10 Essential Tools To Top The OLFU's TCAP and Preboard

Mastering ANTIEMETICS : A story towards mastery
This story will let you master all anti emetic drugs that are usually prescribed to the patients with nausea and
vomiting.
I created this story because of frustration on how to retain those anti-emetics that are very very frequently asked
in the local board exams and in NCLEX / CG Books. Also take note that TAGAMET and PEPCID are antacids used
for heartburn that are also used to prevent nausea and vomiting. MAALOX has many many uses, but it is mainly
an Antacid. The rest, are intended for nausea and vomiting. I did not include BENADRYL because it has variety of
purpose, one is to prevent nausea, vomiting and dizziness specially for patients with Endolymphatic Hydrops
[ Menieres Disease ]
Si Marinol At Penny
Inap na Inap [INAPRINE] na si marinol [MARINOL] sa kakaantay sa kanyang maal [MAALOX] na si penny.
[PHENERGAN]
Dumating na si penny, [PHENERGAN] na Tagamet-ro [TAGAMET] manila pa.
Zofra ka na! [ZOFRAN] Sabay Compaz [COMPAZINE] ng kamay si marinol [MARINOL] para manampal.
Naubos ko na ang pepsi [PEPCID] dito sa tindahan, Ni regla [REGLAN] na ako kaantay bakit ngayon ka lang?
Honey, and drama drama [DRAMAMINE] mo naman.
------
Easy lang to remember no? Hayyyy... atleast wala ng magkakamali. Tinanong sa exam yang Zofran na yan pati
yang Reglan madalas tanungin. Kala ko pampa regla ang reglan, yung zofran naman, kala ko yung nilalagay sa
fried chicken. Jufran pala iyon.
Mastering ANXIOLYTICS, ANTI PARKINSON'S, ANTI

DEPRESSANT Drugs in EASIEST WAY:
Mastering ANXIOLYTICS & ANTI PARKINSON'S Drugs : A story towards mastery
Budek
This is a simple story that will help, if not push those anxiolytics [ anti anxiety ]
drugs for retainment. If you watched or atleast know a little bit of PINOY BIG
BROTHER season I, that will help a little. [ I never watched PBB, But I still memorize
the anxiolytics because of this ]
Ready?
[ANXIOLYTICS]
One morning, Big brother called TRANXENE [sounds like FRANZEN] into a secluded
room because he committed an error and needs to be disciplined.
Big Brother : TRANXENE [ FRANZEN ] hindi mo ba alam na VAWAL [ VALIUM ] ang

mang LIBRE [ LIBRIUM ] sa ating VISITA [ VISTARIL ] ng MILK? [MILTOWN] (Ang
bisita nila that time was ATE V. [ATIVAN]
TRANXENE : Kuya, walang lakas si ATE V. [ ATIVAN ] sasakay pa siya ng BUS

[ BUSPAR ] dapat naman may equality [ EQUANIL ] dito ATAT [ ATARAX ] ka
namang manita INDE [ INDERAL ] Mo naman alam ang punot dulo.
BIG BROTHER : Aba sasagot sagot ka pa, maghintay ka papunta na ako diyan
tatamaan ka sakin!!!
Nakaramdam si TRANXENE ng CABA OF THE SELP
[ ANTI PARKINSON'S ]
C - Cogentin
A - Artane
B - Benadryl
A - Akineton
S - Symmetrel
E - Eldepryl
L - Levodopa
P – Parlodel
ANTI DEPRESSANTS
Si Ana (ANAPRAMINE) at Ella (ELAVIL) ay nagutom kaya kumain sila sa Quezon

Avenue (AVENTYL) nag order sila ng Tofu (TOFRANIL) then nagdecide na manood
ng Sine (SINEQUAN) under Viva (VIVACTYL) Films at si Nora (NORPRAMINE)
ang bida bilang Haciendera (ASCENDIN) partner si Fernando Poe (PROZAC), they
fell in luv (LUVOX) pero nagtaksil (PAXIL) si FPJ at pinili si Pamela (PAMELOR) at
nagsolo (ZOLOFT) papuntang Panama (PARNATE,NARDIL,MARPLAN)
100 Item Obstetrics-Maternal And Child Health Nursing

Examination
100 Item Obstetrics-Maternal And Child Health Nursing Examination
Question Pool
DISCLAIMER: Care has been taken to verify that all answers and rationale below are
accurate. Please comment up if you noticed any errors or contradictions to maintain
accuracy and precision of the answers as not to mislead the readers.
-Budek
DEGREE OF QUESTION DIFFICULTY
4 – Very hard question, 25% Chance of answering correctly

3 – Hard question, 50% Chance of answering correctly
2 – Moderately hard question, 75% of answering correctly
1 – Easy question, 99% will answer the question correctly
Introduction: The questions are coded according to their sources and will only be for
my personal reference. RED questions are original questions I created. FATIMA
students READ and DIGEST each of these questions carefully. Goodluck.
SITUATION : [ND89] Aling Julia, a 32 year old fish vendor from baranggay
matahimik came to see you at the prenatal clinic. She brought with her all her three
children. Maye, 1 year 6 months; Joy, 3 and Dan, 7 years old. She mentioned that
she stopped taking oral contraceptives several months ago and now suspects she is
pregnant. She cannot remember her LMP.
1. Which of the following would be useful in calculating Aling Julia's EDC? [3]
A. Appearance of linea negra

B. First FHT by fetoscope
C. Increase pulse rate
D. Presence of edema
2. Which hormone is necessary for a positive pregnancy test? [1]
A. Progesterone
B. HCG
C. Estrogen
D. Placental Lactogen
3. With this pregnancy, Aling Julia is a [1]
A. P3 G3
B. Primigravida
C. P3 G4
D. P0 G3
4. In explaining the development of her baby, you identified in chronological order of

growth of the fetus as it occurs in pregnancy as [1]
A. Ovum, embryo, zygote, fetus, infant

B. Zygote, ovum, embryo, fetus, infant
C. Ovum, zygote, embryo, fetus, infant
D. Zygote, ovum, fetus, embryo, infant
5. Aling Julia states she is happy to be pregnant. Which behavior is elicited by her
during your assessment that would lead you to think she is stressed? [3]
A. She told you about her drunk husband

B. She states she has very meager income from selling
C. She laughs at every advise you give even when its not funny
D. She has difficulty following instructions
6. When teaching Aling Julia about her pregnancy, you should include personal
common discomforts. Which of the following is an indication for prompt professional
supervision? [2]
A. Constipation and hemorrhoids

B. Backache
C. Facial edema
D. frequent urination
7. Which of the following statements would be appropriate for you to include in Aling
Julia's prenatal teaching plan? [1]
A. Exercise is very tiresome, it should be avoided

B. Limit your food intake
C. Smoking has no harmful effect on the growth and development of fetus
D. Avoid unnecessary fatigue, rest periods should be included in you schedule
8. The best advise you can give to Aling Julia regarding prevention of varicosities is
[3]
A. Raise the legs while in upright position and put it against the wall several times a
day
B. Lay flat for most hours of the day
C. Use garters with nylon stocking
D. Wear support hose
9. In a 32 day menstrual cycle, ovulation usually occurs on the [2]
A. 14th day after menstruation

B. 18th day after menstruation
C. 20th day after menstruation
D. 24th day after menstruation
10. Placenta is the organ that provides exchange of nutrients and waste products
between mother and fetus. This develops by [4]
A. First month
B. Third month
C. Fifth month
D. Seventh month
11. In evaluating the weight gain of Aling Julia, you know the minimum weight gain
during pregnancy is [3]
A. 2 lbs/wk
B. 5 lbs/wk
C. 7 lbs/wk
D. 10 lbs/wk
12. The more accurate method of measuring fundal height is [2]
A. Millimeter
B. Centimeter
C. Inches
D. Fingerbreadths
13. To determine fetal position using Leopold's maneuvers, the first maneuver is to
[1]
A. Determine degree of cephalic flexion and engagement
B. Determine part of fetus presenting into pelvis
C. Locate the back,arms and legs
D. Determine what part of fetus is in the fundus
14. Aling julia has encouraged her husband to attend prenatal classes with her.
During the prenatal class, the couple expressed fear of pain during labor and
delivery. The use of touch and soothing voice often promotes comfort to the laboring
patient. This physical intervention is effective because [2]
A. Pain perception is interrupted

B. Gate control fibers are open
C. It distracts the client away from the pain
D. Empathy is communicated by a caring person
15. Which of the following could be considered as a positive sign of pregnancy ? [1]
A. Amenorrhea, nausea, vomiting

B. Frequency of urination
C. Braxton hicks contraction
D. Fetal outline by sonography
SITUATION : [FFC] Maternal and child health is the program of the department of
health created to lessen the death of infants and mother in the philippines. [2]
16. What is the goal of this program?
A. Promote mother and infant health especially during the gravida stage
B. Training of local hilots
C. Direct supervision of midwives during home delivery
D. Health teaching to mother regarding proper newborn care
17. One philosophy of the maternal and child health nursing is [1]
A. All pregnancy experiences are the same for all woman

B. Culture and religious practices have little effect on pregnancy of a woman
C. Pregnancy is a part of the life cycle but provides no meaning
D. The father is as important as the mother
18. In maternal care, the PHN responsibility is [2]
A. To secure all information that would be needing in birth certificate

B. To protect the baby against tetanus neonatorum by immunizing the mother with
DPT
C. To reach all pregnant woman
D. To assess nutritional status of existing children
19. This is use when rendering prenatal care in the rural health unit. It serves as a
guide in Identification of risk factors [1]
A. Underfive clinic chart

B. Home based mother's record
C. Client list of mother under prenatal care
D. Target list of woman under TT vaccination
20. The schedule of prenatal visit in the RHU unit is [4]
A. Once from 1st up to 8th month, weekly on the 9th month

B. Twice in 1st and second trimester, weekly on third trimester
C. Once in each trimester, more frequent for those at risk
D. Frequent as possible to determine the presence of FHT each week
SITUATION : Knowledge of the menstrual cycle is important in maternal health

nursing. The following questions pertains to the process of menstruation
21. Menarche occurs during the pubertal period, Which of the following occurs first in
the development of female sex characteristics? [2]
A. Menarche
B. Accelerated Linear Growth
C. Breast development
D. Growth of pubic hair
22. Which gland is responsible for initiating the menstrual cycle? [3]
A. Ovaries
B. APG
C. PPG
D. Hypothalamus
23. The hormone that stimulates the ovaries to produce estrogen is [1]
A. GnRH
B. LH
C. LHRF
D. FSH
24. Which hormone stimulates oocyte maturation? [2]
A. GnRH
B. LH
C. LHRF
D. FSH
25. When is the serum estrogen level highest in the menstrual cycle? [4]
A. 3rd day
B. 13th day
C. 14th day
D. End of menstrual cycle
26. To correctly determine the day of ovulation, the nurse must [2]
A. Deduct 14 days at the mid of the cycle

B. Subtract two weeks at cycle's end
C. Add 7 days from mid of the cycle
D. Add 14 days from the end of the cycle
27. The serum progesterone is lowest during what day of the menstrual cycle? [4]
A. 3rd day
B. 13th day
C. 14th day
D. End of menstrual cycle
28. How much blood is loss on the average during menstrual period? [4]
A. Half cup
B. 4 tablespoon
C. 3 ounces
D. 1/3 cup
29. Menstruation occurs because of which following mechanism? [2]
A. Increase level of estrogen and progesterone level

B. Degeneration of the corpus luteum
C. Increase vascularity of the endothelium
D. Surge of hormone progesterone
30. If the menstrual cycle of a woman is 35 day cycle, she will approximately [2]
A. Ovulate on the 21st day with fertile days beginning on the 16th day to the 26th
day of her cycle
B. Ovulate on the 21st day with fertile days beginning on the 16th day to the 21th
day of her cycle
C. Ovulate on the 22st day with fertile days beginning on the 16th day to the 26th
day of her cycle
D. Ovulate on the 22st day with fertile days beginning on the 14th day to the 30th
day of her cycle
SITUATION : Wide knowledge about different diagnostic tests during pregnancy is an

essential arsenal for a nurse to be successful.
31. The Biparietal diameter of a fetus is considered matured if it is atleast [4]
A. 9.8 cm
B. 8.5 cm
C. 7.5 cm
D. 6 cm
32. Quickening is experienced first by multigravida clients. At what week of gestation

do they start to experience quickening? [4]
A. 16th
B. 20th
C. 24th
D. 28th
33. Before the start of a non stress test, The FHR is 120 BPM. The mother ate the
snack and the practitioner noticed an increase from 120 BPM to 135 BPM for 15
seconds. How would you read the result? [3]
A. Abnormal
B. Non reactive
C. Reactive
D. Inconclusive, needs repeat
34. When should the nurse expect to hear the FHR using a fetoscope? [4]
A. 2nd week
B. 8th week
C. 2nd month
D. 4th month
35. When should the nurse expect to hear FHR using doppler Ultrasound? [4]
A. 8th week
B. 8th month
C. 2nd week
D. 4th month
36. The mother asks, What does it means if her maternal serum alpha feto protein is
35 ng/ml? The nurse should answer [4]
A. It is normal
B. It is not normal
C. 35 ng/ml indicates chromosomal abberation
D. 35 ng/ml indicates neural tube defect
37. Which of the following mothers needs RHOGAM? [1]
A. RH + mother who delivered an RH - fetus

B. RH - mother who delivered an RH + fetus
C. RH + mother who delivered an RH + fetus
D. RH - mother who delivered an RH - fetus
38. Which family planning method is recommended by the department of health

more than any other means of contraception? [4]
A. Fertility Awareness Method

B. Condom
C. Tubal Ligation
D. Abstinence
39. How much booster dose does tetanus toxoid vaccination for pregnant women
has? [4]
A. 2
B. 5
C. 3
D. 4
40. Baranggay pinoybsn.tk has 70,000 population. How much nurse is needed to
service this population? [4]
A. 5
B. 7
C. 50
D. 70
SITUATION : [ND2I246] Reproductive health is the exercise of reproductive right

with responsibility. A married couple has the responsibility to reproduce and
procreate.
41. Which of the following is ONE of the goals of the reproductive health concept? [3]
A. To achieve healthy sexual development and maturation

B. To prevent specific RH problem through counseling
C. Provide care, treatment and rehabilitation
D. To practice RH as a way of life of every man and woman
42. Which of the following is NOT an element of the reproductive health? [4]
A. Maternal and child health and nutrition

B. Family planning
C. Prevention and management of abortion complication
D. Healthy sexual development and nutrition
43. In the international framework of RH, which one of the following is the ultimate
goal? [3]
A. Women's health in reproduction

B. Attainment of optimum health
C. Achievement of women's status
D. Quality of life
44. Which one of the following is a determinant of RH affecting woman's ability to

participate in social affairs? [3]
A. Gender issues
B. Socio-Economic condition
C. Cultural and psychosocial factors
D. Status of women
45. In the philippine RH Framework. which major factor affects RH status? [4]
A. Women's lower level of literacy

B. Health service delivery mechanism
C. Poor living conditions lead to illness
D. Commercial sex workers are exposed to AIDS/STD.
46. Which determinant of reproductive health advocates nutrition for better health
promotion and maintain a healthful life? [4]
A. Socio-Economic conditions
B. Status of women
C. Social and gender issues
D. Biological, Cultural and Psychosocial factors
47. Which of the following is NOT a strategy of RH? [3]
A. Increase and improve contraceptive methods

B. Achieve reproductive intentions
C. Care provision focused on people with RH problems
D. Prevent specific RH problem through information dessemination
48. Which of the following is NOT a goal of RH? [3]
A. Achieve healthy sexual development and maturation

B. Avoid illness/diseases, injuries, disabilities related to sexuality and reproduction
C. Receive appropriate counseling and care of RH problems
D. Strengthen outreach activities and the referral system
49. What is the VISION of the RH? [2]
A. Attain QUALITY OF LIFE

B. Practice RH as a WAY OF LIFE
C. Prevent specific RH problem
D. Health in the hands of the filipino
SITUATION : [SORANGE19] Baby G, a 6 hours old newborn is admitted to the NICU

because of low APGAR Score. His mother had a prolonged second stage of labor
50. Which of the following is the most important concept associated with all high risk
newborn? [1]
A. Support the high-risk newborn's cardiopulmonary adaptation by maintaining

adequate airway
B. Identify complications with early intervention in the high risk newborn to reduce
morbidity and mortality
C. Assess the high risk newborn for any physical complications that will assist the
parent with bonding
D. Support mother and significant others in their request toward adaptation to the
high risk newborn
51. Which of the following would the nurse expect to find in a newborn with birth
asphyxia? [1]
A. Hyperoxemia
B. Acidosis
C. Hypocapnia
D. Ketosis
52. When planning and implementing care for the newborn that has been
successfully resuscitated, which of the following would be important to assess? [1]
A. Muscle flaccidity
B. Hypoglycemia
C. Decreased intracranial pressure
D. Spontaneous respiration
SITUATION : [P-I/46] Nurses should be aware of the different reproductive

problems.
53. When is the best time to achieve pregnancy? [2]
A. Midway between periods

B. Immediately after menses end
C. 14 days before the next period is expected
D. 14 days after the beginning of the next period
54. A factor in infertility maybe related to the PH of the vaginal canal. A medication
that is ordered to alter the vaginal PH is: [2]
A. Estrogen therapy
B. Sulfur insufflations
C. Lactic acid douches
D. Na HCO3 Douches
55. A diagnostic test used to evaluate fertility is the postcoital test. It is best timed
[2]
A. 1 week after ovulation

B. Immediately after menses
C. Just before the next menstrual period
D. Within 1 to 2 days of presumed ovulation
56. A tubal insufflation test is done to determine whether there is a tubal

obstruction. Infertility caused by a defect in the tube is most often related to a [3]
A. Past infection
B. Fibroid Tumor
C. Congenital Anomaly
D. Previous injury to a tube
57. Which test is commonly used to determine the number, motility and activity of
sperm is the [2]
A. Rubin test
B. Huhner test
C. Friedman test
D. Papanicolau test
58. In the female, Evaluation of the pelvic organs of reproduction is accomplished by

[2]
A. Biopsy
B. Cystoscopy
C. Culdoscopy
D. Hysterosalpingogram
59. When is the fetal weight gain greatest? [3]
A. 1st trimester
B. 2nd trimester
C. 3rd trimester
D. from 4th week up to 16th week of pregnancy
60. In fetal blood vessel, where is the oxygen content highest? [3]
A. Umbilical artery
B. Ductus Venosus
C. Ductus areteriosus
D. Pulmonary artery
61. The nurse is caring for a woman in labor. The woman is irritable, complains of
nausea and vomits and has heavier show. The membranes rupture. The nurse
understands that this indicates [1]
A. The woman is in transition stage of labor

B. The woman is having a complication and the doctor should be notified
C. Labor is slowing down and the woman may need oxytocin
D. The woman is emotionally distraught and needs assistance in dealing with labor
SITUATION : [J2I246] Katherine, a 32 year old primigravida at 39-40 weeks AOG

was admitted to the labor room due to hypogastric and lumbo-sacral pains. IE
revealed a fully dilated, fully effaced cervix. Station 0.
62. She is immediately transferred to the DR table. Which of the following conditions
signify that delivery is near? [2]
I - A desire to defecate
II - Begins to bear down with uterine contraction
III - Perineum bulges
IV - Uterine contraction occur 2-3 minutes intervals at 50 seconds duration
A. I,II,III
B. I,II,III,IV
C. I,III,IV
D. II,III,IV
63. Artificial rupture of the membrane is done. Which of the following nursing
diagnoses is the priority? [2]
A. High risk for infection related to membrane rupture

B. Potential for injury related to prolapse cord
C. Alteration in comfort related to increasing strength of uterine contraction
D. Anxiety related to unfamiliar procedure
64. Katherine complains of severe abdominal pain and back pain during contraction.
Which two of the following measures will be MOST effective in reducing pain? [4]
I - Rubbing the back with a tennis ball

II- Effleurage
III-Imagery
IV-Breathing techniques
A. II,IV
B. II,III
C. I,IV
D. I,II
65. Lumbar epidural anesthesia is administered. Which of the following nursing

responsibilities should be done immediately following procedure? [1]
A. Reposition from side to side

B. Administer oxygen
C. Increase IV fluid as indicated
D. Assess for maternal hypotension
66. Which is NOT the drug of choice for epidural anesthesia? [4]
A. Sensorcaine
B. Xylocaine
C. Ephedrine
D. Marcaine
SITUATION : [SORANGE217] Alpha, a 24 year old G4P3 at full term gestation is

brought to the ER after a gush of fluid passes through here vagina while doing her
holiday shopping.
67. She is brought to the triage unit. The FHT is noted to be 114 bpm. Which of the
following actions should the nurse do first? [2]
A. Monitor FHT ever 15 minutes

B. Administer oxygen inhalation
C. Ask the charge nurse to notify the Obstetrician
D. Place her on the left lateral position
68. The nurse checks the perineum of alpha. Which of the following characteristic of
the amniotic fluid would cause an alarm to the nurse? [1]
A. Greenish
B. Scantly
C. Colorless
D. Blood tinged
69. Alpha asks the nurse. "Why do I have to be on complete bed rest? I am not
comfortable in this position." Which of the following response of the nurse is most
appropriate? [3]
A. Keeping you on bed rest will prevent possible cord prolapse

B. Completed bed rest will prevent more amniotic fluid to escape
C. You need to save your energy so you will be strong enough to push later
D. Let us ask your obstetrician when she returns to check on you
70. Alpha wants to know how many fetal movements per hour is normal, the correct
response is [4]
A. Twice
B. Thrice
C. Four times
D. 10-12 times
71. Upon examination by the obstetrician, he charted that Alpha is in the early stage
of labor. Which of the following is true in this state? [1]
A. Self-focused
B. Effacement is 100%
C. Last for 2 hours
D. Cervical dilation 1-3 cm
SITUATION : Maternal and child health nursing a core concept of providing health in
the community. Mastery of MCH Nursing is a quality all nurse should possess.
72. When should be the 2nd visit of a pregnant mother to the RHU? [2]
A. Before getting pregnant

B. As early in pregnancy
C. Second trimester
D. Third trimester
73. Which of the following is NOT a standard prenatal physical examination? [1]
A. Neck examination for goiter

B. Examination of the palms of the hands for pallor
C. Edema examination of the face hands, and lower extremeties
D. Examination of the legs for varicosities
74. Which of the following is NOT a basic prenatal service delivery done in the BHS?
[2]
A. Oral / Dental check up

B. Laboratory examination
C. Treatment of diseases
D. Iron supplementation
75. How many days and how much dosage will the IRON supplementation be taken?
[4]
A. 365 days / 300 mg

B. 210 days / 200 mg
C. 100 days/ 100mg
D. 50 days / 50 mg
76. When should the iron supplementation starts and when should it ends? [4]
A. 5th month of pregnancy to 2nd month post partum

B. 1st month of pregnancy to 5th month post partum
C. As early in pregnancy up to 9th month of pregnancy
D. From 1st trimester up to 6 weeks post partum
77. In malaria infested area, how is chloroquine given to pregnant women? [4]
A. 300 mg / twice a month for 9 months

B. 200 mg / once a week for 5 months
C. 150 mg / twice a week for the duration of pregnancy
D. 100 mg / twice a week for the last trimester of pregnancy
78. Which of the following mothers are qualified for home delivery? [2]
A. Pre term
B. 6th pregnancy
C. Has a history of hemorrhage last pregnancy
D. 2nd pregnancy, Has a history of 20 hours of labor last pregnancy.
79. Which of the following is not included on the 3 Cs of delivery? [2]
A. Clean Surface
B. Clean Hands
C. Clean Equipments
D. Clean Cord
80. Which of the following is unnecessary equipment to be included in the home

delivery kit? [4]
A. Boiled razor blade

B. 70% Isopropyl Alcohol
C. Flashlight
D. Rectal and oral thermometer
SITUATION : [NBLUE166] Pillar is admitted to the hospital with the following signs :
Contractions coming every 10 minutes, lasting 30 seconds and causing little
discomfort. Intact membranes without any bloody shows. Stable vital signs. FHR =
130bpm. Examination reveals cervix is 3 cm dilated with vertex presenting at minus
1 station.
81. On the basis of the data provided above, You can conclude the pillar is in the [1]
A. In false labor
B. In the active phase of labor
C. In the latent phase of labor
D. In the transitional phase of labor
82. Pitocin drip is started on Pilar. Possible side effects of pitocin administration
include all of the following except [3]
A. Diuresis
B. Hypertension
C. Water intoxication
D. Cerebral hemorrhage
83. The normal range of FHR is approximately [3]
A. 90 to 140 bpm
B. 120 to 160 bpm
C. 100 to 140 bpm
D. 140 to 180 bpm
84. A negative 1 [-1] station means that [1]
A. Fetus is crowning
B. Fetus is floating
C. Fetus is engaged
D. Fetus is at the ischial spine
85. Which of the following is characteristics of false labor [1]
A. Bloody show
B. Contraction that are regular and increase in frequency and duration
C. Contraction are felt in the back and radiates towards the abdomen
D. None of the above
86. Who's Theory of labor pain that states that PAIN in labor is cause by FEAR [4]
A. Bradley
B. Simpson
C. Lamaze
D. Dick-Read
87. Which sign would alert the nurse that Pillar is entering the second stage of labor?
[1]
A. Increase frequency and intensity of contraction

B. Perineum bulges and anal orifice dilates
C. Effacement of internal OS is 100%
D. Vulva encircles the largest diameter of presenting part
88. Nursing care during the second stage of labor should include [1]
A. Careful evaluation of prenatal history

B. Coach breathing, Bear down with each contraction and encourage patient.
C. Shave the perineum
D. Administer enema to the patient
SITUATION : [NBLUE170] Baby boy perez was delivered spontaneously following a

term pregnancy. Apgar scores are 8 and 9 respectively. Routine procedures are
carried out.
89. When is the APGAR Score taken? [1]

A. Immediately after birth and at 30 minutes after birth
B. At 5 minutes after birth and at 30 minutes after birth
C. At 1 minute after birth and at 5 minutes after birth
D. Immediately after birth and at 5 minutes after birth
90. The best way to position a newboarn during the first week of life is to lay him [3]
A. Prone with head slightly elevated

B. On his back, flat
C. On his side with his head flat on bed
D. On his back with head slightly elevated
91. Baby boy perez has a large sebaceous glands on his nose, chin, and forehead.
These are known as [1]
A. Milia
B. Lanugo
C. Hemangiomas
D. Mongolian spots
92. Baby boy perez must be carefully observed for the first 24 hours for [2]
A. Respiratory distress
B. Duration of cry
C. Frequency of voiding
D. Range in body temperature
93. According to the WHO , when should the mother starts breastfeeding the infant?
[4]
A. Within 30 minutes after birth

B. Within 12 hours after birth
C. Within a day after birth
D. After infant's condition stabilizes
94. What is the BEST and most accurate method of measuring the medication
dosage for infants and children? [3]
A. Weight
B. Height
C. Nomogram
D. Weight and Height
95. The first postpartum visit should be done by the mother within [4]
A. 24 hours
B. 3 days
C. a week
D. a month
96. The major cause of maternal mortality in the philippines is [3]
A. Infection
B. Hemorrhage
C. Hypertension
D. Other complications related to labor,delivery and puerperium
97. According to the WHO, what should be the composition of a commercialized Oral
rehydration salt solution? [4]
A. Potassium : 1.5 g. ; Sodium Bicarbonate 2.5g ; Sodium Chloride 3.5g; Glucose 20

g.
g.
g.
g.
98. In preparing ORESOL at home, The correct composition recommnded by the DOH
is [4]
A. 1 glass of water, 1 pinch of salt and 2 tsp of sugar

B. 1 glass of water, 2 pinch of salt and 2 tsp of sugar
C. 1 glass of water, 3 pinch of salt and 4 tsp of sugar
D. 1 glass of water, 1 pinch of salt and 1 tsp of sugar
99. Milk code is a law the prohibits milk commercialization or artificial feeding for up
to 2 years. Which law provides its legal basis? [4]
A. Senate bill 1044

B. RA 7600
C. Presidential Proclamation 147
D. EO 51
100. A 40 year old mother in her third trimester should avoid [4]
A. Traveling
B. Climbing
C. Smoking
D. Exercising
Passing : 60/100 [ yes I know its brutally hard. ]
100 Item MEDICAL SURGICAL Nursing Examination

Question Pool
MEDICAL SURGICAL NURSING


SITUATION : Dervid, A registered nurse, witnessed an old woman hit by a

motorcycle while crossing a train railway. The old woman fell at the railway. Dervid
Rushed at the scene.
1. As a registered nurse, Dervid knew that the first thing that he will do at the scene
is [3]
A. Stay with the person, Encourage her to remain still and Immobilize the leg while
While waiting for the ambulance.
B. Leave the person for a few moments to call for help.
C. Reduce the fracture manually.
D. Move the person to a safer place.
2. Dervid suspects a hip fracture when he noticed that the old woman’s leg is [4]
A. Lengthened, Abducted and Internally Rotated.

B. Shortened, Abducted and Externally Rotated.
C. Shortened, Adducted and Internally Rotated.
D. Shortened, Adducted and Externally Rotated.
3. The old woman complains of pain. John noticed that the knee is reddened, warm
to touch and swollen. John interprets that this signs and symptoms are likely related
to [2]
A. Infection
C. Thrombophlebitis
B. Inflammation
D. Degenerative disease
4. The old woman told John that she has osteoporosis; Dervid knew that all of the
following factors would contribute to osteoporosis except [4]
A. Hypothyroidism
B. End stage renal disease
C. Cushing’s Disease
D. Taking Furosemide and Phenytoin.
5. Wilma, The old woman was now Immobilized and brought to the emergency room.
The X-ray shows a fractured femur and pelvis. The ER Nurse would carefully monitor
Martha for which of the following sign and symptoms? [3]
A. Tachycardia and Hypotension

B. Fever and Bradycardia
C. Bradycardia and Hypertension
D. Fever and Hypertension
SITUATION: Mr. D. Rojas, An obese 35 year old MS Professor of OLFU Lagro is
admitted due to pain in his weight bearing joint. The diagnosis was Osteoarthritis.
6. As a nurse, you instructed Mr. Rojas how to use a cane. Mr. Rojas has a weakness
on his right leg due to self immobilization and guarding. You plan to teach Mr. Rojas
to hold the cane [4]
A. On his left hand, because his right side is weak.

B. On his left hand, because of reciprocal motion.
C. On his right hand, to support the right leg.
D. On his right hand, because only his right leg is weak.
7. You also told Mr. Rojas to hold the cane [4]
A. 1 Inches in front of the foot.

B. 3 Inches at the lateral side of the foot.
c. 6 Inches at the lateral side of the foot.
D. 12 Inches at the lateral side of the foot.
8. Mr. Rojas was discharged and 6 months later, he came back to the emergency
room of the hospital because he suffered a mild stroke. The right side of the brain
was affected. At the rehabilitative phase of your nursing care, you observe Mr. Rojas
use a cane and you intervene if you see him [4]
A. Moves the cane when the right leg is moved.

B. Leans on the cane when the right leg swings through.
C. keeps the cane 6 Inches out to the side of the right foot.
D. Holds the cane on the right side.
SITUATION: Alfred, a 40 year old construction worker developed cough, night sweats
and fever. He was brought to the nursing unit for diagnostic studies. He told the
nurse he did not receive a BCG vaccine during childhood
9. The nurse performs a Mantoux Test. The nurse knows that Mantoux Test is also
known as [1]
A. PPD
B. PDP
C. PDD
D. DPP
10. The nurse would inject the solution in what route? [1]
A. IM
B. IV
C. ID
D. SC
11. The nurse notes that a positive result for Alfred is [2]
A. 5 mm wheel
B. 5 mm Induration
C. 10 mm Wheel
D. 10 mm Induration
12. The nurse told Alfred to come back after [2]
A. a week
B. 48 hours
C. 1 day
D. 4 days
13. Mang Alfred returns after the Mantoux Test. The test result read POSITIVE. What
should be the nurse’s next action? [3]
A. Call the Physician

B. Notify the radiology dept. for CXR evaluation
C. Isolate the patient
D. Order for a sputum exam
14. Why is Mantoux test not routinely done in the Philippines? [2]
A. It requires a highly skilled nurse to perform a Mantoux test

B. The sputum culture is the gold standard of PTB Diagnosis and it will definitively
determine the extent of the cavitary lesions
C. Chest X Ray Can diagnose the specific microorganism responsible for the lesions
D. Almost all Filipinos will test positive for Mantoux Test
15. Mang Alfred is now a new TB patient with an active disease. What is his category
according to the DOH? [1]
A. I
B. II
C. III
D. IV
16. How long is the duration of the maintenance phase of his treatment? [2]
A. 2 months
B. 3 months
C. 4 months
D. 5 months
17. Which of the following drugs is UNLIKELY given to Mang Alfred during the
maintenance phase? [3]
A. Rifampicin
B. Isoniazid
C. Ethambutol
D. Pyridoxine
18. According to the DOH, the most hazardous period for development of clinical
disease is during the first [4]
A. 6-12 months after

B. 3-6 months after
C. 1-2 months after
D. 2-4 weeks after
19. This is the name of the program of the DOH to control TB in the country [2]
A. DOTS
B. National Tuberculosis Control Program
C. Short Coursed Chemotherapy
D. Expanded Program for Immunization
20. Susceptibility for the disease [ TB ] is increased markedly in those with the
following condition except [3]
A. 23 Year old athlete with diabetes insipidus

B. 23 Year old athlete taking long term Decadron therapy and anabolic steroids
C. 23 Year old athlete taking illegal drugs and abusing substances
D. Undernourished and Underweight individual who undergone gastrectomy
21. Direct sputum examination and Chest X ray of TB symptomatic is in what level of
prevention? [1]
A. Primary
B. Secondary
C. Tertiary
D. Quarterly
SITUATION: Michiel, A male patient diagnosed with colon cancer was newly put in
colostomy.
22. Michiel shows the BEST adaptation with the new colostomy if he shows which of
the following? [2]
A. Look at the ostomy site

B. Participate with the nurse in his daily ostomy care
C. Ask for leaflets and contact numbers of ostomy support groups
D. Talk about his ostomy openly to the nurse and friends
23. The nurse plans to teach Michiel about colostomy irrigation. As the nurse
prepares the materials needed, which of the following item indicates that the nurse
needs further instruction? [3]
A. Plain NSS / Normal Saline

B. K-Y Jelly
C. Tap water
D. Irrigation sleeve
24. The nurse should insert the colostomy tube for irrigation at approximately [3]
A. 1-2 inches
B. 3-4 inches
C. 6-8 inches
D. 12-18 inches
25. The maximum height of irrigation solution for colostomy is [3]
A. 5 inches
B. 12 inches
C. 18 inches
D. 24 inches
26. Which of the following behavior of the client indicates the best initial step in
learning to care for his colostomy? [1]
A. Ask to defer colostomy care to another individual

B. Promises he will begin to listen the next day
C. Agrees to look at the colostomy
D. States that colostomy care is the function of the nurse while he is in the hospital
27. While irrigating the client’s colostomy, Michiel suddenly complains of severe
cramping. Initially, the nurse would [1]
A. Stop the irrigation by clamping the tube

B. Slow down the irrigation
C. Tell the client that cramping will subside and is normal
D. Notify the physician
28. The next day, the nurse will assess Michiel’s stoma. The nurse noticed that a
prolapsed stoma is evident if she sees which of the following? [1]
A. A sunken and hidden stoma

B. A dusky and bluish stoma
C. A narrow and flattened stoma
D. Protruding stoma with swollen appearance
29. Michiel asked the nurse, what foods will help lessen the odor of his colostomy.
The nurse best response would be [4]
A. Eat eggs
B. Eat cucumbers
C. Eat beet greens and parsley
D. Eat broccoli and spinach
30. The nurse will start to teach Michiel about the techniques for colostomy
irrigation. Which of the following should be included in the nurse’s teaching plan? [4]
A. Use 500 ml to 1,000 ml NSS

B. Suspend the irrigant 45 cm above the stoma
C. Insert the cone 4 cm in the stoma
D. If cramping occurs, slow the irrigation
31. The nurse knew that the normal color of Michiel’s stoma should be [1]
A. Brick Red
B. Gray
C. Blue
D. Pale Pink
SITUATION: James, A 27 basketball player sustained inhalation burn that required
him to have tracheostomy due to massive upper airway edema.
32. Wilma, His sister and a nurse is suctioning the tracheostomy tube of James.
Which of the following, if made by Wilma indicates that she is committing an error?
[2]
A. Hyperventilating James with 100% oxygen before and after suctioning

B. Instilling 3 to 5 ml normal saline to loosen up secretion
C. Applying suction during catheter withdrawal
D. Suction the client every hour
33. What size of suction catheter would Wilma use for James, who is 6 feet 5 inches
in height and weighing approximately 145 lbs? [2]
A. Fr. 5
B. Fr. 10
C. Fr. 12
D. Fr. 18
34. Wilma is using a portable suction unit at home, What is the amount of suction
required by James using this unit? [4]
A. 2-5 mmHg
B. 5-10 mmHg
C. 10-15 mmHg
D. 20-25 mmHg
35. If a Wall unit is used, What should be the suctioning pressure required by James?
[4]
A. 50-95 mmHg
B. 95-110 mmHg
C. 100-120 mmHg
D. 155-175 mmHg
36. Wilma was shocked to see that the Tracheostomy was dislodged. Both the inner
and outer cannulas was removed and left hanging on James’ neck. What are the 2
equipment’s at james’ bedside that could help Wilma deal with this situation? [3]
A. New set of tracheostomy tubes and Oxygen tank

B. Theophylline and Epinephrine
C. Obturator and Kelly clamp
D. Sterile saline dressing
37. Which of the following method if used by Wilma will best assure that the
tracheostomy ties are not too tightly placed? [2]
A. Wilma places 2 fingers between the tie and neck

B. The tracheotomy can be pulled slightly away from the neck
C. James’ neck veins are not engorged
D. Wilma measures the tie from the nose to the tip of the earlobe and to the xiphoid
process.
38. Wilma knew that James have an adequate respiratory condition if she notices
that [1]
A. James’ respiratory rate is 18

B. James’ Oxygen saturation is 91%
C. There are frank blood suction from the tube
D. There are moderate amount of tracheobronchial secretions
39. Wilma knew that the maximum time when suctioning James is [1]
A. 10 seconds
B. 20 seconds
C. 30 seconds
D. 45 seconds
SITUATION : Juan Miguel Lopez Zobel Ayala de Batumbakal was diagnosed with
Acute Close Angle Glaucoma. He is being seen by Nurse Jet.
40. What specific manifestation would nurse Jet see in Acute close angle glaucoma
that she would not see in an open angle glaucoma? [3]
A. Loss of peripheral vision

B. Irreversible vision loss
C. There is an increase in IOP
D. Pain
41. Nurse jet knew that Acute close angle glaucoma is caused by [3]
A. Sudden blockage of the anterior angle by the base of the iris

B. Obstruction in trabecular meshwork
C. Gradual increase of IOP
D. An abrupt rise in IOP from 8 to 15 mmHg
42. Nurse jet performed a TONOMETRY test to Mr. Batumbakal. What does this test
measures [1]
A. It measures the peripheral vision remaining on the client

B. Measures the Intra Ocular Pressure
C. Measures the Client’s Visual Acuity
D. Determines the Tone of the eye in response to the sudden increase in IOP.
43. The Nurse notices that Mr. Batumbakal cannot anymore determine RED from
BLUE. The nurse knew that which part of the eye is affected by this change? [3]
A. IRIS
B. PUPIL
c. RODS [RETINA]
D. CONES [RETINA]
44. Nurse Jet knows that Aqueous Humor is produce where? [4]
A. In the sub arachnoid space of the meninges
B. In the Lateral ventricles
C. In the Choroids
D. In the Ciliary Body
45. Nurse Jet knows that the normal IOP is [2]
A. 8-21 mmHg
B. 2-7 mmHg
c. 31-35 mmHg
D. 15-30 mmHg
46. Nurse Jet wants to measure Mr. Batumbakal’s CN II Function. What test would
Nurse Jet implement to measure CN II’s Acuity? [1]
A. Slit lamp
B. Snellen’s Chart
C. Wood’s light
D. Gonioscopy
47. The Doctor orders pilocarpine. Nurse jet knows that the action of this drug is to
[4]
A. Contract the Ciliary muscle

B. Relax the Ciliary muscle
C. Dilate the pupils
D. Decrease production of Aqueous Humor
48. The doctor orders timolol [timoptic]. Nurse jet knows that the action of this drug
is [4]
A. Reduce production of CSF

B. Reduce production of Aquesous Humor
C. Constrict the pupil
D. Relaxes the Ciliary muscle
49. When caring for Mr. Batumbakal, Jet teaches the client to avoid [1]
A. Watching large screen TVs

B. Bending at the waist
C. Reading books
D. Going out in the sun
50. Mr. Batumbakal has undergone eye angiography using an Intravenous dye and
fluoroscopy. What activity is contraindicated immediately after procedure? [4]
A. Reading newsprint
B. Lying down
C. Watching TV
D. Listening to the music
51. If Mr. Batumbakal is receiving pilocarpine, what drug should always be available
in any case systemic toxicity occurs? [2]
A. Atropine Sulfate
B. Pindolol [Visken]
C. Naloxone Hydrochloride [Narcan]
D. Mesoridazine Besylate [Serentil]
SITUATION : Wide knowledge about the human ear, it’s parts and it’s functions will
help a nurse assess and analyze changes in the adult client’s health.
52. Nurse Budek is doing a caloric testing to his patient, Aida, a 55 year old
university professor who recently went into coma after being mauled by her
disgruntled 3rd year nursing students whom she gave a failing mark. After instilling a
warm water in the ear, Budek noticed a rotary nystagmus towards the irrigated ear.
What does this means? [2]
A. Indicates a CN VIII Dysfunction

B. Abnormal
C. Normal
D. Inconclusive
53. Ear drops are prescribed to an infant, The most appropriate method to
administer the ear drops is [2]
A. Pull the pinna up and back and direct the solution towards the eardrum
B. Pull the pinna down and back and direct the solution onto the wall of the canal
C. Pull the pinna down and back and direct the solution towards the eardrum
D. Pull the pinna up and back and direct the solution onto the wall of the canal
54. Nurse Budek is developing a plan of care for a patient with Menieres disease.
What is the priority nursing intervention in the plan of care for this particular patient?
[1]
A. Air, Breathing, Circulation

B. Love and Belongingness
C. Food, Diet and Nutrition
D. Safety
55. After mastoidectomy, Nurse Budek should be aware that the cranial nerve that is
usually damage after this procedure is [3]
A. CN I
B. CN II
C. CN VII
D. CN VI
56. The physician orders the following for the client with Menieres disease. Which of
the following should the nurse question? [1]
A. Dipenhydramine [Benadryl]
B. Atropine sulfate
C. Out of bed activities and ambulation
D. Diazepam [Valium]
57. Nurse Budek is giving dietary instruction to a client with Menieres disease. Which
statement if made by the client indicates that the teaching has been successful? [1]
A. I will try to eat foods that are low in sodium and limit my fluid intake
B. I must drink atleast 3,000 ml of fluids per day
C. I will try to follow a 50% carbohydrate, 30% fat and 20% protein diet
D. I will not eat turnips, red meat and raddish
58. Peachy was rushed by his father, Steven into the hospital admission. Peachy is
complaining of something buzzing into her ears. Nurse Budek assessed peachy and
found out It was an insect. What should be the first thing that Nurse Budek should
try to remove the insect out from peachy’s ear? [3]
A. Use a flashlight to coax the insect out of peachy’s ear

B. Instill an antibiotic ear drops
C. Irrigate the ear
D. Pick out the insect using a sterile clean forceps
59. Following an ear surgery, which statement if heard by Nurse Budek from the
patient indicates a correct understanding of the post operative instructions? [2]
A. Activities are resumed within 5 days

B. I will make sure that I will clean my hair and face to prevent infection
C. I will use straw for drinking
D. I should avoid air travel for a while
60. Nurse Budek will do a caloric testing to a client who sustained a blunt injury in
the head. He instilled a cold water in the client’s right ear and he noticed that
nystagmus occurred towards the left ear. What does this finding indicates? [2]
A. Indicating a Cranial Nerve VIII Dysfunction

B. The test should be repeated again because the result is vague
C. This is Grossly abnormal and should be reported to the neurosurgeon
D. This indicates an intact and working vestibular branch of CN VIII
61. A client with Cataract is about to undergo surgery. Nurse Budek is preparing plan
of care. Which of the following nursing diagnosis is most appropriate to address the
long term need of this type of patient? [1]
A. Anxiety R/T to the operation and its outcome

B. Sensory perceptual alteration R/T Lens extraction and replacement
C. Knowledge deficit R/T the pre operative and post operative self care
D. Body Image disturbance R/T the eye packing after surgery
62. Nurse Budek is performing a WEBERS TEST. He placed the tuning fork in the
patients forehead after tapping it onto his knee. The client states that the fork is
louder in the LEFT EAR. Which of the following is a correct conclusion for nurse
Budek to make? [4]
A. He might have a sensory hearing loss in the left ear

B. Conductive hearing loss is possible in the right ear
C. He might have a sensory hearing loss in the right hear, and/or a conductive
hearing loss in the left ear.
D. He might have a conductive hearing loss in the right ear, and/or a sensory
63. Aling myrna has Menieres disease. What typical dietary prescription would nurse
Budek expect the doctor to prescribe? [2]
A. A low sodium , high fluid intake

B. A high calorie, high protein dietary intake
C. low fat, low sodium and high calorie intake
D. low sodium and restricted fluid intake
SITUATION : [ From DEC 1991 NLE ] A 45 year old male construction worker was
admitted to a tertiary hospital for incessant vomiting. Assessment disclosed: weak
rapid pulse, acute weight loss of .5kg, furrows in his tongue, slow flattening of the
skin was noted when the nurse released her pinch.
Temperature: 35.8 C , BUN Creatinine ratio : 10 : 1, He also complains for postural

hypotension. There was no infection.
64. Which of the following is the appropriate nursing diagnosis? [1]
A. Fluid volume deficit R/T furrow tongue

B. Fluid volume deficit R/T uncontrolled vomiting
C. Dehydration R/T subnormal body temperature
D. Dehydration R/T incessant vomiting
65. Approximately how much fluid is lost in acute weight loss of .5kg? [1]
A. 50 ml
B. 750 ml
C. 500 ml
D. 75 ml
66. Postural Hypotension is [1]
A. A drop in systolic pressure less than 10 mmHg when patient changes position
from lying to sitting.
B. A drop in systolic pressure greater than 10 mmHg when patient changes position
from lying to sitting
C. A drop in diastolic pressure less than 10 mmHg when patient changes position
D. A drop in diastolic pressure greater than 10 mmHg when patient changes position
67. Which of the following measures will not help correct the patient’s condition [1]
A. Offer large amount of oral fluid intake to replace fluid lost

B. Give enteral or parenteral fluid
C. Frequent oral care
D. Give small volumes of fluid at frequent interval
68. After nursing intervention, you will expect the patient to have [1]
1. Maintain body temperature at 36.5 C

2. Exhibit return of BP and Pulse to normal
3. Manifest normal skin turgor of skin and tongue
4. Drinks fluids as prescribed
A. 1,3
B. 2,4
C. 1,3,4
D. 2,3,4
SITUATION: [ From JUN 2005 NLE ] A 65 year old woman was admitted for
Parkinson’s Disease. The charge nurse is going to make an initial assessment.
69. Which of the following is a characteristic of a patient with advanced Parkinson’s

disease? [1]
A. Disturbed vision
B. Forgetfulness
C. Mask like facial expression
D. Muscle atrophy
70. The onset of Parkinson’s disease is between 50-60 years old. This disorder is
caused by [1]
A. Injurious chemical substances

B. Hereditary factors
C. Death of brain cells due to old age
D. Impairment of dopamine producing cells in the brain
71. The patient was prescribed with levodopa. What is the action of this drug? [1]
A. Increase dopamine availability

B. Activates dopaminergic receptors in the basal ganglia
C. Decrease acetylcholine availability
D. Release dopamine and other catecholamine from neurological storage sites
72. You are discussing with the dietician what food to avoid with patients taking
levodopa? [3]
A. Vitamin C rich food

B. Vitamin E rich food
C. Thiamine rich food
D. Vitamin B6 rich food
73. One day, the patient complained of difficulty in walking. Your response would be
[2]
A. You will need a cane for support

B. Walk erect with eyes on horizon
C. I’ll get you a wheelchair
D. Don’t force yourself to walk
SITUATION: [ From JUN 2005 NLE ] Mr. Dela Isla, a client with early Dementia
exhibits thought process disturbances.
74. The nurse will assess a loss of ability in which of the following areas? [2]
A. Balance
B. Judgment
C. Speech
D. Endurance
75. Mr. Dela Isla said he cannot comprehend what the nurse was saying. He suffers
from: [1]
A. Insomnia
B. Aphraxia
C. Agnosia
D. Aphasia
76. The nurse is aware that in communicating with an elderly client, the nurse will
[1]
A. Lean and shout at the ear of the client

B. Open mouth wide while talking to the client
C. Use a low-pitched voice
D. Use a medium-pitched voice
77. As the nurse talks to the daughter of Mr. Dela Isla, which of the following
statement of the daughter will require the nurse to give further teaching? [1]
A. I know the hallucinations are parts of the disease

B. I told her she is wrong and I explained to her what is right
C. I help her do some tasks he cannot do for himself
D. Ill turn off the TV when we go to another room
78. Which of the following is most important discharge teaching for Mr. Dela Isla [2]
A. Emergency Numbers
B. Drug Compliance
C. Relaxation technique
D. Dietary prescription
SITUATION : Knowledge of the drug PROPANTHELINE BROMIDE [Probanthine] Is

necessary in treatment of various disorders.
79. What is the action of this drug? [4]
A. Increases glandular secretion for clients affected with cystic fibrosis

B. Dissolve blockage of the urinary tract due to obstruction of cystine stones
C. Reduces secretion of the glandular organ of the body
D. Stimulate peristalsis for treatment of constipation and obstruction
80. What should the nurse caution the client when using this medication [4]
A. Avoid hazardous activities like driving, operating machineries etc.
B. Take the drug on empty stomach
C. Take with a full glass of water in treatment of Ulcerative colitis
D. I must take double dose if I missed the previous dose
81. Which of the following drugs are not compatible when taking Probanthine? [4]
A. Caffeine
B. NSAID
C. Acetaminophen
D. Alcohol
82. What should the nurse tell clients when taking Probanthine? [4]
A. Avoid hot weathers to prevent heat strokes

B. Never swim on a chlorinated pool
C. Make sure you limit your fluid intake to 1L a day
D. Avoid cold weathers to prevent hypothermia
83. Which of the following disease would Probanthine exert the much needed action
for control or treatment of the disorder? [4]
A. Urinary retention
B. Peptic Ulcer Disease
C. Ulcerative Colitis
D. Glaucoma
SITUATION : [ From DEC 2000 NLE ] Mr. Franco, 70 years old, suddenly could not lift
his spoons nor speak at breakfast. He was rushed to the hospital unconscious. His
diagnosis was CVA.
84. Which of the following is the most important assessment during the acute stage
of an unconscious patient like Mr. Franco? [1]
A. Level of awareness and response to pain

B. Papillary reflexes and response to sensory stimuli
C. Coherence and sense of hearing
D. Patency of airway and adequacy of respiration
85. Considering Mr. Franco’s conditions, which of the following is most important to
include in preparing Franco’s bedside equipment? [1]
A. Hand bell and extra bed linen

B. Sandbag and trochanter rolls
C. Footboard and splint
D. Suction machine and gloves
86. What is the rationale for giving Mr. Franco frequent mouth care? [1]
A. He will be thirsty considering that he is doesn’t drink enough fluids

B. To remove dried blood when tongue is bitten during a seizure
C. The tactile stimulation during mouth care will hasten return to consciousness
D. Mouth breathing is used by comatose patient and it’ll cause oral mucosa dying
and cracking.
87. One of the complications of prolonged bed rest is decubitus ulcer. Which of the
following can best prevent its occurrence? [1]
A. Massage reddened areas with lotion or oils

B. Turn frequently every 2 hours
C. Use special water mattress
D. Keep skin clean and dry
88. If Mr. Franco’s Right side is weak, What should be the most accurate analysis by
the nurse? [4]
A. Expressive aphasia is prominent on clients with right sided weakness

B. The affected lobe in the patient is the Right lobe
C. The client will have problems in judging distance and proprioception
D. Clients orientation to time and space will be much affected
SITUATION : [ From JUN 1988 NLE ] a 20 year old college student was rushed to the
ER of PGH after he fainted during their ROTC drill. Complained of severe right iliac
pain. Upon palpation of his abdomen, Ernie jerks even on slight pressure. Blood test
was ordered. Diagnosis is acute appendicitis.
89. Which result of the lab test will be significant to the diagnosis? [1]
A. RBC : 4.5 TO 5 Million / cu. mm.

B. Hgb : 13 to 14 gm/dl.
C. Platelets : 250,000 to 500,000 cu.mm.
D. WBC : 12,000 to 13,000/cu.mm
90. Stat appendectomy was indicated. Pre op care would include all of the following
except? [1]
A. Consent signed by the father

B. Enema STAT
C. Skin prep of the area including the pubis
D. Remove the jewelries
91. Pre-anesthetic med of Demerol and atrophine sulfate were ordered to : [3]
A. Allay anxiety and apprehension

B. Reduce pain
C. Prevent vomiting
D. Relax abdominal muscle
92. Common anesthesia for appendectomy is [3]
A. Spinal
B. General
C. Caudal
D. Hypnosis
93. Post op care for appendectomy include the following except [1]
A. Early ambulation
B. Diet as tolerated after fully conscious
C. Nasogastric tube connect to suction
D. Deep breathing and leg exercise
94. Peritonitis may occur in ruptured appendix and may cause serious problems
which are [2]
1. Hypovolemia, electrolyte imbalance

2. Elevated temperature, weakness and diaphoresis
3. Nausea and vomiting, rigidity of the abdominal wall
4. Pallor and eventually shock
A. 1 and 2
B. 2 and 3
C. 1,2,3
D. All of the above
95. If after surgery the patient’s abdomen becomes distended and no bowel sounds
appreciated, what would be the most suspected complication? [1]
A. Intussusception
B. Paralytic Ileus
C. Hemorrhage
D. Ruptured colon
96. NGT was connected to suction. In caring for the patient with NGT, the nurse
must [2]
A. Irrigate the tube with saline as ordered

B. Use sterile technique in irrigating the tube
C. advance the tube every hour to avoid kinks
D. Offer some ice chips to wet lips
97. When do you think the NGT tube be removed? [1]
A. When patient requests for it

B. Abdomen is soft and patient asks for water
C. Abdomen is soft and flatus has been expelled
D. B and C only
Situation: Amanda is suffering from chronic arteriosclerosis Brain syndrome she fell
while getting out of the bed one morning and was brought to the hospital, and she
was diagnosed to have cerebrovascular thrombosis thus transferred to a nursing
home.
98. What do you call a STROKE that manifests a bizarre behavior? [4]
A. Inorganic Stroke
B. Inorganic Psychoses
C. Organic Stroke
D. Organic Psychoses
99. The main difference between chronic and organic brain syndrome is that the
former [2]
A. Occurs suddenly and reversible

B. Is progressive and reversible
C. tends to be progressive and irreversible
D. Occurs suddenly and irreversible
100. Which behavior results from organic psychoses? [4]
A. Memory deficit
B. Disorientation
C. Impaired Judgement
D. Inappropriate affect
Passing : 75/100
100 Item MEDICAL SURGICAL Nursing Examination

Correct answers and rationales
Question Pool
MEDICAL SURGICAL NURSING
DISCLAIMER : Care has been taken to verify that all answers and rationale below are
accurate. Please comment up if you noticed any errors or contradictions to maintain
accuracy and precision of the answers as not to mislead the readers.
-Budek

SITUATION : Dervid, A registered nurse, witnessed an old woman hit by a

motorcycle while crossing a train railway. The old woman fell at the railway. Dervid
Rushed at the scene.
1. As a registered nurse, Dervid knew that the first thing that he will do at the scene
is [3]
A. Stay with the person, Encourage her to remain still and Immobilize the leg while
While waiting for the ambulance.
B. Leave the person for a few moments to call for help.
C. Reduce the fracture manually.
D. Move the person to a safer place.
* The old woman is in the middle of a train railway. It is very unsafe to immobilize
here legs and remain still at the middle of a railway considering that a train might
come anytime while waiting for an ambulance. Safety is the utmost importance at
this point. If letter D is not among the choices and the situation is a little less
dangerous, the answer will be A. Remember that in all cases of emergencies,
removing the victim from the scene to a much safer place is a priority.
2. Dervid suspects a hip fracture when he noticed that the old woman’s leg is [4]
A. Lengthened, Abducted and Internally Rotated.

B. Shortened, Abducted and Externally Rotated.
C. Shortened, Adducted and Internally Rotated.
D. Shortened, Adducted and Externally Rotated.
* SADDER should be your keyword. A hip fracture will produce a SHORTENED,

ADDUCTED AND EXTERNALLY ROTATED extremity. Treatment will evolve in casting
the leg and putting it in a EXTENSION, NEUTRALLY POSITIONED and SLIGHT
INTERNAL ROTATION. In Hip prosthesis, The nurse should maintain the client’s leg in
FLEXION, EXTERNAL ROTATION and ABDUCTION to prevent the dislocation of the
prosthesis from the acetabulum. Take note of the difference because I mistakenly
answered the LATTER in casting a hip fracture thinking that it is similar to a the leg
positioning in hip dislocation. Just imagine a patient with a cast that has his leg in
ABDUCTION, EXTERNAL ROTATION AND FLEXION. It will cause flexion contractures.
3. The old woman complains of pain. John noticed that the knee is reddened, warm
to touch and swollen. John interprets that this signs and symptoms are likely related
to [2]
A. Infection
C. Thrombophlebitis
B. Inflammation
D. Degenerative disease
* After a trauma, Inflammation will start almost instantly. Infection occurse 24-48
hours after bone fracture and not immediately. Thrombophlebitis occurs within 4 to 7
days of hospitalization after prolonged immobilization. There is no evidence that the
client has a degenerative disease and degenerative diseases will manifest in variety
of ways and not after a trauma.
4. The old woman told John that she has osteoporosis; Dervid knew that all of the
following factors would contribute to osteoporosis except [4]
A. Hypothyroidism
B. End stage renal disease
C. Cushing’s Disease
D. Taking Furosemide and Phenytoin.
* B,C,D all contributes to bone deminiralization except HYPOTHYROIDISM.

Hyperthyroidism will contribute to bone deminiralization as well as
Hyperparathyroidism due to the increase in PTH, It will cause the movement of
calcium from the bone to the blood causing HYPERCALCEMIA. ESRD will cause
increase in PHOPHSATE due to its poor excretion. The amount of phosphate is
inversely proportional to the amount of calcium. Cushing disease promotes bone
demineralization as well as medications like diuretics and anti convulsants.
5. Martha, The old woman was now Immobilized and brought to the emergency
room. The X-ray shows a fractured femur and pelvis. The ER Nurse would carefully
monitor Martha for which of the following sign and symptoms? [3]
A. Tachycardia and Hypotension

B. Fever and Bradycardia
C. Bradycardia and Hypertension
D. Fever and Hypertension
* hemorrhage results in severing of the vascular supply of the bone of the femur and
the pelvis due to the fracture leading to bleeding causing the s/s of tachycardia and
hypotension.
SITUATION: Mr. D. Rojas, An obese 35 year old MS Professor of OLFU Lagro is

admitted due to pain in his weight bearing joint. The diagnosis was Osteoarthritis.
6. As a nurse, you instructed Mr. Rojas how to use a cane. Mr. Rojas has a weakness
on his right leg due to self immobilization and guarding. You plan to teach Mr. Rojas
to hold the cane [4]
A. On his left hand, because his right side is weak.

B. On his left hand, because of reciprocal motion.
C. On his right hand, to support the right leg.
D. On his right hand, because only his right leg is weak.
* Reciprocal motion is a very important aspect of rehabilitation. Mr. Rojas has a

weakness on his right leg. If a human moves his right leg, the left arm will
accompany the movement of the right leg. That is what you call RECIPROCAL
MOTION which is innate, natural and required to maintain balance. Mr. Rojas has
weakness in his RIGHT LEG. If we put the cane on his right arm, The client will then
be left UNSUPPORTED when he use his stronger leg [LEFT LEG] and stand with his
weaker leg [RIGHT LEG] due to the fact that the opposite arm must accompany the
movement of the opposite leg [RIGHT ARM]. In a more easier term, Always put the
cane on the opposite of the weaker side. A is not correct because the client is NOT
hemiplegic and will never be correct to reason out why the cane must always be at
the opposite of the weaker side, it will always be due to reciprocal motion.
7. You also told Mr. Rojas to hold the cane [4]
A. 1 Inches in front of the foot.

B. 3 Inches at the lateral side of the foot.
c. 6 Inches at the lateral side of the foot.
D. 12 Inches at the lateral side of the foot.
* Remove option A, the client will kick off the cane if it was in the front of the foot.
Remove option D because that is too far and will cause the cane to poorly support
the client because the side, not the tip, is touching the ground. At 3 inches, imagine
how short it is and will cause a very poor supporting base. The correct answer is
anywhere from 6 to 10 inches for both crutches and cane.
8. Mr. Rojas was discharged and 6 months later, he came back to the emergency
room of the hospital because he suffered a mild stroke. The right side of the brain
was affected. At the rehabilitative phase of your nursing care, you observe Mr. Rojas
use a cane and you intervene if you see him [4]
A. Moves the cane when the right leg is moved.

B. Leans on the cane when the right leg swings through.
C. keeps the cane 6 Inches out to the side of the right foot.
D. Holds the cane on the right side.
* If the right side of the brain is affected, weakness will always be CONTRALATERAL
and therefore, Mr. Rojas will have weakness on his left side. Earlier I told you that
cane is held on the opposite side of the weaker side, which in this situation, will be
on the RIGHT. Imagine if the client moves his RIGHT LEG together witht the RIGHT
CANE, it already violated the LAW OF RECIPROCAL MOTION. Moving the right leg will
require Mr. Rojas to move his left arm and not the cane, which is on his right.
SITUATION: Alfred, a 40 year old construction worker developed cough, night sweats
and fever. He was brought to the nursing unit for diagnostic studies. He told the
nurse he did not receive a BCG vaccine during childhood
9. The nurse performs a Mantoux Test. The nurse knows that Mantoux Test is also
known as [1]
A. PPD
B. PDP
C. PDD
D. DPP
* PPD stands for purified protein derivative. It is used to check for TB exposure. All
clients who had BCG need not perform this test because they will always be + .
10. The nurse would inject the solution in what route? [1]
A. IM
B. IV
C. ID
D. SC
* A Wheal is created intradermally and then it is marked and timed. reading will be
done within 2 to 3 days.
11. The nurse notes that a positive result for Alfred is [2]
A. 5 mm wheal
B. 5 mm Induration
C. 10 mm Wheal
D. 10 mm Induration
* 10 mm Induration [ redness ] is considered positive for individuals with

competitive immune response. Wheals are not measured, they will not anymore
enlarge. A 5 mm induration is considered positive for patients with AIDS or
immunocompromised.
12. The nurse told Alfred to come back after [2]
A. a week
B. 48 hours
C. 1 day
D. 4 days
* Clients are asked to comeback within 2 to 3 days for the reading.
13. Mang Alfred returns after the Mantoux Test. The test result read POSITIVE. What
should be the nurse’s next action? [3]
A. Call the Physician

B. Notify the radiology dept. for CXR evaluation
C. Isolate the patient
D. Order for a sputum exam
* The nurse has no authority order the radiology department for a chest x ray
evaluation nor order for a sputum exam. The client need not be isolated because
Mantoux test do not determine the activeness of the disease.
14. Why is Mantoux test not routinely done in the Philippines? [2]
A. It requires a highly skilled nurse to perform a Mantoux test

B. The sputum culture is the gold standard of PTB Diagnosis and it will definitively
determine the extent of the cavitary lesions
C. Chest X Ray Can diagnose the specific microorganism responsible for the lesions
D. Almost all Filipinos will test positive for Mantoux Test
* almost all filipinos tests positive for mantoux test due to the fact that BCG are
required and TB exposure in the country is fullminant. All individuals vaccinated with
BCG will test POSITIVE for mantoux test all their lives.
15. Mang Alfred is now a new TB patient with an active disease. What is his category
according to the DOH? [1]
A. I
B. II
C. III
D. IV
* Category I patients are those with a newly diagnosed TB whose sputum culture are
positive. II are for those who have relapses while III are those with negative sputum
culture but positive chest x ray, or PTB Minimal.
16. How long is the duration of the maintenance phase of his treatment? [2]
A. 2 months
B. 3 months
C. 4 months
D. 5 months
* Clients in category I will have 2 months INTENSIVE and 4 months maintenance
treatment.
17. Which of the following drugs is UNLIKELY given to Mang Alfred during the
maintenance phase? [3]
A. Rifampicin
B. Isoniazid
C. Ethambutol
D. Pyridoxine
* Drugs given in the maintenance phase includes Rifampicin and Isoniazid.

Ethambutol is given on the intensive phase along with rifampicin and isoniazid.
Pyridoxine is given during Isoniazid treatment to prevent peripheral neuritis in
contrast in treatment of parkinson's with levodopa, Pyridoxine or VB6 is restricted.
18. According to the DOH, the most hazardous period for development of clinical
disease is during the first [4]
A. 6-12 months after

B. 3-6 months after
C. 1-2 months after
D. 2-4 weeks after
* According to the department of health, the most hazardous period for development
of clinical disease is during the first 6 to 12 months.
19. This is the name of the program of the DOH to control TB in the country [2]
A. DOTS
B. National Tuberculosis Control Program
C. Short Coursed Chemotherapy
D. Expanded Program for Immunization
* National tuberculosis control program is the name of the program of the DOH to
control and eradicate TB in the country. DOTS refers to the STRATEGY used by the
department in treating TB patients. EPI is not a program for TB control although BCG
is one of the vaccine given in this program.
20. Susceptibility for the disease [ TB ] is increased markedly in those with the
following condition except [3]
A. 23 Year old athlete with diabetes insipidus

B. 23 Year old athlete taking long term Decadron therapy and anabolic steroids
C. 23 Year old athlete taking illegal drugs and abusing substances
D. Undernourished and Underweight individual who undergone gastrectomy
* Nutrition, Long term immunosupression and drug abuse are all factors that affects
the resistance of an individual in acquiring communicable diseases. Other factors
includes extremes of ages, poor environmental sanitation, poverty and poor living
conditions. Diabetes insipidus does not, in anyway alter a persons immune response.
21. Direct sputum examination and Chest X ray of TB symptomatic is in what level of
prevention? [1]
A. Primary
B. Secondary
C. Tertiary
D. Quarterly
* National board exam loves asking about level of prevention. Mastery with the
primary, secondary and tertiary levels of prevention is a must. All diagnostic, case
finding and treatment belongs to the secondary level of prevention.
SITUATION: Michiel, A male patient diagnosed with colon cancer was newly put in
colostomy.
22. Michiel shows the BEST adaptation with the new colostomy if he shows which of
the following? [2]
A. Look at the ostomy site

B. Participate with the nurse in his daily ostomy care
C. Ask for leaflets and contact numbers of ostomy support groups
D. Talk about his ostomy openly to the nurse and friends
* Actual participation conveys positive acceptance and adjustment to the altered

body image. Although looking at the ostomy site also conveys acceptance and
adjustment, Participating with the nurse to his daily ostomy care is the BEST
adaptation a client can make during the first few days after colostomy creation.
23. The nurse plans to teach Michiel about colostomy irrigation. As the nurse
prepares the materials needed, which of the following item indicates that the nurse
needs further instruction? [3]
A. Plain NSS / Normal Saline

B. K-Y Jelly
C. Tap water
D. Irrigation sleeve
* The colon is not sterile, nor the stomach. Tap water is used in enema irrigation and
not NSS. Although some clients would prefer a distilled, mineral or filtered water,
NSS is not always necessary. KY Jelly is used as the lubricant for the irrigation tube
and is inserted 3-4 inches into the colostomy pointing towards the RIGHT. Irrigation
sleeve is use to direct the flow of the irrigated solution out of the stomach and into
the bedpan or toilet.
24. The nurse should insert the colostomy tube for irrigation at approximately [3]
A. 1-2 inches
B. 3-4 inches
C. 6-8 inches
D. 12-18 inches
* Remember 3-4 inches. They are both used in the rectal tube and colostomy
irrigation tube insertion. 1 to 2 inches is too short and may spill out the irrigant out
of the stoma. Starting from 6 inches, it would be too long already and may perforate
the bowel.
25. The maximum height of irrigation solution for colostomy is [3]
A. 5 inches
B. 12 inches
C. 18 inches
D. 24 inches
* If you will answer in the CGFNS and NCLEX, C will be the correct answer. According
to BRUNNER AND SUDDARTHS and Saunders, The height of the colostomy irrigation
bag should be hanging above the clients shoulder at around 18 inches. According to
MOSBY, 12 inches should be the maximum height. According to Lippinncots, 18
inches is the maximum height. According the the board of examiners, 12 inches
should be the maximum height and an 18 inches irrigant height would cause rapid
flow of the irrigant towards the colostomy. Therefore, answer in the local board
should only be at 12 inches.
26. Which of the following behavior of the client indicates the best initial step in
learning to care for his colostomy? [1]
A. Ask to defer colostomy care to another individual

B. Promises he will begin to listen the next day
C. Agrees to look at the colostomy
D. States that colostomy care is the function of the nurse while he is in the hospital
* The client made the best initial step in learning to care for his colostomy once he
looks at the site. This is the start of the client's acceptance on his altered body
image. A,B and D delays learning and shows the client's disintrest regarding
colostomy care.
27. While irrigating the client’s colostomy, Michiel suddenly complains of severe
cramping. Initially, the nurse would [1]
A. Stop the irrigation by clamping the tube

B. Slow down the irrigation
C. Tell the client that cramping will subside and is normal
D. Notify the physician
* Stopping the irrigation will also stop the cramping and pain. During the first few
days of irrigation, The client will feel pain and cramping as soon as the irirgant
touches the bowel. This will start to lessen once the client got accustomed to
colostomy irrigation. Slowing down the irrigation will not stop the pain. Telling the
client that it is normal and will subside eventually is not acceptable when a client
experiences pain. Pain is all encompasing and always a priority over anything else in
most situations. Notifying the physician will not be helpful and unecessary.
28. The next day, the nurse will assess Michiel’s stoma. The nurse noticed that a
prolapsed stoma is evident if she sees which of the following? [1]
A. A sunken and hidden stoma

B. A dusky and bluish stoma
C. A narrow and flattened stoma
D. Protruding stoma with swollen appearance
* A refers to a retracted stoma, B refers to a stoma that is getting a very poor blood
supply. C is a description of stenosis of the stoma.
29. Michiel asked the nurse, what foods will help lessen the odor of his colostomy.
The nurse best response would be [4]
A. Eat eggs
B. Eat cucumbers
C. Eat beet greens and parsley
D. Eat broccoli and spinach
* Kinchay and Pechay helps lessen the odor of the colostomy. Spinach, broccoli,
Cabbage, Cucumbers, Patola or bottle gourd also help lessen the odor BUT are gas
formers. Eggs are not recommended because they are known to cause unpleasant
odors in patients with colostomy.
30. The nurse will start to teach Michiel about the techniques for colostomy
irrigation. Which of the following should be included in the nurse’s teaching plan? [4]
A. Use 500 ml to 1,000 ml NSS

B. Suspend the irrigant 45 cm above the stoma
C. Insert the cone 4 cm in the stoma
D. If cramping occurs, slow the irrigation
* 1 inches is equal to 2.54 cm. Convert the cm if you are not familiar. 45 cm is
around 17 inches which is ideal for colostomy irrigation. Any value from 12 to 18 is
accepted as the colostomy irrigant height. Tap water is used as an irrigant and is
infused at room temperature. 4 cm is a little bit short for the ideal 3-4 inches. If
cramping occurs STOP the irrigation and continue when is subsides.
31. The nurse knew that the normal color of Michiel’s stoma should be [1]
A. Brick Red
B. Gray
C. Blue
D. Pale Pink
* The stoma should be RED in color. Pale pink are common with anemic or
dehydrated patients who lost a lot of blood after an operation. Blue stoma indicated
cyanosis or alteration in perfusion. Stomas are not expected to be Gray.
SITUATION: James, A 27 basketball player sustained inhalation burn that required

him to have tracheostomy due to massive upper airway edema.
32. Wilma, His sister and a nurse is suctioning the tracheostomy tube of James.
Which of the following, if made by Wilma indicates that she is committing an error?
[2]
A. Hyperventilating James with 100% oxygen before and after suctioning

B. Instilling 3 to 5 ml normal saline to loosen up secretion
C. Applying suction during catheter withdrawal
D. Suction the client every hour
* This is unecessary. Suctioning is done on PRN basis and not every hour. A,B and C
are all correct processes of suctioning a tracheostomy.
33. What size of suction catheter would Wilma use for James, who is 6 feet 5 inches
in height and weighing approximately 145 lbs? [2]
A. Fr. 5
B. Fr. 10
C. Fr. 12
D. Fr. 18
* The height is given and it looks like james is a very tall individual. The maximum
height of suction tube is used. fr 12-18 are used for adults while 6-8 are used in
children.
34. Wilma is using a portable suction unit at home, What is the amount of suction
required by James using this unit? [4]
A. 2-5 mmHg
B. 5-10 mmHg
C. 10-15 mmHg
D. 20-25 mmHg
* A is used in pediatric clients. B is for children and C is for adults. 20-25 mmHg is
too much for a portable suction unit and is not recommended.
35. If a Wall unit is used, What should be the suctioning pressure required by James?
[4]
A. 50-95 mmHg
B. 95-110 mmHg
C. 100-120 mmHg
D. 155-175 mmHg
* A is used in pediatric clients. B is for children and C is for adults. 155-175 mmHg is
too much for a wall suction unit and is not recommended.
36. Wilma was shocked to see that the Tracheostomy was dislodged. Both the inner
and outer cannulas was removed and left hanging on James’ neck. What are the 2
equipment’s at james’ bedside that could help Wilma deal with this situation? [3]
A. New set of tracheostomy tubes and Oxygen tank

B. Theophylline and Epinephrine
C. Obturator and Kelly clamp
D. Sterile saline dressing
* In an emergency like this, The first thing the nurse should do is maintaining the
airway patency. With the cannunlas dislodged, The stoma will stenosed and narrows
giving james an obstructed airway. The nurse would insert the kelly clamp to open
the stoma and lock the clamp in place to maintain it open while she uses an
obturator as to prevent further stenosis of the stoma. An obturator is a part of the
NGT package included by most manufacturers to guide the physician or nurses in
inserting the outer cannula.
37. Which of the following method if used by Wilma will best assure that the
tracheostomy ties are not too tightly placed? [2]
A. Wilma places 2 fingers between the tie and neck

B. The tracheotomy can be pulled slightly away from the neck
C. James’ neck veins are not engorged
D. Wilma measures the tie from the nose to the tip of the earlobe and to the xiphoid
process.
* Wilma should place 2 fingers underneath the tie to ensure that it is not too tight
nor too loose. Letter D is the measurement for NGT insertion and is unrelated to
tracheostomy.
38. Wilma knew that James have an adequate respiratory condition if she notices
that [1]
A. James’ respiratory rate is 18

B. James’ Oxygen saturation is 91%
C. There are frank blood suction from the tube
D. There are moderate amount of tracheobronchial secretions
* an RR of 18 means that James is not tachypneic and has an adequate air

exchange. Oxygen saturation should be more than 95%. Frank blood is not expected
in the suction tube. A slight tinged of blood in the tube is acceptable and expected.
Amount of secretion are not in anyway related in assessing the respiratory condition
of a person and so is the amount of blood in the tube.
39. Wilma knew that the maximum time when suctioning James is [1]
A. 10 seconds
B. 20 seconds
C. 30 seconds
D. 45 seconds
* According to our reviewers and lecturers, 10 to 15 seconds is the maximum suction

time. But according to almost all foreign books I read, it should only be 10 seconds
at max. I prefer following Saunders,Mosby and Lippinncots when they are all united.
SITUATION : Juan Miguel Lopez Zobel Ayala de Batumbakal was diagnosed with
Acute Close Angle Glaucoma. He is being seen by Nurse Jet.
40. What specific manifestation would nurse Jet see in Acute close angle glaucoma
that she would not see in an open angle glaucoma? [3]
A. Loss of peripheral vision

B. Irreversible vision loss
C. There is an increase in IOP
D. Pain
* There is NO PAIN in open angle glaucoma. A,B,C are all present in both glaucomas
including the low pressure glaucoma. Pain is absent because the increase in intra
ocular pressure is not initiated abruptly. It is gradual and progressive and will lead to
unoticed loss of peripheral vision. Pain is present in acute close angle glaucoma
because there is a sudden closure or narrowing of the canal of schlemm. Therefore if
you will be ask what s/s is common in both, answer IRREVERSIBLE LOSS OF
PERIPHERAL VISION.
41. Nurse jet knew that Acute close angle glaucoma is caused by [3]
A. Sudden blockage of the anterior angle by the base of the iris

B. Obstruction in trabecular meshwork
C. Gradual increase of IOP
D. An abrupt rise in IOP from 8 to 15 mmHg
* Sudden blockage of the angle will cause s/s of acute angle closure glaucoma. B and
C are all related to open angle glaucoma. D is insignificant, If the client bends or
cough, IOP can increase from 8 to as much as 30 mmHg but then return again to
normal.
42. Nurse jet performed a TONOMETRY test to Mr. Batumbakal. What does this test
measures [1]
A. It measures the peripheral vision remaining on the client

B. Measures the Intra Ocular Pressure
C. Measures the Client’s Visual Acuity
D. Determines the Tone of the eye in response to the sudden increase in IOP.
* Tonometry measures the IOP. Normal range is 8 to 21 mmHg.
43. The Nurse notices that Mr. Batumbakal cannot anymore determine RED from
BLUE. The nurse knew that which part of the eye is affected by this change? [3]
A. IRIS
B. PUPIL
c. RODS [RETINA]
D. CONES [RETINA]
* CONES Are responsible for COLOR VISION and DAY VISION, they are very
sensitive to RED LIGHT that is why red lights are use to guide the elderly towards
the bathroom when they wake up to urinate. Rods are responsible for night vision.
They are sensitive to blue and green lights.
44. Nurse Jet knows that Aqueous Humor is produce where? [4]
A. In the sub arachnoid space of the meninges

B. In the Lateral ventricles
C. In the Choroids
D. In the Ciliary Body
* AH is produced in the CILIARY BODY. It is filtered by the trabecular meshwork into

the canal of schlemm.
45. Nurse Jet knows that the normal IOP is [2]
A. 8-21 mmHg
B. 2-7 mmHg
c. 31-35 mmHg
D. 15-30 mmHg
46. Nurse Jet wants to measure Mr. Batumbakal’s CN II Function. What test would
Nurse Jet implement to measure CN II’s Acuity? [1]
A. Slit lamp
B. Snellen’s Chart
C. Wood’s light
D. Gonioscopy
* CN II is the optic nerve. To assess its acuity, Snellen's chart is used. Slit lamp is
the one you see in the usual Eye glasses shop where in, you need to look into its
binocular-like holes and the optometrist is on the other side to magnify the
structures of the eye to assess gross damage and structure. Woods light is a BLUE
LIGHT used in dermatology. It is use to mark lesions usually caused skin infection.
Gonioscopy is the angle measurement of the eye.
47. The Doctor orders pilocarpine. Nurse jet knows that the action of this drug is to
[4]
A. Contract the Ciliary muscle

B. Relax the Ciliary muscle
C. Dilate the pupils
D. Decrease production of Aqueous Humor
* When the ciliary muscles contract, pupils constrict and the angle widens causing an
increase AH outflow and decrease IOP. Relaxing the ciliary muscle will cause
mydriasis or dilation, it is used as a pre op meds for cataract surgery and eye
examination to better visualize the structures behind the iris. A and C are the same.
Other drugs like betaxolol, Azetazolamide and epinephrine are the drugs used to
decrease AH production.
48. The doctor orders timolol [timoptic]. Nurse jet knows that the action of this drug
is [4]
A. Reduce production of CSF

B. Reduce production of Aqueous Humor
C. Constrict the pupil
D. Relaxes the Ciliary muscle
* All the eye drops the ends in OLOL decreases AH production. They are BETA
BLOCKERS. Watch out for the S/S of congestive heart failure, bradycardia,
hypotension and arrythmias.
49. When caring for Mr. Batumbakal, Jet teaches the client to avoid [1]
A. Watching large screen TVs
B. Bending at the waist
C. Reading books
D. Going out in the sun
* Bending at the waist increase IOP and should be avoided by patients with
glaucoma. Treatment for glaucoma is usually for life. Patients are given laxatives to
avoid stratining at the stool. They should avoid all activities that will lead to sudden
IOP increase like bending at the waist. Clients should bend at the knees.
50. Mr. Batumbakal has undergone eye angiography using an Intravenous dye and
fluoroscopy. What activity is contraindicated immediately after procedure? [4]
A. Reading newsprint
B. Lying down
C. Watching TV
D. Listening to the music
* The client had an eye angiography. Eye angiography requires the use MYDRIATICS
pre-procedure. It is done by injecting an Intravenous dye and visualizes the flow of
the dye throught the fluoroscopy along the vessels of the eye. This is to assess
macular degeneration or neovascularizations [ proliferation of new vessels to
compensate for continuous rupture and aneurysms of the existing vessels ]
Mydratics usually takes 6 hours to a day to wear off. If client uses a mydratic, his
pupil wil dilate making it UNABLE to focus on closer objects. Only A necessitates the
constriction of the pupil to focus on a near object, which Mr.Batumbakals eye cannot
perform at this time.
51. If Mr. Batumbakal is receiving pilocarpine, what drug should always be available
in any case systemic toxicity occurs? [2]
A. Atropine Sulfate
B. Pindolol [Visken]
C. Naloxone Hydrochloride [Narcan]
D. Mesoridazine Besylate [Serentil]
* Atropine sulfate is use to reverse the effects of systemic toxicity of pilocarpine.

Narcan is the antidote for respiratory depression caused by narcotics like morphine
and demerol. Serentil is an antipsychotic.
SITUATION : Wide knowledge about the human ear, it’s parts and it’s functions will
help a nurse assess and analyze changes in the adult client’s health.
52. Nurse Budek is doing a caloric testing to his patient, Aida, a 55 year old
university professor who recently went into coma after being mauled by her
disgruntled 3rd year nursing students whom she gave a failing mark. After instilling a
warm water in the ear, Budek noticed a rotary nystagmus towards the irrigated ear.
What does this means? [2]
A. Indicates a CN VIII Dysfunction

B. Abnormal
C. Normal
D. Inconclusive
* Rotary nystagmus towards the ear [ if warm ] or away from it [ if cool ] is a normal
response. It indicates that the CN VIII Vestibular branch is still intact.
53. Ear drops are prescribed to an infant, The most appropriate method to
administer the ear drops is [2]
A. Pull the pinna up and back and direct the solution towards the eardrum
B. Pull the pinna down and back and direct the solution onto the wall of the
canal
C. Pull the pinna down and back and direct the solution towards the eardrum
D. Pull the pinna up and back and direct the solution onto the wall of the canal
* Instillation for children under age 3 is CHILD : DOWN AND BACK. Directing the
solution towards the eardrum might perforate or damage the infants fragile tympanic
membrane.
54. Nurse Budek is developing a plan of care for a patient with Menieres disease.
What is the priority nursing intervention in the plan of care for this particular patient?
[1]
A. Air, Breathing, Circulation

B. Love and Belongingness
C. Food, Diet and Nutrition
D. Safety
* Although A is priority according to maslow, it is not specific in clients with menieres

disease. The client has an attack of incapacitating vertigo and client is high risk for
injury due to falls. The client will perceive the environment moving due to disruption
of the vestibular system of the ear's normal function.
55. After mastoidectomy, Nurse Budek should be aware that the cranial nerve that is
usually damage after this procedure is [3]
A. CN I
B. CN II
C. CN VII
D. CN VI
* The facial nerve branches from the back of the ear and spread towards the mouth,
cheeks, eyelids and almost all over the face. In mastoidectomy, Incision is made at
the back of the ears to clear the mastoid air cells of the mastoid bone that is
infected. Clients are at very high risk for CN VII injury because of this. Observation
during the post op after mastoidectomy should revolve around assessing the client's
CN VII integrity.
56. The physician orders the following for the client with Menieres disease. Which of
the following should the nurse question? [1]
A. Dipenhydramine [Benadryl]
B. Atropine sulfate
C. Out of bed activities and ambulation
D. Diazepam [Valium]
* Clients with acute attack of Menieres are required to have bed rest with side rails
up to prevent injury. During periods of incapacitating vertigo, patient's eyes will have
rotary nystagmus because of the perception that the environment is moving.
Patients are also observed to hold the side rails so hard because they thought they
are going to fall. Benadryl is used in menieres due to its anti histamine effects. B and
D are used to allay clients anxiety and apprehension.
57. Nurse Budek is giving dietary instruction to a client with Menieres disease. Which
statement if made by the client indicates that the teaching has been successful? [1]
A. I will try to eat foods that are low in sodium and limit my fluid intake
B. I must drink atleast 3,000 ml of fluids per day
C. I will try to follow a 50% carbohydrate, 30% fat and 20% protein diet
D. I will not eat turnips, red meat and raddish
* Clients are advised to limite fluid and sodium intake as not to further cause
accumulation of fluids in the endolymph. C is the diabetic diet. D are the foods not
eaten when clients are about to have a guaiac test.
58. Peachy was rushed by his father, Steven into the hospital admission. Peachy is
complaining of something buzzing into her ears. Nurse Budek assessed peachy and
found out It was an insect. What should be the first thing that Nurse Budek should
try to remove the insect out from peachy’s ear? [3]
A. Use a flashlight to coax the insect out of peachy’s ear
B. Instill an antibiotic ear drops
C. Irrigate the ear
D. Pick out the insect using a sterile clean forceps
* Lights can coax the insect out of the child's ear. This is the first measure employed
in removing a live insect from the childs ear. Insects are not removed ALIVE,
therfore, C and D are both wrong. Antibiotics has no effects since the child do not
have any infection. If the insect did not come out after coaxing it with light, 2nd
measure employs instillation of diluted alcohol or a mineral oil to kill the insect which
is then removed using letter D.
59. Following an ear surgery, which statement if heard by Nurse Budek from the
patient indicates a correct understanding of the post operative instructions? [2]
A. Activities are resumed within 5 days

B. I will make sure that I will clean my hair and face to prevent infection
C. I will use straw for drinking
D. I should avoid air travel for a while
* After ear surgery, Air travel is halted for a while. There is no need to restrict
activities. The client is not allowed to shower for 7 days, Patient can clean himself
using a sponge bath but avoids to shampoo or wet the face and hair. Straws are not
used after ear surgery because sips increases pressure in the ear.
60. Nurse Budek will do a caloric testing to a client who sustained a blunt injury in
the head. He instilled a cold water in the client’s right ear and he noticed that
nystagmus occurred towards the left ear. What does this finding indicates? [2]
A. Indicating a Cranial Nerve VIII Dysfunction
B. The test should be repeated again because the result is vague
C. This is Grossly abnormal and should be reported to the neurosurgeon
D. This indicates an intact and working vestibular branch of CN VIII
* Refer to #52
61. A client with Cataract is about to undergo surgery. Nurse Budek is preparing plan
of care. Which of the following nursing diagnosis is most appropriate to address the
long term need of this type of patient? [1]
A. Anxiety R/T to the operation and its outcome

B. Sensory perceptual alteration R/T Lens extraction and replacement
C. Knowledge deficit R/T the pre operative and post operative self care
D. Body Image disturbance R/T the eye packing after surgery
* Patient do not have signs of anxiety, knowledge deficit or body image disturbance.
The safest answer is B because before cataract surgery, client has a blurry vision
that alters his sensory perception. After surgery client will be APHAKIC and again,
will have an alteration in perception until the aphakic glass is available.
62. Nurse Budek is performing a WEBERS TEST. He placed the tuning fork in the
patients forehead after tapping it onto his knee. The client states that the fork is
louder in the LEFT EAR. Which of the following is a correct conclusion for nurse
Budek to make? [4]
A. He might have a sensory hearing loss in the left ear

B. Conductive hearing loss is possible in the right ear
C. He might have a sensory hearing loss in the right hear, and/or a
conductive hearing loss in the left ear.
D. He might have a conductive hearing loss in the right ear, and/or a sensory
* Webers test assesses both air and bone conduction but is not decisive enough to
judge which is which. When the tuning fork is tapped on the examiners knee, it is
placed in the forehead or above the clients top lip. If the sound lateralizes towards
the left ear, its either, the client has conductive hearing loss towards the left OR a
sensory hearing loss in the right ear.
Why does conductive hearing produces a louder sound ?
Conductive hearing loss is a type of hearing loss where in, the ossicles
hypertrophies, as in OTOSCLEROSIS. The stape is permanently attached to the oval
window and it would not bulge causing a permanent LOUD conduction of sound using
the bone because the stapes is already attached permanently into the inner ear. In a
normal stape, It will not touch the oval window unless a sound is transmitted. [ refer
to the ear anatomy and physiology ]
63. Aling myrna has Menieres disease. What typical dietary prescription would nurse
Budek expect the doctor to prescribe? [2]
A. A low sodium , high fluid intake

B. A high calorie, high protein dietary intake
C. low fat, low sodium and high calorie intake
D. low sodium and restricted fluid intake
* Refer to # 57
SITUATION : [ From DEC 1991 NLE ] A 45 year old male construction worker was
admitted to a tertiary hospital for incessant vomiting. Assessment disclosed: weak
rapid pulse, acute weight loss of .5kg, furrows in his tongue, slow flattening of the
skin was noted when the nurse released her pinch.
Temperature: 35.8 C , BUN Creatinine ratio : 10 : 1, He also complains for postural

hypotension. There was no infection.
64. Which of the following is the appropriate nursing diagnosis? [1]
A. Fluid volume deficit R/T furrow tongue

B. Fluid volume deficit R/T uncontrolled vomiting
C. Dehydration R/T subnormal body temperature
D. Dehydration R/T incessant vomiting
65. Approximately how much fluid is lost in acute weight loss of .5kg? [1]
A. 50 ml
B. 750 ml
C. 500 ml
D. 75 ml
* 1L = 1kg
66. Postural Hypotension is [1]
A. A drop in systolic pressure less than 10 mmHg when patient changes position
from lying to sitting.
B. A drop in systolic pressure greater than 10 mmHg when patient changes
position from lying to sitting
C. A drop in diastolic pressure less than 10 mmHg when patient changes position
D. A drop in diastolic pressure greater than 10 mmHg when patient changes position
* Postural hypotension is exhibited by a drop of systolic BP when client changes

position from lying to sitting or standing.
67. Which of the following measures will not help correct the patient’s condition [1]
A. Offer large amount of oral fluid intake to replace fluid lost

B. Give enteral or parenteral fluid
C. Frequent oral care
D. Give small volumes of fluid at frequent interval
* The patient will not tolerate large amount of oral fluid due to incessant vomiting.
68. After nursing intervention, you will expect the patient to have [1]
1. Maintain body temperature at 36.5 C

2. Exhibit return of BP and Pulse to normal
3. Manifest normal skin turgor of skin and tongue
4. Drinks fluids as prescribed
A. 1,3
B. 2,4
C. 1,3,4
D. 2,3,4
* Client need not maintain a temperature of 36.5 C. As long as the client will exhibit
absence of fever or hypothermia, Nursing interventions are successfully carried out.
SITUATION: [ From JUN 2005 NLE ] A 65 year old woman was admitted for
Parkinson’s Disease. The charge nurse is going to make an initial assessment.
69. Which of the following is a characteristic of a patient with advanced Parkinson’s

disease? [1]
A. Disturbed vision
B. Forgetfulness
C. Mask like facial expression
D. Muscle atrophy
* Parkinson's disease does not affect the cognitive ability of a person. It is a disorder
due to the depletion of the neurotransmitter dopamine which is needed for inhibitory
control of muscular contractions. Client will exhibit mask like facial expression, Cog
wheel rigidity, Bradykinesia, Shuffling gait etc. Muscle atrophy does not occur in
parkinson's disease nor visual disturbances.
70. The onset of Parkinson’s disease is between 50-60 years old. This disorder is
caused by [1]
A. Injurious chemical substances

B. Hereditary factors
C. Death of brain cells due to old age
D. Impairment of dopamine producing cells in the brain
* Dopamine producing cells in the basal ganglia mysteriously deteriorates due to

unknown cause.
71. The patient was prescribed with levodopa. What is the action of this drug? [1]
A. Increase dopamine availability

B. Activates dopaminergic receptors in the basal ganglia
C. Decrease acetylcholine availability
D. Release dopamine and other catecholamine from neurological storage sites
* Levodopa is an altered form of dopamine. It is metabolized by the body and then

converted into dopamine for brain's use thus increasing dopamine availability.
Dopamine is not given directly because of its inability to cross the BBB.
72. You are discussing with the dietician what food to avoid with patients taking
levodopa? [3]
A. Vitamin C rich food

B. Vitamin E rich food
C. Thiamine rich food
D. Vitamin B6 rich food
* Vitamin b6 or pyridoxine is avoided in patients taking levodopa because levodopa

increases vitamin b6 availability leading to toxicity.
73. One day, the patient complained of difficulty in walking. Your response would be
[2]
A. You will need a cane for support

B. Walk erect with eyes on horizon
C. I’ll get you a wheelchair
D. Don’t force yourself to walk
* Telling the client to walk erect neglects the clients complain of difficulty walking.
Wheelchair is as much as possible not used to still enhance the client's motor
function using a cane. Telling the client not to force himself walk is non therapeutic.
The client wants to talk and we should help her walk using devices such as cane to
provide support and prevent injuries.
SITUATION: [ From JUN 2005 NLE ] Mr. Dela Isla, a client with early Dementia
exhibits thought process disturbances.
74. The nurse will assess a loss of ability in which of the following areas? [2]
A. Balance
B. Judgment
C. Speech
D. Endurance
* Perhaps this question from the JUN 2005 NLE is finding what should the nurse NOT
assess because A,B and C are all affected by dementia except ENDURANCE, which is
normally lost as a person ages. There will be alteration in balance because
coordination and spatial ability gradually deteriorates. Judgement is also impaired as
the client exhibits poor memory and concentration. Speech is severely altered. Client
develops aphasia, agnosia and in at end, will lose all the ability to speak without any
manifestation of motor problem.
75. Mr. Dela Isla said he cannot comprehend what the nurse was saying. He suffers
from: [1]
A. Insomnia
B. Aphraxia
C. Agnosia
D. Aphasia
* This question was RECYCLED during the last 2006 NLE. Aphasia is the INABILITY to
speak or understand. Aphraxia is the inability to carry out purposeful tasks. Agnosia
is the inability to recognize familiar objects. Insomnia is the inability to fall asleep.
76. The nurse is aware that in communicating with an elderly client, the nurse will
[1]
A. Lean and shout at the ear of the client

B. Open mouth wide while talking to the client
C. Use a low-pitched voice
D. Use a medium-pitched voice
* Talk as normally as possible. The client has dementia and is not deaf, although
hearing might be impaired progressively as the client ages, the nurse should not
alter his voice, shout or over enunciate the words. Client will preceive this things as
belittling and direspectful.
77. As the nurse talks to the daughter of Mr. Dela Isla, which of the following
statement of the daughter will require the nurse to give further teaching? [1]
A. I know the hallucinations are parts of the disease

B. I told her she is wrong and I explained to her what is right
C. I help her do some tasks he cannot do for himself
D. Ill turn off the TV when we go to another room
* Hallucinations and delusions are part of DEMENTIA and is termed as ORGANIC

PSYCHOSES. The daughter needs further teaching when she try to bargain, explain,
dissprove or advice a client with dementia. the client has an impaired judgement,
concentration, thinking, reasoning and memory and has inability to learn that is why
institutional care for clients with dementia is always required. The disease is
progressive and is not preventable.
78. Which of the following is most important discharge teaching for Mr. Dela Isla [2]
A. Emergency Numbers
B. Drug Compliance
C. Relaxation technique
D. Dietary prescription
* Drug compliance is the most important teaching for Mr. Dela Isla to prevent the
symptoms of psychoses and to control behavioral symptoms.
SITUATION : Knowledge of the drug PROPANTHELINE BROMIDE [Probanthine] Is

necessary in treatment of various disorders.
79. What is the action of this drug? [4]
A. Increases glandular secretion for clients affected with cystic fibrosis

B. Dissolve blockage of the urinary tract due to obstruction of cystine stones
C. Reduces secretion of the glandular organ of the body
D. Stimulate peristalsis for treatment of constipation and obstruction
* Probanthine reduces glandular secretion of the different organs of the body. It is

an anti-cholinergic / anti spasmodic drug and still, not approved by the FDA for
treatment with various disorders. Probanthine exerts benifits for treatment of severe
diaphoresis, Ulcers due to over secretion of HCl, Spasms, PANCREATITS [ Please
take note ] and other conditions of over secretion.
80. What should the nurse caution the client when using this medication [4]
A. Avoid hazardous activities like driving, operating machineries etc.

B. Take the drug on empty stomach
C. Take with a full glass of water in treatment of Ulcerative colitis
D. I must take double dose if I missed the previous dose
* Like other anti cholinergics/ anti spasmodics, Probanthine causes dizziness, blurred
vision and drowsiness. Patients are advised not to drive, operate heavy machineries
etc. Probanthine should be taken with a full glass of water but is contraindicated with
inflammatory bowel diseases like ulcerative colitis and chrons disease. Drug is taken
with meals to prevent irritation of the gastric mucosa and client is advised not to
take double dose in case the previous dose is missed.
81. Which of the following drugs are not compatible when taking Probanthine? [4]
A. Caffeine
B. NSAID
C. Acetaminophen
D. Alcohol
* Probanthine on its own already cause severe dizziness and drowsiness. Addition of
alcohol will further depress the CNS and might lead to potentiation of the side effects
of probanthine. A,B,C are not contraindicated when taking probanthine EXCEPT when
the disease entity itself do not permit intake of such drugs like in Pancreatitis, NSAID
is not use. Pain is controlled using probanthine and meperidine [ demerol ] in cases
of acute pancreatitis.
82. What should the nurse tell clients when taking Probanthine? [4]
A. Avoid hot weathers to prevent heat strokes

B. Never swim on a chlorinated pool
C. Make sure you limit your fluid intake to 1L a day
D. Avoid cold weathers to prevent hypothermia
* Probanthine alters the ability of the body to secrete sweat. Telling the client to
avoid hot weathers to prevent heat stroke is appropriate. Chlorinated pool is
discouraged for patients undergoing skin radiation for skin cancer to prevent
breakdown. Limiting fluid intake and avoiding cold weather are unecessary
teachings.
83. Which of the following disease would Probanthine exert the much needed action
for control or treatment of the disorder? [4]
A. Urinary retention
B. Peptic Ulcer Disease
C. Ulcerative Colitis
D. Glaucoma
* Probanthine is use in PUD to decrease gastric acid secretion. It is also used in
Pancreatitis to rest the pancreas from over secretion of pancreatic enzyme and to
prevent pain and spasm. Probanthine is contraindicated in clients with UC,
Glaucoma. Since this is an anti spasmodic drug, Urinary retention will be a side
effect.
SITUATION : [ From DEC 2000 NLE ] Mr. Franco, 70 years old, suddenly could not lift
his spoons nor speak at breakfast. He was rushed to the hospital unconscious. His
diagnosis was CVA.
84. Which of the following is the most important assessment during the acute stage
of an unconscious patient like Mr. Franco? [1]
A. Level of awareness and response to pain

B. Papillary reflexes and response to sensory stimuli
C. Coherence and sense of hearing
D. Patency of airway and adequacy of respiration
* Airway is always a priority in an unconscious client. Refer to maslows hierarchy of

needs for prioritization. Although this is not absolute, knowledge with
pathophysiology will best lead you to the correct option.
85. Considering Mr. Franco’s conditions, which of the following is most important to
include in preparing Franco’s bedside equipment? [1]
A. Hand bell and extra bed linen

B. Sandbag and trochanter rolls
C. Footboard and splint
D. Suction machine and gloves
* CVA patients has impaired swallowing ability and if not absent, depressed gag
reflex. Client is at the highest risk for aspiration when eating or drinking that is why
NGT is initiated early in the hospitalization. B prevent EXTERNAL ROTATION in hip or
leg fracture. Footboards and splint prevents FOOTDROP seen in clients that has a
severed peroneal nerve or prolonged immobilization usually due to fractures that
eventually puts pressure on the peroneal nerve. A is not specific to clients with CVA.
86. What is the rationale for giving Mr. Franco frequent mouth care? [1]
A. He will be thirsty considering that he is doesn’t drink enough fluids

B. To remove dried blood when tongue is bitten during a seizure
C. The tactile stimulation during mouth care will hasten return to consciousness
D. Mouth breathing is used by comatose patient and it’ll cause oral mucosa
dying and cracking.
* Client will be on NGT once comatose, A is removed first. Client with CVA MAY have
seizures, but it is RARE enough that it must require a frequent mouth care, B is
eliminated next. Knowing that tactile stimulation is done by touching the patient and
not by peforming mouth care will lead you to letter D. Comatose patient uses the
mouth to breathe predisposing himself to drying, cracking and infections.
87. One of the complications of prolonged bed rest is decubitus ulcer. Which of the
following can best prevent its occurrence? [1]
A. Massage reddened areas with lotion or oils
B. Turn frequently every 2 hours
C. Use special water mattress
D. Keep skin clean and dry
* Frequent turning and positioning is the single most important nursing intervention
to prevent ulcer formation. Skins are massaged but once the areas are reddened
already [ CLASS I Ulcer ], It is not anymore massaged as not to prevent further
breakdown. Lotions and Oils are not use in clients skin because it will further
enhance skin breakdown. Water matress are used in BURN patients to limit the
pressure on the skin by his own body weight. An alternating-inflatable air matress is
much more compatible in periodic distribution of pressure in clients with prolong
immobility. Keeping skin clean and dry is important but not as important as frequent
turning and positioning.
88. If Mr. Franco’s Right side is weak, What should be the most accurate analysis by
the nurse? [4]
A. Expressive aphasia is prominent on clients with right sided weakness

B. The affected lobe in the patient is the Right lobe
C. The client will have problems in judging distance and proprioception
D. Clients orientation to time and space will be much affected
* If the client's right side is weak, the affected lobe is the LEFT LOBE which is where
the broca's area is located. Client will exhibit expressive aphasia, careful and slow
movements and right sided weakness. Judging distance and proprioception is usually
impaired in clients with RIGHT sided stroke. Telling that the clients orientation to
time and space will be much affected is a blind shot analysis. This is seen on clients
with severe and massive hemorrhagic stroke with recovery failure related to
aneurysms producing long term and permanent coma. Mr. Franco right side is weak,
not paralysed, meaning, some functions are still left intact.
SITUATION : [ From JUN 1988 NLE ] a 20 year old college student was rushed to the
ER of PGH after he fainted during their ROTC drill. Complained of severe right iliac
pain. Upon palpation of his abdomen, Ernie jerks even on slight pressure. Blood test
was ordered. Diagnosis is acute appendicitis.
89. Which result of the lab test will be significant to the diagnosis? [1]
A. RBC : 4.5 TO 5 Million / cu. mm.

B. Hgb : 13 to 14 gm/dl.
C. Platelets : 250,000 to 500,000 cu.mm.
D. WBC : 12,000 to 13,000/cu.mm
* WBC increases with inflammation and infection.
90. Stat appendectomy was indicated. Pre op care would include all of the following
except? [1]
A. Consent signed by the father

B. Enema STAT
C. Skin prep of the area including the pubis
D. Remove the jewelries
91. Pre-anesthetic med of Demerol and atrophine sulfate were ordered to : [3]
A. Allay anxiety and apprehension

B. Reduce pain
C. Prevent vomiting
D. Relax abdominal muscle
* Pain is not reduced in appendicits. Clients are not given pain medication as to
assess whether the appendix ruptured. A sudden relief of pain indicates the the
appendix has ruptured and client will have an emergency appendectomy and prevent
peritonitis. Demerol and Atropine are used to allay client's anxiety pre operatively.
92. Common anesthesia for appendectomy is [3]
A. Spinal
B. General
C. Caudal
D. Hypnosis
* Spinal anesthesia is the most common method used in appendectomy. Using this
method, Only the area affected is anesthetized preventing systemic side effects of
anesthetics like dizziness, hypotension and RR depression.
93. Post op care for appendectomy include the following except [1]
A. Early ambulation
B. Diet as tolerated after fully conscious
C. Nasogastric tube connect to suction
D. Deep breathing and leg exercise
* Client's peristalsis will return in 48 to 72 hours post-op therefore, Fluid and food
are witheld until the bowel sounds returns. Remember that ALL PROCUDURES
requiring GENERAL and SPINAL anesthesia above the nerves that supply the
intestines will cause temporary paralysis of the bowel. Specially when the bowels are
traumatized during the procedure, it may take longer for the intestinal peristalsis to
resume.
94. Peritonitis may occur in ruptured appendix and may cause serious problems
which are [2]
1. Hypovolemia, electrolyte imbalance

2. Elevated temperature, weakness and diaphoresis
3. Nausea and vomiting, rigidity of the abdominal wall
4. Pallor and eventually shock
A. 1 and 2
B. 2 and 3
C. 1,2,3
D. All of the above
* Peritonitis will cause all of the above symptoms. The peritoneum has a natural
tendency to GUARD and become RIGID as to limit the infective exudate exchange
inside the abdominal cavity. Hypovolemia and F&E imbalance are caused by severe
nausea and vomiting in patients with peritonitis because of acute pain. As
inflammation and infection spreads, fever and chills will become more apparent
causing elevation in temperature, weakness and sweating. If peritonitis is left
untreated, Client will become severely hypotensive leading to shock and death.
95. If after surgery the patient’s abdomen becomes distended and no bowel sounds
appreciated, what would be the most suspected complication? [1]
A. Intussusception
B. Paralytic Ileus
C. Hemorrhage
D. Ruptured colon
* Paralytic Ileus is a mechanical bowel obstruction where in, the patients intestine
fails to regain its motility. It is usually caused by surgery and anesthesia.
Intusussusception, Appendicitis and Peritonitis also causes paralytic ileus.
96. NGT was connected to suction. In caring for the patient with NGT, the nurse
must [2]
A. Irrigate the tube with saline as ordered

B. Use sterile technique in irrigating the tube
C. advance the tube every hour to avoid kinks
D. Offer some ice chips to wet lips
* NGT after appendectomy is used not to deliver nutrients but to decompress the GI
tract because of the absence of peristalsis after appendectomy. The stomach and
intestines are not sterile, Clean technique is sufficient during irrigation. NGT is placed
and not anymore advanced as long as it already reach the stomach. Naso enteric
tubes are the one that are advanced periodically until obstruction is reached in the
intestine. The client still needs assessment and confirmation of the return of
peristalsis before anything is given per orem. Irrigations are done to prevent
obstruction in the tube.
97. When do you think the NGT tube be removed? [1]
A. When patient requests for it

B. Abdomen is soft and patient asks for water
C. Abdomen is soft and flatus has been expelled
D. B and C only
* When flatus is expelled, it means that peristalsis has returned and theres is no
need for continuing the NGT.
Situation: Amanda is suffering from chronic arteriosclerosis Brain syndrome she fell
while getting out of the bed one morning and was brought to the hospital, and she
was diagnosed to have cerebrovascular thrombosis thus transferred to a nursing
home.
98. What do you call a STROKE that manifests a bizarre behavior? [4]
A. Inorganic Stroke
B. Inorganic Psychoses
C. Organic Stroke
D. Organic Psychoses
* Organic psychoses is a broad and collective term used for psychoses and
schizophrenia that has an organic cause. [ Due to Creutzfeldt jakob disease,
huntington, hydrocephalus, increase ICP, dementia, stroke etc. ] Manifesting signs
and symptoms like hallucination, delustions, illusion, ideas of reference etc. that is
similar to schizophrenia and psychoses in absence of organic causes.
99. The main difference between chronic and organic brain syndrome is that the
former [2]
A. Occurs suddenly and reversible

B. Is progressive and reversible
C. tends to be progressive and irreversible
D. Occurs suddenly and irreversible
* Chronic brain syndrome tends to be progressive and irreversible. Organic brain

syndrome is acute and irreversible or reversible depending on the causative factor.
100. Which behavior results from organic psychoses? [4]
A. Memory deficit
B. Disorientation
C. Impaired Judgement
D. Inappropriate affect
* B, C and D are all behaviors that results from organic psychoses. The questions
seems to ask EXCEPTION which is A. MEMORY DEFICIT. Organic psychoses is the
same as the usual psychoses except that the causative factor of organic psychoses is
evidently caused by a disease process of the brain or affecting the brain. Example
are patients who suffer stroke suddenly experience hallucinations and delusions.
Organic psychoses is simply a psychoses that has an IDENTIFIED CAUSE. Knowing
this will lead you to understand that psychoses is manifested by B,C, and D but NOT
MEMORY DEFICIT.
Abdominal Assessment: A story towards mastery

Abdominal Assessment: A story towards mastery
Nag mumuni muni si Nars Budek sa emergency unit ng Ospital ng Fatima medical
center. Bigla biglang may pumasok na pasyente para sa admission. Masakit raw ang
kanyang tyan.
Inobserbahan siya ni Nars Budek. Aba, napakabilis ng kanyang pag hinga.

Namumutla pa ang kaniyang mga labi at parang tuyong tuyo at nagbabakbak.
“Ang bilis rin ng kanyang heart rate ah, 110 bpm, tachycardic ito, siguro may
masamang nararamdaman o may nararamdamang sakit?” Ang naisip ni Budek.
Ang pasyente natin ay si nanay ester, isang matandang pasyente. Siya ay 74 taong
gulang na na may chief complaint na “MASAKIT ANG TIYAN KO”
What are the possible causes of abdominal pain in the elderly ?
Nurse Budek thinks of : Constipation? Gas accumulation? Impaction?

Inflammatory Bowel Disease? Appendicitis? Cholecystitis? Cholelithiasis?
Ulcers? Peritonitis? Colon cancer? Ovarian or uterine cancer? PID? And
many many more.
“Okay nanay, dadalhin ko muna po kayo sa lab para po sa isang work up.”
Hmm… work up? Did nanay ester understands what nurse budek said….
WORK UP? Perhaps, this will be better :
“Okay nanay, pupunta na po tayo sa laboratoryo para po maisagawa natin ang ibat
ibang pagsusulit upang malaman kung ano po ang sanhi ng pananakit ng inyong
tiyan.”
Natanggap na ni Nars Budek ang mga laboratory results. Hmmm, 13 mg/dl ang
kanyang hemoglobin at 56% ang kanyang hematocrit. Ang potassium level nya ay
nasa 5.0 meq/L. Ang WBC nya ay nasa 8,000 / cc3. Wala namang diprensya ang
kanya lab results ah.
Really? Are you sure that all the lab results are normal? Let us review the
normal values :
WBC : 8,000 / cc3 is normal. An increase beyond 10,000 / cc3 is indicative

of infection.
Hgb : Hemoglobin levels of aling ester are within normal limits. Meaning,
there is no or minimal bleeding.
Hct : Hematocrit levels of aling ester are high, indicating that she is
dehydrated or bleeding.
K : The potassium level is within the normal limits of 4.5 to 5.5 meq/L.
Using the selected lab results above, we can then eliminate many possible
causes of the abdominal pain of aling ester. Remove : PERITONITIS,
APPENDICITIS, INFECTION, INFLAMMATORY BOWEL DISEASE AND ULCERS.
“Aling ester halika po at humiga po kayo rito at titingnan ko po ang inyong tiyan.”
Did Nurse Budek use an effective approach on asking aling ester to lie down
for an abdominal assessment?
How about this :
“Aling ester, Abutin nyo po ang kamay ko. halika po kayo rito at aalalayan ko kayo
papunta dito sa higaan para po tingnan ko ang inyong tiyan.”
The client is age 74 and in PAIN. It is NOT therapeutic to ask the client to
come and lie down on the examiners table on her own.
“Aling ester, mahiga po kayo dito at titingnan ko po kayo.”
What should be aling esters position for an abdominal assessment?
A. Supine, with head and feet FLAT on bed

B. High fowlers with the feet in extension
C. Prone position
D. Low fowlers with the knee on flexion
“Aling ester, itataas ko na po ng kaunti ang ulo ninyo at paki baluktot po lamang ang
inyong tuhod.”
Correct answer is LETTER D. To promote abdominal relaxation, The head of

the bed should be SLIGHTLY elevated and the knee of the client on flexed
position.
A and B will promote abdominal rigidity making it hard for Nurse Budek to
PALPATE the abdomen.
If your answer is C, you should try to imagine how can you assess the
patient’s abdomen if she is in prone position?
Humiga na si aling ester at mag uumpisa na si Nurse Budek sa pag assess ng tiyan
ni aling ester.
What should be Nurse Budek’s INITIAL STEP in assessing aling ester’s

abdomen?
A. Palpation
B. Inspection
C. Auscultation
D. Percussion
Tiningnan ni Nurse Budek ang tiyan ni aling ester, Hmm.. wala namang kakaiba sa
tiyan ni aling ester. Round sha, may mga stretch mark marahil dulot ng kanyang
pagbubuntis at panganganak. Lubog ang pusod at malinis naman ito. Wala naman
akong nakikitang gumagalaw galaw mukhang maaliwalas at tahimik naman ang
kanyang tiyan kung titingnan.
Kinuha ni Nurse Budek ang stethoscope at kanyang pinakinggan ang tiyan ni aling
ester. “Aba eh! Wala akong marinig na kung ano man. Hypoactive ang bowel sound
ni aling ester. Sa loob ng isang minuto ay nakarinig ako ng tatlong bowel sound.”
How did Nurse Budek concluded that aling ester’s bowel sound is
hypoactive?
A. The bowel sounds are more than 35 per minute

B. There is NO bowel sounds on aling ester’s assessment
C. There is less than 5 bowel sounds per minute on the assessment
D. The bowel sounds are less than 15 per minute
Sa isip ni Nurse Budek, “Ang normal bowel sounds ay 5-35, nabasa ko iyan kay
saunders nung akoy nag aaral pa! Kawawa naman si nanay, mukhang constipated
ata ah?”
“Teka nga I auscultate ko dito sa ILEO-CECAL VALVE para maka sigurado sa aking
bilang.”
Where is the ILEO-CECAL VALVE?
A. Left lower quadrant

B. Right lower quadrant
C. Left upper quadrant
D. Right upper quadrant
Why did Nurse Budek use the ILEO-CECAL VALVE Location to further assess
aling esters bowel sounds?
A. Because that is the location where bowel sounds are produced

B. The ICV is the only location in the large intestine where bowel sounds are
heard
C. Bowel sounds are always heard in the ICV more than any other quadrants
D. ICV is located in the small intestines, it is where gas are formed and
release giving a gurgling sound
Nilagay ni Nurse Budek ang kanyang steth sa may RIGHT LOWER QUADRANT upang
marinig ang tunog sa may ileo-cecal valve kung saan, parati itong mayroong bowel
sounds kumpara sa ibang abdominal quadrant.
“ I percuss ko na nga ang tiyan ni nanay. Tingnan natin kung marami ng laman
laman ito. “
Sa pag percuss ng tiyan ni aling ester, Nakarinig si Budek ng isang DULL o

mababang tunog sa may LEFT LOWER QUADRANT ni aling Ester. “ Aha, mukhang
meron ditong isang hindi kanais nais na bagay ah. “
What are the different sounds that Nurse Budek can percuss on aling Ester’s
abdomen?
1. DULLNESS : May be percussed on the R U Q because of the Liver and in

the L U Q because of the spleen.
An impaction of feces also produce a DULL sound on percussion.
2. HYPERRESONANCE/RESONANCE : An over inflated area such as the

LUNGS can produce a hyperresonanec/resonant sound.
3. FLAT : FLUID sounds FLAT on percussion. Usually heard on bowel

obstruction due to volvulus, diverticulosis/litis and intussusception.
4. TYMPANY : The TUNOG TAMBOL, is heard when the intestine or stomach

is air filled.
At sa huling bahagi, kinapa [ PALPATION ] ni Nurse budek ang tiyan ni aling ester.
Nag umpisa siya sa Right lower quadrant, papuntang right upper quadrant hanggang
makakapa siya ng isang maliit at matigas na mass sa may left lower quadrant ni
aling ester.
“ Ito yung dull na narinig ko kanina “ Ang nasabi ni Budek.
Why did Nurse Budek follows : INSPECTION, AUSCULTATION, PERCUSSION

AND PALPATION in exact and correct order in assessing aling esters
abdomen?
A. Doing Percussion and Palpation last will help limit stimulation of bowel
sound therefore, An accurate assessment of the abdominal status is
recorded.
B. Inspection and Ausculation are done first as not to cause PAIN on aling
ester that will prevent her from not cooperating with the abdominal
assessment.
C. Palpation is done last on an elderly client because of the sensitivity of the
abdominal muscle that might cause severe discomfort to aling ester.
D. Inspection is done first as to directly observe the general status of aling
ester’s abdomen before doing specific assessments of each quadrants.
“Hayyy, Mukhang alam ko na aling ester kung bakit masakit ang tiyan natin ha.” Ang
sabi ni Nurse Budek.
“Ay,!!” sa loblob ni Budek. “May hanging question nga pala tayo. Bakit nga ba hinuli
ko ang palpation at sinunod ang step na I,A,PE,PA. O “ I am PePa.” Kasi nga, pag
pinalpate ko agad, ma ii stimulate ko ang bowel sound ni nanay kaya hindi accurate
ang bowel sound na maririnig ko, hindi ko masasabi na HYPO o HYPERACTIVE ang
bowel sound ni nanay dahil na apektuhan ng percussion o palpation. Hindi ba,
manipulation increases peristalsis, baka mamaya mag 30 pa ang bowel sounds ni
nanay ester at hindi maging tama ang aking palagay na kaya masakit ang tiyan nya
dahil hypoactive ang pag galaw ng kanyang bituka at CONSTIPATED SIYA.”
“Nanay ester, kailan po kayo huling nadumi?” Ang tanong ni Nurse Budek.
“Abay hindi ko na matandaan iho. Malamang isang linggo na akong hindi nadudumi
eh, iyon ba ang dahilan bakit masakit ang aking tiyan? “ Ang sabi ni aling ester.
“Abay opo nanay, dapat po Isang dumi kada dalawang araw po ang pinaka
mababa ninyong pag dumi, sabi po iyan sakin ng aking bestfriend na si Lippinncott “
Sabi ni Nurse Budek.
“Nay, Ang dry dry naman niyang bibig nyo. Umiinom po ba kayo ng maraming tubig
sa isang araw? “ Sabi ni Nurse Budek
“Abay oo naman ano, marami akong iniinom na tubig sa isang araw.”
Did Budek asked the right question? Let us see if this question is better….
“Nay, ang dry dry naman niyang bibig nyo, Ilang baso po bang tubig ang iniinom nyo
sa isang araw?” Ang tanong ni Nurse Budek.
“Nakaka tatlong baso ako sa isang araw, sapat na ba iyon?” tugon ni aling ester.
“ Nay, dapat po 6-8 glassess ang iniinom natin bawat araw. Kaya naman pala hindi
kayo madumi ng regular walang panulak at dulas ang inyong bituka eh. “ Sagot ni
Nurse Budek.
Ibinahagi ni Budek ang kanyang natuklasan kay Doctor tuklaw na nangangalaga kay
aling ester. Ipinag utos ng doktor ang Fleet enema kay aling ester ngunit nag
reklamo si Nurse Budek.
Why did Nurse Budek reacted and disagreed to the doctors order of fleet
enema?
A. Fleet enema is contraindicated among elderly

B. Fleet enema can cause dependence
C. Fleet enema will causes fluid overload
D. Fleet enema will cause further dehydration
“Doktor, san ba kayo graduate? Bat fleet enema eh tanda tanda na ni nanay
dehydrated pa.. gusto nyong lalong ma dehydrate si nanay?” Ang matapang na
sagot ni Budek
“Ah ganun ba? Ano ba dapat?” Sabi ni Dr. Tuklaw
“ Kasi hypertonic saline ang fleet, Each 118-mL delivered dose contains 19 g
monobasic sodium phosphate monohydrate and 7 g dibasic sodium phosphate
heptahydrate. Kung hypertonic sha imagine, sisipsipin nito ang tubig sa large
intestine ni nanay at lalong matutoyo si nanay. Baka ma cardiac arrest pa yan due to
hypokalemia sige ka. “ Ang mayabang na sabi ni budek.
“ I NSS enema ko nalang di kaya tap water, mamili ka dok ano ang gusto mo?” Ang
tugon ni Budek.
“Bahala ka sa buhay mo” Ang tugon ni Dr. Tuklaw
“ Ok , I order mo ako ng NSS enema para wala tayong problema sa fluid and
electrolate balance” Ang tugon ni Budek.
“ Yes doc, masusunod po “ Ang sagot ni Dr. Tuklaw
Binalikan ni Nurse Budek si nanay ester sa kanyang silid.
“ Nanay ester, Ready ka na ba sa gagawin natin?” Sabi ni Budek.
“ Oo, ready na.. masakit ba yan? Ano ba ang gagawin mo sa akin?” Ang tugon ni
aling ester.
“ Bali papalabasin mo natin ang mga dumi po ninyo na naiwan at bumara na diyan
sa inyong bituka para po hindi na kayo masaktan at maisayos po natin ang normal
na pag dumi ninyo “ Ang sagot ni budek.
“ Nay, pumuwesto na po kayo. …….”
What should be aling ester’s postion when preparing to give an enema?
A. Left sims position

B. Prone position
C. Right sims position
D. Dorsal Recumbent position
“ Nay, pumuwesto na po kayo. Tumagilid po kayo at humiga sa inyong kaliwa at I

baluktot niyo po ang kanang tuhod ninyo [ LEFT SIMS POSITION ], Tulungan ko po
kayo” Ang sabi ni Nars Budek.
“ Bakit ganito pa dapat ang aking posisyon? Ano ang importansya nitong ganitong
posisyon nurse?” Ang tanong ni aling Ester.
Why is the patient positioned in the LEFT SIMS position when administering
an enema?
A. The Left sims position will facilitate descent of the solution towards the
rectum and the colon
B. The Left sims position is used to prevent injury to the bladder when
inserting the enema tube
C. The Left sims position will prevent the solution from going into the
kidneys that will cause hydronephrosis
D. Female clients are put in the LEFT SIMS position to prevent leakage of
the solution towards the cervix that will cause sever inflammatory reaction.
“Nay, kasi po ang rectum po natin ay PABABA pag tayoy naka left sims. Kung naka
right sims ka eh babalik lang po yung tubig palabas dahil po paangat po ang
kaalangan niyang daluyan, hindi po siya makakarating ng tama sa colon” Ang tugon
ni Budek. [Refer to the normal anatomy of the large intestine]
At nang matapos na ni Nurse Budek ang pag I enema kay nanay, Limang malalaking
bilog bilog na kasinglaki ng chico ang kanyang nakuha at matapos nito, malalambot
na ang dumi na lumabas kay nanay Ester.
“Hayyy, gumaan na ang aking pakiramdam Nurse Budek, salamat sa tulong mo ha..
hindi na siya masakit” Ang pasasalamat ni nanay Ester.
Ngumiti si budek sabay bigkas “ Nay, tandaan… tubig tubig tubig at masustansya at
balanseng pagkain na mataas sa fiber tulad ng gulay at prutas para hindi na
mangyari iyan ulet sa inyo. ”
Napangiti si aling ester at siya ay parang nasalangit sa gaan ng kanyang

pakiramdam at ginhawang nararamdaman.
Follow up questions :
Answer the following questions :
1. What is the minimum and maximum height of the enema can?

2. How long should budek insert the rectal tube? What kind of lubricant
should he use?
3. What should be nurses budek’s first intervention in case cramping occurs
during enema instillation?
4. When should nurse budek STOP irrigating aling ester’s colon?
5. What are the contraindications when administering an enema?
50 item Psychiatric Exam Answers and Rationales

PSYCHIATRIC NURSING
CORRECT ANSWERS AND RATIONALE
1. 60 year old post CVA patient is taking TPA for his disease, the nurse understands
that this is an example of what level of prevention?
C. Tertiary : The client already had stroke, TPA stands for TRANSPLASMINOGEN
ACTIVATOR which are thrombolytics, dissolving clots formed in the vessels of the
brain. We are just preventing COMPLICATIONS here.
2. A female client undergoes yearly mammography. This is a type of what level of

prevention?
b. secondary : The client is never sick of anything but we are detecting the
POSSIBILITY by giving yearly mammography. Remember that all kinds of tests, case
findings and treatment belongs to the secondary level of prevention.
3. A Diabetic patient was amputated following an unexpected necrosis on the right

leg, he sustained and undergone BKA. He then underwent therapy on how to use his
new prosthetic leg. this is a type of what level of prevention?
c. tertiary : Tertiary prevention involves rehabilitation. Client is now being assisted

to perform ADLs at his optimum functioning. Remember that all kinds of
rehabilitatory and palliative management is included in tertiary prevention.
4. As a care provider, The nurse should do first:
d. Early recognition of the client’s needs. : we are talking about what should the
nurse do first. ASSESSMENT involves early recognition of clients needs. A,B,C are all
involve in the intervention phase of the nursing process.
5. As a manager, the nurse should:
d. Works together with the team. : As a nurse manager, you should be able to
work with the team. A,B,C are not specific of a nurse manager. They can be done by
an ordinary R.N.
6. the nurse shows a patient advocate role when

a. defend the patients right : An advocate role is shown when the nurse defends
the rights of the client. Interceding in behalf of the patient should not be done by a
nurse. Counter transference can develop in that case and we should avoid that. Only
the family and the health attorney of the patient can intercede or speak for the
patient.
7. which is the following is the most appropriate during the orientation phase ?
d. establishment of regular meeting of schedules : Orientation phase is

synonymous with CONTRACT ESTABLISHMENT. Here, the nurse will establish regular
meeting of schedule, agreements and giving the client information that there is a
TERMINATION. Letter A and B assesses the client’s coping skills, which is in the
working phase and so is letter B. In working phase, The nurse assesses the coping
skills of the client and formulate plans and intervention to correct deficiencies.
Although assessment is also made in the orientation phase, COPING SKILLS are
assessed in the working phase.
8. preparing the client for the termination phase begins :
c. working : Telling the client that there is a TERMINATION PHASE should be in the
ORIENTATION PHASE, however, in preparing the client for the TERMINATION, it
should be done in the working phase. The nurse will start to lessen the number of
meetings to prevent development of transference or counter transference.
9. a helping relationship is a process characterized by :
c. growth facilitating : In psychiatric nursing, The epitome of all nursing goal

should focus on facilitating GROWTH of the client.
10. During the nurse patient interaction, the nurse assess the ff: to determine the
patients coping strategy :
d. How does your problem affect your life? : this is the only question that
determines the effects of the problem on the client and the ways she is dealing with
it. Letter A can only be answered by FINE and close further communication. B is
unrelated to coping strategies. Letter C, asking the client what do you think can help
you right now is INAPPROPRIATE for the nurse to ask. The client is in the hospital
because she needs help. If she knows something that can help her with her problem
she shouldn’t be there.
11. As a counselor, the nurse performs which of the ff: task?
a. encourage client to express feelings and concerns : A counselor is much

more of a listener than a speaker. She encourage the client to express feelings and
concerns as to formulate necessary response and facilitate a channel to express
anger, disappointments and frustrations.
12. Freud stresses out that the EGO
a. Distinguishes between things in the mind and things in the reality. : The
ego is responsible for distinguishing what is REAL and what is NOT. It is the one that
balances the ID and super ego. B and D is a characteristic of the SUPER EGO which
is the CONTROLLER of instincts and drives and serve as our CONSCIENCE or the
MORAL ARM. The ID is our DRIVES and INSTINCTS that is mediated by the EGO and
controlled by the SUPER EGO.
13. A 16 year old child is hospitalized, according to Erik Erikson, what is an

appropriate intervention?
a. tell the friends to visit the child : The child is 16 years old, In the stage of
IDENTITY VS. ROLE CONFUSION. The most significant persons in this group are the
PEERS. B refers to children in the school age while C refers to the young adulthood
stage of INTIMACY VS. ISOLATION. The child is not dying and the situation did not
even talk about the child’s belief therefore, calling the priest is unnecessary.
14. NMS is characterized by :
a. hypertension, hyperthermia, flushed and dry skin. : Neuroleptic malignant

syndrome is a side effect of neuroleptics. This is characterized by fever, increase in
blood pressure and warm, flushed, dry skin.
15. Which of the following drugs needs a WBC level checked regularly?
b. Clozaril : Clozapine is a dreaded aypical antipsychotic because it causes severe

bone marrow depression, agranulocytosis, infection and sore throat. WBC count is
important to assess if the clients immune function is severely impaired. The first
presenting sign of agranulocytosis is SORE THROAT.
SITUATION : Angelo, an 18 year old out of school youth was caught shoplifting in a
department store. He has history of being quarrelsome and involving physical fight
with his friends. He has been out of jail for the past two years
16. Initially, The nurse identifies which of the ff: Nursing diagnosis:
b. impaired social interaction : There is no such nursing diagnosis as A , looking

at C and D, they are much more compatible to schizophrenia which is not a
characteristic of an ANTI SOCIAL P.D which is shown in the situation. Remember that
Personality Disorder is FAR from Psychoses. When client exhibits altered thought
process or sensory alteration, It is not anymore a personality disorder but rather, a
sign and symptom of psychoses.
17. which of the ff: is not a characteristic of PD?
b. loss of cognitive functioning : As I said, symptoms of PD will never show

alteration in cognitive functioning. They are much more of SOCIAL Disturbances
rather than PSYCHOLOGICAL.
18. the most effective treatment modality for persons if anti social PD is
c. behavior therapy : The problem of the patient is his behavior. A is done for
patient who has insomnia or severe anxiety. B is a therapy that promotes growth by
providing a contact, either a person or an environment who will facilitate the growth
of an individual. It is a humanistic psychotherapeutic model approach. D is done on
clients who are in crisis like trauma, post traumatic disorders, raped or accidents.
19. Which of the following is not an example of alteration of perception?
b. flight of ideas : Flight of ideas is a condition in which patient talks continuously

and then switching to unrelated topic. An example is “ Ang ganda ng bulaklak na ito
no budek? Rose ito hindi ba? Kilala mo ba si jack yung boyfriend ni rose? Grabe yung
barko no ang laki laki tapos lumubog lang. Dapat sana nag seaman ako eh, gusto
kasi ng nanay ko. “. Loose association is somewhat similar but the switch in topic is
more obvious and completely unrelated. Example “ Ang cute nung rabbit, paano si
paul kasi tanga eh, papapatay ko yan kay albert. Ang ganda nung bag na binigay ni
jenny, tanga nga lang yung aswang dun sa kanto. Pero bakit ka ba andito? Wala
akong pagkain, Penge ako kotse aakyat ako everest.”
A,C,D are all alteration in perception. A refers to a person thinking that everyone is
talking about him. C and D are all sensory alterations. The difference is that, in
hallucination, there is no need for a stimuli. In illusion, a stimuli [ A phone cord ] is
mistakenly identified by the client as something else [ Snake ]
20. The type of anxiety that leads to personality disorganization is :
d. panic : Panic is the only level of anxiety that leads to personality disorganization.
21. A client is admitted to the hospital. Twelve hours later the nurse observes hand
tremors, hyperexicitability, tachycardia, diaphoresis and hypertension. The nurse
suspects alcohol withdrawal. The nurse should ask the client:
a. at what time was your last drink taken? : This question will give the nurse
idea WHEN will the withdrawal occur. Withdrawal occurs 5 to 10 hours after the last
intake of alcohol. This is a crucial and mortality is very high during this period. Client
will undergo delirium tremens, seizures and DEATH if not recognize earlier by the
nurse. B is very judgmental, C is non specific, whether it is a beer or a wine It is still
alcohol and has the same effects. D is a valuable question to determine the chronic
effects of alcohol ingestion but asking letter A can broaden the line between life and
death.
22. client with a history of schizophrenia has been admitted for suicidal ideation. The
client states "God is telling me to kill myself right now." The nurse's best response is:
a. I understand that god’s voice are real to you, But I don’t hear anything. I
will stay with you. : The nurse should first ACKNOWLEDGE that the voices are real
to the patient and then, PRESENT REALITY by telling the patient that you do not hear
anything. The third part of the nursing intervention in hallucination is LESSENING
THE STIMULI by either staying with the patient or removing the patient from a highly
stimulating place.
Telling the client that the voices is part of his illness is not therapeutic. People with
schizophrenia do not think that they are ILL. Letter C and D disregards the client’s
concern and therefore, not therapeutic.
23. In assessing a client's suicide potential, which statement by the client would give
the nurse the HIGHEST cause for concern?
c. I’ve thought about taking pills and alcohol till I pass out : This is the only
statement of the client that contains a specific and technical plan. B,D are all
indicative of suicidal ideation but it contains no specific plans to carry out the
objective. Letter A admits the client thinks of hurting himself, but not doing it
because it scares him, therefore, it is not indicative of suicidal ideation.
24. A client with paranoid schizophrenia has persecutory delusions and auditory
hallucinations and is extremely agitated. He has been given a PRN dose of Thorazine
IM. Which of the following would indicate to the nurse that the medication is having
the desired effect?
c. Stops pacing and sits with the nurse : Thorazine is a neuroleptic. Desired
effect evolve on controlling the client’s psychoses. Letter A is the side effect of the
drug, which is not desired. B and D indicates that the drug is not effective in
controlling the client’s agitation, restlessness and disorders of perception.
25. A client who was wandering aimlessly around the streets acting inappropriately
and appeared disheveled and unkempt was admitted to a psychiatric unit and is
experiencing auditory and visual hallucinations. The nurse would develop a plan of
care based on:
c. schizophrenia : When disorders of perception and thoughts came in, The only
feasible diagnosis a doctor can make is among the choices is schizophrenia. A,B and
D can occur in normal individuals without altering their perceptions. Schizophrenia is
characterized by disorders of thoughts, hallucination, delusion, illusion and
disorganization.
26. A decision is made to not hospitalize a client with obsessive-compulsive disorder.

Of the following abilities the client has demonstrated, the one that probably most
influenced the decision not to hospitalize him is his ability to:
c. Perform activities of daily living : If a client can do ADLs , there is no reason

for that client to be hospitalized.
27. A client is admitted to the inpatient psychiatric unit. He is unshaven, has body
odor, and has spots on his shirt and pants. He moves slowly, gazes at the floor, and
has a flat affect. The nurse's highest priority in assessing the client on admission
would be to ask him:
b. If he is thinking about hurting himself : The client shows typical sign and
symptoms of DEPRESSION. Moving slowly, gazes on the floor, blank stares and
showing flat affect. The highest priority among depressed client is assessing any
suicide plans or ideation for the nurse to establish a no suicide contract early on or,
in any case client do not participate in a no suicide contract, a 24 hour continuous
monitoring is established.
28. The nurse should know that the normal therapeutic level of lithium is :
a. .6 to .12 meq/L : According to brunner and suddarths MS nursing, The normal
therapeutic level of lithium is .6 to 1.2 meq/L. Some books will say .5 to 1.5 meq/L.
29. The patient complaint of vomiting, diarrhea and restlessness after taking lithane.
The nurse’s initial intervention is :
a. Recognize that this is a sign of toxicity and withhold the next

medication. : The nurse should recognize that this is an early s/s of lithium toxicity.
Taking the clients vital signs will not confirm diarrhea, vomiting or restlessness.
Notifying the physician is unnecessary at this point and the physician will likely to
withhold the medication.
30. The client is taking TOFRANIL. The nurse should closely monitor the patient for :
c. Increase Intra Ocular Pressure : Tofranil is a neuroleptic. It is well known that

this is the antipsychotic that increases the IOP and contraindicated in patients with
glaucoma. Hypertension is not specific with TOFRANIL. All neuroleptics can cause
NMS or the neuroleptic malignant syndrome.
31. A client was hospitalized with major depression with suicidal ideation for 1 week.
He is taking venlafaxine (Effexor), 75 mg three times a day, and is planning to
return to work. The nurse asks the client if he is experiencing thoughts of self-harm.
The client responds, "I hardly think about it anymore and wouldn't do anything to
hurt myself." The nurse judges:
c. The depression to be improving and the suicidal ideation to be

lessening. : too obvious, no need to rationalize.
32. The client is taking sertraline (Zoloft), 50 mg q AM. The nurse includes which of
the following in the teaching plan about Zoloft?
a. Zoloft causes erectile dysfunction in men : When you take zoloft, mag
zozoloft ka nalang sa buhay. Because it causes erectile dysfuntion and decrease
libido. Letter B and C are specific of TCAs. Zoloft will exert its effects as early as 1
week.
33. After 3 days of taking haloperidol, the client shows an inability to sit still, is
restless and fidgety, and paces around the unit. Of the following extrapyramidal
adverse reactions, the client is showing signs of:
b. Akathisia : The client shows sign of motor restlessness, which is specific for
Akathisia or MAKATI SYA.
34. After 10 days of lithium therapy, the client's lithium level is 1.0 mEq/L. The nurse
knows that this value indicates which of the following?
b. An anticipated therapeutic blood level of the drug.
35. When caring for a client receiving haloperidol (Haldol), the nurse would assess
for which of the following?
b. Extrapyramidal symptoms : Haldol is a neuroleptic, Specific to these
neuroleptics are the EPS. The client will likely be hypotensive than hypertensive
because neuroleptics causes postural hypotension, The client will complaint of dry
mouth due to its anticholinergic properties. Dizziness and drowsiness are side effects
of neuroleptics but not oversedation.
36. A client is brought to the hospital’s emergency room by a friend, who states, "I
guess he had some bad junk (heroin) today." In assessing the client, the nurse
would likely find which of the following symptoms?
c. Decreased respirations, constricted pupils, and pallor. : Heroin is a narcotic.

Together with morphine, meperidine, codeine and opiods, they are DEPRESSANTS
and will cause decrease respiration, constricted pupils and pallor due to
vasoconstriction.
37. The client has been taking the monoamine oxidase inhibitor (MAOI) phenelzine
(Nardil), 10 mg bid. The physician orders a selective serotonin reuptake inhibitor
(SSRI), paroxetine (Paxil), 20 mg given every morning. The nurse:
b. Questions the physician about the order : 2 anti depressants cannot be given
at the same time unless the other one is tapered while the other one is given
gradually.
38. Which of the following client statements about clozapine (Clozaril) indicates that
the client needs additional teaching?
d. "I need to call my doctor whenever I notice that I have a fever or sore
throat." : Clozapine causes AGRANULOCYTOSIS and bone marrow depression. Early
s/s includes fever and sore throat. The medication is to be withheld this time or the
patient might develop severe infection leading to death.
39. A client has been taking lithium carbonate (Lithane) for hyperactivity, as
prescribed by his physician. While the client is taking this drug, the nurse should
ensure that he has an adequate intake of:
a. Sodium : The levels of lithium in the body are dependent on sodium. The higher
the sodium, The lower the levels of lithium. Clients should have an adequate intake
of sodium to prevent sudden increase in the levels of lithium leading to toxicity and
death.
40. The client has been taking clomipramine (Anafranil) for his obsessive-compulsive
disorder. He tells the nurse, "I'm not really better, and I've been taking the
medication faithfully for the past 3 days just like it says on this prescription bottle."
Which of the following actions would the nurse do first?
a. Tell the client to continue taking the medication as prescribed because it

takes 5 to 10 weeks for a full therapeutic effect. : Anafranil is an anti
depressant, effects are noticeable within 1 to 2 weeks.
41. The nurse judges correctly that a client is experiencing an adverse effect from
amitriptyline hydrochloride (Elavil) when the client demonstrates:
d. Urinary retention : Elavil is an TC antidepressant. It should not cause insomnia.
Hypertension are specific of MAOI anti depressants when tyramine is ingested. Due
to the anticholinergic s/e of TCAs, Urinary retention is an adverse effect.
42. Which of the following health status assessments must be completed before the
client starts taking imipramine (Tofranil)?
a. Electrocardiogram (ECG). : Aside from tonometry or IOP measurement, Client

should undergo regular ECG schedule. Most TCAs causse tachycardias and ECG
changes, an ECG should be done before the client takes the medication.
43. A client comes to the outpatient mental health clinic 2 days after being
discharged from the hospital. The client was given a 1-week supply of clozapine
(Clozaril). The nurse reviews information about clozapine with the client. Which client
statement indicates an accurate understanding of the nurse's teaching about this
medication?
b."I need to keep my appointment here at the hospital this week for a blood
test." : Regular blood check up is required for patients taking clozaril. As frequent as
every 2 weeks. Clozapine can cause bone marrow depression, therefore, frequent
blood counts are necessary.
44. The client is taking risperidone (Risperdal) to treat the positive and negative
symptoms of schizophrenia. Which of the following negative symptoms will improve?.
d. Asocial behaviour and anergia : A,B and C are all positive symptoms of
schizophrenia. Negative symptoms includes anhedonia, anergia, associative
looseness and Asocial behavior.
45. The nurse would teach the client taking tranylcypromine sulfate (Parnate) to
avoid which food because of its high tyramine content?
b. Aged cheeses. : This is high in tyramine, and therefore, removed from patients
diet to prevent hypertensive crisis.
46. Which of the following clinical manifestations would alert the nurse to lithium
toxicity?
d.Anorexia with nausea and vomiting.
47. The client with depression has been hospitalized for 3 days on the psychiatric
unit. This is the second hospitalization during the past year. The physician orders a
different drug, tranylcypromine sulfate (Parnate), when the client does not respond
positively to a tricyclic antidepressant. Which of the following reactions should the
client be cautioned about if her diet includes foods containing tryaminetyramine?
d. Hypertensive crisis.
48. After the nurse has taught the client who is being discharged on lithium
(Eskalith) about the drug, which of the following client statements would indicate
that the teaching has been successful?
c. "I'll call my doctor right away for any vomiting, severe hand tremors, or
muscle weakness." : This is a sign of light lithium toxicity. Increasing fluid intake
will cause dilutional decrease of lithium level. Restriction of sodium will cause
dilutional increase in lithium level.
49. A nurse is caring for a client with Parkinson's disease who has been taking
carbidopa/levodopa (Sinemet) for a year. Which of the following adverse reactions
will the nurse monitor the client for?
c. hypotension : Hypotension, dizziness and lethargy are side effects of anti

parkinson drugs like levodopa and carbidopa.
50. A client is taking fluoxetine hydrochloride (Prozac) for treatment of depression.

The client asks the nurse when the maximum therapeutic response occurs. The
nurse's best response is that the maximum therapeutic response for fluoxetine
hydrochloride may occur in the:
c. Third week : A and B are similar, therefore , removed them first. Recognizing
that most antidepressants exerts their effects within 2-3 weeks will lead you to letter
C.
Medical Surgical Nursing : FLUID AND ELECTROLYTES

LECTURE
This is a lecture I created for a review class [ mga classmates ko rin na bilib na bilib
sa akin, mga anim ulet :) ] scattered questions are in the documents and they are
left blank, some are filled in, read and refresh your fluid and electrolytes mastery.
Answers will be up tomorrow hopefully on our psychatric examination, I'll try to

rationalize the easy way. I am still halfway finishing lippinncots nclex so I am so very
busy. I already finished MOSBY and its very very fulfilling to finish a book that thick.
100 items questions on MS about all topics under the sun are already in my MS Word
ill published it on 1 or 2 parts and we will rationalize again. Hopefully within this
week.
I saw a copy of my exam being used by another website, is it OK as long as you will
not sell it for a profit. Please give a credit by linking pinoybsn.tk to it.
I'll try to sneak in and insert june 2006 board exam questions on my projects but I
will make it VERY VERY LESS obvious as not to incriminate myself.
Council wants exam 'leakage' probed

Monday, July 03, 2006
Council wants exam 'leakage' probed

THE City Council will ask concerned agencies to push for an in-depth investigation on
the alleged "leakage" in the board examinations for nurses simultaneously
administered by the Professional Regulatory Commission (PRC) last June 11 and 12.
This was agreed upon by members of the Association of Deans of Philippine College
of Nursing (ADPCN) in Cordillera and the Philippine Nurses Association (PNA) in
Baguio who appeared before the City Council session last week.
The two nurses' association requested the City Council's support to ensure speedy
action on the leakage allegation. "We are confident that just like us, you abhor any
form of dishonesty done by anybody else," the groups said in a letter. According to
the nurses, the alleged leakage may have been done nationwide even as Baguio
examinees were the only ones "brave enough to come out despite and in spite of
threats." The leakage happened when the examinees noticed that reviewees from a
particular review school, earlier identified as the R.A. Gapuz Review Center, used
handwritten "emergency drill materials" provided to them just hours before the
exams. Upon seeing the materials, the examinees noticed that many of the questions
in the emergency drill materials were similar to one set of the examination. Names
and situations in the board examinations were exactly same, the examinees stated in
their affidavit. This prompted 92 Baguio examinees to file their complaint. The PNA
also deplored the conclusive and "sweeping statement" published in a national daily
that "there is no leakage" when no investigation has yet been conducted. "Help us
guard the integrity of our nursing profession," the nurses told the City Council. The
letters were also sent to the PRC asking for a thorough investigation on the
controversy.
(July 3, 2006 issue from SUNSTAR BAGUIO)
Budek comments : I saw a copy of the alleged leakage and the questions are
EXACTLY similar to what has been asked in the actual board exam according to my
friends whom i asked to determine if the questions I managed to get was really
asked. Including the name of the character in the situation. Kung hindi nga lang
bawal i publish ang mga board question i would have published it para makita ng
marami.
I still don't know though, Maybe I am still in denial that is why i really can't say there
was a leakage in the previous board exam. a RETEST, though will be a burden, is
more equitable for all of the examinees.
Hindi na maganda yung issue, its already a battle between the PNA and the BON,
PNA is still the more powerful body regarding this matter in my opinion because
under pa rin sa kanila ang mga members ng board. If the PNA believe na there was
a 'leak' I think BON couldn't do anything more about it other than investigate and
hold the results further.
The agony however, will still be at the nursing students shoulders.
Sunday, July 02, 2006

50 Item Psychiatric Nursing Exam
This is an exam I created for my classmates who attended my review session,
[ Siguro mga anim sila, dami no? Lahat naman sila pasado nung TCAP or the first
preboard ] I created most of the questions, some are lifted from Lippincotts while
other, from Our lady of fatima's previous TCAP/Preboard questions.
I will post the correct answers soon, first, try to answer it as honest as possible then
come back after mga 3 days to 1 week dun ko lang i post yung correct answers. If
you want to request for a rationale, just put a COMMENT and put the number of
question na gusto mong i rationalize ko. Wag naman lahat ha. Ill try to publish more
test questions soon and lets rationalize it together.
PSYCHIATRIC NURSING
By Budek
1. 60 year old post CVA patient is taking TPA for his disease, the nurse understands
that this is an example of what level of prevention?
a. primary
b. secondary
c. tertiary
d. nota
2. A female client undergoes yearly mammography. This is a type of what level of

prevention?
a. primary
b. secondary
c. tertiary
d. nota
3. A Diabetic patient was amputated following an unexpected necrosis on the right

leg, he sustained and undergone BKA. He then underwent therapy on how to use his
new prosthetic leg. this is a type of what level of prevention?
a. primary
b. secondary
c. tertiary
d. nota
4. As a care provider, The nurse should do first:
a. Provide direct nursing care.

b. Participate with the team in performing nursing intervention.
c. Therapeutic use of self.
d. Early recognition of the client’s needs.
5. As a manager, the nurse should:
a. Initiates nursing action with co workers.

b. Plans nursing care with the patient.
c. Speaks in behalf of the patient.
d. Works together with the team.
6. the nurse shows a patient advocate role when
a. defend the patients right

b. refer patient for other services she needs
c. work with significant others
d. intercedes in behalf of the patient.
7. which is the following is the most appropriate during the orientation phase ?
a. patients perception on the reason of her hospitalization

b. identification of more effective ways of coping
c. exploration of inadequate coping skills
d. establishment of regular meeting of schedules
8. preparing the client for the termination phase begins :
a. pre orientation
b. orientation
c. working
d. termination
9. a helping relationship is a process characterized by :
a. recovery promoting
b. mutual interaction
c. growth facilitating
d. health enhancing
10. During the nurse patient interaction, the nurse assess the ff: to determine the
patients coping strategy :
a. how are you feeling right now?

b. do you have anyone to take you home?
c. what do you think will help you right now?
d. How does your problem affect your life?
11. As a counsellor, the nurse performs which of the ff: task?
a. encourage client to express feelings and concerns

b. helps client to learn a dance or song to enable her to participate in activities
c. help the client prepare in group activities
d. assist the client in setting limits on her behaviour
12. Freud stresses out that the EGO
a. Distinguishes between things in the mind and things in the reality.

b. Moral arm of the personality that strives for perfection than pleasure.
c. Reservoir of instincts and drives
d. Control the physical needs instincts.
13. A 16 year old child is hospitalized, according to Erik Erikson, what is an

appropriate intervention?
a. tell the friends to visit the child
b. encourage patient to help child learn lessons missed
c. call the priest to intervene
d. tell the child’s girlfriend to visit the child.
14. NMS is characterized by :
a. hypertension, hyperthermia, flushed and dry skin.

b. Hypotension, hypothermia, flushed and dry skin.
c. Hypertension, hyperthermia, diaphoresis
d. Hypertension, hypothermia, diaphoresis
15. Which of the following drugs needs a WBC level checked regularly?
a. Lithane
b. Clozaril
c. Tofranil
d. Diazepam
Angelo, an 18 year old out of school youth was caught shoplifting in a department
store. He has history of being quarrelsome and involving physical fight with his
friends. He has been out of jail for the past two years
16. Initially, The nurse identifies which of the ff: Nursing diagnosis:
a. self centred disturbance

b. impaired social interaction
c. sensory perceptual alteration
d. altered thought process
17. which of the ff: is not a characteristic of PD?
a. disregard rights of others

b. loss of cognitive functioning
c. fails to conform to social norms
d. not capable of experiencing guild or remorse for their behaviour
18. the most effective treatment modality for persons if anti social PD is
a. hypnotherapy
b. gestalt therapy
c. behaviour therapy
d. crisis intervention
19. Which of the following is not an example of alteration of perception?
a. ideas of reference
b. flight of ideas
c. illusion
d. hallucination
20. The type of anxiety that leads to personality disorganization is :

a. Mild b. moderate c. severe d. panic
21. A client is admitted to the hospital. Twelve hours later the nurse observes hand
tremors, hyperexicitability, tachycardia, diaphoresis and hypertension. The nurse
suspects alcohol withdrawal. The nurse should ask the client:
a. at what time was your last drink taken?

b. Why didn’t you tell us you’re a drinker?
c. Do you drink beer or hard liquor?
d. How long have you been drinking?
22. client with a history of schizophrenia has been admitted for suicidal ideation. The
client states "God is telling me to kill myself right now." The nurse's best response is:
a. I understand that god’s voice are real to you, But I don’t hear anything. I will stay
with you.
b. The voices are part of your illness, it will stop if you take medication
c. The voices are all in your imagination, think of something else and itll go away
d. Don’t think of anything right now, just go and relax.
23. In assessing a client's suicide potential, which statement by the client would give
the nurse the HIGHEST cause for concern?
a. my thoughts of hurting my self are scary to me

b. I’d like to go to sleep and not wake up
c. I’ve thought about taking pills and alcohol till I pass out
d. Id like to be free from all these worries
24. A client with paranoid schizophrenia has persecutory delusions and auditory
hallucinations and is extremely agitated. He has been given a PRN dose of Thorazine
IM. Which of the following would indicate to the nurse that the medication is having
the desired effect?
a. Complains of dry mouth

b. State he feels restless in his body
c. Stops pacing and sits with the nurse
d. Exhibits increase activity and speech
25. A client who was wandering aimlessly around the streets acting inappropriately
and appeared disheveled and unkempt was admitted to a psychiatric unit and is
experiencing auditory and visual hallucinations. The nurse would develop a plan of
care based on:
a. borderline personality disorder

b. anxiety disorder
c. schizophrenia
d. depression
26. A decision is made to not hospitalize a client with obsessive-compulsive disorder.

Of the following abilities the client has demonstrated, the one that probably most
influenced the decision not to hospitalize him is his ability to:
a. Hold a job.
b. Relate to his peers.
c. Perform activities of daily living.
d. Behave in an outwardly normal
27. A client is admitted to the inpatient psychiatric unit. He is unshaven, has body
odor, and has spots on his shirt and pants. He moves slowly, gazes at the floor, and
has a flat affect. The nurse's highest priority in assessing the client on admission
would be to ask him:
a. How he sleeps at night.

b. If he is thinking about hurting himself.
c. About recent stresses.
d. How he feels about himself.
28. The nurse should know that the normal therapeutic level of lithium is :
a. .6 to .12 meq/L
b. 6 to 12 meq/L
c. .6 to .12 cc/ml
d. .6 to .12 cc3/L
29. The patient complaint of vomiting, diarrhea and restlessness after taking lithane.
The nurse’s initial intervention is :
a. Recognize that this is a sign of toxicity and withhold the next medication.
b. Notify the physician.
c. Check V/S to validate patient’s concerns.
d. Recognize that this is a normal side effects of lithium and still continue the drug.
30. The client is taking TOFRANIL. The nurse should closely monitor the patient for :
a. Hypertension
b. Hypothermia
c. Increase Intra Ocular Pressure
d. Increase Intra Cranial Pressure
31. A client was hospitalized with major depression with suicidal ideation for 1 week.
He is taking venlafaxine (Effexor), 75 mg three times a day, and is planning to
return to work. The nurse asks the client if he is experiencing thoughts of self-harm.
The client responds, "I hardly think about it anymore and wouldn't do anything to
hurt myself." The nurse judges:
a. The client to be decompensating and in need of being readmitted to the hospital.

b. The client to need an adjustment or increase in his dose of antidepressant.
c. The depression to be improving and the suicidal ideation to be lessening.
d. The presence of suicidal ideation to warrant a telephone call to the client's
physician
32. The client is taking sertraline (Zoloft), 50 mg q AM. The nurse includes which of
the following in the teaching plan about Zoloft?
a. Zoloft causes erectile dysfunction in men.

b. Zoloft causes postural hypotension
c. Zoloft increases appetite and weight gain
d. It may take 3-4 weeks before client will start feeling better.
33. After 3 days of taking haloperidol, the client shows an inability to sit still, is
restless and fidgety, and paces around the unit. Of the following extrapyramidal
adverse reactions, the client is showing signs of:
a. Dystonia.
b. Akathisia.
c. Parkinsonism.
d. Tardive dyskinesia.
34. After 10 days of lithium therapy, the client's lithium level is 1.0 mEq/L. The nurse
knows that this value indicates which of the following?
a. A laboratory error.
b. An anticipated therapeutic blood level of the drug.
c. An atypical client response to the drug.
d. A toxic level.
35. When caring for a client receiving haloperidol (Haldol), the nurse would assess
for which of the following?
a. Hypertensive episodes.
b. Extrapyramidal symptoms.
c. Hypersalivation.
d. Oversedation.
36. A client is brought to the hospital’s emergency room by a friend, who states, "I
guess he had some bad junk (heroin) today." In assessing the client, the nurse
would likely find which of the following symptoms?
a. Increased heart rate, dilated pupils, and fever.

b. Tremulousness, impaired coordination, increased blood pressure, and ruddy
complexion.
c. Decreased respirations, constricted pupils, and pallor.
d. Eye irritation, tinnitus, and irritation of nasal and oral mucosa.
37. The client has been taking the monoamine oxidase inhibitor (MAOI) phenelzine
(Nardil), 10 mg bid. The physician orders a selective serotonin reuptake inhibitor
(SSRI), paroxetine (Paxil), 20 mg given every morning. The nurse:
a. Gives the medication as ordered.

b. Questions the physician about the order.
c. Questions the dosage ordered.
d. Asks the physician to order benztropine (Cogentin) for the side effects.
38. Which of the following client statements about clozapine (Clozaril) indicates that
the client needs additional teaching?
a. "I need to have my blood checked once every several months while I’m taking this
drug."
b. "I need to sit on the side of the bed for a while when I wake up in the morning."
c. "The sleepiness I feel will decrease as my body adjusts to clozapine."
d. "I need to call my doctor whenever I notice that I have a fever or sore throat."
39. A client has been taking lithium carbonate (Lithane) for hyperactivity, as
prescribed by his physician. While the client is taking this drug, the nurse should
ensure that he has an adequate intake of:
a. Sodium.
b. Iron.
c. Iodine.
d. Calcium.
40. The client has been taking clomipramine (Anafranil) for his obsessive-compulsive
disorder. He tells the nurse, "I'm not really better, and I've been taking the
medication faithfully for the past 3 days just like it says on this prescription bottle."
Which of the following actions would the nurse do first?
a. Tell the client to continue taking the medication as prescribed because it takes 5
to 10 weeks for a full therapeutic effect.
b. Tell the client to stop taking the medication and to call the physician.
c. Encourage the client to double the dose of his medication.
d. Ask the client if he has resumed smoking cigarettes.
41. The nurse judges correctly that a client is experiencing an adverse effect from
amitriptyline hydrochloride (Elavil) when the client demonstrates:
a. An elevated blood glucose level.

b. Insomnia.
c. Hypertension.
d. Urinary retention.
42. Which of the following health status assessments must be completed before the
client starts taking imipramine (Tofranil)?
a. Electrocardiogram (ECG).
b. Urine sample for protein.
c. Thyroid scan.
d. Creatinine clearance test.
43. A client comes to the outpatient mental health clinic 2 days after being
discharged from the hospital. The client was given a 1-week supply of clozapine
(Clozaril). The nurse reviews information about clozapine with the client. Which client
statement indicates an accurate understanding of the nurse's teaching about this
medication?
a."I need to call my doctor in 2 weeks for a checkup."

b."I need to keep my appointment here at the hospital this week for a blood test."
c. "I can drink alcohol with this medication."
d. "I can take over-the-counter sleeping medication if I have trouble sleeping."
44. The client is taking risperidone (Risperdal) to treat the positive and negative
symptoms of schizophrenia. Which of the following negative symptoms will improve?.
a. Abnormal thought form.
b. Hallucinations and delusions.
c. Bizarre behaviour.
d. Asocial behaviour and anergia.
45. The nurse would teach the client taking tranylcypromine sulfate (Parnate) to
avoid which food because of its high tyramine content?
a. Nuts.
b. Aged cheeses.
c. Grain cereals.
d. Reconstituted milk.
46. Which of the following clinical manifestations would alert the nurse to lithium
toxicity?
a. Increasingly agitated behaviour.

b. Markedly increased food intake.
c. Sudden increase in blood pressure.
d.Anorexia with nausea and vomiting.
47. The client with depression has been hospitalized for 3 days on the psychiatric
unit. This is the second hospitalization during the past year. The physician orders a
different drug, tranylcypromine sulfate (Parnate), when the client does not respond
positively to a tricyclic antidepressant. Which of the following reactions should the
client be cautioned about if her diet includes foods containing tryaminetyramine?
a. Heart block.
b. Grand mal seizure.
c. Respiratory arrest.
d. Hypertensive crisis.
48. After the nurse has taught the client who is being discharged on lithium
(Eskalith) about the drug, which of the following client statements would indicate
that the teaching has been successful?
a. "I need to restrict eating any foods that contain salt."

b. "If I forget a dose, I can double the dose the next time I take it."
c. "I'll call my doctor right away for any vomiting, severe hand tremors, or muscle
weakness."
d. "I should increase my fluid”
49. A nurse is caring for a client with Parkinson's disease who has been taking
carbidopa/levodopa (Sinemet) for a year. Which of the following adverse reactions
will the nurse monitor the client for?
a. dykinesia
b. glaucoma
c. hypotension
d. respiratory depression
50. A client is taking fluoxetine hydrochloride (Prozac) for treatment of depression.

The client asks the nurse when the maximum therapeutic response occurs. The
nurse's best response is that the maximum therapeutic response for fluoxetine
hydrochloride may occur in the:
a. 10-14 days
b. First week
c. Third week
d. Fourth week
Correct answers will be posted via the COMMENT BOX as soon as possible. Passing is
38/50.
Saturday, July 01, 2006

The NCP that made a hospital owner BOW to a nursing
student... almost!
Ito ang NCP na hinding hindi ko makakalimutan. When our group stayed in SANTOS
GENERAL HOSPITAL in malolos for a duty, we are required to present a case study
based on our patient at the last day of our duty. Ang patient ko noon ay isang
matandang na stroke. Ako ang naka duty sa ICU noon. So as usual, ang mga
ginagawa ko ay V/S , NGT Feeding, nililinis ko si tatay, pinapakain, dinadamitan at
nag pupulse oximetry.
Ang nurse naman na naka duty noon eh wala lang, parang invisible. Nag chachart
lang sha with matching patanong tanong to test our knowledge. Kasama ko sa duty
noon ay ang aking ate na classmate ko rin.
So dumating na ang last day, at natapos ko na ang aking NCP. Ako ang tipo ng
studyante na 3 days bago makatapos ng isang NCP kasi talagang ginagandahan ko
para walang makitang butas, although kaya ko rin naman gumawa ng ncp sa loob ng
5 minutes kasi usually sa exam required na gumawa ng NCP sa ganoong kabilis na
time.
So as usual, i didiscuss namin yung NCP at ako yata ang isa sa huling tinawag. So
chika chika lang habang dinidiscuss ko ang NCP humirit si Dr. Santos , yung owner
ng hospital.
Dr. Santos : How can you assess the placement of the NGT Tube? Wag ka
mashadong malikot bat paikot ikot ka. [Coz nilalaro ko yung chair dahil umiikot sha
sarap mag pa ikot ikot] Wag kang kabahan.
Budek : Ay! [Sabay ngiti, pati mga groupmate ko tawanan] Well, we have 3 different
ways to assess the placement of an NG Tube sir. One is via aspiration of the fluid
and testing it with the litmus paper. If the return is acidic, definitely it is from the
stomach. The paper will then turn to Red. We should then return what we aspirated
as not to disturbed the fluid and electrolyte balance of the patient.
Second, We can introduce air via the asepto syringe and auscultate for the bubbling
sound in the mid epigastric area. If we heard a gugrling sound in the epigastrium,
Then the NGT Must be in the stomach, although we cannot certainly assure it, that is
why we have the 3rd step which is the Confirmatory test to determine the NGT
placement, which is Chest X-ray which is not usually done in the philippines kasi nga
its not that cost effective.
Dr. Santos : Wow ha, kumpleto. What is it in the NGT tube that made it visible sa X-
ray?
Budek : [Honestly di ko alam, so birit nalang at nanghula] Well, The manufucturer

really intended to made the tube opaque as to not allow light to pass during X-ray
making it visible in the film.
Dr. Santos : Wow talaga! ang ganda ng ncp mo talagang practical. Matalino ba
talaga to? [Tanong nya sa mga classmate ko]
Mga groupmates : Sir opo, future topnotcher po namin yan sa board exam! [ mga
loko loko talaga]
Budek : Hindi naman [hiyang hiya]
Dr. Santos : O sige last question nalang, pag nasagot mo ito BAW ako sayo. [Aba
talagang nang dadare] What is the normal caloric requirement for an adult
individual?
Budek : [ Diyos ko day, eh nababasa ko yan sa likod ng mga chichirya at noodles na

kinakain ko no ] Sir, the average daily requirement for an adult individual is 2,000 to
2,500 calories per day.
Dr. Santos : [Na nangiti parang feeling nya mahirap yung tanong nya at ang galing
galing ko talaga] Wow talaga, grabe ang galing mo naman, basa ka siguro ng basa?
Mga groupmates : Wow naman debu galing galing mo!
Budek : hindi naman over naman tong mga to.
Dr. Santos : O last na tanong na, pag nasagot mo talaga ito talagang BAW na ako sa
iyo.[Teka kala ko ba tapos na yang tanong mo at BAW ka na sakin?] Kung ako ang
patient mo, Paano mo i didistribute yung 2,000 calorie na yan?
Budek : Sir diba mas marami dapat carbo then protein at fats ?
Dr. Santos : Hindi nga, yung exactong number gusto kong makuha. Ilang calorie
bawat isa?
Budek : Sir anong patient ba? diabetic or mga nagpapagaling? kasi diba depende eh.
Dr. Santos : Hindi mo alam no?
Budek : Ahmmmm... hindi ko alam sir eh. [Nag give up na ako hindi ko alam ano
gusto nyang sabihin eh]
Dr. Santos : O, risearch mo yan ha then tell me tomorrow ha.

Then after the presentation, kinamayan nya ako and sabi nya wag ko raw shang
kakalimutan pag nag top ako [As if naman] at pinakilala nya ako at pinagmayabang
sa mga doctors at nurses sa hospital dahil lahat daw ng tanong nya nasagot ko.
Ohhhh what a feeeeeling ! After the event nagtatago na ako nahihiya kasi ako hindi
ako sanay sa spotlight. Then i researched on the answer, that he meant pala is
paano ko i divide yung 2,000 calorie between protein,carbo and fats which is 4 , 4, 9.
Pero it was really complicated , kailangan ng calculator. computing the caloric

breakdown for a 2,000 calorie diet we need to divide 2,000 by .5 .3 and .2 to
measure the calories between carbo, fats and protein.
2,000 x .5 = 1,000 from carbohydrates

2,000 x .3 = 600 from fats
2,000 x .2 = 400 from protein
So we had an intake of about 250 grams of carbohydrates. 67 grams of fats and 100
grams of protein. Balance? Balanced!
250 grams x 4 = 1,000 calories from carbohydrates

67 grams x 9 = 600 calories from fats
100 grams x 4 = 400 calories from protein
Sayang, kung nasagot ko sana! pero ang hirap talaga hindi ko alam yan during that
time medyo nalimutan ko na yung nutrition ko :) dont forget that ha baka matanong
ka rin diyan.
10 Essential tools to TOP your university’s nursing pre-

board examination part III
6. DOH Website [ http://www.doh.gov.ph/ ]
Ma pa board exam man or preboard, ito ang website na kailangang I MEMORIZE. I

scanned the previous board exam, MOST of the “weird” questions are found sa
website na ito. One example is the MARBURG virus that was asked during the 2004
yata or 2005 board exam. Other common questions are the Morbidity and Mortality
figures which are found sa website na ito.
Tanda ko pa ang tanong sa preboard ng Fatima is yung common cause ng morbidity

at mortality , pati narin ang mga formulas ng maternal mortality rate etc. Makikita
mo naman ang figures sa DOH Manual pero outdated. Ang leading cause of morbidity
today is PNEUMONIA na not diarrhea pero kung titingnan mo yung DOH manual mo
diarrhea pa rin nakalagay. So make sure updated ka sa FHSIS info which is found sa
DOH website. Mali po ang sagot ko kasi DIARRHEA ang sinagot ko e pneumonia na
pala. Susunugin ko talaga yang DOH manual na yan.
Another common questions is yung mga PROGRAMS. Like sang milyong sipilyo,
sentrong sigla, mag pa DRE tayo pare. Kaunti lang ang programs sa DOH Manual
unlike sa website, kumpleto halos doon. Read about the programs of the department
of health and understand it. Question before was about SANG MILYONG SIPILYO.
Ano daw ang paraan ng sang milyong sipilyo program para mapatupad ng maayos
ang programa. Answer is SOCIAL MOBILIZATION kasi hinihikayat niya ang SOCIETY
para mag donate ng mga toothbrush para sa mga hindi makabili. Pag mag dodonate
ng sipilyo wag yung HAN CHANG ha, yung mga sipilyong made in china na parang
alambre dahil ang titigas. ORAL B naman dahil baka pagduguin mo pa bibig ng
gagamit nung toothbrush mo murahin ka pa non.
Dapat alam mo rin kalian nagaganap ang mga programs na ito. Like Cancer
awareness month, Nutrition month, AIDS month at IWAS PAPUTOK. Baka naman
magkamali ka pa sa iwas paputok isagot mo February ha shempre December.
Masarap basahin ang website ng DOH hindi ka aantukin talagang detalyado at simple
lang.
May mga articles din ang DOH about the health news from various newspaper. LIBRE
ang mga ito so basahin ninyo [ HEALTH NEWS CLIPPINGS ]. Hindi naman ito lalabas
sa preboard pero sa board exam LUMALABAS po. I still remember a journal from
MANILA TIMES year 2003 ata iyon na pinagkuwaan ng tanong. The question asks
about what MINERAL works with VITAMIN E to strengthen the immune response.
Answer is SELENIUM.
Andito rin sa site na to ang mga info about BIRD FLU, MENINGGOCOCCEMIA at mga
NEW PROGRAMS na pwedeng itanong. Tinanong ano raw program ang nagbebenta
ng murang gamot sa mga kababayan nating gusting makamura. Answer : GMA 50.
Wala nyan sa DOH Manual pero nasa website.
May bagong program nga ang DOH dahil kulang na kulang ang mga doctors sa mga
barrios sa province. Nako baka itanong din yan, the DOCTORS TO THE BARRIOS
program. Hindi ko alam kung tinanong na ito sa board pero bago lang yung program
kaya baka itanong sa future questions.
Under the DOH website is the FHSIS website [ FIELD HEALTH SERVICES
INFORMATION SYSTEM ] Papaputol ko ang kuko ko sa paa pag walang tinanong sa
FHSIS website. Ito nga yung sinasabi ko na mortality, morbidity and other
DEMOGRAPHICS about the Philippines. Always answer using that website dahil
OUTDATED Po ang FHSIS ng ating DOH Manual. Sunugin na talaga yan!
7. Previous Board Exam Questions
Unang una, hindi naman inuulit ang tanong pero NAUULIT. Yung alma ata Russia na
yan ilang beses na ulit. Yung mga EO, RA, LOI, Vision, Mission at kung ano ano pa.
Dapat nabasa mo ang board questions during the past 5 years. You can buy this sa
mga tindahan sa tabi ng PRC meron mga yan. I managed to get a copy of board
exams from 1988-2005 and I tell you, compare sa NCLEX questions na binabasa ko,
para akong bumalik sa grade 1 dahil napaka straight to the point ng mga board
questions. Not really EASY pero the questions wouldn’t require you to think. Pag
hindi mo talaga alam, MALI KA NA unlike in NCLEX na iimaginine mo pa yung
situation and pwede kang manghula.
Examples :
[ December 1992 board question ]
Which of the following is not an adverse effect of anti-psychotic drug?

A. Sedation B. Hypertensive Crisis C. EPS side effects D. Anti cholinergic Side effects
[ NCLEX Question ]
Which of the following sign and symptoms of client taking

CHLORPROMAZINE [ THORAZINE ] Will require the nurse to report the
symptoms to the physician?
A. Tongue protrusion B. Dry mouth C. Blurred Vision D. Wry neck
Comparing the question, look at the local board… GENERAL ang approach nya.
Antipsychotic drugs has EPS and ANTICHLONERGIC side effects so I will remove
those options first. Sedation is another side effect ng anti psychotics because of the
disturbance of neurotransmitters.
Hypertensive crisis is seen sa mga ANTI DEPRESSANT, particularly, sa MAOI right?

What we see sa neuroleptics [ other name ng antipsychotics ] is the NMS or
neuroleptic malignant syndrome. So B is the right answer.
Looking at the NCLEX Question, compare sa approach ng local, sobrang HIRAP ng

approach sa Nclex. According nga kay Sir Allan Santos [ Board topnotcher 2005 ] na
¼ lang daw ang hirap ng local compare sa NCLEX and I will agree. Dito specific ang
drug na tinatanong so pag hindi mo alam kung ano ang classification ng thorazine
hindi mo masasagot. Sa local board, kinlassify na sha.
Ngayon looking at the choices, you need to CLASSIFY nanaman ang choices.
Dry mouth and Blurred vision are all ANTICHOLINERGIC Side effects of the drug
therefore, eliminate mo na dahil it is NORMAL. We could use an eye drops na
ipapatak sa eyes para ma lubricate ang eyes to relieve blurred vision and pwede
nating bigyan ng ice chips or sugarless gum ang ating patient to relieve dry mouth.
Wry neck is a DYSTONIC side effect of the drug. We can give the client drugs to
relieve Dystonia like BENADRYL.
Tongue protrusion is a sign of TARDIVE DYSKINESIA, of all the side effects of

neuroleptics, TD is the one that would force the physician to stop using the drug
indefinitely because TD is IRREVERSIBLE.
So now you see the reason bakit gusto ng mga prof nyo na kumuha from NCLEX
rather than local. The more you train kasi sa harder question ng NCLEX, the more
SISIW the local boards will be. Hilig ng Fatima na kumuha ng question sa previous
board, WORD PER WORD po kinuha ni sir Vasquez ang some questions nya sa aming
preboard from the 1992 board exam and nalaman ko lang AFTER ko na mabasa,
which is SAD kasi sayang! OB pa naman ako mahina.
MOST of the questions ng preboard are taken from NCLEX and PREVIOUS BOARD so
make sure you read previous board questions bago ka sumabak. Fatima do not like
making new questions, most are recycled from MOSBY, SAUNDERS, LIPPINCOTT +
LOCAL BOARDS. The book of SIA will help. SIA’S NURSING QUESTIONS AND
ANSWERS I , II, III collects selected questions from 2004 and 2003 board questions
and she will rationalize it for you. Although may mga MALI siyang sagot, most
naman ay tama. Usually nagkakamali si SIA sa mga questions na may EXCEPT at sa
mga Questions na WALANG REFERENCE [ meaning, subjective kung sino gumawa ng
tanong siya lang ang makakasagot ]
Example :
Diagnostic assessment of Mr. Gary would probably NOT reveal [ talking

about LEUKEMIA ]
A. A predominance of lymphoblasts C. Abnormal blast cell in the bone marrow

B. Leukocytosis D. An elevated thrombocyte count
Ang sagot ni SIA is B. Leukocytosis. But the right answer is D. An elevated

thrombocyte count.
Because LEUKEMIA is an abnormal proliferation of immature WBC right? The WBC is

so immature that it is not effective in dealing with foreign antigens. The proliferation
of WBC CROWDS out the rest of the cell and will cause the THROMBOCYTE to
decrease. Leukocytosis is the increase in WBC and will be present in leukemia.
LEUKOCYTOPENIA is the one na hindi makikita sa leukemia.
There are around 6 more questions na medyo na lito si SIA in his TEST III [ meron
ding errors ang I and II ] book dahil sa mga except except na yan. Dapat hindi ka
basta tanggap ng tanggap ng rationale, always check and verify using your own
knowledge and resources. Pero I recommend her book.
Mapapansin nyo rin sa book nya na MOST OF THE RATIONALES are taken from the
DOH website and her books. Sabi ko sa inyo important ang DOH website eh! Yung
book nya naman ng OB and PEDIA maganda rin around 1 cm thick and small frame
siya, pero not worth reading as I said, EXAM QUESTIONS na lang ang basahin ninyo
then refer to WONG or PILLETERI if you want to know more about the topic.
8. Final Coaching materials of the previous batch.
Maging FRIENDLY ka dapat sa mga 4th years. Dapat may BEST FRIEND ka atleast
isa na fourth year student. Siya ang mag susupply sa inyo ng mga previous final
coaching materials bakit? Kasi doon din kukuhain ng university nyo specially ng
Fatima ang mga tanong sa compre at quali. [preboard exams ] Ito rin yung mga
tanong na I rerecycle sa susunod na preboard so you better get a hand of those. Ako
kasi kumpleto when it comes to these things eh, I make sure na makukuha ko lahat
lahat ng binibigay ng institution dapat ganun ka rin.
I remember that the materials given during the final coaching of FATIMA December
2005 was RECYCLED and became the COMPREHENSIVE EXAM [ First pre-board ] of
the next batch. Alam ko kasi I got a hold of the final coaching materials given during
December 2005 and SADLY, I haven’t read it kaya galit ako sa mundo after that
examination. Minumura ko nga si Maam bautista sa isip ko eh kasi kinuha lahat ng
psyche exam doon sa final coaching nya. Pero favorite teacher ko si Maam Bautista
ha. [ pambawi baka may magsabi kay maam bautista I-ECT ako.]
9. Review center examinations [ Pentagon, Gapuz, Oracle, St. Louis, etc. ]
Tandang tanda ko pa na LAHAT LAHAT LAHAT ng inexam namin tungkol sa

RESEARCH during our QUALI [second pre-board] are taken from PENTAGON’s
research questions. Swerte ko binasa ko kaya natuwa naman ako. Around 30 items
yata ang research at 100% are taken from pentagon’s examinations. Buti nalang
may pentagon materials ako that I asked from a friend of mine na nag review sa
pentagon.
Pero usually naman na galling sa mga review centers na ito are taken rin from
previous national board exam. Pero if you have a chance to get a copy of this review
materials, Get them and read them.
10. Prayer
Shempre mawawala ba ang prayer? Bago ka mag exam always make sure that you
PRAY with all your heart and clear intentions. There can be miracles you know when
you believe. Although hindi ako madasaling tao, Everytime na mag e exam
nagdadasal naman ako. Siguro sa loblob ni God sa akin Letse ka, magdadasal ka
lang tuwing exam!
Honestly, when you pray…. Bababa ang anxiety mo because prayer is a source of
CONSOLATION. Anxiety interferes during the exam, anjan yung PARA at SYMPA
effect that are affected by the rising level of anxiety. Tremors, Tachycardia, Increase
peristalsis, stimulation of the detrusor muscle and contraction of the bladder. [Dapat
memorize mo ang effect ng para at sympa] Kaya pag ninenerbyos ka na wiwiwi ka
sa salawal mo. Mag diaper ka honestly, ano gusto mo bumagsak O tumambok ang
pwet? [ Ano nga ba yung brand ng adult diaper? Dr. something yun e ] alam mo
naman no ang feeling ng ihing ihi diba? Nag iinit ka, di ka mapakali, ayaw gumana
ng utak mo mamumura mo yung tubig na ininom mo kaninang umaga basta!!!
Babagsak ka pag nangyari sa iyo yan kahit kasing talino mo pa si Einstein.
Eh lalong masama pag nag peristalsis ka habang nag eexam. Normal lang naman
ang peristalsis ang masama pag over active. I can’t imagine and I don’t want to
imagine ano mangyayari pag ito nangyari sa akin. bawal po lumabas during the
exam. So to sum it all, Prayers and Diapers ang number 10. Remember, sa preboard
at board, future mo na ang nakataya kaya dapat give your best shot. Pag bumagsak
ka ng preboard sorry, di ka makakatake ng board… sayang naman.

10 Essential Tools To Top The OLFU's TCAP and Preboard

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10 Essential Tools To Top The OLFU's TCAP and Preboard

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Mastering ANTIEMETICS : A story towards mastery

Dumating na si penny, [PHENERGAN] na Tagamet-ro [TAGAMET] manila pa.

Honey, and drama drama [DRAMAMINE] mo naman.

Mastering ANXIOLYTICS, ANTI PARKINSON'S, ANTI

Big Brother : TRANXENE [ FRANZEN ] hindi mo ba alam na VAWAL [ VALIUM ] ang

TRANXENE : Kuya, walang lakas si ATE V. [ ATIVAN ] sasakay pa siya ng BUS

Nakaramdam si TRANXENE ng CABA OF THE SELP

Si Ana (ANAPRAMINE) at Ella (ELAVIL) ay nagutom kaya kumain sila sa Quezon

100 Item Obstetrics-Maternal And Child Health Nursing

DEGREE OF QUESTION DIFFICULTY

4 – Very hard question, 25% Chance of answering correctly

A. Appearance of linea negra

2. Which hormone is necessary for a positive pregnancy test? [1]

3. With this pregnancy, Aling Julia is a [1]

4. In explaining the development of her baby, you identified in chronological order of

A. Ovum, embryo, zygote, fetus, infant

A. She told you about her drunk husband

A. Constipation and hemorrhoids

A. Exercise is very tiresome, it should be avoided

9. In a 32 day menstrual cycle, ovulation usually occurs on the [2]

A. 14th day after menstruation

12. The more accurate method of measuring fundal height is [2]

A. Pain perception is interrupted

A. Amenorrhea, nausea, vomiting

16. What is the goal of this program?

A. All pregnancy experiences are the same for all woman

18. In maternal care, the PHN responsibility is [2]

A. To secure all information that would be needing in birth certificate

A. Underfive clinic chart

20. The schedule of prenatal visit in the RHU unit is [4]

A. Once from 1st up to 8th month, weekly on the 9th month

SITUATION : Knowledge of the menstrual cycle is important in maternal health

24. Which hormone stimulates oocyte maturation? [2]

A. Deduct 14 days at the mid of the cycle

29. Menstruation occurs because of which following mechanism? [2]

A. Increase level of estrogen and progesterone level

SITUATION : Wide knowledge about different diagnostic tests during pregnancy is an

31. The Biparietal diameter of a fetus is considered matured if it is atleast [4]

32. Quickening is experienced first by multigravida clients. At what week of gestation

37. Which of the following mothers needs RHOGAM? [1]

A. RH + mother who delivered an RH - fetus

38. Which family planning method is recommended by the department of health

A. Fertility Awareness Method

SITUATION : [ND2I246] Reproductive health is the exercise of reproductive right

A. To achieve healthy sexual development and maturation

A. Maternal and child health and nutrition

A. Women's health in reproduction

44. Which one of the following is a determinant of RH affecting woman's ability to

A. Women's lower level of literacy

47. Which of the following is NOT a strategy of RH? [3]

A. Increase and improve contraceptive methods

48. Which of the following is NOT a goal of RH? [3]

A. Achieve healthy sexual development and maturation

49. What is the VISION of the RH? [2]

A. Attain QUALITY OF LIFE

SITUATION : [SORANGE19] Baby G, a 6 hours old newborn is admitted to the NICU

A. Support the high-risk newborn's cardiopulmonary adaptation by maintaining

SITUATION : [P-I/46] Nurses should be aware of the different reproductive

53. When is the best time to achieve pregnancy? [2]

A. Midway between periods

A. 1 week after ovulation

56. A tubal insufflation test is done to determine whether there is a tubal

58. In the female, Evaluation of the pelvic organs of reproduction is accomplished by