Chapter ONE
To rule out subdural hematoma, blood pressure is 40 palpatory with GCS of 7.
“Don’t look like you don’t know what to do Mr. Clark, insert a central line, prepare your emergency drugs and get the hell out of here” said the plump physician who is now storming out of the emergency room. Fifteen patients were simultaneously taken cared of, one unluckily died, so that makes fourteen of them.
“What difference does it make if seven of you are here and me alone? said Gen.
“Give me the scalpel, now!” and 3…2…1… Cut.
Half Life won 3 consecutive Emmy Awards and has been the most prominent medical TV series in America. Yes! That’s right, America. Hollywood in fact. I remember the days when she poses for cameras in mobile. It even came to me how she clearly put into mind her words for portraying a mentally retarded girl. I saw her cry, I saw her laugh, and I even witnessed for most of the blissful years on her behalf. Gen Higgins was her name on this series but 10 years ago, I can attest who Genevieve Vivas is.
It was ten past nine, when I enter the threshold of my room 107 in Chouette Houtellier Inn. There was a noticeable distortion on the front doormat and French people normally at this hour don’t run along corridors. I thought maybe housekeepers were the culprit. The thermostat reads 22 degrees and I barely can’t remove my cardigan. The chilling breeze of 31st October here in France is like summer weather in Baguio and Tagaytay.
I suddenly remember my third year days in my baccalaureate degree. It was my 1st time to be in Manila and all in my memory was fun and totally in awe. I stop keeping memories on my mind when I slept on a piece of parchment rolling unkempt in my bed.
It left me smiling, as it reads …
BSN4 – D 2007 Reunion in Hawaii
Sa tanan tanan nga BSN4-D 2007, may reunion kita sa Maui, Hawaii
sa November 11-13, 2017, tanan-tanan gid ya dapat ara ha! Indi pwede
nga wala. Contact me on any additional problem and info’s.
Von Gustilo.
I was the Vice President of the class 06-07 and Von is the President. He was called so many rude names and insulted by different people because of his color and total aura.
But damn! He is born to lead by example. Last time I knew about him was he being a father of Nicole and Ryan my “ina-anaks”, the head of the Coronary Care Unit in Maui State Hospital and an author of Test Taking Strategy Book that left millions of nurses to pass local and international exams.
I called Genevieve who is now flying from France to London for a shoot of a love story with actor Shia LaBeouf resembling the likes of “Sweet November” and “Forces of Nature”. I’m supposed to produce and direct it but I am still finishing the eighth season of Half – Life and currently working on for my Academy Award scripts.
“Why is it so sudden?,” Gen said as she makes pattering sound on the phone.
“I knew it weeks before but I am so busted I forgot to tell you.” I replied.
“Ok, but I think I’ll have to make a shoot break on the tenth and flew from London to Maui by eleventh, I don’t have a choice but to make it on the twelve.” said Gen.
“Sounds cool, and fetch Sheena over Surrey after her Valentino runway in Bismarck, and don’t forget to send my gift in Omega and Kim’s La Feminin’ boutique opening tomorrow” I said.
“Sure I’ll just keep you in touch, Bye.” snarled Gen.
Without saying bye, I heard the dropping sound on the phone. I was about to lie and take some nap when I gaze unconsciously at my watch. It reads 9:45 and I am about to meet some classmates of mine over downtown Arc de Triomphe and steadfastly attend the inaugural exhibit of Oliver Marcasote’s French canvass. I hurriedly went down to check out.
Two steps down and I am about to hit the floor of the hotelier. I saw a man very very much familiar and a lady carrying a 4 year old boy. His dimples were very clear as I came to approach the man. Closer and closer I get, the clearer his face registered into memory. Aha’ Leomel Tingson that’s him. I was right when he shockingly smiles at me and offer a seat. She is with his wife and son and yes’ I am so right, Jennifer Reyes his wife never looked old…still her youthful face seems to be a timeless portrait.
“You never told me you were here” I said.
“We’re just having a vacation leave because I was promoted to be a Nursing Service Supervisor, said Leomel.
“Wow, that’s great.” I said.
It was about 09:52 on my watch and still keeps saying to myself that I still have 8 minutes to chitchat.
“Huh’, not really, actually Aiza Mabayag was also promoted to be head of the Geriatrics Department in Wyoming and she is currently doing job trainings for Geriatric Management of Care in Nursing Home Facility in Dalesville, Colorado, we are just in the same medical department in Wyoming.” said Leomel.
I hesitated the offer of a coffee because I was in a hurry. I told Leomel about the reunion in Hawaii and invite him to Oliver’s Painting Gallery Exhibit. I left the inn and have a 10-minute walk from Palms Street to Arc de Triomphe. When I arrived, I expect to find four people. I was dismayed to find only Genny Seridon and Roxanne Ito looking guilty to have waited for me.
“You were late for about 15 minutes” Genny said.
“I know..i know, I met Leomel at the cafeteria down the inn and I just cant help but to chat a bit.” I said.
Roxanne said nothing. She just looks sturdily at Genny who is now murmuring along the street. Genny is still Genny, I thought. She is currently working at Madrid Penitentiary Clinic as a head nurse and a nurse anesthetist in Spain. Last month, Genny was awarded by the Philippine Government as one of the most influential women in the Philippines and one of the known advocator of women and children as her fight against women violence and crime led her to the success more of Gabriela.
We were walking like heaven, having some conversations. Roxanne confesses about her life in United Arab Emirates and how beautiful it is to be a head nurse in a PICU ward. She was also invited to conduct and assist medical missions in certain part of Middle East particularly in Iraq and Saudi Arabia. Currently, she is pursuing her doctorate degree here in France.
The hall was majestic, not ordinary but extraordinary. The settee looks cozy and pictures of naked people on canvass brought the life to a bloody tinge wall along blank stairs. I saw Oliver in his jammed French coat but my mind was blown up when someone shouts at my left ear.
“We’ve waited 15 minutes, you were late” said the mysterious voice. I look back to see Novie Muyco in her red Christian Dior couture bridging her very sexy outline.
“You are fabulous, look’ I am really so sorry. I am late because you know what, I saw Leomel Tingson at my inn and we did just a little chitchat” I defended.
“So, you informed him about the reunion?” Novie confirmed.
“I did, and I told him that I would take no for an answer” I replied.
Novie and I did a little conversation after that. She was beginning to take Communicable Diseases study for her doctorate degree at the same time she was helping out on making fashion style and flair to Kim and Omega’s boutique and guess what? Novie, flies home every year to promote scholarship education for the children in Narawis and she is currently beginning to have her own charity organization catering to the children of Hinigaran.
I suddenly remember Raymund. He is just a diva since college. Last time I knew that he will be here in Paris as well together with Novie, Roxanne, and Genny but where the hell is he? I keep wondering where he is and suppose to ask Novie but they all just disappear right onto my eyes. I didn’t mind it at all because I was looking ferociously on that chalice of a man. I just can’t help but to taste the splash of Martini’s cocktail the man in the lounge was drinking. I want to taste it but I wonder where did he get it. I approach him but I hesitated because he is so white and so lucrative to look at. I thought in my mind maybe he would ignore me, but no’ I really have to do this. I move closer to ask him and seconds later I was shocked.
“Cubid, is that you?” I gasped.
“Yes, why…haha’ I’m still me.” he said.
“How are you? Oh my god’ you look fabulous” I reacted.
“Well as always, I am currently specializing in genito-urinary studies in Winnipeg, California but I will be in reciprocity with Virgnia this coming December to conduct a seminar for a Dialysis Unit, u know like taking BP and all” he said.
“Really, so are u married or what?, I asked.
“Well I am still single but dating, don’t worry I am very much happy. Ernestine and Dysa will be launching their 3rd branch of “Charcoal’s Cuisine” restaurant around 12midnight in Les’ Cheaux’ Avenue, she would really thanked me because I was the one who had come up with the whole idea, so wanna come? he asked.
“Really, I never knew that, sure I wanna come, why not. It’s going to be such a very nice get together here in Paris. Wait! where’s Genny and the others? I said confusedly looking at some people flocking on a nude Donna Ploteňa canvass.
“Come on, let’s get there’ it’s about to start.” Cubid said as he grip my arms and dragging me towards a flock of people.
Monday, October 29, 2007
Test 1 June NLE Questions...SET A
NURSING PRACTICE I – Foundations of Professional Nursing Practice
Situation 1 – Richard has a nursing diagnosis of ineffective airway clearance related to excessive secretions and is at risk for infection because of retained secretions. Part of Nurse Mario’s nursing care plan is to loosen and remove excessive secretions in the airway.
1. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:
A. Client lying flat on his back and then flat on his abdomen.
B. Client lying on his right then left side on Trendelenburg position.
C. Client lying on his back then flat on his abdomen on Trendelenburg position.
D. Client seated upright in bed or on a chair then leaning forward in sitting position then
flat on his back and on his abdomen.
2. When documenting outcome of Richard’s treatment, Mario should include the following in his
recording EXCEPT:
A. Character of breath sounds and respiratory rate before and after the procedure.
B. Color, amount and consistency of sputum
C. Amount of fluid intake of client before and after the procedure
D. Significant changes in the vital signs
3. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:
A. Respiratory rate, breath sounds and location of congestion
B. Doctor’s order regarding position restrictions and client’s tolerance for lying flat
C. Teaching the client’s relatives to perform the procedure
D. Amount of food and fluid taken during the last meal before treatment
4. Mario prepares Richard for postural drainage and percussion. Which of the following is a special consideration when doing the procedure?
A. Respiratory rate of 16 to 20 per minute
B. Client can tolerate sitting and lying positions
C. Client has no signs of infection
D. Time of last food and fluid intake of the client
5. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:
A. Percussion slaps the chest to loosen secretions while vibration shakes the secretions
along with the inhalation of air.
B. Percussion uses only one hand while vibration uses both hands
C. Percussion delivers cushioned blows to the chest with cupped palms while vibration
gently shakes secretion loose on the exhalation cycle.
D. In both percussion and vibration, the hands are on top of each other and hand action
is in tune with client’s breath rhythm.
Situation 2 – The use of massage and meditation to help decrease stress and pain have been strongly recommended based on document testimonials.
6. Martha wants to do a study on this topic: “Effects of massage and meditation on stress and pain”. The type of research that best suits this topic is:
A. basic research
B. applied research
C. quantitative research
D. qualitative research
7. The type of research design that does not manipulate independent variable is
A. non-experimental design
B. quasi-experimental design
C. quantitative design
D. experimental design
8. This research topic has the potential to contribute to nursing because it seeks to
A. clarify an ambiguous modality of care
B. resolve a clinical problem
C. include new modalities of care
D. enhance client care
9. Martha does review of related literature for the purpose of
A. to identify if problem can be replicated
B. gathering data about what is already known or unknown about the problem
C. answering the research question
D. determine statistical treatment of data research
10. Client’s rights should be protected when doing research using human objects. Martha identifies these right as follows EXCEPT:
A. right of self-determination
B. right to compensation
C. right not to be harmed
D. right of privacy
Situation 3 – The nurse’s understanding of ethico-legal responsibilities will guide his/her nursing practice:
11. The principles that govern right and proper conduct of a person regarding life, biology and the health professions is referred to as:
A. Morality
B. Religion
C. Bioethics
D. Values
12. The purpose of having a nurses’ code of ethics is:
A. To define the roles and functions of the health care givers, nurses, clients.
B. To help the public understand professional conduct expected of nurses.
C. Identify nursing action recommended for specific health care situations.
D. Delineate the scope and areas of nursing practice
13. The most important nursing responsibility where ethical situations emerge in patient care is to:
A. Be accountable for his or her own actions
B. Not take sides, remain neutral and fair
C. Assume that ethical questions are the responsibility of the health team
D. Act only when advised that the action is ethically sound
14. You inform the patient about his rights which include the following EXCEPT:
A. Right to expect that the records about his care will be treated as confidential
B. Right to obtain information about another patient
C. Right to consent to or decline to participate in research studies or experiments
D. Right to expect reasonable continuity of care
15. This principle states that a person has unconditional worth and has the capacity to determine his own destiny.
A. Bioethics
B. Justice
C. Fidelity
D. Autonomy
Situation 4 – Management of nurse practitioners is done by qualified nursing leaders who have had clinical experience and management experience.
16. An example of a management function of a nurse is:
A. Directing and evaluating the staff nurses
B. Performing nursing procedures for clients
C. Teaching patient do breathing and coughing exercises
D. Preparing for a surprise party for a client
17. Your head nurse in the unit believes that the staff nurses are not capable of decision making so she makes the decisions for everyone without consulting anybody. This type of leadership is:
A. Democratic leadership
B. Autocratic leadership
C. Managerial leadership
D. Laissez faire leadership
18. When the head nurse in your ward plots and approves your work schedules and direct your work, she is demonstrating:
A. Delegation
B. Authority
C. Accountability
D. Responsibility
19. The following tasks can be safely delegated by a nurse to a non-nurse health worker EXCEPT:
A. Irrigation of a nasogastric tube
B. Take vital signs
C. Change IV infusions
D. Transfer a client from bed to chair
20. You made a mistake in giving the medicine to the wrong client. You notify the client’s doctor and write an incident report. You are demonstrating:
A. Authoritarian
B. Accountability
C. Autocracy
D. Responsibility
Situation 5 – Mrs. Seva, 52 years old, asks you about possible problems regarding her elimination now that she is in the menopausal stage.
21. Instruction on health promotion regarding urinary elimination is important. Which would you include?
A. If burning sensation is experienced while voiding, drink pineapple juice.
B. Tell client to empty the bladder at each voiding.
C. Hold urine as long as she can before emptying the bladder to strengthen her
sphincter muscles.
D. After urination, wipe from anal area up towards the pubis.
22. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?
A. inhibition of the parasympathetic reflex
B. decreased ability to absorb fluids in the lower intestines
C. loss of tone of the smooth muscles of the colon
D. weakness of sphincter muscles of the anus
23. The nurse understands that one of these factors contributes to constipation:
A. excessive exercise
B. high fiber diet
C. no regular time for defecation daily
D. prolonged use of laxatives
24. Mrs. Seva talks about fear of being incontinent due to a prior experience of dribbling urine when laughing or sneezing and when she has a full bladder. Your most appropriate instruction would be to:
A. ask the client to bring change of underwear “just in case”
B. instruct client to start wearing thin adult diapers
C. teach client pelvic exercise to strengthen perineal muscles
D. tell client to drink less fluids to avoid accidents
25. Mrs. Seva asked for instructions for skin care for her mother who has urinary incontinence and is always almost in bed. Your instruction would focus on prevention of skin irritation and breakdown by:
A. Using thick diapers to absorb urine well
B. Drying the skin with baby powder to prevent or mask the smell of ammonia
C. Thorough washing, rising and drying of skin area that get wet with urine
D. Making sure that linen are smooth and dry at all times
Situation 6 – Nancy, mother of 2 young kids, 36 years old, had a mammogram and was told that she has breast cysts and that she may need surgery. This causes her anxiety as shown by increase in her pulse and respiratory rate, sweating and feelings of tension.
26. Considering her level of anxiety, the nurse can best assist Nancy by:
A. Giving detailed explanations about the treatments she will undergo
B. Giving her clear but brief information at the level of her understanding
C. Giving her activities to divert her attention
D. Preparing her and her family in case surgery is not successful
27. Nancy blames God for her situation. She is easily provoked to tears and wants to be left alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or go to church stating that God has abandoned her. The nurse understands that Nancy is grieving for her self and is in the stage of:
A. denial
B. anger
C. acceptance
D. bargaining
28. The nurse visits Nancy and prods her to eat her food. Nancy replies “what’s the use? My time is running out.” The nurse’s best response would be.
A. “You sound like you are giving up”
B. “The doctor ordered full diet for you so that you will be strong for surgery”
C. “Have you told your doctor how you feel? Are you changing your mind about your surgery?
D. “I understand how you feel but you have to try for your children’s sake”
29. The nurse feels sad about Nancy’s illness and tells her head nurse during the end of shift endorsement that “It’s unfair for Nancy to have cancer when she is still so young and with two kids”. The best response of the head nurse would be.
A. Advise the nurse to “be strong and learn to control her feelings”
B. Assign the nurse to another client to avoid sympathy for the client.
C. Ask other nurses what they feel about the patient to find out if they share the same feelings.
D. Reassure the nurse that the client has hope if she goes through all treatments prescribed for her.
30. Realizing that she feels angry about Nancy’s condition, the nurse learns that being self-aware is a conscious process that she should do in any situation like these because:
A. The nurse is a role model for the client and should be strong.
B. This is a necessary part of the nurse-client relationship process
C. How the nurse thinks and feels affect her actions towards her client and her work.
D. The nurse has to be therapeutic at all times and should not affected.
Situation 7 – Using Maslow’s need theory, Airway, Breathing and Circulation are the physiological needs vital to life. The nurse’s knowledge and ability to identify and immediately intervene to meet these needs is important to save lives.
31. Which of these clients has a problem with the transport of oxygen from the lungs to the tissues?
A. Brigette with diarrhea
B. Carol with a tumor in the brain
C. Sonnyboy with a fracture in the femur
D. Theresa with anemia
32. You noted from the lab exams in the chart of M. Santos that he has reduced oxygen in the blood. This condition is called.
A. Hypoxia
B. Anemia
C. Cyanosis
D. Hypoxemia
33. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of insertion of the tubing for an adult would be:
A. eight to ten inches
B. tip of the nose to the base of the neck
C. the distance from the tip of the nose to the middle of the cheek
D. the distance from the tip of the nose to the tip on the ear lobe
34. While doing nasopharyngeal suctioning on Mr. Abad, the nurse can avoid trauma to the area by:
A. Using gloves to prevent introduction of pathogens to the respiratory system
B. Apply suction for at least 20-30 seconds each time to ensure that all secretions are removed
C. Applying no suction while inserting the catheter
D. Rotating catheter as it is inserted with gentle suction
35. Myrna has difficulty of breathing when on her back and must sit upright in bed to breath effectively and comfortably. The nurse documents this condition as:
A. Orthopnea
B. Tachypnea
C. Apnea
D. Dyspnea
Situation 8 – Nurse Rivera witnesses a vehicular accident near the hospital where she works. She decides to get involved and help the victims of the accident.
36. Her priority nursing action would be to:
A. assess the extent of injuries incurred by the victims of the accident
B. Assist in the police investigation since she is a witness
C. Report the incident immediately to the local police authorities
D. Assess damage to property
37. Priority attention should be given to which of these clients?
A. Ryan who has chest injury, is pale and with difficulty of breathing
B. Noel who has lacerations on the arms with mild bleeding
C. Linda who shows severe anxiety due to trauma of the accident
D. Andy whose left ankle swelled and has some abrasions
38. In the emergency room, Nurse Rivera is assigned to attend to the client with lacerations on the arms. While assessing the extent of the wound the nurse observes that the wound is now starting to bleed profusely. The most immediate nursing action would be to:
A. Apply antiseptic to prevent infection
B. Clean the wound vigorously of contaminants
C. Bandage the wound and elevate the arm
D. Control and reduce bleeding of the wound
39. The nurse applies pressure dressing on the bleeding site. This intervention is done to:
A. Protect the wound from microorganisms in the air
B. Promote hemostasis
C. Reduce the need to change dressing frequently
D. Allow the pus to surface faster
40. After the treatment, the client is sent home and asked to come back for follow-up care.
Your responsibilities when the client is to be discharged include the following EXCEPT:
A. Encouraging the client to go to the outpatient clinic for follow-up care
B. Instructing the client to see you after discharge for further assistance
C. Accurate recording of treatment done and instructions given to the client
D. Providing instructions regarding wound care
Situation 9 – You are assigned to take care of 10 patients during the morning shift. The endorsement includes the IV infusion and medications for these clients.
41. Mr. Felipe, 36 year old is to be given 2700 ml of D5LR to infuse for 18 hours starting at 8am. At what rate should the IV fluid be flowing hourly?
A. 100 ml per hour
B. 210 ml per hour
C. 150 ml per hour
D. 190 ml per hour
42. Mr. Atienza is to receive 150 ml/hour of D5W IV infusion for 12 hours for a total of 1800ml.
He is also losing gastric fluid which must be replaced every two hours. Between 8am and 10am, Mr. Atienza has lost 250 ml of gastric fluid. How much fluid should he receive at 11am?
A. 250 ml per hour
B. 275 ml per hour
C. 400 ml per hour
D. 350 ml per hour
43. You are to apply a transdermal patch of nitroglycerin to your client. The following are important guidelines to observe EXCEPT:
A. Wear gloves to avoid any medication on your hand
B. Patches may be applied to distal part of the extremities like forearm
C. Change application and site regularly to prevent irritation of the skin
D. Apply to hairless clean area of the skin not subject to much wrinkling
44. You will be applying eye drops to Miss Romualdez. After checking all the necessary information and cleaning the affected eyelid and eyelashes, you administer the ophthalmic drops by instilling the eye drops:
A. pressing on the lacrimal duct
B. into the outer third of the lower conjunctival sac
C. from the inner canthus going towards the side of the eye
D. directly onto the cornea
45. When applying eye ointment, the following guidelines apply EXCEPT:
A. apply the ointment from the inner canthus going outward of the affected eye
B. hold the tube above the conjunctival sac, do not let tip touch the conjunctive
C. discard the first bead of the eye ointment before application because the tube is likely to expel more than desired amount of ointment
D. squeeze about 2 cm of ointment and gently close but not squeeze eye
Situation 10 – The staff nurse supervisor requests all the staff nurses to “brainstorm” and learn ways to instruct diabetic clients on self administration of insulin. She wants to ensure that there are nurses available daily to do health education classes.
46. The plan of the nurse supervisor is an example of
A. in service education process
B. primary prevention
C. efficient management of human resources
D. increasing human resources
47. When Mrs. Guevarra, a nurse, delegates aspects of the clients care to the nurse-aide who is an unlicensed staff, Mrs. Guevarra
A. does not have to supervise or evaluate the aide
B. makes the assignment to teach the staff member
C. most know how to perform task delegated
D. is assigning the responsibility to the aide but not the accountability for those tasks
48. Connie, the new nurse, appears tired and sluggish and lacks the enthusiasm she had six weeks ago when she started the job. The nurse supervisor should.
A. discuss how she is adjusting to her new job
B. ask about her family life
C. tell her to take the day off
D. empathize with the nurse and listen to her
49. Process of formal negotiations of working conditions between a group of registered nurses and employer is
A. grievance
B. strike
C. collective bargaining
D. arbitration
50. You are attending a certification program on cardiopulmonary resuscitation (CPR) offered and required by the hospital employing you. This is
A. professional course towards credit
B. continuing education
C. in service education
D. advance training
---- END ---- hanggang Diyan lang.
Situation 1 – Richard has a nursing diagnosis of ineffective airway clearance related to excessive secretions and is at risk for infection because of retained secretions. Part of Nurse Mario’s nursing care plan is to loosen and remove excessive secretions in the airway.
1. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:
A. Client lying flat on his back and then flat on his abdomen.
B. Client lying on his right then left side on Trendelenburg position.
C. Client lying on his back then flat on his abdomen on Trendelenburg position.
D. Client seated upright in bed or on a chair then leaning forward in sitting position then
flat on his back and on his abdomen.
2. When documenting outcome of Richard’s treatment, Mario should include the following in his
recording EXCEPT:
A. Character of breath sounds and respiratory rate before and after the procedure.
B. Color, amount and consistency of sputum
C. Amount of fluid intake of client before and after the procedure
D. Significant changes in the vital signs
3. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:
A. Respiratory rate, breath sounds and location of congestion
B. Doctor’s order regarding position restrictions and client’s tolerance for lying flat
C. Teaching the client’s relatives to perform the procedure
D. Amount of food and fluid taken during the last meal before treatment
4. Mario prepares Richard for postural drainage and percussion. Which of the following is a special consideration when doing the procedure?
A. Respiratory rate of 16 to 20 per minute
B. Client can tolerate sitting and lying positions
C. Client has no signs of infection
D. Time of last food and fluid intake of the client
5. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:
A. Percussion slaps the chest to loosen secretions while vibration shakes the secretions
along with the inhalation of air.
B. Percussion uses only one hand while vibration uses both hands
C. Percussion delivers cushioned blows to the chest with cupped palms while vibration
gently shakes secretion loose on the exhalation cycle.
D. In both percussion and vibration, the hands are on top of each other and hand action
is in tune with client’s breath rhythm.
Situation 2 – The use of massage and meditation to help decrease stress and pain have been strongly recommended based on document testimonials.
6. Martha wants to do a study on this topic: “Effects of massage and meditation on stress and pain”. The type of research that best suits this topic is:
A. basic research
B. applied research
C. quantitative research
D. qualitative research
7. The type of research design that does not manipulate independent variable is
A. non-experimental design
B. quasi-experimental design
C. quantitative design
D. experimental design
8. This research topic has the potential to contribute to nursing because it seeks to
A. clarify an ambiguous modality of care
B. resolve a clinical problem
C. include new modalities of care
D. enhance client care
9. Martha does review of related literature for the purpose of
A. to identify if problem can be replicated
B. gathering data about what is already known or unknown about the problem
C. answering the research question
D. determine statistical treatment of data research
10. Client’s rights should be protected when doing research using human objects. Martha identifies these right as follows EXCEPT:
A. right of self-determination
B. right to compensation
C. right not to be harmed
D. right of privacy
Situation 3 – The nurse’s understanding of ethico-legal responsibilities will guide his/her nursing practice:
11. The principles that govern right and proper conduct of a person regarding life, biology and the health professions is referred to as:
A. Morality
B. Religion
C. Bioethics
D. Values
12. The purpose of having a nurses’ code of ethics is:
A. To define the roles and functions of the health care givers, nurses, clients.
B. To help the public understand professional conduct expected of nurses.
C. Identify nursing action recommended for specific health care situations.
D. Delineate the scope and areas of nursing practice
13. The most important nursing responsibility where ethical situations emerge in patient care is to:
A. Be accountable for his or her own actions
B. Not take sides, remain neutral and fair
C. Assume that ethical questions are the responsibility of the health team
D. Act only when advised that the action is ethically sound
14. You inform the patient about his rights which include the following EXCEPT:
A. Right to expect that the records about his care will be treated as confidential
B. Right to obtain information about another patient
C. Right to consent to or decline to participate in research studies or experiments
D. Right to expect reasonable continuity of care
15. This principle states that a person has unconditional worth and has the capacity to determine his own destiny.
A. Bioethics
B. Justice
C. Fidelity
D. Autonomy
Situation 4 – Management of nurse practitioners is done by qualified nursing leaders who have had clinical experience and management experience.
16. An example of a management function of a nurse is:
A. Directing and evaluating the staff nurses
B. Performing nursing procedures for clients
C. Teaching patient do breathing and coughing exercises
D. Preparing for a surprise party for a client
17. Your head nurse in the unit believes that the staff nurses are not capable of decision making so she makes the decisions for everyone without consulting anybody. This type of leadership is:
A. Democratic leadership
B. Autocratic leadership
C. Managerial leadership
D. Laissez faire leadership
18. When the head nurse in your ward plots and approves your work schedules and direct your work, she is demonstrating:
A. Delegation
B. Authority
C. Accountability
D. Responsibility
19. The following tasks can be safely delegated by a nurse to a non-nurse health worker EXCEPT:
A. Irrigation of a nasogastric tube
B. Take vital signs
C. Change IV infusions
D. Transfer a client from bed to chair
20. You made a mistake in giving the medicine to the wrong client. You notify the client’s doctor and write an incident report. You are demonstrating:
A. Authoritarian
B. Accountability
C. Autocracy
D. Responsibility
Situation 5 – Mrs. Seva, 52 years old, asks you about possible problems regarding her elimination now that she is in the menopausal stage.
21. Instruction on health promotion regarding urinary elimination is important. Which would you include?
A. If burning sensation is experienced while voiding, drink pineapple juice.
B. Tell client to empty the bladder at each voiding.
C. Hold urine as long as she can before emptying the bladder to strengthen her
sphincter muscles.
D. After urination, wipe from anal area up towards the pubis.
22. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?
A. inhibition of the parasympathetic reflex
B. decreased ability to absorb fluids in the lower intestines
C. loss of tone of the smooth muscles of the colon
D. weakness of sphincter muscles of the anus
23. The nurse understands that one of these factors contributes to constipation:
A. excessive exercise
B. high fiber diet
C. no regular time for defecation daily
D. prolonged use of laxatives
24. Mrs. Seva talks about fear of being incontinent due to a prior experience of dribbling urine when laughing or sneezing and when she has a full bladder. Your most appropriate instruction would be to:
A. ask the client to bring change of underwear “just in case”
B. instruct client to start wearing thin adult diapers
C. teach client pelvic exercise to strengthen perineal muscles
D. tell client to drink less fluids to avoid accidents
25. Mrs. Seva asked for instructions for skin care for her mother who has urinary incontinence and is always almost in bed. Your instruction would focus on prevention of skin irritation and breakdown by:
A. Using thick diapers to absorb urine well
B. Drying the skin with baby powder to prevent or mask the smell of ammonia
C. Thorough washing, rising and drying of skin area that get wet with urine
D. Making sure that linen are smooth and dry at all times
Situation 6 – Nancy, mother of 2 young kids, 36 years old, had a mammogram and was told that she has breast cysts and that she may need surgery. This causes her anxiety as shown by increase in her pulse and respiratory rate, sweating and feelings of tension.
26. Considering her level of anxiety, the nurse can best assist Nancy by:
A. Giving detailed explanations about the treatments she will undergo
B. Giving her clear but brief information at the level of her understanding
C. Giving her activities to divert her attention
D. Preparing her and her family in case surgery is not successful
27. Nancy blames God for her situation. She is easily provoked to tears and wants to be left alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or go to church stating that God has abandoned her. The nurse understands that Nancy is grieving for her self and is in the stage of:
A. denial
B. anger
C. acceptance
D. bargaining
28. The nurse visits Nancy and prods her to eat her food. Nancy replies “what’s the use? My time is running out.” The nurse’s best response would be.
A. “You sound like you are giving up”
B. “The doctor ordered full diet for you so that you will be strong for surgery”
C. “Have you told your doctor how you feel? Are you changing your mind about your surgery?
D. “I understand how you feel but you have to try for your children’s sake”
29. The nurse feels sad about Nancy’s illness and tells her head nurse during the end of shift endorsement that “It’s unfair for Nancy to have cancer when she is still so young and with two kids”. The best response of the head nurse would be.
A. Advise the nurse to “be strong and learn to control her feelings”
B. Assign the nurse to another client to avoid sympathy for the client.
C. Ask other nurses what they feel about the patient to find out if they share the same feelings.
D. Reassure the nurse that the client has hope if she goes through all treatments prescribed for her.
30. Realizing that she feels angry about Nancy’s condition, the nurse learns that being self-aware is a conscious process that she should do in any situation like these because:
A. The nurse is a role model for the client and should be strong.
B. This is a necessary part of the nurse-client relationship process
C. How the nurse thinks and feels affect her actions towards her client and her work.
D. The nurse has to be therapeutic at all times and should not affected.
Situation 7 – Using Maslow’s need theory, Airway, Breathing and Circulation are the physiological needs vital to life. The nurse’s knowledge and ability to identify and immediately intervene to meet these needs is important to save lives.
31. Which of these clients has a problem with the transport of oxygen from the lungs to the tissues?
A. Brigette with diarrhea
B. Carol with a tumor in the brain
C. Sonnyboy with a fracture in the femur
D. Theresa with anemia
32. You noted from the lab exams in the chart of M. Santos that he has reduced oxygen in the blood. This condition is called.
A. Hypoxia
B. Anemia
C. Cyanosis
D. Hypoxemia
33. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of insertion of the tubing for an adult would be:
A. eight to ten inches
B. tip of the nose to the base of the neck
C. the distance from the tip of the nose to the middle of the cheek
D. the distance from the tip of the nose to the tip on the ear lobe
34. While doing nasopharyngeal suctioning on Mr. Abad, the nurse can avoid trauma to the area by:
A. Using gloves to prevent introduction of pathogens to the respiratory system
B. Apply suction for at least 20-30 seconds each time to ensure that all secretions are removed
C. Applying no suction while inserting the catheter
D. Rotating catheter as it is inserted with gentle suction
35. Myrna has difficulty of breathing when on her back and must sit upright in bed to breath effectively and comfortably. The nurse documents this condition as:
A. Orthopnea
B. Tachypnea
C. Apnea
D. Dyspnea
Situation 8 – Nurse Rivera witnesses a vehicular accident near the hospital where she works. She decides to get involved and help the victims of the accident.
36. Her priority nursing action would be to:
A. assess the extent of injuries incurred by the victims of the accident
B. Assist in the police investigation since she is a witness
C. Report the incident immediately to the local police authorities
D. Assess damage to property
37. Priority attention should be given to which of these clients?
A. Ryan who has chest injury, is pale and with difficulty of breathing
B. Noel who has lacerations on the arms with mild bleeding
C. Linda who shows severe anxiety due to trauma of the accident
D. Andy whose left ankle swelled and has some abrasions
38. In the emergency room, Nurse Rivera is assigned to attend to the client with lacerations on the arms. While assessing the extent of the wound the nurse observes that the wound is now starting to bleed profusely. The most immediate nursing action would be to:
A. Apply antiseptic to prevent infection
B. Clean the wound vigorously of contaminants
C. Bandage the wound and elevate the arm
D. Control and reduce bleeding of the wound
39. The nurse applies pressure dressing on the bleeding site. This intervention is done to:
A. Protect the wound from microorganisms in the air
B. Promote hemostasis
C. Reduce the need to change dressing frequently
D. Allow the pus to surface faster
40. After the treatment, the client is sent home and asked to come back for follow-up care.
Your responsibilities when the client is to be discharged include the following EXCEPT:
A. Encouraging the client to go to the outpatient clinic for follow-up care
B. Instructing the client to see you after discharge for further assistance
C. Accurate recording of treatment done and instructions given to the client
D. Providing instructions regarding wound care
Situation 9 – You are assigned to take care of 10 patients during the morning shift. The endorsement includes the IV infusion and medications for these clients.
41. Mr. Felipe, 36 year old is to be given 2700 ml of D5LR to infuse for 18 hours starting at 8am. At what rate should the IV fluid be flowing hourly?
A. 100 ml per hour
B. 210 ml per hour
C. 150 ml per hour
D. 190 ml per hour
42. Mr. Atienza is to receive 150 ml/hour of D5W IV infusion for 12 hours for a total of 1800ml.
He is also losing gastric fluid which must be replaced every two hours. Between 8am and 10am, Mr. Atienza has lost 250 ml of gastric fluid. How much fluid should he receive at 11am?
A. 250 ml per hour
B. 275 ml per hour
C. 400 ml per hour
D. 350 ml per hour
43. You are to apply a transdermal patch of nitroglycerin to your client. The following are important guidelines to observe EXCEPT:
A. Wear gloves to avoid any medication on your hand
B. Patches may be applied to distal part of the extremities like forearm
C. Change application and site regularly to prevent irritation of the skin
D. Apply to hairless clean area of the skin not subject to much wrinkling
44. You will be applying eye drops to Miss Romualdez. After checking all the necessary information and cleaning the affected eyelid and eyelashes, you administer the ophthalmic drops by instilling the eye drops:
A. pressing on the lacrimal duct
B. into the outer third of the lower conjunctival sac
C. from the inner canthus going towards the side of the eye
D. directly onto the cornea
45. When applying eye ointment, the following guidelines apply EXCEPT:
A. apply the ointment from the inner canthus going outward of the affected eye
B. hold the tube above the conjunctival sac, do not let tip touch the conjunctive
C. discard the first bead of the eye ointment before application because the tube is likely to expel more than desired amount of ointment
D. squeeze about 2 cm of ointment and gently close but not squeeze eye
Situation 10 – The staff nurse supervisor requests all the staff nurses to “brainstorm” and learn ways to instruct diabetic clients on self administration of insulin. She wants to ensure that there are nurses available daily to do health education classes.
46. The plan of the nurse supervisor is an example of
A. in service education process
B. primary prevention
C. efficient management of human resources
D. increasing human resources
47. When Mrs. Guevarra, a nurse, delegates aspects of the clients care to the nurse-aide who is an unlicensed staff, Mrs. Guevarra
A. does not have to supervise or evaluate the aide
B. makes the assignment to teach the staff member
C. most know how to perform task delegated
D. is assigning the responsibility to the aide but not the accountability for those tasks
48. Connie, the new nurse, appears tired and sluggish and lacks the enthusiasm she had six weeks ago when she started the job. The nurse supervisor should.
A. discuss how she is adjusting to her new job
B. ask about her family life
C. tell her to take the day off
D. empathize with the nurse and listen to her
49. Process of formal negotiations of working conditions between a group of registered nurses and employer is
A. grievance
B. strike
C. collective bargaining
D. arbitration
50. You are attending a certification program on cardiopulmonary resuscitation (CPR) offered and required by the hospital employing you. This is
A. professional course towards credit
B. continuing education
C. in service education
D. advance training
---- END ---- hanggang Diyan lang.
Gustilo, Sales, and Quezon seeks opportunities in Manila
In such a short while, some of the BSN4-D's are parting and leaving the City of Smiles as they seek opportunities in a wider world. Sales will be leaving next week for opportunities in Laguna, followed by Quezon and Von consequently. It will be a hard time but we hope you guys the best and go-BSN4D! But wait! will Jerhart eventually leave his long lost brother who seats right at the very edge of the first row at the back part? (you know the friend of Nong Joseph') Will he and the controversial gf Shane meet again? Will he exchange his ipod for a P9 again? hmmm... and will Von carry his orangutan with him in Manila..we'll its Father and Son business...no comment! hahahaha!
Cerezo's Grandpa Died
The ADHD diagnosed Jecca Cerezo is finally showing her emotional side as her grandfather died. This is something very emotional because Jecca is really close to her lolo and that all her life she was with her lolo. She never forgets all the lessons she learned from herlolo but she always forgets the lessons in class...
We are heartfully extending our condolences to the family of Cerezo, especially to Jecca who had been one of the best people in BSN4-D. We understand the grieving and
we are praying for Jecca's lolo to rest in peace. Once again, our condolences to Cerezo family from BSN4-D Family...
Sugar-Mommy wanted for Jack B.
All Jack B. wants is to explore, and that is trying out with some sugar-mommies....
Exactly! Jack B. is looking for sugar moommy who can give him allowances, clothes,
new touch-screen cp, ipod' touch, in exchange of "tawag ng laman".
This 24-year old hottieof BSN4-D was so consistent in saying this as he would like to experiment something.Jack B. will be starting his auditions afterthe board exam because he wants to start it on December cause you know.."give love on X-mas day" hahaha! but we'll see what happens, when you see Jack B. with so much new gadgets in such a liittle time....sense something, because what Jack B. wants Jack B. gets.
Snatched 8210 of Granada Happened in Jeepstar.
The 5' 3' stout yet muscular Aaron turning 21 next Friday Oct. 26 had premonitions not to bringhis N70 phone the morning of 0ct. 15 and yes! he is right. As he went home that dayafter a strenouos gaming session at Daj's, the snatching incident happened exactly inside Jeepstar as he stands along a pile of people looking for seats. "I also feel that something like a hand was running beneath my pocket but i never mind this at all because i thoughtit was just the hands of other people who were crowding the bus" Aaron said as some BSN4D question his innocence or "langka-ness" about the incident. When he reached for his cp to text,ayte'''wala na, kag bal-an ya man nga gin snatch na...aysus! nano man.
"Well' you know if you get horny at times and something like a hand was caressing your pocket down to your *e**s, 8210 can be really exchanged for an orgasm...
Tuesday, October 16, 2007
Palacios Discovers 3rd Party
After a despise doubt about the relationship, Palacios finally has the evidence, the evidence showing his boyfriends and the mistery third pary. You are very lucky to have read this because we have an exclusive footage and pics of the evidence-based photos but when confronted about this topic, Palacios' boyfriend and bestfriend simply denies...Anger and Betrayal was being felt by Placios as she cringes ads ncries for help at Vivas' lap yesterday afternoon. This is such a shocking revelation now that they are having the realtionship for years....Look closely at the pics, would it be his cousin or hmmmm...3rd party.
Yanson not to take NLE Exams
Glenn Yanson the Chairman of "Bureau of Fisheries and Lokon Resources" of the BSN4-D finally decided not to take the Board Exam on December. He will be flying to Manila this Sunday to process her employment requirement for caregiver in Texas and will be waiting after three long months for his visa. Many have claims that this is not a good decision but Yanson's decision is irrevocable. He is currently processing his TOR and Diploma and the only fear we have is Yanson to battle with sex withdrawal but for him it's a good thing there are Mexican's and Latina's in Texas...hmmmm..
1st BSN4-D To Volunteer in A Hospital Already Named
Garnering 80% in NLE exam, DYSA APOLINARIO is the 1st BSN4-D to work in a hospital facility. This Black Princess of the Class finally stood up for her professional degree runnning past Jerhart "THE DRAGON" Quezon, and VON "THE UNRESEPCTED PRESIDENT" Gustilo as well as Nycinth "THE SILENT BEAUTY" De Asis, GEORGE "THE NANAY" Hojilla, Josie "THE SAY-SAY-FRANK LOVE AFFAIR", Lovella "THE MS. MADS LOOK-ALIKE" Sales, Charish "THE PLACENTA HABONERA" Paredes and Mary Cris Anne "LOMOLOBO ANG LOBO" Maru after hired passing all the exams and hired by Dorothy Apolinario as an Emergency Nurse in Valladolid District Hospital...
Nepomuceno 1st Agustinian to finish PRC Filing...
Dexie once says "I came, I saw, I conkered" and yet despite her tomato-englishes and 36 freckles on extremities, Dexie is a winner. Waking up at 2am and queued on the break of dawn, Nepomuceno finishes the filing for only 7 hours and that makes her the 1st Agustinian and BSN4-D to finish PRC Filing. Followed by Christleen Cerezo, and Genevieve Vivas. Of course, (Dexie is 1st because her certifications are only four pieces all of her scrubs are under NE-MEN-ZO...)
Cubid submits "Affidavit of Discrepancy"
After months of retort changing of scrubs and signing of clinical instructors, Raymund Cubid was bravely considering that her or his name is "deferred". This is so much alarming because Agi was so in distress to file for only one day but this admonition was just a fantasy. Cubid scampered to a family attorney and immediately pay 30pesos for his affidavit to correct his or her NSO name and finally release his application. But despite of these problems Cubid remains his flair and poise like a "diva", eventually Agi told us "see you on newspaper"!
Infante Broke Fuentes' Glass
The alleged controversial cum laude of the BSN4-D had stepped into such a mysterious clairvoyant after the shocking shattering of the drinking glass he is holding. Before the day of the filing, The DOTA boys went into Fuentes' house with two cars and invited Ernestine, Janmark, Rand, Mado, and Jane for a joy-ride. In which circumstance, after they broke in FDuentes' house, Infante managed to hold the glass and surprisingly shattered it into pieces at a split of a second...Hmm! is this something of a future perception...no comment! but Fuentes became a maid after the incident...hahaha!
Tuesday, October 2, 2007
Kokak Rushed to E.R.
Edward Occeno, one of the most profitable person in the class finally understood that Health is Wealth. At 5:30 in the afternoon while Occeno was cleaning his ear because of thicking earwaxes brought about by jammed headset of DAJ'S and 15-hour Dota online, he was surpsrised to pull-out the cotton stick only without the cotton itself.This incident give rise for Occeno to be rushed in E.R. and paid 250 pesos for the intervention, but this issue had queued queries to the blog like is it a cottonbud or he was just sticking the cotton in the stick?
Many have their own versions, however the question is just like this; why would a student with a 20,000 monthly allowance and drove a honda suv bought just a second-rated cheap cottonbud?
Nava Buys CD-Reviewer to a Metrosexual Chatmate!
Josh, the 25-year old chatmate of the unknown gender Cris Nava had finally appeared right in frontof our very eyes consequently following the plan of specific date and time. The deal is for 500 pesos, Josh will give a his review materials to Cris Nava on a CD-based method as well as with bonus powerpoint package comprising all concepts. The only reason why Nava had stucked herself with Audio Review Materials is that"Im not just a book-type person, im more like an audio one" she exclaimed after a question raised about her studying techniques.
Nava is now enjoying listening his rather her CD simultaneously capturing herself in
a photo wearing a 2-piece lingerie.
Salcedo Struggles with Chickenpox.
The call center agent in the class Joeralph Salcedo battles his varicella zoster infectionthat had noticeably scattered all over his body. This alarmed every BSN4-D who have not been on Chickenpox before as Joeralph appeared himself in the review after a series of 10 days of rest and medications.
As his appearance on the said review, Sherlyn Baloyo a BSN4-B was so
shocked to know that she could be infected after Salcedo had passed on her side to and fro and touch her intimately but other people says that Baloyo doesn't have to fear or pretend on having chickenpox because her face alone tells that she has a chickenpox, measles, and thrombocytopenic purpura all in one.
Class Prophecy entitled: Who Drank the Lidocaine?
The 12-page class prophecy with 5 chapters will be out this October, so watch
for it guys! It will be posted in the blog.
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