TEST DRILL 2

• Raniel is taking care of a client with sexually transmitted disease. If he divulges information about his client, he may be liable for:

• a. Libel b. Tort • c. Slander d. Invasion of privacy

• Raniel is taking care of a client with sexually transmitted disease. If he divulges information about his client, he may be liable for:

• a. Libel b. Tort • c. Slander d. Invasion of privacy

• Romulo is a newly appointed manager of a primary hospital in Sta. Maria. As a new manager, he deems it is appropriate that he gains competency in his professional responsibilities. He knows that the fundamental responsibility is 4-fold. One is considered the BASIC of these responsibilities.

• a. Restoration of Health c. promotion of health• b. Alleviation of suffering d. Illness prevention

• Romulo is a newly appointed manager of a primary hospital in Sta. Maria. As a new manager, he deems it is appropriate that he gains competency in his professional responsibilities. He knows that the fundamental responsibility is 4-fold. One is considered the BASIC of these responsibilities.

• a. Restoration of Health c. promotion of health

• b. Alleviation of suffering d. Illness prevention

– Single most effective and least expensive method to prevent nosocomial infection

A. vaccine

B. vitamins C

C. hand washing

D. application of 70% alcohol

– Single most effective and least expensive method to prevent nosocomial infection

A. vaccine

B. vitamins C

C. hand washing

D. application of 70% alcohol

Nurse Joy forgot to raise the side rails of the patient who is having a seizure, nurse joy commits which of the following

a. malpractice c. tort

b. maleficence d. negligence

Nurse Joy forgot to raise the side rails of the patient who is having a seizure, nurse joy commits which of the following

a. malpractice c. tort

b. maleficence d. negligence

• during the lunch break nurse Noah tells his co-nurse, nurse Elmo that his patient have an HIV and may not make it till Christmas, what rights of the patient have been violated

a.confidentiality c. negligence

b. malpractice d. tort

• during the lunch break nurse Noah tells his co-nurse, nurse Elmo that his patient have an HIV and may not make it till Christmas, what rights of the patient have been violated

a.confidentiality c. negligence

b. malpractice d. tort

• Nurse Briana conducted a seminar about the importance of breast feeding among mothers in her community, what role of a nurse, nurse Briana practices

a. councilor c. educator

b. clinician d. advocate

• Nurse Briana conducted a seminar about the importance of breast feeding among mothers in her community, what role of a nurse, nurse Briana practices

a. councilor c. educator

b. clinician d. advocate

• Safe nursing practice refers to appropriate and rationale acts of the nurse that ensure:

A. promotion of health and wellness

B. a balanced ecosystem

C. restoration of optimum functioning

D. all of the above

• Safe nursing practice refers to appropriate and rationale acts of the nurse that ensure:

A. promotion of health and wellness

B. a balanced ecosystem

C. restoration of optimum functioning

D. all of the above

• after assessing a client the nurse formulates relevant nursing diagnoses. Which of the following is a complete nursing diagnosis statement?

• a. Ineffective airway clearance related to mucus plugs and nonproductive cough

• b. Hyperventilation related to anxiety

• c. Tachycardia

• d. Shortness of breath related to anxiety

• after assessing a client the nurse formulates relevant nursing diagnoses. Which of the following is a complete nursing diagnosis statement?

• a. Ineffective airway clearance related to mucus plugs and nonproductive cough

• b. Hyperventilation related to anxiety

• c. Tachycardia

• d. Shortness of breath related to anxiety

• Evaluate a client’s posterior tibial pulse, where should the nurse palpate?

a. Medially in the antecubital space

b. Midway between the superior iliac spine and symphysis pubis

c. On the inner aspect of the ankle, below the medial malleolus

d. Along the top of the foot, over the instep.

• Evaluate a client’s posterior tibial pulse, where should the nurse palpate?

a. Medially in the antecubital space

b. Midway between the superior iliac spine and symphysis pubis

c. On the inner aspect of the ankle, below the medial malleolus

d. Along the top of the foot, over the instep.

• The nurse is assessing a postoperative client. Which of the following should the nurse document as subjective data?

a. Vital signs

b. Laboratory test results

c. Client’s description of pain

d. Electrocardiographic (ECG) waveforms

• The nurse is assessing a postoperative client. Which of the following should the nurse document as subjective data?

a. Vital signs

b. Laboratory test results

c. Client’s description of pain

d. Electrocardiographic (ECG) waveforms

• A client comes to the clinic for diagnostic allergy testing. Why is intradermal injection used for such testing?

a. Intradermal injection is less painful.

b. Intradermal drugs are easier to administer.

c. Intradermal drugs diffuse more rapidly.

d. Intradermal drugs diffuse more slowly.

• A client comes to the clinic for diagnostic allergy testing. Why is intradermal injection used for such testing?

a. Intradermal injection is less painful.

b. Intradermal drugs are easier to administer.

c. Intradermal drugs diffuse more rapidly.

d. Intradermal drugs diffuse more slowly.

• All of the following components may be part of a client’s medical record. Which one is the major source of subjective data about the client’s health status?

a. Health history

b. Physical findings

c. Laboratory test results

d. Radiologic findings

• All of the following components may be part of a client’s medical record. Which one is the major source of subjective data about the client’s health status?

a. Health history

b. Physical findings

c. Laboratory test results

d. Radiologic findings

• What are the activities of planning, except?

a. Collection and classification of data

b. Formulation of policies

c. Identification of needs and priority setting

d. Recruitment

• What are the activities of planning, except?

a. Collection and classification of data

b. Formulation of policies

c. Identification of needs and priority setting

d. Recruitment

• As a staff nurse, which of the following is your most important function?

a. Nursing process

b. Caring

c. Intravenous injection

d. Giving comfort measures

• As a staff nurse, which of the following is your most important function?

a. Nursing process

b. Caring

c. Intravenous injection

d. Giving comfort measures

• Under the Good Samaritan Act, a nurse may be held liable for patient abandonment at the scene of an emergency in which of the following cases?

A. The nurse does not stop to provide assistance.B. The nurse begins assistance and then abruptly

stops.C. The nurse does not initiate careD. The nurse does not perform under the direct

order of physician.

• Under the Good Samaritan Act, a nurse may be held liable for patient abandonment at the scene of an emergency in which of the following cases?

A. The nurse does not stop to provide assistance.

B. The nurse begins assistance and then abruptly stops.

C. The nurse does not initiate care

D. The nurse does not perform under the direct order of physician.

• When obtaining vital signs on a sleeping three-month-old infant, which of the following assessments would a nurse obtain first?

A. respiratory rate

B. apical pulse

C. axillary temperature

D. blood pressure

• When obtaining vital signs on a sleeping three-month-old infant, which of the following assessments would a nurse obtain first?

A. respiratory rate

B. apical pulse

C. axillary temperature

D. blood pressure

• Which intervention is inappropriate when administering a Z-tract medication?

A. placing 0.2 cc of air in the syringe

B. bunching the skin

C. aspirating for blood

D. waiting 5 to 10 seconds while needle is still in the skin

• Which intervention is inappropriate when administering a Z-tract medication?

A. placing 0.2 cc of air in the syringe

B. bunching the skin

C. aspirating for blood

D. waiting 5 to 10 seconds while needle is still in the skin

• Like other professions, what is unique in professional nursing?

a. Its compassionate and caring role

b. Its caring role

c. A well-defined body of knowledge and expertise

d. Its environment in nursing research

• Like other professions, what is unique in professional nursing?

a. Its compassionate and caring role

b. Its caring role

c. A well-defined body of knowledge and expertise

d. Its environment in nursing research

• Florence Nightingale conceptualizes that nursing is.

a. the act of utilizing the environment of the patient to assist him in his recovery

b. assisting the individual sick or well in the performance of those activities contributing to health or its recovery or to peaceful death

c. a humanistic science dedicated to compassionate concern with rehabilitating the sick or disabled.

d. a unique profession, in that it is concerned with all the variables affecting an individual’s response to stressors.

• Florence Nightingale conceptualizes that nursing is.

a. the act of utilizing the environment of the patient to assist him in his recovery

b. assisting the individual sick or well in the performance of those activities contributing to health or its recovery or to peaceful death

c. a humanistic science dedicated to compassionate concern with rehabilitating the sick or disabled.

d. a unique profession, in that it is concerned with all the variables affecting an individual’s response to stressors.

• The Rural Health Doctor orders Dextran 12% 1000 ml within 8 hours for a client. Drop factor is 12 gtt/ml. Solve for the gtt/min.

• a. 24.5 gtts/min b. 25 gtts/min c. 25.5 gtts/min d. 26 gtts/min

• The Rural Health Doctor orders Dextran 12% 1000 ml within 8 hours for a client. Drop factor is 12 gtt/ml. Solve for the gtt/min.

• a. 24.5 gtts/min b. 25 gtts/min c. 25.5 gtts/min d. 26 gtts/min

• . Hand washing is important in every setting including hospitals. Which of the following is inappropriate during hand washing when observing a sterile technique.

• a. Hold the hands higher than the elbows during hand washb. Maintaining the hands uppermost when applying soapc. After washing and rinsing, use a towel to dry one hand thoroughly in a rotating motion from the elbow to the fingers d. Let the running water run from the fingertips to the elbows

• . Hand washing is important in every setting including hospitals. Which of the following is inappropriate during hand washing when observing a sterile technique.

• a. Hold the hands higher than the elbows during hand washb. Maintaining the hands uppermost when applying soapc. After washing and rinsing, use a towel to dry one hand thoroughly in a rotating motion from the elbow to the fingers d. Let the running water run from the fingertips to the elbows

• An important reason why erasures In the patient's chart should be avoided is:

a. chart would look dirty and reflects, the nurse personality

b. recording maybe illegible

c. chart is a legal document

d. chartings are essential for endorsement and follow-up care of patient

• An important reason why erasures In the patient's chart should be avoided is:

a. chart would look dirty and reflects, the nurse personality

b. recording maybe illegible

c. chart is a legal document

d. chartings are essential for endorsement and follow-up care of patient

• The most important values of the use of nursing diagnosis in care planning is:

a. highlights your critical thinking and decision-makingb. focuses in cause of the illnessc. helps to define what is healthd. identifies what the nurse can prescribe

• The most important values of the use of nursing diagnosis in care planning is:

a. highlights your critical thinking and decision-makingb. focuses in cause of the illnessc. helps to define what is healthd. identifies what the nurse can prescribe

• The meet basic goal of health promotion is:

• a. healthyb. absence of diseasec. no illness d. wellness

• The meet basic goal of health promotion is:a. healthyb. absence of diseasec. no illness d. wellness

• You are a factory nurse in a bottling industry. What priority health promotion program can you undertake?

• a. Physical fitness programb. Accident prevention programc. Formulating work strategyd. Relaxation exercises

• You are a factory nurse in a bottling industry. What priority health promotion program can you undertake?

• a. Physical fitness programb. Accident prevention programc. Formulating work strategyd. Relaxation exercises

• Monthly examination (BSE) can help in early detection of breast CA. When do you perform BSE?

• a. once a month after menstruation b. once a month before menstruation c. every ether month after menstruationd. every other month before menstruation

• Monthly examination (BSE) can help in early detection of breast CA. When do you perform BSE?

• a. once a month after menstruation b. once a month before menstruation c. every ether month after menstruationd. every other month before menstruation

• Which of the following steps should the nurse take first when preparing to insert a nasogastric tube?a. Wash handsb. Apply sterile glovesc. Apply a mask and gownd. Open ail necessary kits and tubing

• Which of the following steps should the nurse take first when preparing to insert a nasogastric tube?a. Wash handsb. Apply sterile glovesc. Apply a mask and gownd. Open ail necessary kits and tubing

• Which of the following drug forms can be administered through a nasogastric tube? a. Enteric b. Oral c. Parenteral d. Sublingual

• Which of the following drug forms can be administered through a nasogastric tube? a. Enteric b. Oral c. Parenteral d. Sublingual

• Which of the following characteristics of the client goal in the plan of care is correct?

• a. Nurse-focused, flexible, measurable and realistic b. Client-focused, flexible, realistic and measurable c. Nurse-focused, time-limited, realistic, and measurable d. Client-focused, time-limited, realistic, and measurable

• Which of the following characteristics of the client goal in the plan of care is correct?

• a. Nurse-focused, flexible, measurable and realistic b. Client-focused, flexible, realistic and measurable c. Nurse-focused, time-limited, realistic, and measurable d. Client-focused, time-limited, realistic, and measurable

• A client is to receive Meperidine for his pain ! hour after administration, the nurse checks on the client if there was pain relief. This is in what step of the nursing process?

• a. Assessment c. Evaluation

• b. Planning d. Implementation

• A client is to receive Meperidine for his pain ! hour after administration, the nurse checks on the client if there was pain relief. This is in what step of the nursing process?

• a. Assessment c. Evaluation

• b. Planning d. Implementation

• According to Benner, a nurse who has 3-5 yrs experience is categorized under which level of expertise?

a. Advanced beginner c. Competent

b. Expert d. Proficient

• According to Benner, a nurse who has 3-5 yrs experience is categorized under which level of expertise?

a. Advanced beginner c. Competent

b. Expert d. Proficient

• All of the following situation would result to an erroneously high BP, reading except:

A. Assessing immediately after a meal

B. Cuff is wrapped too tight

C. Bladder cuff too narrow

D. Bladder cuff too wide

• All of the following situation would result to an erroneously high BP, reading except:

A. Assessing immediately after a meal

B. Cuff is wrapped too tight

C. Bladder cuff too narrow

D. Bladder cuff too wide

• When a nurse is making rounds, which of the following personal spaces is she using?

A. Intimate distance

B. Personal distance

C. Social distance

D. Public distance

• When a nurse is making rounds, which of the following personal spaces is she using?

A. Intimate distance

B. Personal distance

C. Social distance

D. Public distance

• When assessing the epigastric area of a patient, the nurse is aware that all of the following body parts are found in that area except:

A. Pancreas

B. Aorta

C. Spleen

D. Part of the liver

• When assessing the epigastric area of a patient, the nurse is aware that all of the following body parts are found in that area except:

A. Pancreas

B. Aorta

C. Spleen

D. Part of the liver

• Which if the following is true regarding pulse rate?

A. Pulse normally is not affected by physical activity

B. A person in hypovolemic shock normall has an increased pulse rate

C. As age increases, pulse rate also increases.

D. Pulse rate decreases when there is an increased metabolic rate

• Which if the following is true regarding pulse rate?

A. Pulse normally is not affected by physical activity

B. A person in hypovolemic shock normall has an increased pulse rate

C. As age increases, pulse rate also increases.

D. Pulse rate decreases when there is an increased metabolic rate

• Which site is usually recommended for infants 7months old and younger who will receive intramuscular injection.

a. Ventrogluteal site

b. Dorsogluteal site

c. Vastus lateralis

d. Deltoid

• Which site is usually recommended for infants 7months old and younger who will receive intramuscular injection.

a. Ventrogluteal site

b. Dorsogluteal site

c. Vastus lateralis

d. Deltoid

• A Nurse is giving health teachings to a diabetic patient who is about to be discharged. This is an example of:

a. Collaborative intervention

b. Interdependent Intervention

c. Dependent Intervention

d. Independent Intervention

• A Nurse is giving health teachings to a diabetic patient who is about to be discharged. This is an example of:

a. Collaborative intervention

b. Interdependent Intervention

c. Dependent Intervention

d. Independent Intervention

• Which of the following is not true regarding the principles and practices of surgical asepsis?

A. All object used in a sterile field must be sterile

B. Sterile items that are not in the field of vision may be considered sterile or unsterile depending on certain condition

C. The edges of a sterile field is considered unsterile

D. The skin cannot be sterilezed and is considered unsterile.

• Which of the following is not true regarding the principles and practices of surgical asepsis?

A. All object used in a sterile field must be sterile

B. Sterile items that are not in the field of vision may be considered sterile or unsterile depending on certain condition

C. The edges of a sterile field is considered unsterile

D. The skin cannot be sterilezed and is considered unsterile.

• A child is brought to the hospital because of fever which the mother described as always remaining above normal but fluctuates between high and low. This is known as:

a. Intermittent Fever c. Relapsing Fever

b. Remittent Fever d. Constant Fever

• A child is brought to the hospital because of fever which the mother described as always remaining above normal but fluctuates between high and low. This is known as:

a. Intermittent Fever c. Relapsing Fever

b. Remittent Fever d. Constant Fever

• An adult patient is to receive Hepatitis B vaccine. Which of the following site is recommended for administration?

a. Vastus lateralis

b. Dorsogluteal site

c. Ventro gluteal site

d. Deltoid site

• An adult patient is to receive Hepatitis B vaccine. Which of the following site is recommended for administration?

a. Vastus lateralis

b. Dorsogluteal site

c. Ventro gluteal site

d. Deltoid site

• A patient admitted to the hospital because of hypothermia. Which of the following is not a clinical sign of hypothermia?

a. Pale, cool clammy skin

b. Disorientation

c. Increased pulse and respiratory rates

d. Drowziness

• A patient admitted to the hospital because of hypothermia. Which of the following is not a clinical sign of hypothermia?

a. Pale, cool clammy skin

b. Disorientation

c. Increased pulse and respiratory rates

d. Drowziness

• A nurse is performing an assessment on a patient newly admitted to the hospital. Which of the following is an example of a subjective data?

a. A client cried during the interview.

b. Patient skin is pale and diaphoretic.

c. Patient states he is out of breath.

d. Patient’s abdomen is distended.

• A nurse is performing an assessment on a patient newly admitted to the hospital. Which of the following is an example of a subjective data?

a. A client cried during the interview.

b. Patient skin is pale and diaphoretic.

c. Patient states he is out of breath.

d. Patient’s abdomen is distended.

• Which type of transmission based precaution should be implemented for a patient with pneumonia?

A. airborne precaution

B. droplet precaution

C. contact precaution

D. reverse isolation

• Which type of transmission based precaution should be implemented for a patient with pneumonia?

A. airborne precaution

B. droplet precaution

C. contact precaution

D. reverse isolation

• A nurse administer heparin injection to a patient which of the following guidelines should the nurse take into consideration?

a. Do not forget to aspirate when giving heparin

b. Administer heparin injection via the intramuscular route

c. Do not massage the site after injection.

d. None of the above

• A nurse administer heparin injection to a patient which of the following guidelines should the nurse take into consideration?

a. Do not forget to aspirate when giving heparin

b. Administer heparin injection via the intramuscular route

c. Do not massage the site after injection.

d. None of the above

• Nurse Sarah is caring to clients who have difficulty of breathing and some having heart problems. The position of choice for these clients is:A. Supine positionB. Trendelenburg positionC. Fowler’s positionD. Orthopneic position

• Nurse Sarah is caring to clients who have difficulty of breathing and some having heart problems. The position of choice for these clients is:A. Supine positionB. Trendelenburg positionC. Fowler’s positionD. Orthopneic position

• Mrs. Smith is for an examination of her genitalia. Nurse Cassie should assist her to assume which position?

• a. Dorsal recumbent position • b. Knee-chest position

c. Sim’s position • d. Genupectoral position

• Mrs. Smith is for an examination of her genitalia. Nurse Cassie should assist her to assume which position?

• a. Dorsal recumbent position • b. Knee-chest position

c. Sim’s position • d. Genupectoral position

• Monitoring of client’s VS should not be a routine procedure. The following are times to assess VS except:

A. On admission to a health care agency

B. Before and after surgery or invasive procedure

C. According to a nursing or medical order

D. Only after administration of medications

• Monitoring of client’s VS should not be a routine procedure. The following are times to assess VS except:

A. On admission to a health care agency

B. Before and after surgery or invasive procedure

C. According to a nursing or medical order

D. Only after administration of medications

• Which of the following is not a cardinal sign?

• a. Temperature c. Heart rate

• b. Blood pressure d. Pain

• Which of the following is not a cardinal sign?

• a. Temperature c. Heart rate

• b. Blood pressure d. Pain

• Nurse Jasmine knows that the best way to prevent transfer of microorganisms is:

• a. Use of hand sanitizer • b. Handwashing• c. Disinfection of used materials • d. Health assessment

• Nurse Jasmine knows that the best way to prevent transfer of microorganisms is:

• a. Use of hand sanitizer • b. Handwashing• c. Disinfection of used materials • d. Health assessment

• Mr. Yang is suffering from hyperthermia. Nurse Julian knows that the center for thermoregulation is:

• a. Pituitary gland c. Medulla oblongata

• b. Hypothalamus d. Pons

• Mr. Yang is suffering from hyperthermia. Nurse Julian knows that the center for thermoregulation is:

• a. Pituitary gland c. Medulla oblongata

• b. Hypothalamus d. Pons

• The primary center for respiration is:

• a. Pituitary gland c. Medulla oblongata

• b. Hypothalamus d. Pons

• The primary center for respiration is:

• a. Pituitary gland c. Medulla oblongata

• b. Hypothalamus d. Pons

• Respiration is the act of breathing. The primary chemical stimulation for breathing is:

a. Low CO2 level in the blood

b. Stress

• c. High O2 level in the blood d. High CO2 level in the blood

• Respiration is the act of breathing. The primary chemical stimulation for breathing is:

a. Low CO2 level in the blood

b. Stress

• c. High O2 level in the blood d. High CO2 level in the blood

• Which of the following is a non – modifiable factor affecting the blood pressure?a. Stress c. Exercise

• b. Race d. Diet

• Which of the following is a non – modifiable factor affecting the blood pressure?a. Stress c. Exercise

• b. Race d. Diet

• The most accessible and convenient method of taking temperature is: a. Oral c. Rectal b. Axillary d. Tympanic

• The most accessible and convenient method of taking temperature is: a. Oral c. Rectal b. Axillary d. Tympanic

• After taking the temperature per orem, Nurse Pido must clean the thermometer in what manner?

• a. From bulb to stem in a back and forth motion • b. From stem to bulb in a rotating motion • c. From bulb to stem in a rotating motion • d. From center down and upward

• After taking the temperature per orem, Nurse Pido must clean the thermometer in what manner?

• a. From bulb to stem in a back and forth motion • b. From stem to bulb in a rotating motion • c. From bulb to stem in a rotating motion • d. From center down and upward

• Mr. Dido is in traction, in order to assess good circulation in the foot, Nurse Pido must palpate for:a. Apical pulse c. Posterior tibial

• b. Radial pulse d. Femoral pulse

• Mr. Dido is in traction, in order to assess good circulation in the foot, Nurse Pido must palpate for:a. Apical pulse c. Posterior tibial

• b. Radial pulse d. Femoral pulse

• The use of appropriate size of the BP cuff is an important factor to get an accurate reading. Nurse Lindsay knows that a cuff that is too narrow or tight can cause which findings?

• a. Hypertension c. False high reading

• b. False low reading . d. Ecchymosis

• The use of appropriate size of the BP cuff is an important factor to get an accurate reading. Nurse Lindsay knows that a cuff that is too narrow or tight can cause which findings?

• a. Hypertension c. False high reading

• b. False low reading . d. Ecchymosis

• Mrs. Lee is taking a beta blocker medication. Nurse Wolverine knows that this drug causes which of the following?

• a. Decrease RR c. Decrease Temperature

• b. Decrease PR d. Decrease BP

• Mrs. Lee is taking a beta blocker medication. Nurse Wolverine knows that this drug causes which of the following?

• a. Decrease RR c. Decrease Temperature

• b. Decrease PR d. Decrease BP

• Nurse Ray is going to take the RR of Mr. Black. Upon entrance in the room, he noticed that Mr. Black has deep and rapid respiration. Based from your assessment, what acid – base imbalance will occur?

• a. Metabolic acidosis c. Respiratory acidosis• b. Metabolic alkalosis d. Respiratory alkalosis

• Nurse Ray is going to take the RR of Mr. Black. Upon entrance in the room, he noticed that Mr. Black has deep and rapid respiration. Based from your assessment, what acid – base imbalance will occur?

• a. Metabolic acidosis c. Respiratory acidosis• b. Metabolic alkalosis d. Respiratory alkalosis

• Nico is the student nurse assigned at the neonatal intensive care unit. Dr. Lopez requested him to take the heart rate of Baby See. After doing so, Nico knows that the normal heart rate of a newborn is:

• a. 80 – 180 beats/min c. 80 – 140 breaths/min

• b. 75 – 120 beats/min d. 60 – 100 breaths/min

• Nico is the student nurse assigned at the neonatal intensive care unit. Dr. Lopez requested him to take the heart rate of Baby See. After doing so, Nico knows that the normal heart rate of a newborn is:

• a. 80 – 180 beats/min c. 80 – 140 breaths/min

• b. 75 – 120 beats/min d. 60 – 100 breaths/min

• Rectal temperature taking is the most accurate method of measurement. To reduce friction and prevent trauma to the mucous membranes, Nurse Cindy must do which of the following?

• a. Lubricate thermometer with soap • b. Insert thermometer 4 inches above the sphincter • c. Lubricate thermometer with water soluble jelly • d. Instruct the client to breathe out then insert

thermometer

• Rectal temperature taking is the most accurate method of measurement. To reduce friction and prevent trauma to the mucous membranes, Nurse Cindy must do which of the following?

• a. Lubricate thermometer with soap • b. Insert thermometer 4 inches above the sphincter • c. Lubricate thermometer with water soluble jelly • d. Instruct the client to breathe out then insert

thermometer

• If there is repeated vomiting or increasing abdominal distension while giving NGT rehydration what is the most appropriate nursing action?

A. Suggest insertion of Foley Catheter

B. Suggest administration of diuretics

C. Refer immediately to the doctor

D. Give the fluid more slowly

• If there is repeated vomiting or increasing abdominal distension while giving NGT rehydration what is the most appropriate nursing action?

A. Suggest insertion of Foley Catheter

B. Suggest administration of diuretics

C. Refer immediately to the doctor

D. Give the fluid more slowly

• You are to measure the client’s initial blood pressure reading by doing all of the following EXCEPT:

• a. Take the blood pressure reading on both arms for comparison

• b. Listen to and identify the phases of Korotkoff’s sound

• c. Pump the cuff to around 50 mmHg above the point where the pulse is obliterated

• d. Observe procedures for infection control

• You are to measure the client’s initial blood pressure reading by doing all of the following EXCEPT:

• a. Take the blood pressure reading on both arms for comparison

• b. Listen to and identify the phases of Korotkoff’s sound

• c. Pump the cuff to around 50 mmHg above the point where the pulse is obliterated

• d. Observe procedures for infection control

• Mrs. Simon is obese. When administering a subcutaneous injection to an obese patient, it is best for the nurse to:

• a. Inject needle at a 15 degree angle' over the stretched skin of the client

• b. Pinch skin at the Injection site and use airlock technique

• c. Pull skin of patient down to administer the drug in a Z track

• d. Pull skin of patient at the injection site and inject needle at a 45-90 degree angle

• Mrs. Simon is obese. When administering a subcutaneous injection to an obese patient, it is best for the nurse to:

• a. Inject needle at a 15 degree angle' over the stretched skin of the client

• b. Pinch skin at the Injection site and use airlock technique

• c. Pull skin of patient down to administer the drug in a Z track

• d. Pull skin of patient at the injection site and inject needle at a 45-90 degree angle

• Albert was hospitalized because of the injury caused by car accident. The physician ordered a foley catheter. After 3 days of hospitalization, Albert acquired urinary tract infection. This infection is classified as:

a. Nosocomial Infection c. Viral infection

b. Bacterial infection d. All of the above

• Albert was hospitalized because of the injury caused by car accident. The physician ordered a foley catheter. After 3 days of hospitalization, Albert acquired urinary tract infection. This infection is classified as:

a. Nosocomial Infection c. Viral infection

b. Bacterial infection d. All of the above

• Felipe, 36 years old is to be given 2700ml of D5RL to infuse for 18 hours starting at 8am. At what rate should the IV fluid be flowing hourly?

• a. 100 ml/hour b. 210 ml/hour c. 150 ml/hour d. 90 ml/hour

• Felipe, 36 years old is to be given 2700ml of D5RL to infuse for 18 hours starting at 8am. At what rate should the IV fluid be flowing hourly?

• a. 100 ml/hour b. 210 ml/hour c. 150 ml/hour d. 90 ml/hour

• 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. directly onto the cornea

B. pressing on the lacrimal duct

C. into the outer third of the lower conjunctival sac

D. from the inner canthus going towards the side of the eye

• 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. directly onto the cornea

B. pressing on the lacrimal duct

C. into the outer third of the lower conjunctival sac

D. from the inner canthus going towards the side of the eye

• A client is placed in isolation. Client isolation techniques attempt to break the chain of infection by interfering with the

• a. Agent c. transmission modeb. susceptible host d. portal of entry

• A client is placed in isolation. Client isolation techniques attempt to break the chain of infection by interfering with the

• a. Agent c. transmission modeb. susceptible host d. portal of entry

• All the statements concerning measurement of axillary temperature as opposed to oral or rectal temperature in pediatric patient are true, EXCEPT:

A. Oral temperature is difficult to take in young children who do not understand instructions

B. In a frightened child, insertion of an instrument into the rectum will serve to increase anxiety

C. Axillary temperature can be determined more rapidly than oral or rectal temperature

D. Rectal temperature is the most accurate of the three methods for assessing body temperature

• All the statements concerning measurement of axillary temperature as opposed to oral or rectal temperature in pediatric patient are true, EXCEPT:

A. Oral temperature is difficult to take in young children who do not understand instructions

B. In a frightened child, insertion of an instrument into the rectum will serve to increase anxiety

C. Axillary temperature can be determined more rapidly than oral or rectal temperature

D. Rectal temperature is the most accurate of the three methods for assessing body temperature