December 2010 Nursing Board Exam 

Preboard Examination
By. NURSINGCRIB.COM

1.    Which of the following neurotransmitters is decreased in Parkinson’s disease?

a. Adrenaline
b. Serotonin
c. Epinephrine
d. Dopamine

Parkinson's disease (also known as Parkinson's, Parkinson disease, or PD) is a degenerative disorder of the

central nervous system that impairs motor skills, cognitive processes, and other functions. PD is the most common
cause of chronic progressive parkinsonism, a term which refers to the syndrome of tremor, rigidity, bradykinesia and
postural instability. Among non motor symptoms are autonomic dysfunction, cognitive and neurobehavioral problems
including dementia, and sensory and sleep difficulties. PD usually appears around the age of 60, although there are
young-onset cases. Symptoms result from insufficient formation and action of dopamine produced in the
dopaminergic neurons of the midbrain (specifically the substantia nigra).

2.    The doctor prescribed Mr. Lorenzo with Bromocriptine (Parlodel). What classification does this drug belong?
a. Anticholinergic drugs
b. Dopamine Metabolism Inhibitor
c. Dopamine Receptor Agonist
d. Dopamine Precursor

Medications used to treat Parkinson’s disease are those drugs that decrease the level of acethycholine
(anticholinergic drugs) and those that increase dopamine levels (dopaminergic agents). Anticholinergic Drugs
includes the ff: (1) Trihexyphenidyl (Artane) (2) Benztropine Mesylate (Cogentin) (3) Biperiden (Akineton) (4)
Dipenhydramine (Benadryl) (5) Ethoproprazine (Parsidol) (6) Procyclidine (Kemadrin) while Dopaminergic Drugs are
the ff: (1) Dopamine Precursor:LEVODOPA (Dopar, Larodopa) CARDIDOPA-LEVODOPA (Sinemet) (2) Dopamine
Receptor Agonist: BROMOCRIPTINE (Parlodel)PERGOLIDE (Permax)(3) Dopamine Metabolism
Inhibitor:SELEGILINE (Eldepryl).

3.    The primary clinical manifestations of Parkinson’s disease include the following apart from:
a. Pill-rolling tremors
b. Loss of intellectual capacity
c. Slowed retarded movements
d. Muscular rigidity

The three primary clinical manifestations of Parkinson’s Disease are 1) tremors (pill-rolling), 2) bradykinesia (slowed
retarded movements) and 3) muscular rigidity. Secondary symptoms ofParkinson’s disease include: • Constipation •
Dysphagia • Hypersalivation • Excessive sweating • Loss of bladder and bowel control • Loss of intellectual capacity
(dementia) – LATE stage • Microphagia (small cramped handwriting) • Hypophonia (soft, whispery voice)

4.    The nurse understood that the medication therapy for Parkinson’s disease is:
a. Curative – cures the disorder
b. Producing unwanted side effects a week after administration.
c. Palliative – manages the symptoms only
d. Administered for 2-4 weeks only.

Medications given for Parkinson’s disease only manages the symptoms but do not correct or cures the disorder,
hence, it is palliative. The cause of PD is unknown, however theories were brought up that absence or defects of
dopaminergic receptors in the brain decreases dopamine levels causing the disorder. Other explanations focused on
the imbalance between the acetylcholine and dopamine. Thus, the client needs a long-term medication regimen not
short-term or 2-4 weeks only. As the disease advances, the continuous use of medications (not a week after) leads to
a second stage in which the patient develops motor complications called dyskinesias which make management
difficult. Situation: Emma, 18 years old has grossly inappropriate affect. She is introvert and avoids close
relationships with family and friends. Her attention is focused on reading books and she functions well when she is
alone. Diagnosis: Personality Disorder

For Question no. 5-10 Situation: Emma, 18 years old has grossly inappropriate affect. She is introvert and avoids
close relationships with family and friends. Her attention is focused on reading books and she functions well when
she is alone. Diagnosis: Personality Disorder

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5.    The nurse is encouraging Emma to join the group session. Emma verbalized no desire for social involvement.
She further told the nurse that her pleasure is on reading books and not on joining the group. Based on Emma’s
history, she has no close friends or confidants and she seemed indifferent to criticism and praise by others. What
type of personality disorder does Emma has?
a. Schizoid personality disorder
b. Avoidant personality disorder
c. Antisocial personality disorder
d. Schizotypal personality disorder

Synonyms for someone with a schizoid personality disorder include introvert and loner because the person has no
desire for social involvement. The clinical symptoms include a pervasive pattern of detachment from social
relationships and a restricted range of emotional expression in interpersonal settings. The individual avoids close
relationships with family or others, chooses solitary activities, has little interest in sexual experiences, does not take
pleasure in activities, lacks close friends or confidants, appears indifferent to praise or criticism, and exhibits
emotional coldness such as detachment or flattened affect. Attention is usually focused on objects such as books and
cars rather than people. He or she may function well in vocations where one generally works alone. FLAT AFFECT
and LITTLE EMOTION. Avoidant Personality Disorder - The client with avoidant personality disorder is highly
sensitive to rejection, criticism, humiliation, disapproval, or shame, appearing devastated by the slightest amount of
disapproval. This extreme sensitivity interferes with participation in occupational activities, development of
interpersonal relationships, and the ability to take personal risks or engage in new activities. Social withdrawal occurs
because the client views him- or herself as socially inept, personally unappealing, or inferior to others. Antisocial
Personality Disorder - Characterized by pervasive pattern of disregard for and violation of the rights of others- and
with the central characteristics of deceit and manipulation. Schizotypal Personality Disorder - The classification of
schizotypal personality disorder is used to diagnose persons whose symptoms are similar to, but not severe enough
to meet, the criteria for schizophrenia. Clients generally exhibit a disturbance in thought processes referred to as
magical thinking, superstitiousness, or telepathy (a sixth sense). Pervasive pattern of social and interpersonal
deficits marked by acute discomfort with and reduced capacity for close relationships as well as cognitive or
perceptual distortions and behavioral eccentricities.

6.    Emma’s classified personality disorder is under which cluster?

a. Cluster A
b. Cluster B
c. Cluster C
d. Not classified

Schizoid personality disorder is under Cluster A. Cluster A : odd, eccentric (includes paranoid, schizoid and
schizotypal PD) Cluster B: dramatic, emotional or erratic (includes antisocial, borderline, histrionic and narcissistic
PD) Cluster C: anxious, fearful (includes avoidant, dependent and Obesseive-Compulsive PD) Not classified PD:
passive-aggressive PD and depressive PD

7.    Personality disorders (PD) are listed by the DSM-IV-TR as a separate and distinct category from other mental
illnesses. The disorder falls on the Axis II of the multi-axial classificationsystem. The following statements are true of
personality disorders except:
a. Most patients with personality disorders are treated in acute care settings due to the inflexible and
maladaptive personality.
b. Nurses most often encounter clients with antisocial and borderline personality disorders.
c. There is difficulty diagnosing and treating clients with PD because of the similarities and subtle differences
between categories and types.
d. Many people with PD have also coexisting mental illnesses.

Most patients with personality disorders are NOT treated in acute care settings due to the inflexible and maladaptive
personality but due to physical injuries or for another major mental illness.

8.    PD’s under cluster B includes which of the following?

a. Paranoid
b. Narcissistic
c. Dependent
d. Passive-aggressive

a. Paranoid – Cluster A b. Narcissistic – Cluster B c. Dependent – Cluster C d. Passive-aggressive – not classified

PD

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9.    Medications given to clients with PD focus on the client’s symptoms rather than the particular subtype. Cognitive-
perceptual disturbances respond to low-dose antipsychotic medications. Symptoms under cognitive-perceptual
disturbance does not include:
a. Depression
b. Magical thinking
c. Odd beliefs
d. Ideas of references

Depression is a form of mood dysregulation. Magical thinking, odd beliefs, suspiciousness, ideas of references and
low-grade psychotic symptoms are cognitive-perceptual disturbances.

10.    During the nurse’s rounds, Emma gestured as if she is listening to someone. Then she told the nurse that she
hears voices. Initially, the nurse should respond:
a. “What are you thinking about?”
b. “I understand how you feel, but I don’t hear any voices.”
c. “You must be kidding me.”
d. “What are the voices telling you?”

KEYWORD of the question: initially. Auditory hallucinations are the most common form of hallucination. If the client
verbalizes that she hears voices, the nurse should assess what is the content of the auditory hallucination. If the
voices are telling the client to kill her or others, safety for possible violence is implemented. Asking the client what is
she thinking is inappropriate in this situation as the client already told the nurse that she hears voices. After knowing
the content of the voices it would be appropriate for the nurse to present the reality. Situation: Nursing theories are
important for nurses to know. It expected on nurses to integrate the theories governing the field while providing care
to clients.

11.    Maslow’s heirachy of needs is very helpful in prioritizing nursing interventions. Nurse Anna, is caring for patients
in the ward. In prioritizing her nursing care services she should first implement:
a. Identifying the support system of a depressed patient
b. Changing bed linens
c. Initiating oxygen therapy
d. Discussing about the love life of a teenager patient

Maslows hierarchy of needs has five levels top priority is on: 1. Physiologic needs (food, air, water) 2. Safety needs 3.
Love and belongingness 4. Self-esteem 5. Self-actualization

12.    In the current conceptual model, the four main concepts that appears common to nursing are the following: 1.    
Psychology 2.    Medicine 3.    Person 4.    Nursing 5.    Environment 6.    Health
a. 1,2,3,4
b. 2,3,4,5
c. 3,4,5,6
d. 1,3,5,6

Concepts common in the nursing Conceptual models are the person, nursing, environment and health.

13.    Throughout Nurse Anna’s shift her topmost priority in order to create a therapeutic milieu or environment for her
patient should be on:
a. Accepting her individuality as a person
b. Promoting safety
c. Orienting new nurses to the physical set-up of the hospital
d. Explaining the disease process to the patient

Accepting her self as a unique person and self-awareness is the topmost priority in promoting a therapeutic
environment.

14.    As a nurse, Nurse Anna assumes different roles in caring for her patients. Which of the following demonstrates
the nurse’s role as an educator:
a. Informs the client about the progress of his condition
b. Evaluate the client’s learning needs and his/her readiness to learn
c. Allow the client to actively participate in his/her care
d. Communicate the needs of the client

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Evaluating the client’s learning needs and his/her readiness to learn is assuming the role of an educator or teacher.
A, C, and D are demonstrating advocacy.

15.    Florence Nightingale became the “Mother of Modern Nursing” for the reason of:
a. Providing services to the wounded soldiers during the Crimean war
b. Establishing the red cross movement
c. Bringing light of what a professional nursing should really be and putting up a school of nursing
d. Serving all patients for free

Florence Nightingale became the “Mother of Modern Nursing” because she brought light of what a professional
nursing is and put up a school of nursing.

16.    A nurse is obtaining supplies necessary to start an IV line for a client who will be undergoing blood transfusion.
Which needle size should the nurse select for the initiation of the IV?
a. 23-gauge
b. 18-gauge
c. 20-gauge
d. 25-gauge

For the administration of blood products 16-, 18- or 19- gauge is used. For peripheral fat emulsion infusions, a 20- or
21- gauge needle is used. A 22- or 23- gauge needle is used for the standard IV solutions. 25-gauge needles are
used for subcutaneous injections.

17.    A client on clear liquid diet complained of nausea and has vomited. The doctor prescribed an anti-emetic drug.
After the administration of the drug, the client appears to be relaxed. After 4 hours the client asked for something to
eat because he is hungry. Which food is appropriate to be given to the client?
a. Apple juice
b. Hot tea
c. Hot milk
d. Dry toast

Cold foods or room temperature foods are better tolerated by a client who is nauseated. Hot food items may increase
the nausea because of the aromas emitted. Dry toast and crackers are tolerated by nauseated clients. However, in
this case the client is on a clear liquid diet, thus, dry toast should not be given.

18.    The client who underwent a nasal surgery was brought back to the surgical unit. Which position would the nurse
anticipate for the doctor to prescribe in this client, in order to reduce swelling?
a. Fowler’s position
b. Lithotomy position
c. Sim’s position
d. Prone position

To reduce nasal swelling the client’s upper body part should be elevated (fowler’s position). Lying flat would not
provide relief of nasal swelling.

19.    A nasogastric tube is in place. Nurse Anna keeps in mind that though NGT is beneficial in some clients its use
still present possible complications. One of the common complications is aspiration pneumonia. What causes
aspiration pneumonia in NGT feeding?
a. Streptococcus pneumonia
b. a virus reaches the lungs when airborne droplets are inhaled through the mouth and nose
c. Histoplasma capsulatum and blastomyces infestation
d. Regurgitation of formula contents from the stomach into the respiratory tract

Aspiration pneumonia is a common complication of NGT feeding. It is caused by the regurgitation of formula contents
from the stomach into the respiratory tract. a. Streptococcus pneumonia – bacterial pneumonia b. a virus reaches the
lungs when airborne droplets are inhaled through the mouth and nose – viral pneumonia c. Histoplasma capsulatum
and blastomyces infestation – fungal pneumonia

20.    To prevent aspiration pneumonia, what should the nurse do?
a. Place the client in a left-side lying position
b. Elevating the head of bed at all times
c. Increase fluid intake of the client

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d. Place the client in a right side-lying position

A common complication is aspiration pneumonia, which is caused by regurgitation of formula contents from the
stomach into the respiratory tract. Keeping the head of the bed elevated 30 degrees at all times assists in preventing
this complication.

21.    Formulating a patient’s discharge plan begins during:

a. Prior to patient discharge
b. During admission
c. A day after the surgery
d. When the client leaves the hospital

Discharge plan should be formulated on the day of admission.

22.    The surgeon is liable for the negligent acts of the nurses and other members of the OR team during a surgery
when he/she has the right to control and supervise. This is based on the on rule or doctrine called:

b. Borrowed servant rule

c. Doctrine of corporate negligence
d. Res Ipsa Liquitor

By the borrowed servant rule, the surgeon is liable for acts of team members only when he or she has the right
control and supervise the way in which the an RN or surgical technologist performs the work. Doctrine of respondent
superior – an employer is held liable for the employee’s negligent conduct (master-servant employment relationship.
Doctrine of corporate negligence – facility is held liable not because of the negligence of the employees but for its
own negligence in failing to ensure an acceptable level of care is provided. In the common law of negligence, the
doctrine of res ipsa loquitur (Latin for "the thing speaks for itself") states that the elements of duty of care and breach
can be sometimes inferred from the very nature of the accident, even without direct evidence of how any defendant
behaved. Upon a proof of res ipsa loquitur, the plaintiff need only establish the remaining two elements of negligence
—namely, that the plaintiff suffered damages, of which the accident was the legal cause.

23.    Any nurse practicing nursing without license is guilty of:

a. Tort
b. Malpractice
c. Misdemeanor
d. Negligence

A nurse who is practicing nursing without license is guilty of misdemeanor. A tort is a legal wrong committed by a
person involving injury of another or loss of or damage to personal property. A malpractice is any professional
misconduct, unreasonable lack of skill or judgment, or illegal or immoral act. Negligence is defined as failure to use
such care as a reasonably prudent and careful person would use under similar circumstances.

24.    What is the main difference between assault and battery?

a. Assault is the carrying out of physical harm while battery is a threat to harm someone physically.
b. Assault is a legal wrong committed by a person involving injury of another or loss of or damage to personal
property while battery is failure to use such care as a reasonably prudent and careful person would use
under similar circumstances.
c. Assault is failure to use such care as a reasonably prudent and careful person would use under similar
circumstances while battery is a legal wrong committed by a person involving injury of another or loss of or
damage to personal property.
d. Assault is done by telling someone that you will kill or harm him physically while battery is the
performance of the actual physical harm.

Assault is an unlawful threat to harm another physically while battery is the carrying out of body harm, as by touching
the person without authorization or consent. A tort is a legal wrong committed by a person involving injury of another
or loss of or damage to personal property. Negligence is defined as failure to use such care as a reasonably prudent
and careful person would use under similar circumstances.

25.    A foreign object is left in a patient’s body which results to sustained injury by a patient. Which doctrine applies in
this situation?
a. Doctrine of respondent superior
b. Borrowed servant rule

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c. Doctrine of corporate negligence
d. Res Ipsa Liquitor

In the common law of negligence, the doctrine of res ipsa loquitur (Latin for "the thing speaks for itself") states that
the elements of duty of care and breach can be sometimes inferred from the very nature of the accident, even without
direct evidence of how any defendant behaved. Upon a proof of res ipsa loquitur, the plaintiff need only establish the
remaining two elements of negligence—namely, that the plaintiff suffered damages, of which the accident was the
legal cause. By the borrowed servant rule, the surgeon is liable for acts of team members only when he or she has
the right control and supervise the way in which the an RN or surgical technologist performs the work. Doctrine of
respondent superior – an employer is held liable for the employee’s negligent conduct (master-servant employment
relationship. Doctrine of corporate negligence – facility is held liable not because of the negligence of the employees
but for its own negligence in failing to ensure an acceptable level of care is provided.

26.    The four D’s of malpractice includes the following choices apart from:
a. Duty to demonstrate and deliver a standard of care directly proportional to the degree of specialty training
received.
b. Deviation of that duty by omission or commission.
c. Damage to the nurse or nurse’s personal property.
d. Direct cause of a personal injury or damage because of deviation of duty.

The four D’s of malpractice are: • Duty to demonstrate and deliver a standard of care directly proportional to the
degree of specialty training received. • Deviation of that duty by omission or commission. • Damage to the PATIENT
or personal property. • Direct cause of a personal injury or damage because of deviation of duty.

27.    Liability for assault and battery may be charged if the surgeon goes beyond the limits to which the patient
consented. However, during the operation, the surgeon performed an additional surgery during the course of an
authorized surgical procedure to correct an abnormality when an unexpected condition is encountered. Which
doctrine implies that the doctor is not charged of assault and battery?
a. Doctrine of respondent superior
b. Extension doctrine
c. Doctrine of informed consent
d. Doctrine of Res Ipsa Liquitor

Extension doctrine implies that the patient’s explicit consent for surgical procedure serves as an implicit consent for
any or all surgical procedures deemed necessary to cope with unpredictable situations that jeopardize the patient’s
health. Doctrine of informed consent recognizes the physician’s duty to inform the patient and obtain consent before
treatment.

28.    The physician fails to inform the patient about the surgical operation and the nurse did not obtained an informed
consent before the surgical procedure is done. The acts of the medical team is considered as:
a. Malpractice
b. Assault
c. Breach of duty
d. Battery

Doctrine of informed consent recognizes the physician’s duty to inform the patient and obtain consent before
treatment. Failure of doing this may be considered a breach of duty.

29.    Which of the following is true of continuing education?

a. Continuing education is a measurement of proven competence in practice.
b. Continued education helps the practitioner keep abreast of current trends and practices.
c. Continuing education is the only method of self-development.
d. Continuing education is not a personal responsibility but rather should be mandated by the institution.

Continued education helps the practitioner keep abreast of current trends and practices. It is NOT a measurement of
proven competence in practice, but it is the most widely accepted method of self-development. Joining workshops,
seminars, conferences and other educational offerings are personal responsibility of professional nurses and surgical
technologist.

30.    To safeguard the OR team from possible lawsuits, which of the following preventive strategy should be
implemented:
a. Maintenance of good communications with each team members.

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b. Establishing a positive rapport with patients.
c. Documentations of assessments, interventions and evaluations of patient care.
d. All of the above.

A preventive strategy in OR the following should be done: • Maintenance of good communications with each team
members. • Establishing a positive rapport with patients. • Documentations of assessments, interventions and
evaluations of patient care. • Compliance with legal statutes and standards of accrediting agencies, professional
associations and health care facility. • Control of further insult or damage if an injury occurs by reporting problems
and taking corrective actions.

For Questions no. 31-40 Situation:  Charles, a 4-year old child, was brought to the ER who is observed to be
drooling, has a hyperextended neck and is leaning in a tripod position. The child has a fever, has difficulty breathing
and muffled cough and looks very ill.

31.    Basing on the given data, the child most likely has the respiratory disorder of:
a. Laryngotracheobronchitis
b. Epiglottitis
c. Croup
d. Pneumonia

Epiglottitis is presented with a muffled cough, drooling and hyperextension of the neck (due to painful swallowing),
sits in a tripod position and looks very ill. Cough in epiglottitis is muffled while cough in laryngotrachebronchitis or
croup is a croup/barking cough.

32.    As the child’s condition is considered an emergent one, which equipment should the nurse prepare at the
bedside?
a. Endotracheal tube
b. Nasogastric tube
c. Tongue depressor
d. Catheter

In epiglottitis Endotracheal tube (ET tube) is prepared at the bedside for possible airway obstruction. Manipulating the
airway through the use of tongue depressor is contraindicated for clients with epiglottitis as this can cause further
worsening of the condition.

33.    During assessment the nurse expects that Charles' history of present illness would possibly reveal which of the
following data?
a. Aspiration
b. Cough becoming worst at night
c. Tonsillitis
d. Eating disorder

Epiglottitis is usually preceded by an upper respiratory tract infection such as tonsillitis, pharyngitis, sinusitis, common
colds, laryngitis and otitis media. In epiglotitis, the affected child suddenly becomes very ill. Cough becoming worst at
night is noted with croup or laryngotracheobronchitis. Eating disorders has not been associated with epiglotitis.

34.    The doctor ordered diagnostic test to be performed to Charles. Basing on the patient’s condition the nurse
would expect which of the following test to be done to the client?
a. Lateral neck radiograph
b. Echocardiogram (ECG)
c. Mantoux test
d. Bronchoscopy
Lateral neck radiograph will show an enlarged epiglottis in epiglottitis. Mantoux test is used to signify the exposure to
Mycobacterium Tubercle Bacilli. A bronchoscopy is the direct observation of the larynx, trachea and bronchi through
a flexible or rigid bronchoscope. This diagnostic test is used in removing a foreign object or to excise lesions and is
not used in epiglotitis. ECG is used for cardiovascular disorders.

35.    Which of the following physician’s order should the nurse question in the case of Charles?
a. Cefuroxime 20 mg/kg IV every 12 hours
b. Cefuroxime 125 mg PO every 12 hours
c. Endotracheal intubation
d. Prophylactic tracheostomy

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Second-generation cephalosporin (e.g Cefuroxime) may be prescribed by the physician for Epigottitis. Because
children with epiglottitis can’t swallow the medication is administered through the IV line. Children like Charles’ case
need a prophylactic tracheostomy or endotracheal intubation.

36.    Charles is in what stage of cognitive development according to Jean Piaget’s theory?
a. Sensorimotor
b. Preoperational stage
c. Concrete operational
d. Formal operations

Charles is 4 years old and is under the preoperational stage of cognitive development. Sensorimotor: 0-24 months
Preoperational Stage: 2-7 years old Concrete Operations: 7-11 years Formal Operations: 12- adulthood

37.    The nurse expects that Charles is most afraid of:

a. Unfamiliar people
b. Strangers
c. Being fat or having acne
d. Being cut or wounded

Preschoolers (3-5 y.o.) is having a castration anxiety. They are afraid to be cut or wounded. Stranger anxiety –
infancy Separation anxiety – toddler Castration anxiety – preschooler
38.    Knowing Charles age, the nurse would expect these characteristics to be observed in the patient apart from:
a. Button buttons
b. Lace shoes
c. Identifies with his mother and is attached to his father
d. Curious, creative, imaginative and imitative

By 4 years of age you expect a child to button buttons (the child learns to unbutton first before buttoning) and lace
shoes. Preschoolers are curious, creative, imaginative and imitative. Complexes are present at this age where the
child identifies with the same sex and is attached by the parent of the opposite sex. For Charles, Oedipal complex will
be noted where he will identify with his father and will be attached to his mother.

39.    Regarding dental hygiene the nurse expects Charles (basing on his age) to do which task?
a. Brushing teeth alone
b. Brushing teeth with assistance
c. Begins brushing teeth
d. All of the above

Beginning of toothbrush: 2 ½ years Brushing teeth with little assistance: 3 years Brushing teeth alone: 6 years old

40.    Based on Erik Erickson’s psychosocial theory, Charles is in what stage?

a. Initiative vs. Guilt
b. Phallic
c. Autonomy vs. Shame and Doubt
d. Latency

Preschoolers are under the developmental task of initiative vs. guilt. Phallic is also for preschoolers but it is under the
psychosexual development of Sigmund Freud. Autonomy vs. Shame and Doubt – Toddler Latency – (Psychosexual)
Schoolage
For Questions no. 41-43 Situation:  A student is brought to the school clinic because of a nose bleeding episode.

41.    Which of the following interventions, when done by the school nurse should be corrected?
a. Cold compress application
b. Instruct the student not to blow the nose for 2 days after the removal of the nasal packs.
c. Avoid oral-temperature taking.
d. Pressure over the soft tissue of the nose for 2-3 minutes.

Pressure over the soft tissue of the nose should be continuously done for at least 5 minutes to stop the bleeding.
Nursing interventions for epistaxis: • Sit-up, lean forward, head-tipped. • Cold compress • Nasal pack with
neosenephrine (3-5 days) Liquid diet, then soft diet Avoid oral-temperature taking Do not blow nose for 2 days after
the removal of the nasal pack • Notify physician if epistaxis is recurrent

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42.    The doctor identified the student’s case to be an anterior nose bleeding which accounts for the most common
type. The following management is applicable in this case apart from:
a. Proper positioning
b. Application of topical vasoconstrictors
c. Pressure over the soft tissues of the nose
d. Nose packing with gauze impregnated with petroleum jelly or antibiotic ointment

There are two types of nose bleeding (NB), anterior NB and posterior NB. The most common type, anterior NB is
managed by proper positioning, pressure (5-10 minutes) and topical vasoconstrictors (neosenephrine). Posterior NB,
the rare form can be managed by a cotton tampon, suctioning, and if bleeding is not identified nose packing with
gauze impregnated with petroleum jelly or antibiotic ointment may be used. However prior to insertion, a typical spray
and decongestant may be used.

43.    The student asked the nurse of what are the possible causes of nose bleeding or epistaxis. The nurse correctly
identifies the cause of epistaxis by stating which of the following?
a. “Irritation of the nasal cavity most commonly causes the rupture of tiny, distended vessels in the
mucous membrane of any area of the nose.”
b. “All posterior nose bleeding episodes are caused by a deviated nasal septum.”
c. “Humidity has nothing to do with nose bleeding.”
d. “Drinking ASA most commonly cause nose bleeding.”

The most common cause of nose bleeding is the irritation of the nasal mucosa that resulted to the rupture of tiny,
distended vessels. Not all posterior nose bleeding is caused by a deviated nasal septum. Low humidity causes
epistaxis. Drinking ASA can cause bleeding tendencies but it is not the common cause of epistaxis.
For Questions no. 44-46 Leadership is a learned behavior involving influence and role modeling that inspires people
to achieve personal and group goals.

44.     During a meeting the head nurse allows the nursing staff to make decisions concerning the completion of their
work. She provided the members with all the materials they need to accomplish their goals and allowed them to set
their goal independently. The head nurse is using which style of leadership?
a. Authoritarian
b. Democratic
c. Laissez Faire
d. Multi critic

The Laissez Faire Leadership Style was first described Lewin, Lippitt, and White in 1938 along with the autocratic
leadership and the democratic leadership styles. The laissez faire style is sometimes described as a "hands off"
leadership style because the leader provides little or no direction to the followers. The characteristics of the laissez
faire style include: • Allows followers to have complete freedom to make decisions concerning the completion of their
work or ask questions of the leader • The leader provides the followers with the materials they need to accomplish
their goals and answers questions to the follower's questions. Authoritarian - directive style of supervision * Low
degree of participation by the people involved * High degree of punitiveness * Pressure placed on the worker for
output Democratic Leadership - conducive to the process of exploration and discovery of the individual. MAJOR
ELEMENT - MUTUAL TRUST Multi critic - Leader utilizes varying styles depending on the situation.

45.    In another hospital the head nurse does not consult the employees for any problems and decides on her own.
She does not allow any one during meeting to give any output and expect the members to obey the orders without
explanation. A structured set of rewards and punishments are produced to motivate everyone to follow. This is an
example of which leadership style?
a. Authoritarian
b. Democratic
c. Laissez Faire
d. Multi critic

Authoritarian - directive style of supervision * Low degree of participation by the people involved * High degree of
punitiveness * Pressure placed on the worker for output

46.    Which of the following situations does a democratic leadership style should not be used?
a. The manager doesn’t understand his or her responsibilities and is hoping the employees can cover for him or
her.
b. Managers are unable to thank employees for their good work.

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 December 2010 Nursing Board Exam Preboard Examination
By. NURSINGCRIB.COM
c. There is not enough time to get everyone’s input.
d. All of the above

Democratic leadership should not be used when: • There is not enough time to get everyone’s input. • It’s easier and
more cost-effective for the manager to make the decision. • The business can’t afford mistakes. • The manager feels
threatened by this type of leadership. • Employee safety is a critical concern. Laissez Faire leadership style should
not be used when: • It makes employees feel insecure at the unavailability of a manager. • The manager cannot
provide regular feedback to let employees know how well they are doing. • Managers are unable to thank employees
for their good work. • The manager doesn’t understand his or her responsibilities and is hoping the employees can
cover for him or her.

47.    "The increase in the fertility rate in the United States from the years 1976 to 2006 was due to increased levels
of income and economic stability." The independent variable in this statement is:
a. Fertility rate
b. Income and economic stability
c. In the United States from the years 1976-2006
d. Increase in fertility rate

An independent variable is a variable that brings change or affects a dependent variable. Income and economic
stability causes a change in the fertility rate in the US from the years 1976-2006. If the income and economic stability
is increased the fertility rate also surges. Thus, the income and economic stability is the independent variable as it
causes change in the dependent variable (fertility rate).

48.    Danny and Jane decided to study the effects of incomplete laboratory equipments to the level of competency of
nursing students. The dependent variable in the statement is:
a. Level of competency
b. Laboratory equipments
c. Nursing students
d. Danny and Jane

A dependent variable is a variable that is changed by the interference of an independent variable. In this case, Jane
and Danny initiate the study on the effects incomplete laboratory equipments to the level of competency in nursing
students. Thus, the incomplete laboratory equipments (independent variable) can have an EFFECT to the level of the
competency (dependent variable) of nursing students.

49.    Abstract in writing up a research has the following purposes except:

a. Re-establish the topic of the research
b. Indicate the methodology used
c. Present the main conclusion
d. Introduce the research by presenting its context or background

The main purpose of an INTRODUCTION is to introduce the research by presenting its context or background.
Introductions usually go from general to specific, introducing the research problem and how it will be investigated).
The main purpose of an ABSTRACT is to summarize the research (particularly the objective and the main
finding/conclusion), NOT to introduce the research area.

50.    IMCI strategy is very important for nurses to know. Which statement incorrectly identifies the principle of
integrated care?
a. a. All sick children must be examined for “general danger signs”.
b. b. Diagnosis is the topmost priority in IMCI.
c. c. Counseling of caretakers about home management
d. d. Use limited number of essential drugs and encourage active participation of caretakers in the treatment of
children

Classification(s) rather than a diagnosis is the topmost priority in IMCI. PRINCIPLES of integrated care: All sick
children must be examined for “general danger signs”. All sick children must be routinely assessed for: major
symptoms, nutritional, Vit A and Immunization status, feeding problems, other potential problems Classification(s)
rather than a diagnosis Only limited number of carefully-selected clinical signs Address most, but not all, of the
major reasons a sick child is brought to a clinic Use limited number of essential drugs and encourage active
participation of caretakers in the treatment of children Counseling of caretakers about home management

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