of the following parameter would show the most
serious side effect of the drug? *
 1 point

A. AST= 45 units/liter

B. Neutrophils= 97/ul

C. BP= 80/60 mmHg

D. Petechial rashes on the trunk

193. During the review of documentation, which of the following endorsement

instructions would need further nursing discussion and action regarding parenteral
medications? *

1 point

A. Monitor the client’s blood pressure and heart rate

B. Always double check if the client was able to take in the drug being prescribed during
administration

C. Conduct a teaching regarding the expected effects of psychotropic drugs such as EPS

D. Ensure that parenteral medications are given only when the patient is restrained

194. With the administration of Chlorpromazine, the client complains of dry mouth and
constipation. Which intervention should not be implemented to the client? *

1 point

A. Plan a daily physical activity regimen with the client

B. Encourage the client to drink 6-8 liters of fluid daily

C. Advise the client to rinse mouth with water as necessary

D. Consult with the client’s physician about changing the antipsychotic medications

195. While reviewing the client’s chart pre-duty, the nurse read “formication” in the
assessment form. Which of the following is the interpretation of the documentation? *

1 point
 A. Presence of crawling objects under the skin

B. Apathy with coprolalia

C. Presence of involuntary and repetitive use of obscene language

D. Presence of non-linear thought pattern and occurs when the focus of a conversation drifts,
but often comes back to the point

196. Which of the following interventions should the nurse include when caring for a
patient with delusions? SATA.

1. Initiate activities such as chess and scrabble

2. Provide pet therapy

3. Decrease the environmental stimuli such as noise, lighting and activity around the
client

4. Reorient client to time, person and place

5. Avoid whispering or laughing around the client

1 point

A. 1,3,4,5

B. 3,4,5

C. 2,3,4,5

D. 1,2,4
197. During nurses’ rounds, the client was observed to have active psychosis and
disorientation as he shouts out “You are all living demons, get me out of this hell!”,
which of the following should not be included in the plan of care to the client? *

1 point

A. Reality orientation to time, person and place

B. Immediate restraint to ensure that no one will get hurt by the client

C. Talk down technique to let the client verbalize his feelings with a calm and more appropriate
way

D. Avoid sending nonverbal cues which can be interpreted as an agreement to false ideas

198. The long-term use of major tranquilizers may cause extrapyramidal symptoms as
side effect. Which of following statements are true about tardive dyskinesia? *

1 point

A. Takes for about at least eight months before it manifests

B. Shows as an acute side effect of a long-term psychotropic use

C. Is reversible by Depakote as an antidote

D. Includes laryngospasm is a life-threatening effect and should be a priority

199. Since admission 4 days ago, a client has refused to take a shower, stating, “There
are poison crystals hidden in the shower head. They’ll kill me if I take a shower.” Which
nursing action is most appropriate for the nurse to do? *

1 point

A. Dismantling the showerhead and showing the client that there is nothing in it

B. Explaining that other clients are complaining about the client’s body odor

C. Asking a security officer to assist in giving the client a shower

D. Respecting these fears and allowing the client to take a sponge bath
200. A client is about to be discharged with a prescription for the antipsychotic agent
haloperidol (Haldol), 10 mg by mouth twice per day. During a discharge teaching
session, the nurse should provide which instruction to the client? *

1 point

A. The client may decrease the dose being taken once the signs of illness decrease

B. Increase the dose with 5mg per day if the signs of illness is observed to not decrease

C. Apply sunscreen before being exposed to the sun

D. Take the medication 2 hours post prandial

Situation : Kayla, a 21-year-old woman who is 8 weeks pregnant, visits the clinic
for her first prenatal check-up.

201. Kayla asks you, "Is it possible to hear my baby's heartbeat right now?". You
responded: *

1 point

A. Yes, it is possible by using an electronic doppler.

B. Yes, it is possible by using a fetoscope.

C. Yes, it is possible by using a stethoscope.

D. No, it is not possible.

202. She said that her last LMP was November 16, 2024 and ended on November 21,
2024. She asks you when is she expected to deliver her baby. Using Naegle's rule, you
answered: *

1 point

A. July 23, 2025

B. August 23, 2025

 C. July 28, 2025

D. August 28, 2025

203. Kayla said that she took a pregnancy test prior to visiting the clinic and asked if a
pregnancy test is the most accurate indicator of pregnancy. You told her that the most
accurate indication that a woman is pregnant is: *

1 point

A.. Positive pregnancy test

B. Presence of fetal heart rate

C. Amenorrhea

D. Quickening

204. While interviewing Kayla, she mentioned that she is experiencing nausea and
vomiting every morning upon waking up. Which health teaching should you not include?
*

1 point

A. Small, frequent feedings

B. Dry toast or crackers

C. Use antiemetic drugs

D. Low-fat diet

205. Kayla asks you when will the sex of her child be determined by the ultrasound.
Which of the following is an appropriate response? *

1 point

A. 16th week of pregnancy

B. 20th week of pregnancy

 C. 24th week of pregnancy

D. 28th week of pregnancy

206. A woman has an OB history of gravida 5 Para 3114. This means that *

1 point

A. She has one abortion, one preterm delivery, and four living children

B. She has three full-term deliveries, one post-mature delivery, and four pregnancies

C. She has five pregnancies and three living children

D. She has four living children, three premature deliveries, and 1 full-term delivery

207. You are asking a student nurse about the correct sequence in fetal growth and
development. The student nurse is correct if she answers: *

1 point

A. Zygote blastocyst morula embryo fetus

B. Zygote embryo blastocyst morula fetus

C. Zygote fetus embryo morula blastocyst

D. Zygote morula blastocyst

208. What prolongs the life of the corpus luteum for the 1 st 6-8 weeks of pregnancy? *

1 point

A. Human placental lactogen

B. Human chorionic somatomammotropin

C. Human chorionic gonadotropin

D. Estrogen

209. A 28-year-old woman visits the clinic after experiencing a delayed menstrual period
and taking an over-the-counter pregnancy test, which showed a positive result. She
expresses both excitement and nervousness about the possibility of being pregnant.
However, during the visit, a blood test and ultrasound reveal that she is not pregnant.
Confused and concerned about the discrepancy, she turns to you to ask for an
explanation. Which statement made the client would explain the false positive results?
*

1 point

A. I took the test after drinking a lot of water which may have diluted my urine and caused a
false positive result.

B. I left the test for a few hours before checking it, and the positive line appeared.

C. I took antibiotics for my infection and that must have caused a positive result.

D. I am taking anti-anxiety medications and that must have caused a false positive result.

210. A multigravida woman who is currently pregnant with her 3 rd child visits the clinic
for a check-up. She wants to know when is her expected delivery date but she does not
know when she had her last menstrual period. When asked if she had already felt her
baby move, she said she had and she felt it last January 22, 2025. With the given
information, when is her expected date of birth? *

1 point

A. June 22, 2025

B. October 22, 2025

C. June 3, 2025

D. June 29, 2025

211. A client who is 28 weeks pregnant would expect to have a fundic height of ___ *

1 point

A. +1 cm above the umbilicus

 B. +2 cm above the umbilicus

C. +3 cm above the umbilicus

D. +4 cm above the umbilicus

212. Samantha, a postpartum client who gave birth three days ago, has been observed
by Nurse Jason taking on mothering responsibilities. She has begun performing tasks
independently without requesting help. Which stage of postpartum adaptation is
Samantha currently experiencing? *

1 point

A. Taking-hold phase

B. Letting-go phase

C. Taking-in phase

D. Recovery phase

213. Kathy has been diagnosed with a urinary tract infection and was prescribed to take
nitrofurantoin. Which among the choices will enhance the effectiveness of the
medication? *

1 point

A. Grapefruit juice

B. Tomato juice

C. Cranberry juice

D. Strawberry juice

214. A pregnant woman came to the clinic for her first prenatal check-up. She asked
you when her EDD would be if her LMP was December 21, 2023. You are correct if you
responded: *

1 point
 A. October 28, 2024

B. October 21, 2024

C. September 21, 2024

D. September 28, 2024

215. You are delivery room nurse and you are currently taking care of a pregnant client
who is currently on the transition phase of the first stage of labor. As a knowledgeable
nurse, which of the following would you expect to occur? *

1 point

A. Feeling the urge to push

B. Irregular short contractions

C. Cervical dilatation of 4 to 7 cm

D. Onset of the first contractions

216. Which of the following is the antidote for magnesium sulfate toxicity? *

1 point

A. Acetylcysteine

B. Calcium gluconate

C. Atropine

D. Flumazenil

217. Ella, a 26-year-old pregnant client, is on the first trimester of pregnancy and was
newly diagnosed. She tells you, "With all these discomforts that come with pregnancy,
I'm not sure if I still want to continue this!". As a registered nurse, you are aware that
Ella is currently experiencing: *

1 point
 A. Inability to care for self

B. Rejection of pregnancy

C. Normal ambivalence

D. Rejection of pregnancy

218. After a tubal rupture, the referred pain that radiates to the neck and right shoulder
caused by the stimulation of the phrenic nerve is called: *

1 point

A. Obturators sign

B. Homan's sign

C. Levine's sign

D. Kehr's sign

219. Which of the following findings would lead you to suspect that your client has mild
preeclampsia? Select all that apply.

1. Seizures

2. Blurry vision

3. Hypertension

4. Proteinuria

5. Abdominal pain

6. Low urine output

7. Edema

1 point

A. 1, 3, 7

B. 3, 4, 7

C. 2, 3, 4

D. 1, 2, 3

220. You are an RN currently assigned to the OB ward of NCT Medical Center. Your
charge nurse assigned a postpartum client with thrombophlebitis to you. Your charge
nurse will need to intervene if you do which of the following: *

1 point

A. Elevate the legs of the client

B. Apply support hose to the client

C. Massage the client's leg

D. Apply moist heat on the client's legs.

Situation 2: Pauline gave birth to her first baby, named Angela, 6 months ago. She
brought her baby to WISH Medical Center for a check-up.

221. If Angela weighed 2,500 grams upon birth, how much should she weigh now? *

1 point
 A. 5,000 grams

B. 7,500 grams

C. 3,000 grams

D. 3,500 grams

222. Angela was measured to be 48 centimeters in length. How much is she expected
to grow in her first year? *

1 point

A. 25%

B. 50%

C. 75%

D. 100%

223. Pauline asked, "What solid food should I introduce to my baby first?". You are
correct if you responded: *

1 point

A.. Fruits

B. Vegetables

C. Egg yolk

D. Rice/Cereal

224. Angela has turned two years old. When assessing Angela, who was brought by
Pauline to the clinic for a routine check-up, which of the following would you expect
Angela to be able to do?*

1 point

A. Use blunt scissors

 B. Ride a tricycle

C. Kick a ball forward

D. Tie her shoelaces

225. You are teaching Pauline about temper tantrums. You would know that your
teaching has been effective if Pauline states which of the following?*

1 point

A. "I will ignore her temper tantrums"

B. "I will put her in time out"

C. "I should pick her up during a tantrum"

D. "I will talk to her during the tantrum"

226. A mother of a school-aged child with cystic fibrosis asks the nurse what sports can
her child be involved in when they become older. Which of the following activities would
be the most appropriate to suggest?*

1 point

A. Javelin throwing

B. Swimming

C. Baseball

D. Track

227. You are caring for a child with iron deficiency anemia. The mother asks you about
what type of food can she offer to her child. Which of the following foods is the most
appropriate to suggest? *

1 point

A. Rice cereal, whole milk, and yellow vegetables

 B. Pudding, green vegetables, and rice

C. Macaroni, cheese, and ham

D. Potatoes, peas, and chicken

228. A child who is 18 months old was diagnosed with Kawasaki disease. She is
irritable, refuses to eat and drink, and has peeling skin on her hands and feet. Which will
you do first? *

1 point

A. Offer food that the toddler likes

B. Encouraging the parents to rest

C. Placing the toddler in a quiet environment

D. Apply lotions to her hands and feet

229. As a nurse, you are providing teachings to a group of parents whose children are
diagnosed with cystic fibrosis. When talking about the diet, what should you suggest? *

1 point

A. Low-protein diet

B. High fat diet

C. Low carbohydrate diet

D. High-calorie diet

230. A 5-year-old child is admitted to the emergency room with a history of ingesting a
large dose of acetaminophen. What would you assess for? *

1 point

A. Headache

B. RUQ pain
 C. Hypertension

D. Oliguria

231. Which among the following require droplet precautions: *

1 point

A. Diphtheria

B. Measles

C. Rotavirus

D. Varicella

Situation- You are a nurse assigned to the general medicine ward.

232. A client with hypertension came in and is to be admitted to a semi-private room. To

whom will this client be roomed in? *

1 point

A. Client with MRSA

B. Client with seizures

C. Client with acute pancreatitis

D. All of the above

233. You are planning for the client assignment for the day. Among the clients, who is
the most appropriate to be assigned to the nursing assistant? *

1 point

A. A client who needs tap water enemas

B. A client with difficulty of swallowing

C. A client needing colostomy irrigation

D. A client requiring continuous tube feedings.

234. You received the assignment for the day shift. After doing the initial rounds and
checking all the assigned clients, who will you prioritize to care for first? *

1 point

A. The ambulatory client in room 301

B. The postoperative client in room 312

C. The client who has a fever and is diaphoretic and restless in room 305

D. The client who is scheduled for physical therapy at 3pm in room 300

235. A conflict arises between the GenMed ward and the NICU. As the head nurse of
Gen Med, you have the knowledge and strategies of conflict management. What
strategy will you implement? *

1 point

A. Accommodating

B. Compromising

C. Competing

D. Collaborating

236. While doing rounds, you noticed that one of your patients who is receiving IV fluid
infusion is experiencing dyspnea, tachycardia, hypotension, and decreased sensorium.
You suspect an air embolism. After clamping the tube, you position the client: *

1 point

A. Right side, head of bed lowered

B. Left side, head of bed lowered

C. Right side, head of bed elevated

D. Left side, head of bed elevated

237. Which among the following has the highest concentration of caffeine? *

1 point

A. Decaffeinated coffee

B. Instant coffee

C. Brewed coffee

D. None of the above

238. You have a patient with renal failure and was prescribed to take sodium
polysterene sulfonate. Which of the following results indicate the need for medication?
*

1 point

A. Potassium 6.8 mEq/L

B. Sodium 110 mEq/L

C. Calcium 12.5 mEq/L

D. Magnesium 3 mEq/L

239. During a renal biopsy, the patient is placed in what position? *

1 point

A. Lithotomy

B. Supine

C. Semi- fowler's

D. Prone

240. When teaching a client with hypertension about a low-sodium diet, which of the
following would you instruct them to avoid? *
 1 point

A. Green salad

B. Mangoes

C. Steamed cauliflower

D. Hotdogs

241. The VDRL test for syphilis is obtained at the first prenatal visit and is repeated by:
*

1 point

A. 12th week

B. 24th week

C. 36th week

D. Only one test is obtained.

242. The definitive diagnosis for aganglionic megacolon is: *

1 point

A. Fecalysis for parasites

B. Barium enema

C. Rectal biopsy

D. Lower GI series

243. Your patient is receiving factor VIII concentrate. Knowing the risks associated with
the administration, which of the following should you report? *

1 point

A. Jaundice
 B. Periorbital edema

C. Constipation

D. Abdominal distention

244. To achieve the closure of the patent ductus arteriosus, which of the following drug
is administered? *

1 point

A. Furosemide

B. Indomethacin

C. Digoxin

D. Prednisone

245. You learned that restraints are used as a last resort. Among the clients, who would
require restraint application? *

1 point

A. The client who was told to stay in their room but keeps going to the nurse's station.

B. The restless client who keeps pulling out their IV fluids, urinary catheter, and NGT and keeps
getting out of bed putting them at high risk for falls.

C. The client who is verbally abusing the nurses

D. The confused client who keeps getting out of bed.

246. The nurse is preparing to administer the client's 1 PM medications. The client,
however, is away from his room for an ultrasound of the whole abdomen. What should
the nurse do? *

1 point

A. Leave the medication on the bedside table.

 B. Ask the client's relatives to keep the medication.

C. Have the client skip the last dose of medication.

D.. Lock the medications in the medicine preparation area until the client returns.

247. Which of the following statements made by the mother of an 18-month-old would
indicate that the child needs to have their lead levels checked? *

1 point

A. "She does not always wash her hands after playing outside."

B. "She drinks 3 glasses of milk per day"

C. "She is smaller than kids her age"

D. "She has more tantrums than other kids"

248. What is the appropriate position for a neonate with unrepaired myelomeningocele?
*

1 point

A. Semi-fowler's position with chest and abdomen elevated

B. Right side-lying position with knees flexed

C. Prone with hips in abduction

D. Supine the hip at 90 degrees flexion

249. An 8-year-old client was admitted to the hospital because of decreased urine
output and periorbital edema. the child was diagnosed with glomerulonephritis. Which of
the following interventions should you do first? *

1 point

A. Obtaining serum electrolyte levels daily

B. Obtaining daily weight measurements

 C. Assessing vital signs every 4 hours

D. Monitoring intake and output every 12 hours

250. The structure left after the ovum has been discharged is known as *

1 point

A. Chorion

B. Corpus luteum

C. Graafian follicle

D. Blastocyst