Nursing Practice IV - CARE OF THE CLIENTS (PART B)
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Situation 1: - The Hospital Research Coordinator is discussing the basics of research with the members of the Research Committee as part of continuing education. Questions and Answers were also part of the program.
1. During the open forum, the Hospital Research Coordinator raised the question as to who among the following provides information in the questionnaires. *
1 point
2. One of the members of the Research committee wishes to conduct a study involving an interdisciplinary team of colleagues. This study is termed as _____. *
1 point
3. In conducting a qualitative research, a nurse should follow the logical reasoning process termed as, which of the following? *
1 point
4. The lecturer reminded the committee members that bias is an influence that distorts study results. In Quantitative research, which will eliminate bias? *
1 point
5. One of the committee members raised the question on how to make an abstract. The question was followed by how many hours are required in an abstract should (APA) style be followed? What is the correct answer? *
1 point
Situation 2: The clinical instructor (CI) is conducting a ward class on how to perform the breast self examination (BSE).
6. The CI is expected to set the atmosphere by welcoming everyone and by _____. *
1 point
7. For the students better understanding about the anatomy of the breast, the CI shares_____. *
1 point
8. The clinical instructor proceeded with the lecture to the students using the ____. *
1 point
9. When the lecture presentation was finished, the CI proceeded with the ____. *
1 point
10. The last and necessary part of the activity is ____ *
1 point
Situation 3 -  Hypovolemic Shock. the adult patient on his way to the office met a vehicular accident and was continuously bleeding from the head. He was brought to nearest hospital by the bystanders.
11. What must the Emergency Rooms nurse do FIRST? *
1 point
12. Due to continuous bleeding the patient goes into the second stage of shock with BP 80/60. what are the possible effects on the heart in this stage? *
1 point
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13. The BEST position for the patient to assume in case of shock is _____. *
1 point
14. What isotonic electrolyte solution are COMMONLY used as fluid replacement in hypovolemic shock? *
1 point
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15. In case the patient would go into cardiovascular overload as a result of the intravenous fluid therapy, the PRIORITY nursing action should focus on ______. *
1 point
Situation 4 – Patient Tita, a 53-year-old mother of 6, been having involuntary urine leaks aggravated whenever she sneezes or cough. She is diagnosed with urinary incontinence. The next 5 questions refer to this case.
16. The type of incontinence patient Tita manifests, where there is involuntary loss of urine as a result of sneezing, coughing or even changing position is called ____. *
1 point
17. The nurse is aware that urinary incontinence brings about psychosocial cost, including the following, EXCEPT____ *
1 point
18. The nurse instructs the patient that the BEST time for an incontinent patient to take his diuretics is ____ *
1 point
19. When providing health teaching to the patient with urinary incontinence, the nurse must STRESS that it is ___ *
1 point
20. The aim of pelvic muscle exercises for the patient with urinary incontinence is to strengthen the muscles that control the _____. *
1 point
Situation 5: - Nurses should not only abide by the laws, but be guided by the Code of Ethics for Nurses as well.
21. The code of Ethics for nurses have articles relating to the relationship of nurses on ____ (SELECT ALL THAT APPLY) *
1 point
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22. The Code of Ethics adopted all the principles under the _____. *
1 point
23. According to the Code of Ethics, WHO determines the coverage and scope of the examination for the practice of Nursing in the Philippines? *
1 point
24. What are the three important legal principles in nursing professional ethics? *
1 point
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25. The “end-justifies-the means” ethics is described as ____. *
1 point
Situation 6: -Ms. Lani aged 40, has varying degrees of weakness on the lower extremities, inability to perform voluntary movements and paresthesias. Her physician gives a tentative diagnosis of Guillain-Barre Syndrome (GBS).
26. Which is a common verbalization of the patient with GBS regarding the EARLY ONSET of symptoms. *
1 point
27. The nurse is aware that which occurrence in the patient’s health history *
1 point
28. A PRIORITY nursing diagnosis in Guillain Barre Syndrome is ____. *
1 point
29. If the patient is unable to talk, how should the nurse BEST communicate to the patient? *
1 point
30. The nurse informs the patient and family that rehabilitation prior to discharge is BEST described as ___. *
1 point
Situation 7- Elmo, a 69 years of age, is diagnosed with Benign Prostatic Hyperplasia (BPH).
31. The nurse anticipates that the signs and symptoms of BPH do not include _____. *
1 point
32. Elmo asks the nurse to explain his condition (BPH). Which statements are CORECT explanation by the nurse? *
1 point
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33. What IMMEDIATE danger should the nurse anticipate post Transurethral Resection of the Prostate (TURP)? *
1 point
34. The nurse knows that the normal color of the bladder irrigation drainage right after TURP is ____. *
1 point
35. Sexual dysfunction like impotence, erectile dysfunction and lack of libido are likely possibilities in what prostatic surgery? *
1 point
SITUATION 8 - General concepts of immunology must be learned by the nurse to appreciate the management of her patients.
36. Immunity that the baby gets from the immune mother through breastfeeding is: *
1 point
37. Cell-mediated immunity is NOT usual by associated with that condition: *
1 point
38. When a person vaccinated with a Covid-19 Vaccine produces antibodies to the disease, the immunity is termed: *
1 point
39. The blood protein involved in the immune system is: *
1 point
40. The immunity conferred by tetanus toxoid is best described as: *
1 point
SITUATION 9 - Even if still a staff nurse, Minda, can well contribute to the management of the resources and environment of her unit.
41. The electric in the unit sparks occasionally but continues to function relatively well. Nurse Minda though knows that she____ *
1 point
42. The electric fan now stops every now and then and continues to spark at intervals. The best thing to DO NEXT is to___ *
1 point
43. The last fire in the hospital was due to a malfunctioningequipment. The fire extinguisher was no where to be found. What should have been practiced. *
1 point
44. The staff assigned to check the fire extinguisher failed to monitor the “whereabouts” of assigned equipment. The following statements are true EXCEPTS/___ *
1 point
45. Because of the failure to replace the detective electric fan immediately, a fire broke out and its became big enough to burn a major portion of the unit because the fire extinguisher was missing. What lesson can be gained from this? *
1 point
SITUATION 10 - In order for the medical team to work best, there must be smooth collaboration and teamwork among its members.
46. John, the patient with Urinary Tract Infection (UTI) is on his 3rd day of antibiotic but is still having high fever. There is a need for the nurse to refer her observation to which of the following ? *
1 point
47. Urine for culture and sensitivity (C& S) was ordered and the nurse was told by the secretary from the laboratory that the result will be due in 5-7 days. The nurse knows from her readings that bacterial culture and Sensitivity may be reported in three days’ time. Thus, she plants to follow up the result from which of the health allied professionals? *
1 point
48. The patient developed worsening cough and was given an anti-cough elixir. After 30minutes he developed itchiness with hives. The nurse is hesitant to call anyone since it is already midnight, and there was no one else since it is a holiday. Who will she refer the patient to? *
1 point
49. The patient suddenly develop chest pain. The result of the stat Trop I revealed high results. What steps are CORRECT and according to protocol in this situation? *
1 point
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50. The patient was prescribed a number of stat medications to prevent any untoward complication. The nurse closely coordinates with which professional to facilitate the immediate release of the necessary medicines and supplies? *
1 point
SITUATION 11 - Romy, 58 years old, has been a cigarette smoker since age 15. He has nagging cough and hoarseness of voice and dyspnea. Based on the physical and laboratory findings, the physician suspected him of having lung cancer.
51. Which of the following is NOT a known predisposing factor to lung cancer? *
1 point
52. Upon history-taking, the nurse notes that the cough of a patient with lung cancer usually START off to be__ *
1 point
53. Which diagnostic procedure is commonly used to establish the diagnosis of lung cancer which provides a detailed description of the tracheobronchial tree and allow for biopsies of suspicious areas? *
1 point
54. To help patient with his breathing difficulty, the nurse place him in which position? *
1 point
55. Roy is diagnosed with small cell lung cancer (SCLC), a rapidly growing type of cancer. He and his family were shocked when told by the doctor that the patient will just undergo palliative treatment. Which nursing action is MOST APPROPRIATE? *
1 point
SITUATION 12 - Proper recording is the vital task that the nurse is trained to do properly in nursing school and expected to practice as professional.
56. Nurse are taught as student that the ideal and PROPER time for recording vital signs and notes on the patient is____ *
1 point
57. Right after endorsement and during the rounds, the incoming nurse, observes that the IV fluid is at 800 cc level and not 400cc, as endorsed. What is the CORRECT information that she will chart? *
1 point
58. Which is the APPROPRIATE way to correct an error in the nurses Notes? *
1 point
59. It a medicine is unavailable and therefore not given to the patient, how is it charted? *
1 point
60. If the patient referred to another consultant and the latter has made an order already, what can the Nurse CORRECTLY chart? *
1 point
SITUATION 13 - Dog Bites are relatively common in the Philippines. The presence of a number of stray dogs predisposes to the occurrence of rabies.
61. Upon entry of the patient to ER, the nurse must FIRST perform which nursing intervention? *
1 point
62. The nurse knows that a dog bite has a shorter incubation for rabies if located in the____ *
1 point
63. The nurse anticipate that which one is prescribed to prevent a common bacterial complication from the dog bite? *
1 point
64. In the administering the rabieglobulin (Rig), the nurse’s immune globulin (Rig), the nurse infiltrates the calculated dose around the wound edge and rest of the dose injected___. *
1 point
65. According to RA 9482 or the ant- Rabies Act 2007, which of the following statements regarding rabies exposure prophylaxis is APPLICABLE? *
1 point
SITUATION 14 - The 3-year-old child has just finished ingesting the kerosene stored I a Lem-O-Lime bottle. When the mother saw the child, she immediately brought him to the nearest hospital.
66. The assessment of the patient with ingested poison must include ___ *
1 point
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67. In case of poisoning, the nurse is aware that the main goals in poisoning are to__ *
1 point
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68. To remove the ingested poisonous substance, the physician ordered a gastric lavage. What is role of the nurse immediately prior to the procedure. *
1 point
69. The is aware that the proper management of poisoning includes the following EXCEPT to___ *
1 point
70. Discharge instruction made by the nurse to the parents should include. *
1 point
SITUATION 15- Nurse Emma is working in the ER when a strong earthquake shook the city. Fifteen minutes later, a number of patient have been starting to arrive in the ER.
71. As a triage Nurse, which of the following will be Emma’s priority? *
1 point
72. Patient brought in who are unresponsive with penetrating head wounds are tagged by the triage nurse in which color? *
1 point
73. Those who suffered stable abdominal wounds significant bleeding will be tagged___ *
1 point
74. It is very important that the nurses must plan for mass casualties, which include___ *
1 point
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75. Nurse Emma must work with the disaster Committee for an appropriate disaster response strategy, in order to succeed, must have physical assets which includes which of the following? *
1 point
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SITUATION 16- The nurse when practicing the profession must adhere to ethical principles.
76. When the nurse treats the patient in the air-conditioned rooms favorably compared to those in the charity wing, she violate which of the following ethical principles? *
1 point
77. The nurse has obligation to tell the truth. When she admits mistakes promptly, she manifest____. *
1 point
78. The cancer patient has been frequently complaining of pain and demands that the pain reliever b administered even before the due time. The nurse prepares to inject NSS as a placebo. Which principle will she transgress? *
1 point
79. The nurse knows that ethical dilemmas may be referred to the hospital ethics committee that has the PRIMARY role to___ *
1 point
80. Nurse were overhead talking about the patient and his prognosis. What ethical principle was violated? *
1 point
SITUATION 17- Nurse must continually grow as a person and as a professional.
81. As a newly licensed nursed employed in a tertiary hospital, you are required to attend continuing Professional Development (CPD) program. When the training program is for the enrichment of nurses in the hospital, it is called____. *
1 point
82. The professional development of a nurse can be achieved through various ways, such as___ *
1 point
83. When nurses projected in a television advertisement as sex symbols, what APPROPRIATE action is expected from a concerned nurse? *
1 point
84. To grow as person, the student nurse can attend lecture-demonstration on which of the following procedures? *
1 point
85. Nurse Merry’s application to Canada has finally been approved and she was advised to depart in three months. But she is also enrolled in the graduate school and ambivalent to go because of this engagement plus the fact that her mother has just been discharged from the hospital. Which of the following actions is BEST? *
1 point
SITUATION 18 - Marlene a kasambahay, this admitted for leukemia in exacerbation. She appears shy and seldom talks to hospital staff, except with the watcher who is her sister.
86. Nurse Myra wants to draw the patient out of her shell so she would be better able to elicit the patient’s cooperation. Which of the following actions in MOST helpful? *
1 point
87. Friendly but professional overtures have finally made Marlene open up her circumstances to the nurse, including their financial difficulty. What has been established at this time? *
1 point
88. One morning during rounds, Nurse Myra nticed that Marlene was unduly sad. The nurse’s BEST way of Communicating her concern is___ *
1 point
89. Leukemia is a chronic illness and it is expected the patient will be in and out of the hospital. To maintain communication, the nurse will ___ *
1 point
90. Leukemia is a chronic illness, and it is expected that the patient will be in and out of the hospital. To maintain communication, the nurse will____ *
1 point
SITUATION 19- You are the quality Improvement office of the Hospital X. To achieve safe and quality outcomes, necessary protocol must be in place and error or adverse event investigated to find the root cause and thereafter apply the necessary improvement.
91. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury to a patient. As the officer, what is your INITIAL STEP following a sentinel event? *
1 point
92. In one of the board meatings, the officer will report the results of Quality Improvement effort in the hospital. The report will be presented much BETTER by using which of the following ? ( Select all that apply) *
1 point
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93.The WHO surgical safety checklist claims to increase the safety of patients undergoing surgery. Is being adopted by the hospital’s quality department. Based on the checked list you are aware that the surgeon, nurse and anesthetist should be present during the recapitulation and reassurance of correct patient identity, correct site and correct procedure, which occur right before skin incision. In phase should the above place? *
1 point
94. As the QI Officer, you have strongly recommended to the Operating room to the Surgery Department the adoption of the WHO Surgical Safety Checklist to prevent a wrong site surgery? *
1 point
95. The OT Officer, conducts her random visit to the Operating Room. She asks one of the OR nurses in what phase in the WHO Surgical Safety Checklist Will the nurse account for the sponges and needles used in the surgery? *
1 point
SITUATION 20 – Tommy, a 50-year-old chain smoker, is suspected to have lung cancer after he was seen and examined by his physician. He and his wife got very worried about his diagnosis.
96. Which procedure has to be done to the patient to establish a definitive diagnosis of lung cancer? *
1 point
97. The MOST significant contributory factor to the development of lung cancer is____ *
1 point
98. The patient while in the hospital is complaining of chest pain. When the nurse is assessing the degree of pain of the patient, the MOST APPROPRIATE basis is____. *
1 point
99. Health teaching on chemotherapy includes informing Tommy on the adverse effect of bleeding related indicates further to bone marrow depression. Which verbalization of the patient indicates further teaching? *
1 point
100. The patient underwent a left pneumonectomy due lung cancer. During surgery the phrenic nerve is accidentally cut. This incident will result to____. *
1 point
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