Recalls 5 NP3

A. Gonadal atrophy

Situation: Mr. GI Joe is 55 year old, married, a car dealer has consulted the ER because of on and fever, indigestion, weight loss, right abdominal pain, body malaise, and itchiness of the skin. Based on the health history the patient has been a chain smoker and drinks alcoholic beverages almost every day especially when he has clients to entertain. His physical examination showed he has suspected liver cirrhosis. He was advised for admission for further work-up and treatment.

You are the nurse on duty when Mr. GI Joe was admitted in the pay floor. In your observational data what additional EARLY SIGN of liver cirrhosis do you expect patient to manifest?

A. Gonadal atrophy

B. Hypotension

C. Splenomegaly

D. Ankle edema

A. 1, 2, 3, and 4

Which of the following statements is TRUE of liver cirrhosis?
1.    Nutritional deficiency with decreased protein intake contributes to liver damage.
2.    Cirrhosis can happen to people with alcohol intake
3.    Women are at greater risk for the development of alcohol-induced liver disease
4.    Most patients affected by liver cirrhosis are between 40 to 60 years of age.

A. 1, 2, 3, and 4

B. 1 & 2 

C. 1, 2 & 3

D. 2 & 3

B. High calorie and high carbohydrate

Situation: Mr. GI Joe is 55 year old, married, a car dealer has consulted the ER because of on and fever, indigestion, weight loss, right abdominal pain, body malaise, and itchiness of the skin. Based on the health history the patient has been a chain smoker and drinks alcoholic beverages almost every day especially when he has clients to entertain. His physical examination showed he has suspected liver cirrhosis. He was advised for admission for further work-up and treatment.

At early stage of Mr. GI Joe’s disease process, the physician ordered this SPECIFIC diet for Mr. GI Joe, You emphasized to the dietitian that he should be served foods that is _________.

A. High carbohydrate and low sodium

B. High calorie and high carbohydrate

C. Low protein and high fat

D. High protein and high fat

D. Bronchopneumonia

Situation: Juliet, a Pediatric Cardiovascular Nurse is assigned to take care of 3 children in her unit. She just admitted a 12- year- old female patient suffering from Rheumatic Fever (RF)

When doing an assessment, which ONE of the following conditions is NOT present based on the Jones Criteria?

A. Erythema Marginatum

B. Subcutaneous nodules

C. Chorea

D. Bronchopneumonia

B. Take the heart rate for one full minute

 Marimar, 6 years old, is receiving digitals for having Patent Ductus Arteriosus with heart failure with heart failure. Prior to the administration of the medicines, which of the following nursing actions should be done by nurse Rica?

A. Take the carotid pulse rate for one full minute.

B. Take the heart rate for one full minute

C. Take the respiratory rate

D. Take the blood pressure

B. 65 year old diabetic woman

Which of the following patients is MOST at risk during the induction of anesthesia?

A. 6-year-old with history of allergy

B. 65 year old diabetic woman

C. 35 year old TB case

D. 25 year old Polio Case

D. Maintain surgical aseptic technique during the procedure

As a circulating nurse, which of the following is your PRIORITY nursing action to promote safety of your patient?

A. Prevent peri-operative position injury

B. Provide adequate lighting during the procedure

C. Optimize surgeon’s access to surgical site

D. Maintain surgical aseptic technique during the procedure

D. Sedentary life and obesity

There are several factors contributing to the development of these conditions.  Which of the following are the PRIORITY causative factors that should be emphasized by Nurse Lydia in her health teaching?

A. Cigarette smoking

 B. Aging process and alcohol intake

C. Stress and overacidity

D. Sedentary life and obesity

C. Increased urine elimination

 The patient has been receiving, Digoxin 0.25 mg per day to regulate his heart rate. Which of the following outcomes would indicate that his medication is achieving its desired effects?

A. Improved appetite

B. Increased pedal edema

C. Increased urine elimination

D. Improved bowel elimination

C. Place affected extremities in a dependent position

The other patient of Nurse Brilliantina is suffering from Buerger’s disease. He has been complaining of intermittent claudication of the lower extremities which has been giving him so much discomfort. What is the Best nursing action she should perform to address the patient’s complaint?

A. Allow the patient to lie flat on bed

B. Teach him foot care and leg exercises.

C. Place affected extremities in a dependent position

D. Apply hot water bag to the affected extremities

D. Increasing pain on the surgical incision.

Gloria, 58 years old, beautician has undergone bowel obstruction surgery. During his first day post-op. she vomited clear liquids about three times during your shift. Her vital signs include: temp-37.9 degree C. 138/84 PR-78/min and RR- 26/min. her surgical incision is intact, slight bleeding, swilling and tenderness with slight pain.

Which of the following manifestations would indicate the development of wound infection?

A. Presence of elevated red blood cells count.

B. Profuse and increasing perspiration.

C. Increased blood pressure, respiratory rate and pulse rate.

D. Increasing pain on the surgical incision.

B. Pinkish-red

If the wound draining is serosanguineous, it means that the secretion is colored ______.

A. Yellow-tinged

B. Pinkish-red

C. Green-tinged

D. Bright-red

C. Administer the pain medication at once

 Later during the day, Gloria became confused, started to pull out her IV fluids as well as her wound dressings. Complained of severe pain over the wound area. The PRIORITY action of the NURSE is to ________.

A. Apply sterile dressings over the surgical wound

B. Call the surgeon at once for the health status of the patient

C. Administer the pain medication at once

D. Restrain the hands of the patient

A. Morphines S04

 The drug of choice of pain relief to patient Gloria considering score of 8 which was assessed by the nurse based on the rating scale of 0-10 (0-lowest, 10 is the highest) is ________.

A. Morphines S04

B. Ibuprofen

C. Demerol

D. Paracetamol

D. Assessing wakefulness of the patient at least every 2 hours

 When patient is receiving opioid medication, the nurse should observe complications from the side effects by ______.

A. Checking for the presence of loose bowel movement

B. Observing signs and symptoms of addiction

C. Assessing changes of circulatory status

D. Assessing wakefulness of the patient at least every 2 hours

B. Root cause Analysis

Mr Rodney, a post- operative, was given Amoxycillin at 12 midnight by the nurse on duty (NOD). The physician asked the patient during his rounds if he has receive the drug, the patient answered “NO”. The physician clarified the claim from the chart and from the chart and from the NOD.

When the physician clarifies the process of Drug Administration, this Quality Improvement Process is known as

A. System analysis

B. Root cause Analysis - addresses why smth happened

C. Problem identification

D. Pareto Chart

D. “Don’t Say that, I will discuss your concerns with your anaesthesiologist.”

While giving health instructions to Anthony. He looks very anxious and said to you, “I might not be able to wake from anesthesia after my operation.” Your BEST response is _________.

A. “Do not worry, everything will be alright.”

B. “Let me tell to your family your fear.”

C. “I will not let you go to the OR until I have talked to your surgeon.”

D. “Don’t Say that, I will discuss your concerns with your anaesthesiologist.”

B. Loss of appetite

After 5 days, Mr. Anthony is ready to go home. His discharge instructions include observations of the following complications, EXCEPT:

A. Palpitation

B. Loss of appetite - expected at GI surgeries

C. Increased body temperature

D. Bleeding

A. 1, 3

Which of the following emergency medicines should be available at the emergency cart at the Cardio Ward?
1. Epinephrine        3. Valium
2. Demerol         4. Coumadin

A. 1, 3

B. 1, 2

C. 2, 4

D. 3, 4

A. 1, 2, 3

When stocking fluids in the emergency cart. What should Nurse Meg instruct the nurses?
1. Put the recently- delivered at the back of the old stock
2. Put the old stock in front of the newly-delivered ones
3. Check the fluids for sediments and discoloration
4. Keep the fluids inside the cooler

A. 1, 2, 3

B. 1, 4

C. 3, 4

D. 2, 3

D. Tense, rigid abdomen

Mr. Nelson, 62 year old, an Executive of a shoe company was brought to the hospital after having vomited bright red blood immediately after supper. He claimed he had drinking session with his former classmates in college. He was already advised by their family physician not to drink alcohol due to a suspected fatty liver. You are the nurse-on-duty when he was admitted.

Based on your assessment and history taking for Mr. Nelson which PRIORITY FINDINGS should you document and report to the physician?

A. Use of anti-inflammatory drugs.

B. Vital signs BP- 140/90, PR- 88/min, PR-24/min.

C. abdominal pain (3 in a scale of 10)

D. Tense, rigid abdomen

A. Normal Saline Solution

The physician orders insertion of nasogastric tube with lavage to Mr. Nelson. What kind of solution will you expect to be written in the doctor’s order when a patient will undergo a lavage?

A. Normal Saline Solution

B. Distilled Water

C. Tap warm water

D. Dextrose 5% in water

A. RA 9173 of Nursing Law

Ms. Kendall an R.N was invited as a resource person in a nursing conference. The curriculum vitae she submitted to the PRC Continuing Professional Development Council reflects the word Masters of Arts in Nursing (MAN) after her name. She only completed academic requirements but not her thesis writing. Which of the following did Ms. Paras violate?

A. RA 9173 of Nursing Law

B. Code of Professional Ethics for Teachers

C. Magna Carta for Health Workers

D. Code of Ethics for Registered Nurse

b. Percussion

Which component of chest physiotherapy involves rhythmic clapping with cupped hands on the chest wall over the area being drained?

a. Postural drainage

b. Percussion

c. Nebulization

d. Vibration

C. Gravity

Postural drainage improves clearance and drainage of secretions by which principle?

A. Entropy

B. Enthalpy

C. Gravity

D. Motion

B. Expand collapsed alveoli

A goal for a post-operative patient using incentive spirometry is:

A. Decrease pulmonary ventilation

B. Expand collapsed alveoli

C. Potentiate effects of general anesthesia

D. Thicken respiratory secretions

D. Inform the family members that there is a palliative care available.0

Nurse Berroya is taking care of Ms. Gonzaga with a multi-organ disorder. The health care team believes that patient’s survival rate is only 50%. Which of the following nursing actions is MOST APPROPRIATE to be done by Nurse Berroya?

A. Avoid discussion of death when family members are present.

B. Arrange with the family the available funeral parlors incase of death of the patient.

C. Request the husband to prepare a living will.

D. Inform the family members that there is a palliative care available.

D. demonstration and return demonstration

The group came up with an effective Strategy in the teaching of Universal Health precaution to the attendees. Which of the following is the BEST strategy for this program?

A. Film Showing

B. Case Analysis

C. Lecture with interactive discussion

D. Demonstration and return demonstration

B. T-test

The quality assurance nurse who works closely with nurse Kim request her to conduct a study by comparing the average length of hospitalization of cardiac patient in a regular ward with that of patients with same disorders in an intensive care unit.
What statistical test is MOST appropriate to use in this study?

A. Analysis of variance

B. T-test

C. Chi-square

D. Coefficient of correlation

A. Follow-up

The research team together with the gastro-intestinal department also conducted a study on the alcohol consumption of patients as heavy drinkers and developed liver cirrhosis over a 20 year period.

A. Follow-up

B. Cross-sectional

C. Trend

D. Panel

C. Descriptive

Jenny with her team would like to conduct a research on “Perceptions of professional Health practitioners on the competence and level of acceptance on Nurse-Led Clinic”.
What type of research design should nurses Kim and her team adopt?

A. Experimental

B. Correlational

C. Descriptive

D. Quasi-experimental

D. Ask the patient’s husband’s name

Nurse Liza is assigned on a 3-11 shift in the female medical ward of a Tertiary Hospital. Patient Alma has been complaining of excruciating abdominal pain and was asking for pain medication. She was referred to the physician on duty (POD) for an immediate relief of pain

In addition to the identification bracelet worn by the patient, how can the nurse on duty (NOD) verify the identity of her patient when administering the drugs?

A. Ask the question, “Are you Ms. Alma?”

B. Read the patient’s name at the foot of the bed

C. Ask the patient’s name from the watcher.

D. Ask the patient’s husband’s name - CROSS CHECK

B. When the physician writes the drug as needed in the order sheet.

The physician orders a PRN pain medication to patient Alma. When will Nurse Liza administer a PRN drug?

A. A standing order is carried out as specified until discontinued for another order.

B. When the physician writes the drug as needed in the order sheet.

C. A single dose of the drug, carried out by the nurse at a time specified by the physician.

D. An order written by the physician that has to be carried out immediately.

A. severe

Prior to the administration of pain medication, Nurse Liza assesses the degree of the pain of patient before and after the drug administration. Using the numeric scale of 0-10 (0 is the lowest and 10 is the highest) on pain, when the patient has rated her pain as 7 it means it is ____________.

A. severe

B. tolerated

C. Slight

D. moderate

C. 2, 4, 3, 1, 6 & 5

In educating effectively the patient and family on how to use a pain rating scale, the following are the STEPS to be followed by the nurse __________.
1. discuss pain as a broad concepts
2. set goals for comfort and function
3. explain parts of the rating scale
4. show pain rating scale and purpose
5. verify if patient understands broad concepts of pain.
6. ask patient to practice the pain rating scale

A. 1, 2, 3, 4, 6 & 5

B. 4, 3, 1, 5, 6 & 2

C. 2, 4, 3, 1, 6 & 5

D. 3, 1, 2, 5, 4 & 6

D. working phase

 When the nurse explores thoughts and feelings about the patient’s surgery, this phase in the helping-relationship is in _______________.

A. introductory phase

B. termination phase

C. resolution phase

D. working phase

B. Endoscopic Ultrasonography

The MOST useful diagnostic test is to validate whether Ms. Len is suffering from Pancreatitis is for her to undergo ___________.

A. Endoscopic Retrograde Cholangio Pancreatography

B. Endoscopic Ultrasonography

C. Percutaneous Transhepatic Cholangiography

D. Cholesterol Serum level

D. administer IV fluids to replace electrolytes lost.

When managing a patient with acute pancreatitis the first priority is to ____________.

A. insert urinary catheter for adequate elimination.

B. encourage oral fluids to improve elimination.

C. insert nasogastric tube to decompress stomach

D. administer IV fluids to replace electrolytes lost.

B. Respiratory distress

One of the SAFETY alerts that the Nurse-on-duty (NOD) will have to watch for patient with acute pancreatitis is ___________.

A. Diabetes insipidus

B. Respiratory distress

C. Hypercalcemia

D. Pericarditis

D. ketoacids

Patient Norilee upon admission has a breath characteristics of fruity acetone, this is brought about by the presence of ______________.

A. lactic acids

B. uric acid

C. nitric acid

D. ketoacids

D. normal Saline solution

Based on the presenting manifestations of patient Norilee you expect that the physician will likely order which of the following treatment?

A. 50% dextrose

B. 5% Lactated ringers

C. Dextrose 10% in water

D. normal Saline solution

D. 1, 2, 3, 4

When caring for patient Norilee, which of the following should be included in your teaching plan?
1. Signs and symptoms of hypoglycemia
2. Self-glucose monitoring
3. Administration of insulin
4. Meal planning and exercise

A. 2, 3, 4

B. 2, 3

C. 1, 2

D. 1, 2, 3, 4

D. Descriptive-correlational

Ms. Arce is the Research Coordinator of the Medical Center who is concerned about the increased incidence of nosocomial infections in the hospital and has convinced the management to allot a budget for the conduct of research on the clinical problem.

What type of research is appropriate for this study?

A. Quasi-experimental

B. Experimental

C. Historical

D. Descriptive-correlational

B. Patient’s refusal to fully divulge information.

During the data collection, Ms. Rita encountered a patient who does not want to talk to him. Which of the following is a limitation of the study?

A. Contacts of patients with history of fever and cough.

B. Patient’s refusal to fully divulge information.

C. Patient’s with the history of fever and cough

D. Patients admitted or who seek consultation at the ER and doctor’s offices

D. it is generalized to other settings or samples.

Her colleague asks about the EXTERNAL validity of the research findings. Which of the following is the APPROPRIATE response of Ms. Rita?

A. it is reflected as a result of extraneous variables.

B. the findings are free of selection biases.

 

C. the result is shown only from the effect of the independent variable.

D. it is generalized to other settings or samples.