PRE-BOARD EXAM I (NURSING PRACTICE I) 1

PRE-BOARD EXAMINATION I NURSING PRACTICE I - Foundation of Professional Nursing Practice

GENERAL INSTRUCTIONS: 1. This test booklet contains 100 test questions. 2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheet. 3. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer. 4. AVOID ERASURES. INSTRUCTIONS: 1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. 2. Write the subject title Nursing Practice I on the box provided. 3. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B.

SITUATION 1: Family Planning is a one of the programs that you implement in the rural health Unit. 1) The national Family Planning program emphasizes the following, EXCEPT: a) Respect the value of life b) Freedom to choose Family Planning Method c) None of these d) Departments of Healths role as facilitator rather than as regulator 2) As a resource person you discussed the contraceptive methods. Which of these is least effective? a) Oral contraceptives c. Condom b) Tubal ligation d. IUD 3) The IUD should not be given to a woman with: a) Anemia b) Dysmenorrhea c) Acute pelvic inflammatory disease d) Heart disease 4) A man who has undergone vasectomy is considered sterile: a) After 25 ejaculations b) One week after the procedure c) Immediately after the procedure d) After a zero sperm count 5) Some of your clients need counseling. Youre an effective cou nselor if you are able to: a) Give good advice b) Help clients identify their own problems and act on them c) Identify the problems for your clients d) Convince to follow your instructions SITUATION 2: The Public health nurse plans and implements nursing care services in the light of the following concept and objectives: 6) Health is viewed today on a more individual basis as: a) Absence of disease in an individual b) Psychosomatic well-being pf a person c) Complete physical, mental and social well-being d) Each persons maximum capacity to live happily and productively 7) The level of community health is influenced by the following factors, EXCEPT: a) Political factors b) Physical and biological factors c) None of these d) Social, cultural and economic factors 8) The objectives of community health nursing includes: a) Disability prevention and rehabilitation only b) Health promotion and disease prevention only

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c) Health promotion, disease prevention, early diagnosis treatment, disability prevention and rehabilitation d) Early diagnosis, prompt and appropriate treatment only 9) In the community, a persons psychosocial somatic well -being is influenced by which of the following factors? a) Heredity b) Health care services c) Heredity, behavior, environment and health care services d) Persons behavior 10) Community health nursing is population focus. This means that the: a) Services are focused only to the high risk members of the community b) Unit of care is individual patient or family c) Services provided are ecologically oriented d) Services are directed to the health of all population groups SITUATION 3: This pertains to the application of the nursing process during parturition. 11) Gilda is bought back to her room after delivery. The staff in the unit recognizes that during the first hour, she assesses the vital signs every: a) 25 mins. c) 15 mins. b) 10 mins. d) 20 mins. 12) The nurse determines profuse blood after birth, with the presence of which of these? a) Lochia-saturating peri pad within 15 mins. And pain sensation b) Very frank-red bloody discharge c) Lochia-saturating peri pad within 1 hr. d) Blood clots 13) Another nursing responsibility after delivery is to check on the patients urinary function that at least there is about 100 cc. For each voiding. Distended bladder may: a) Elevate the fundus below umbilicus, pushing below the midline b) Hasten urine contraction thus causing hemorrhage c) Affect the urinary elimination process d) Inhibit uterine contraction with an increased risk of blood loss 14) For comfort and safety, the nurse provided which of these hygienic measures? a) Oral and peri care, sponge both and keep clean and dry b) Keep patient clean and dry only for the 1st 24 hrs c) Give only oral and perineal care d) Warm with blankets and do sponge bath after the 43 hrs. From delivery 15) You noted down signs indicating an impending hemorrhagic shock. Due to the fast turning of events requiring immediate nursing measures, you decided to do all these, EXCEPT: a) Massage the fundus if boggy and expel clots with downward pressured and elevate legs from the hip b) Start an IV, and administer ovia mask 8 to 20 ml. / min. c) Stay with the patient and call for help d) Quickly leave the patient to get help SITUATION 4: A Clinical Instructor. Mrs. Luansing, was reviewing some concepts in Psychiatric Nursing with the fourth year nursing students 16) The antipsychotic drugs often called neuroleptics are used to: a) Reduce anxiety related to depressing b) Decrease dangerous levels of hyperactivity c) Promote mood stabilization d) Increase energy levels 17) One of the most effective treatments for treating severe depression especially for patients who are acutely suicidal is: a) Crisis Therapy b) Hypotherapy c) Milieu therapy d) Electroconvulsive therapy 18) Cognitive theories of personality is best described in one of the following statements: a) Emphasizes the social determinants of personality development b) Series of stages characterized by inborn tendency of all individuals to reduce tensions and seek pleasure c) Focuses on the processes of knowing and understanding the world

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d) Personality consists of behavior that can be seen, heard and felt. 19) A therapeutic technigue in communication is seeking clarification as exemplified by: a) I am not sure I follow you. What doesnt seem to matter? b) Where would you like to begin? c) Has this happened to you before? d) I would like to speak with you? 20) An example of maladaptive use of defense mechanism: a) A physically handicapped person excels in her class b) After a quarrel with her husband, the wife criticizes her mother in law c) A man becomes blind after seeing his wife flirting with other men d) An employee is unable to report for work because of terrible headache SITUATION 5: Topic pertains to intrapartal nursing care. 21) During labor when nurse assesses the fetal presenting part at plus one this means that the fetal head is: a) One cm. Below the ischial spines b) One inch below ischial spines c) One inch above ischial spines d) One cm. Above ischial spines 22) At the health center the nurse explains to the pregnant mother, the Leopolds maneuver. The purpose of this assessment is, to: a) Locate the fetal hand b) Approximate the growth of the fetus c) Determine the fetal position d) Determine the fetal length 23) Nurse Valdez is about to do the Leopolds maneuver on a pregnant patient. Before this assessment, she instructs the patients to: a) Urinate just prior to the procedure b) Take short deep breaths to relieve pain c) Observe strict bedrest prior to the procedure d) Be on NPO the night before the procedure 24) What is the priority nursing intervention after the membranes rupture? The nurse must assess. a) Fetal heart rate c) BP b) Presentation d) LOC 25) In the labor room, the nurse is timing the contraction in a patient who is 7 cm. Dilated frequency of contraction is measured. a) From the beginning of the contraction to the end b) From the beginning of a contraction to the beginning of the next c) From the beginning of a contraction to the beginning of the end d) From the end of a contraction to the beginning of the next SITUATION 6: Mrs. Jimenez lives in an urbanized community. She is positive to syphilis so she too goes to the Health Center for proper management 26) This disease is characterized by: a) Greenish yellow odorous discharge in females b) Feeling of dryness and discomfort about the genitals and conjunctivitis c) Painless chance at site of entry of germ with serous exudates d) Painful frequent urination and prudulent discharge 27) The following facts will guide you in health teachings EXCEPT: a) A pregnant woman can transfer syphilis to her unborn child b) There is no danger of any complication c) The community can be protected through the control of prostitution d) Aside from physical examination diagnosis of this disease can be confirmed blood test 28) As part of your health teaching, you informed Mrs. Jimenez that syphilis can be transmitted to another through: a) Sexual contract b) Any of these modes of transmission c) Blood transfusion d) Indirect contract with contaminated articles 29) The incubation period of this disease is:

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a) b) c) d) 5 to 10 days 5 to 10 months 2 to 5 days 10 days to 10 weeks

30) Prevention and control of syphilis shall be one of the agenda in your conference with the midwives. Which of these is not relevant? a) Immunizations of contacts b) Need to immediately report cases found in their contact to health authority c) Need for early diagnosis and treatment d) Symptoms of syphilis and is mode of transmission SITUATION 7: The following questions pertain to certain concepts in relation to community health nursing and disease prevention: 31) In community health nursing, the unit of concern includes: a) All theses groups b) Community members who are in need of care c) Community members who do not seek of care d) Segment of the community who do not receive care 32) Measures designed to promote general optimum health or the establishment of barrios against the agents in the environment are referred to as: a) Health promotion b) Primary prevention c) Tertiary prevention d) Secondary prevention 33) Tertiary prevention would best described as: a) Health teaching and immunization b) Early diagnosis and treatment c) Recovery from physical limitation and psychological regression d) Preventing disability and maximum use of remaining capacity 34) The process of killing infectious agents outside the body by directly applying chemical or physical means is: a) Specific protection c) Disinfections b) Disability limitation d) Disinfestations 35) A person that process specific protective antibiotics or cellular immunity as a result of previous infection or immunization is referred to as: a) Immune person c) Infected person b) Carrier d) Disinfestations SITUATION 8: Pneumonia remains to be one of the leading causes of deaths. Hence, this was discussed in one of the conferences during the Nurses week. 36) This disease is characterized by: a) Sudden onset with chills, fever, pleural pain and cough productive of rusty sputum b) Fever, headache, malaise, anorexia and non- productive cough c) Fever, fatigue, cough , chest pain and loss of weight d) Fever, cough hoarseness and hemoptysis 37) Pneumonia is transmitted through which of these modes: a) Through articles freshly with respiratory discharges b) By direct oral contact c) By droplet spread d) Any of these modes of transmission 38) The reservoir of the pathogenic organism pneumonia is:: a) Air c) Man b) Infected food d) Infected water 39) During home visits as a preventive measure the patient and other members of the family will be advised to: a) Have the other members of the family immunized b) Avoid overcrowding in living and sleeping rooms whenever possible c) Properly prepare and cook for the patient d) Boil drinking water if unsafe 40) The following is an appropriate control measure(s) for pneumonia that should be discussed with the family: a) Concurrent disinfections and discharges from nose and throat

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b) Isolation of patient for least 5 days c) Immunization of contract d) All theses measures SITUATION 9: In your professional caring role it is essential to establish a meaningful Nurse-patient relationship. 41) A helping nurse-patient relationship is a process characterized by which of the following: a) Recovery promoting b) Growth facilitating c) Mutual interaction d) Health enhancing 42) Demonstrating a helping relationship enables you to establish in the patient: a) Compliance to treatment b) Positive response to illness c) Gratitude for your services d) Some sense of trust in you 43) Therapeutic communication begins with: a) Giving initial care b) Knowing your patient c) Interacting with patient d) Slowing empathy 44) Which of the following approaches would most likely make your patient accept your help? a) Attending to all his needs b) Demonstrating a relaxed attending attitude c) Calling him by first name d) Asking personal question for health information 45) Is an effective nurse-patient relationship, this is not a desirable nurse caring attitude: a) Respect c) Empathy b) Genuineness d) Firmness SITUATION 10: The Public health Nurse participate actively in the treatment and or control of tuberculosis (TB) in her place of assignment: 46) Under the national TB control program of the Department of Health, the following cases are given priority for the short coarse chemotherapy. a) All sputum positive and cavitary eases b) All sputum positive cases c) All cavity cases d) All TB symptomatics 47) Which of the following is or more important methods of control of this disease: a) Examination of patients, contact and suspects b) Provision of facilities for early treatment of cases and for persons at high risk of infection c) Preventive treatment of contracts d) All these are important methods of control 48) Preventive treatment of isoniazid INH should not be given to patients with the following conditions: a) Pregnancy b) Acute liver disease c) All these conditions d) History of previous adverse reaction to INH

49) The short course chemotherapy (SCC) treatment is terminated when: a) Any of these conditions b) Patients failed to collect their drug supply for one month from date of the last collection c) Patients present reactions like jaundice shortness of breath d) Patient have completed the 168 daily collection of drugs within a period of 6 to 8 months 50) Patients who have completed treatment shall be followed up by sputum examination at the following interval and for a period of 1 year. a) Every 2 months b) Every month c) Every 6 months d) Every 3 months

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SITUATION 11: Typhoon Auring caused vehicular collision along Kenon Road going up to Baguio and hurt several passengers 51) Rita is complaining of severe pain on her hips while waiting for assistance, you should: a) Tell her to remain lying down b) Ask her to stand to avoid obstructing the way c) Let her sit d) Offer a glass of water 52) Petra sustained a big wound on her wrist and it is bleeding, the first thing you should do: a) Wrap the affected area very well with your clean handkerchief b) Look for a telephone and call an ambulance c) Cover the affected area very well with your clean handkerchief d) Ask one of the people to call for a doctor 53) Ina, is having epistaxis, the nursing management is, let her: a) Remain in upright position with the head hyperextended b) Insert tissue in the nose to prevent further bleeding c) Blow slowly her nose d) Remain in upright position with the head forward 54) Nursing intervention to another passenger with epitaxis: a) Apply pressure on the nose b) Apply ice collar on the nose c) Apply pressure on the nostrils d) Apply ice bag on the head 55) The following are coagulant drugs that may be prescribed, EXCEPT. a) Acquamephyton b) ASA c) Hemostan d) Synkavit

SITUATION 12: Mr. Dee, 27 years old with asthma is admitted in the medical ward. 56) Routine admission care was done; your assessment findings are the following, EXCEPT: a) Tachycardia, cool and moist skin b) Tachycardia, warm and moist skin c) Ability only to speak a few words without taking a deep breath d) Air Hunger and presence of wheezing sound 57) With your assessment, which of these symptoms would you expect to develop later? a) Cyanosis b) Lips pursed in an effort to exhale c) Use of accessory muscles for breathing d) Nasal flaring 58) Which has the fewer tendencies to precipitate asthmatic attack? a) Molds, house dust b) Cold water c) Air pollution d) Change in climate 59) The following are your nursing plans for Mr. Dee, EXCEPT: a) Give bricanyl tablet to ease his breathing b) Keep his back always dry c) Keep the siderails up d) Force fluids to liquefy the secretions 60) The position that would make him more comfortable is: a) Orthopneic c) Supine b) Sitting d) Fowlers SITUATION 13: Fernan is 30 years old man with a medical diagnosis of paranoid Personality disorder.

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61) A person with paranoid thinking is commonly characterized by; a) Anger c) Self-centeredness b) Fear d) Suspiciousness 62) Initially, the nurse would identify this nursing diagnosis: a) Personal identity disturbance b) Altered role performance c) Ineffective individual coping d) Self-esteem disturbance 63) It is postulated that the patient like Fernan uses this defense mechanism in coping with his anxiety. a) Projection c) Sublimation b) Introjections d) Displacement 64) One of the essential elements of nursing intervention for a patient with personality disorder is: a) Decrease environmental stimuli b) Establishment a therapeutic relationship c) Involve him in social activities d) Encourage verbal expressions of feelings

65) An effective nursing intervention for Fernan is: a) Set constructive limits approach in dealing with him b) Encourage him to express his thoughts and feelings directly c) Encourage him to participate in group activities SITUATION 14: Auricita, an executive secretary in an insurance company has been increasingly afraid of riding in an elevator. She was examined by the company physician and did not find physiologic basis for his symptoms. 66) Based on the data presented, She is most likely suffering from: a) Somatization disorder b) Dissociative disorder c) Obsessive-compulsive disorder d) Phobic disorder 67) To reduce the anxiety level of the client, an anxiolytic drug was prescribed on a short-term basis. This would be: a) Chlorpromazine (Thorazine) 25 mg. Orally three times a day b) Diazepam (Valium) 5 mg. Orally three times a day c) Thiorizine hydrochloride (Mellaril) 100 mg. Orally four times a day d) Benztropine meslyate (Cogentine) 2 mg. Orally twice a day 68) While taking the anxiolytic drug, Client should be cautioned to avoid: a) Aged cheese b) Foods high in fat c) Drinking beverage containing caffeine d) Foods high in sodium 69) The nurse identifies one of the following as a relevant nursing diagnosis: a) Self esteem disturbance b) Altered thought process c) Anxiety, severe d) Impaired adjustment 70) An effective therapy for the client would be: a) Biofeedback b) Psychodrama c) Psychotherapy d) Relaxation therapy SITUATION 15: Paeng, 16 years old, was brought by his parents to the regional psychiatric hospital who states that he had difficulty concentrating in his school work. On admission he was incoherent and stated he was hearing voices. 71) Schizophrenia is more common in what age group a) Pre-adolescence (6-12 years) b) Adolescence (12-17) c) Early childhood (1-6 years)

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d) Early (17-24 years)

72) The physician ordered neuroleptic/ antipsychotic medication for the client. a) Improve thought process b) Decrease level of anxiety c) Decrease level of depression d) Increase in affect and motivation 73) Paeng is at what stage of psychosexual development according to Freud? a) Genital c) Anal b) Latency d) Phalic 74) When Paeng says to the nurse I see the doctor is here, and he is out to get me and destroy me He is experiencing: a) Hallucination c) Delusion b) Concrete thinking d) Illusion 75) The nurses therapeutic response would be: a) Yes the doctor is here, but I know he wont hurt you. b) It is true, the doctor is here what made you think he is her to get you? c) Yes the doctor is here, and you have to see him. d) It is true doctor is true the doctor to see and talk you about your treatment. SITUATION 16: Mr. Ramos, 54 years old, a well known alcoholic, appears jaundice and is confined in the hospital 76) Cirrhosis of the liver was established after thorough examination. Which of the following is least expected to be seen in the assessment? a) Renal failure c) Dry skin b) Esophageal d) Lower leg edema 77) Identify the clinical problem in cirrhosis of the liver? a) Pollakuria b) Portal hypertension c) Portal hypertension d) CBC are increased 78) The goals of intervention for the client are the following, EXCEPT: a) Prevent pruritus b) Prevent infection c) Control disabling symptoms d) Maximize liver function 79) Describe the manifestation of hypomagnesemia that may occur to the client: a) Trousseaus sign is negative b) Chovosteks sign is positive c) Tachycardia d) Depression 80) Paengs doctor wrote in his chart progress note, advanced cirrhosis. The following are the severe complications that may occur, EXCEPT: a) Gastrointestinal bleeding b) Obesity c) Splenomegaly d) Anemia SITUATION 17: Don Juan was admitted for hemorroidectomy. 81) On his first 24hours postoperative period, you observed closely for sign of hemorrhage. Which of these would indicate sign of hemorrhage: a) Rapid pulse and weak respiration b) Rapid and strong pulse and low blood pressure c) Rapid and strong pulse d) Rapid and thready pulse 82) He inquired when will his rectal packing be removed? Your reply is:

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a) b) c) d) Normally 1 day after surgery Normally 8 hours after surgery Usually 2 days after surgery Normally 4 hours after surgery

83) To lessen the discomfort during the removal of rectal pack, you would instruct him to: a) Open his mouth and take a slow breath b) Take a deep breath c) Open his mouth and take a slow breath d) Take a slow breath and close his mouth 84) If his complication occur, your nursing measure is to: a) Apply ice cap on the head b) Administer Demerol 75 mg IM c) Apply warm compress on the operative site d) Apple ice cap on the operative site 85) The following fruits are allowed to the client, EXCEPT: a) Grapefruit c) Cantaloupe b) Watermelon d) Guava SITUATION 18: A 75-year-old widower, Mr. Galope was admitted with dementia. He is often confused and disoriented. 86) In planning for daily schedule of activities for the client, nurse Cythia takes note of one of the following factors: a) The psychotic symptoms brought about by organic pathology b) Deterioration of his memory c) The possible personality changes d) Limited physical capacity to perform some activities 87) Mr. Galope on the third day of confinement, says to Nurse Cynthia, Wheres my supper? I havent eaten this day. The nurse has seen him consume the meals served to him. This manifestation is due to one of the following a) Gradual memory impairment is characteristic of senile dementia b) His feeling of hunger symbolizes the feeling of deprivation c) Elderly makes up stories to relieve his anxiety d) Elderly seeks attention always

88) Nurse Cynthia identifies an appropriate nursing diagnosis as: a) Disturbance in self-esteem b) Ineffective individual coping c) Altered thought process d) Impaired social interaction 89) A nursing intervention which allows self-expression and reinforces reality is: a) Talk with the client about familiar and meaningful things b) Focus on one piece of information at a time c) Do not argue or refute delusions d) Speak slowly, use short simple words

90) When Mr. Lopez constantly recalls past events in his life, the family members should listen to his recollections. The rationale for this is: a) Reduce his feelings of anxiety by helping him recall past events b) Provide a stimulating environment for him c) Reduce his feelings of isolation and loneliness d) Lessen the progressive loss of memory SITUATION 19: Mr. Tan, 42 years old, executive director of a government office, was admitted in status asthmaticus after a heated argument with his secretary. 91) The nurse assessment upon admission would help her identify this patients problem: a) Altered tissue perfusion b) Impaired gas exchange c) Potential for suffocation

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d) Ineffective airway clearance 92) For patients with psycho-physiologic disorder, the initial goal of medical and nursing intervention is: a) Providing a safe environment b) Assist the patient in identifying alternative methods of coping to reduce stress c) Attending to the patients physiologic needs d) Teach the patient relaxation technics 93) When acceptable feelings or behaviors are kept out of awareness by developing the opposite feeling or behaviors are kept out of awareness by developing the opposite feeling or behavior, this defense mechanism used by patients with psychophysiologic disorder is known as: a) Projection b) Displacement c) Sublimation d) Reaction-formation 94) One morning, the client says, I cant sleep I stayed awake all night. The nurse responds by asking, You have difficulty sleeping? This communication technigue is: a) Exploring c) Reflecting b) Restating d) Focusing

95) Since emotional experience can precipitate psychophysiologic disorder, an anxiolytic drug is ordered: a) Haloperidol (Haldol) b) Diazepam (Valium) c) Chlorpromazine (Thorazine) d) Lithium carbonate (Lithonate) SITUATION 20: As a nurse-in-charge you noted that a lot of confusion occur in your unit due to some disorganization. You decided to improve work performance. 96) A deliberate course of action that results in alteration of something different in a nursing unit is refer to as: a) Planned change c) Re-education b) Improve systems d) Nursing process 97) When resistance threatens needed change, what important measure would you use to overcome the resistance? a) Send a memorandum for change b) Use a problem-solving strategy c) Gain early support from staff d) Conduct staff re-education 98) This is a factor most influencing acceptance of staff in change: a) Externally imposed b) Share benefit c) Staff participates in decision d) Planned ahead 99) The first step in change process is facilitating change. This is called: a) Refreezing c) Moving b) Unfreezing d) Status quo 100) These are important qualities of a change agent, EXCEPT: a) Leadership skills c) Credibility b) Sociability d) Management Skills

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Wisdom is knowing what to do next; virtue is doing it.

David Star Jordan