Professional Documents
Culture Documents
procedure.
1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a need for sterile
supply which is not in the sterile field, who hands out these items by opening its outer cover?
a. Circulating nurse
b. Anesthesiologist
c. Surgeon
d. Nursing aide
2. The OR team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame
and deliver a standard patient outcome. White the surgeon performs the surgical procedure, who monitors the status of
the client like urine output, blood loss?
a. Scrub nurse
b. Surgeon
c. Anesthesiologist
d. Circulating nurse
3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward
where the patient is confined. For orthopedic cases, what department is usually informed to be present in the OR?
a. Rehabilitation department
b. Laboratory department
c. Maintenance department
d. Radiology department
4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team who else to be present
when a client undergoes laparoscopic surgery?
a. Information technician
b. Biomedical technician
c. Electrician
d. Laboratory technicial
5. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to be alerted to
coordinate closely with the patient's family for immediate blood component therapy?
a. Security Division
b. Chaplaincy
c. Social Service Section
d. Pathology department
Situation 2 - You are assigned in the Orthopedic Ward where clients are complaining of pain in varying degrees upon
movement of body parts.
6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain. Which of the
following observation would prompt you to call the doctor?
7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at 5 pm. The next dose
of Demerol 50 mg I.M. is given:
8. You continuously evaluate the client's adaptation to pain. Which of the following behaviors-indicate appropriate
adaptation?
9. Pain in Ortho cases may not be mainly due to the surgery. There might be other factors such as cultural or
psychological that influence pain. How can you alter these factors as the nurse?
a. Explain all the possible interventions that may cause the client to worry.
b. Establish trusting relationship by giving his medication on time
c. Stay with the client during pain episodes
d. Promote client's sense of control and participation in pain control by listening to his concerns
10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority
care in such a case?
Situation 3 - Records are vital tools in any institution and should be properly maintained for specific use and time.
11. The patient's medical record can work as a double-edged swords. When can the medical record become the
doctor's/nurse worst enemy?
12. Disposal of medical records in government hospitals/institutions must be done in close coordination with what
agency?
13. In the hospital, when you need-the medical record of a discharged patient for research, you will request permission
through:
a. Doctor in charge
b. The hospital director
c. The nursing Service
d. Medical records section
14. You readmitted a client who was in another department a month ago. Since you will need the previous chart, from
whom do you request the old chart?
15. Records Management and Archives Offices of the DOH is responsible for implementing its policies on record,
disposal. You know that your institution is covered by this policy it;
Situation 4 - In the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all
these to safeguard the safety and quality to patient delivery outcome.
16. Which of the following should be given highest priority when receiving patient in the OR?
17. Surgeries like I and D (incision and drainage) and debribement are relatively short procedures but considered ‘dirty
cases’. When are these; procedures best scheduled?
a. Last case
b. In between cases
c. According to availability of anesthesiologist
d. According to the surgeon's preference
18. OR nurses should be aware that maintaining the client's safety is the overall goal of nursing care during the
intraoperative phase. As the circulating nurse, you make certain that throughout the procedure...
19. Another nursing check that should not be missed before the induction of general anesthesia is:
20. Some different habits and hobbies affect postoperative respiratory function. If your client smokes 3 packs of
cigarettes a day for the part 10 years, you will anticipate increased risk for:
Situation 5 - Nurses hold a variety of roles when providing care to a perioperative patient.
21. Which of the following role would be the responsibility of the scrub nurse?
22. As a perioperative nurse, how can you best meet the safety need of the client after administering preoperative
narcotic?
a. Put side rails up and ask client not to get out of bed
b. Send the client to ORD with the family
c. Allow client to get up to go to the comfort room
d. Obtain consent form
23. It is the responsibility of the pre-op, nurse to do skin prep for patients undergoing surgery. If hair at the operative
site is not shaved, what should be done to make suturing easy and lessen chance of incision infection?
a. Draped
b. Pulled
c. Clipped
d. Shampooed
24. It is also the nurse's function to determine when infection is developing in the surgical incision. The perioperative
nurse should observe for what signs of impending infection?
25. Which of the following nursing intervention is done when examining the incision wound and changing the
dressing?
Situation 6 - Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min and he appears to be in
acute respiratory distress.
27. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse, what its indication the nurse
will say is:
28. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction will include the
following EXCEPT:
29. The asthmatic client asked you what breathing technique he can best practice when asthmatic attack starts. What
will be the best position?
30. As a nurse you are always alerted to monitor status asthmaticus who will likely and initially manifest symptoms of:
a. metabolic alkalosis
b. respiratory acidosis
c. respiratory alkalosis
d. metabolic acidosis
Situation 7 - Joint Commission on Accreditation of Hospital Organization (JCAHP) patient safety goals and
requirements include the care and efficient use of technology in the OR arid elsewhere in the healthcare facility.
31. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm systems?
32. Over dosage of medication or anesthetic can happen even with the aid of technology like infusion pump,
sphymomanometer, and similar devices/machines. As a staff, how can you improve the safety of using infusion pumps?
33. JCAHOs universal protocol for surgical and invasive procedures to prevent wrong site, wrong person, and wrong
procedures/surgery includes the following EXCEPT:
34. You identified a potential risk of pre and post operative clients. To reduce the risk of patient harm resulting from
fall, you can implement the following EXCEPT:
a. Assess potential risk of fail associated with the patient's the following EXCEPT: medication regimen
b. Take action to address any identified risks through Incident Report (IR)
c. Allow client to walk with relative to the OF?
d. Assess and periodically reassess individual client's risk for falling
35. As a nurse you know you can improve on accuracy of patient's identification by 2 patient identifiers, EXCEPT:
a. identify the client by his/her wrist tag and verify with family members
b. identify client by his/her wrist tag and call his/her by name
c. call the client by his/her case and bed number
d. call the patient by his/her name and bed number
36. If you are the nurse in charge for scheduling surgical cases, what important information do you need to ask the
surgeon?
37. In the OR, the nursing tandem for every surgery is:
38. While team effort is needed in the OR for efficient and quality patient care delivery, we should limit the number of
people in the room for infection control. Who comprise this team?
39. When surgery is on-going, who coordinates the activities outside, including the family?
a. Orderly/clerk
b. Nurse supervisor
c. Circulating nurse
d. Anaesthesiologist
a. Electricity
b. Inadequate supply
c. Leg work
d. Communication
Situation 9 - Colostomy is a surgically created anus- It can be temporary or permanent, depending on the disease
condition.
41. Skin care around the stoma is critical. Which of the following is not indicated as a skin care barriers?
a. Apply liberal amount of mineral oil to the area
b. Use karaya paste and rings around the stoma
c. Clean the area daily with soap and water before applying bag
d. Apply talcum powder twice a day
42. What health instruction will enhance regulation of a colostomy (defecation) of clients?
a. increased weight
b. Irritation of skin around the stoma
c. Liquid stool
d. Establishment of regular bowel movement
44. The following are appropriate nursing interventions during colostomy irrigation EXCEPT:
a. Increase the irrigating solution flow rate when abdominal cramps is felt
b. Insert 2-4 inches of an adequately lubricated catheter to the stoma
c. Position client in semi-Fowler
d. Hand the solution 18 inches above the stoma
45. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be
drained?
a. Sensation of taste
b. Sensation of pressure
c. Sensation of smell
d. Urge to defecate
Situation 10 - As a beginner in research, you are aware that sampling is an essential element of the research process.
a. Control group
b. Study subjects
c. General population
d. Universe
a. Randomization
b. Appropriate location
c. Appropriate number
d. Representativeness
49. Which of the following sampling methods allows the use of any group of research subject?
a. Purposive
b. Convenience
c. Snow-bail
d. Quota
50. You decided to include 5 barangays in your municipality and chose a sampling method that would get
representative samples from each barangay. What should be the appropriate method for you to use in this care?
a. Cluster sampling
b. Random sampling
c. Stratifies sampling
d. Systematic sampling
Situation 11 -After an abdominal surgery, the circulating and scrub nurses have critical responsibility about sponge and
Instrument count.
52. What major supportive layer of the abdominal wall must be sutured with long tensile strength such as cotton or
nylon or silk suture?
a. Fascia
b. Muscle
c. Peritoneum
d. Skin
53. Like sutures, needles also vary in shape and uses. If you are the scrub nurse for a patient who is prone to keloid
formation and has a low threshold of pain, what needle would you prepare?
a. Round needle
b. A traumatic needle
c. Reverse cutting needle
d. Tapered needle
54. Another alternative "suture" for skin closure is the use of _______________:
a. Staple
b. Therapeutic glue
c. Absorbent dressing
d. invisible suture
55. Like any nursing interventions, counts should be documented. To whom does the scrub nurse report any
discrepancy of country so that immediate 'and appropriate action in instituted?
a. Anesthesiologist
b. Surgeon
c. Or nurse supervisor
d. Circulating nurse
Situation 12 - As a nurse, you should be aware and prepared of the different roles you play.
56. What role do you play, when you hold all clients’ information entrusted to you in the strictest confidence?
a. Patient's advocate
b. Educator
c. Patient's Liaison
d. Patient's arbiter
57. As a nurse, you can help improve the effectiveness of communication among healthcare givers
58. As a nurse, your primary focus in the workplace is the client's safety. However, personal safety is also a concern.
You can communicate hazards to your co-workers through the use of the following EXCEPT:
a. Formal training
b. Posters
c. Posting IR in the bulletin board
d. Use of labels and signs
59. As a nurse, what is one of the best way to reconcile medications across the continuum of care?
60. As a nurse, you protect yourself and co-workers from misinformation and misrepresentations through the following
EXCEPT:
a. Provide information to clients about a variety of services that can help alleviate the client's pain and other conditions
b. Advising the client, by virtue of your expertise, that which can contribute to the client's well-being
c. Health education among clients and significant others regarding the use of chemical disinfectant
d. Endorsement thru trimedia to advertise your favorite disinfectant solution
61. A one-day postoperative abdominal surgery client has been complaining of severe throbbing abdominal pain
described as 9 in a 1-10 pain rating. Your assessment reveals bowel sounds on all quadrants and the dressing is dry and
intact. What nursing intervention would you take?
62. Pentoxicodone 5 mg IV every 8 hours was prescribed for post abdominal pain. Which will be your priority nursing
action?
63. The client complained of abdominal and pain. Your nursing intervention that can alleviate pain is:
64. Surgical pain might be minimized by which nursing action in the OR:
a. Skill of surgical team and lesser manipulation
b. Appropriate preparation For the scheduled procedure
c. Use of modem technology in closing the wound
d. Proper positioning and draping of clients
Situation 14 - You were on duty at the medical ward when Zeny came in for admission for tiredness, cold intolerance,
constipation, and weight gain. Upon examination, the doctor's diagnosis was hypothyroidism.
67. As the nurse, you should anticipate to administer which of the following medications to Zeny who is diagnosed to
be suffering from hypothyroidism?
a. Levothyroxine
b. Lidocaine
c. Lipitor
d. Levophed
68. Your appropriate nursing diagnosis for Zeny who is suffering from hypothyroidism would probably include which
of the following?
69. Myxedema coma is a life threatening complication of long standing and untreated hypothyroidism with one of the
following characteristics.
a. Hyperglycemia
b. hypothermia
c. hyperthermia
d. hypoglycemia
70. As a nurse, you know that the most common type of goiter is related to a deficiency
a. thyroxine
b. thyrotropin
c. iron
d. iodine
Situation 15 - Mrs. Pichay is admitted to your ward. The MD ordered "Prepared for thoracentesis this pm to remove
excess air from the pleural cavity."
71. Which of the following nursing responsibility is essential in Mrs. Pichay who will undergo thoracentesis?
72. Mrs. Pichay who is for thoracentesis is assisted by the nurse to any of the following positions, EXCEPT:
a. straddling a chair with arms and head resting on the back of the chair
b. lying on the unaffected side with the bed elevated 30-40 degrees
c. lying prone with the head of the bed lowered 15-30 degrees
d. sitting on the edge of the bed with her feet supported and arms and head on a padded overhead table
73. During thoracentesis, which of the following nursing intervention will be most crucial?
74. To prevent leakage of fluid in the thoracic cavity, how wilt you position the client after thoracentesis?
75. Chest x-ray was ordered after thoracentesis. When you client asks what is the reason for another chest x-ray, you
will explain:
Situation 16 - In the hospital, you are aware that we are helped by the .use of a variety of equipment/devices to enhance
quality patient care delivery;
76. You are initiate an IV line to your patient, Kyle, 5, who is febrile. What IV administration set will you prepare?
77. Kyle is diagnosed to have measles. What will your protective personal attire include?
a. Gown
b. Eyewear
c. Face mask
d. Gloves
78. What will you do to ensure that Kyle, who is febrile, will have a liberal oral fluid intake?
79. Before bedtime, you went to ensure Kyle's safety in 'bed. You will do which of the following:
80. Kyle's room is fully mechanized. What do you teach the watcher and Kyle to alert the nurse for help?
81. You are the nurse of Tony who will undergo T and A in the morning. His mother asked you if Tony will be put to
sleep. Your teaching will focus on:
a. spinal anesthesia
b. anesthesiologist’s preference
c. local anesthesia
d. general anesthesia
82. Mothers of children undergoing tonsillectomy and adenoidectomy usually ask what food prepared and give their
children after surgery. You as the nurse will say:
83. The RR nurse should monitor for the most common postoperative complication of:
a. hemorrhage
b. endotracheal tube perforation
c. esopharyngeal edema
d. epiglottis
84. The PACU nurse will maintain postoperative T and A client in what position?
85. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You as the RN
will make sure that the family knows to:
Situation 18 - Rudy was diagnosed to have chronic renal failure. Hemodialysis is ordered that an A-V shunt was
surgically created.
86. Which of the following action would be of highest priority with regards to the external shunt?
87. Diet therapy for Rudy, who has acute renal failure, is tow-protein, low potassium and sodium. The nutrition
instruction should include:
a. Recommend protein of high biologic value like eggs, poultry and lean meat
b. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
c. Allowing the client cheese, canned foods, and other processed food
d. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet
88. Rudy undergoes hemodialysis for the first time and was scared of disequilibrium syndrome. He asked you how this
can be prevented. Your response is:
89. You are assisted by a nursing aide with the care of the client with renal failure. Which delegated function to the aide
would you particularly check?
90. A renal failure patient was ordered for creatinine clearance. As the nurse you will collect
Situation 19 - Fe is experiencing left sharp pain and occasional hematuria. She was advised to undergo IVP by her
physician.
91. Fe was so anxious about the procedure and particularly expressed her low pain threshold. Nursing health instruction
will include:
a. assure the client that the pain is associated with the warm sensation during the administration of the Hypaque by IV
b. assure the client that the procedure painless
c. assure the client that contrast medium will be given orally
d. assure the client that x-ray procedure like IVP is only done by experts
92. What will the nurse monitor and instruct the client and significant others, post IVP?
93. Post IVP, Fe should excrete the contrast medium. You instructed the family to include more vegetables in the diet
and
94. The IVP reveals that Fe has small renal calculus that can be passed out spontaneously. To increase the chance of
passing the stones, you instructed her to force fluids and do which of the following?
a. Balanced diet
b. Ambulance more
c. Strain all urine
d. Bed rest
a. Colelithiasis
b. Nephrolithiasis
c. Ureterolithiasis
d. Urolithiasis
Situation 20 - At the medical-surgical ward, the nurse must also be concerned about drug interactions.
96. You have a client with TPN. You know that in TPN, like blood transfusion, there should be no drug incorporation.
However, the MD's order read; incorporate insulin to present TPN. Will you follow the order?
97. The RN should also know that some drugs have increased absorption when infused in PVC container. How will you
administer drugs such as insulin, nitroglycerine hydralazine to promote better therapeutic drug effects?
98. One patient has a 'runaway' IV of 50% dextrose. To prevent temporary excess of insulin transient hyperinsulin
reaction, what solution should you prepare in anticipation of the doctors order?
100. In insulin administration, it should be understood that our body normally releases insulin according to our blood
glucose level. When is insulin and glucose level highest?
a. After excitement
b. After a good night's rest
c. After an exercise
d. After ingestion of food