NURSING PRACTICE I

FOUNDATION OF PROFESSIONAL NURSING PRACTICE

1. While caring for an 8-year-old child with a broken wrist, the nurse notices red, raised streaks on the child’s back. The child’s father enters the room and the child becomes quiet and distant, leaning away from the father as he approaches. What is the best nursing action?a. Chart the child was probably beaten by the fatherb. Notify the supervisor to report possible child abusec. Disregard suspicions and care for the immediate needs of the childd. No action is required; there is no actual proof of abuse to the child

Answer: BRationale: Any suspected child abuse should be reported to the appropriate agencies.Source: Illustrated Study Guide for the NCLEX-RN Exam by JoAnn Zerweck, 6 th edition, page 615

2. A nurse manager has been notified to obtain a bed for a client. Of the following clients, which one would the nurse anticipate being able to discharge?a. A client who had myocardial infarction 2 days ago. His vital signs are: BP 150/94 mmHg, pulse 84 beats/min and irregular, respiration 28 breaths/min, minimal chest painb. A client who underwent an abdominal aneurysm resection 3 days ago. His vital signs are BP 130/88 mmHg, pulse 88 beats/min, respiration 22 breaths/min, and oral temperature 101º F. He is beginning oral intake without problemsc. A client who has a subdural hematoma. He is lethargic; pulse is 60 beats/min, respiration is 28 breaths/min, temperature is 99º Fd. A client who had abdominal surgery for a bowel obstruction 4 days ago. He has bowel sounds, is taking fluids orally, has an abdominal Penrose drain, and is continuing to experience abdominal pain.

Answer: DRationale: D represents the most stable client that could be discharged. Clients in A and C are showing signs of being unstable with their diagnosis. The client in B is stable, but because of the extensiveness of his surgery and because he had surgery only 3 days ago, he is a less likely candidate to move than the client in option D.Source: Illustrated Study Guide for the NCLEX-RN Exam by JoAnn Zerweck, 6 th edition, page 615

3. Delegation is the process of transferring work to subordinates. A nurse-manager can appropriately delegate which task?a. Scheduling staff assignments for the next monthb. Terminating a nursing assistant for insubordinationc. Deciding on salary increases for licensed practical nurses after they complete orientationd. Telling a staff nurse to initiate disciplinary action aginst one of her peers

Answer: ARationale: Scheduling may be safely and appropriately delegated. Termination, disciplinary action, and salary increases shouldn’t be delegated to staff, which doesn’t have the power and

the authority to take such actionsSource: NCLEX-RN Questions and Answers made Incredibly Easy, 2nd edition, 2003, page 780

4. The nurse is planning assignments. Which task can be safely delegated to a nursing assistant?a. Obtain a stool specimen from a client with diarrheab. Assist client with a new colostomy in practicing his first colostomy irrigationc. Evaluate the voiding pattern for a client who had a urinary retention catheter removedd. Obtain a dietary history from a client with peptic ulcer disease.

Answer: ARationale: The assignment in A has the most specific guidelines for performance. The other procedures require assessment and judgment and should not be assigned to a nursing assistant.Source: Illustrated Study Guide for the NCLEX-RN Exam by JoAnn Zerweck, 6 th edition, page 614

5. A staff nurse on a busy pediatric unit is an excellent role model for her colleagues. She encourages them to participate in the unit’s decision-making process and helps them improve their clinical skills. This nurse is functioning effectively in which role?a. Manager b. Autocrat c. Leader d. Authority

Answer: C Rationale: A leader doesn’t have formal power and authority but influences the success of a unit by being an excellent role model and by guiding, encouraging, and facilitating professional growth and development.Source: NCLEX-RN Questions and Answers made Incredibly Easy, 2nd edition, 2003, page 778

6. A nurse-manager on an oncology unit has been informed that she must determine which nursing care delivery system is the best for efficient client care, client satisfaction, and cost reduction. Knowing that 2 or 3 registered nurses, 4 licensed practical nurses, and 5 nursing assistants are generally on duty on each shift and that the clients can be grouped fairly easily by geographic location and client care needs, the nurse-manager and her staff appropriately decide to implement which nursing care delivery system?a. Functional nursing c. Team Nursingb. Case management d. Primary Nursing

Answer: CRationale: Team nursing is efficient and cost less to implement than primary or case management systems. Because the staff members know each other well, they can function effectively as a team. Although functional nursing is the most cost effective, care is commonly fragmented and client satisfaction decreased. Case management and primary nursing require more registered nurses than are available.Source: NCLEX-RN Questions and Answers made Incredibly Easy, 2nd edition, 2003, page 779

7. The charge nurse is planning assignments for the nursing staff. One of the staff nurses is pregnant. Which client would not be appropriate to assign to this nurse?a. Child with brain tumor being treated with radiation b. Infant with respiratory syncytial virus receiving ribavirinc. Toddler who is HIV+ and has an opportunistic respiratory tract infectiond. Child with leukemia who is receiving Oncovin (Vincristine) and Zyloprim (allopurinol)

Answer: BRationale: Involves contact with a medication that is teratogenic and is classified as Pregnancy Risk category X. The other clients do not pose a risk to the pregnant nurse.Source: Illustrated Study Guide for the NCLEX-RN Exam by JoAnn Zerweck, 6th edition, page 615

8. A nurse-manager appropriately behaves as an autocrat in which situation?a. Planning vacation time for staffb. Directing staff activities if a client has a cardiac arrestc. Evaluating a new medication administration processd. Identifying the strengths and weaknesses of a client education video

Answer: BRationale: In a crisis situation, the nurse- manager should take command for the benefit of the client. Planning vacation time and evaluating procedures and client resources require staff input characteristic of a democratic or participative manager.Source: NCLEX-RN Questions and Answers made Incredibly Easy, 2nd edition, 2003, page 781

9. There are phases in the change process to be considered, the first one should be:a. Refreezing b. Unfreezing c. Changing d. Resisting

Answer: BRationale: In the change process the first step is unfreezing followed by moving and refreezing.Source: Guide to Nursing Management and Leadership by Ann Tomey, 6th edition, 2000, page 273

10. Form of communication that travels from staff and lower middle level management personnel and continues up the organizational hierarchy is:a. Downward b. Upward c. Matrix d. Grapevine

Answer: BRationale: Upward communication emanates from subordinates and goes upward.Source: Nursing Management towards Quality Care by Lydia Venzon, 2nd edition, page 102

11. What is a key component in a quality assurance program?a. Patient satisfaction questionnaireb. Determination of criteria to meet standardsc. Case management for continuity of cared. An acuity system for client classification

Answer: BRationale: In a quality assurance program, there must be standards from which to measure

progress. Criteria are established to obtain objective measurement.Source: Illustrated Study Guide for the NCLEX-RN Exam by JoAnn Zerweck, 6th edition, page 615

12. Which of the following tools can be most helpful in the evaluation of staff performance?a. Performance assessment c. Performance auditb. Performance standard d. Performance appraisal

Answer: DRationale: Performance appraisal is a control process in which employee’s performance is evaluated against standards. It is the most valuable tool in controlling human resources and productivity.Source: Nursing Management towards Quality Care by Lydia Venzon, 2nd edition, page 128

13. A storm has prevented most of the staff members from getting to work on a busy medical-surgical unit. One registered nurse, 2 licensed practical nurses, and 3 nursing assistants have been able to work. The nurse-manager must decide which nursing care delivery system should be implemented for the best possible client care during this staffing crisis. The nurse-manager directs the staff to implement which delivery system?a. Team nursing c. Functional nursingb. Primary nursing d. Case management

Answer: CRationale: Functional nursing best uses the skills in a timely manner during this crisis. This delivery system requires the least staff and delegates tasks to those who can best perform them.Source: NCLEX-RN Questions and Answers made Incredibly Easy, 2nd edition, 2003, page 780

14. The nurse-manager of a 20-bed coronary care unit isn’t on duty when a staff nurse makes a serious medication error. The client, who received an overdose of medication, nearly dies. Which statement accurately reflects the accountability of the nurse-manager?a. The nursing supervisor on duty will call the nurse-manager at home and apprise her of the problemb. Because the nurse-manager is off duty, she isn’t accountable for incidents that occur in her absence. Therefore, the nurse manager won’t be notifiedc. The nurse-manager will be informed of the incident when returning to work on Monday because the nurse-manager was officially off duty when the incident took placed. Although the nurse-manager is off duty, the nursing supervisor believes that the manager has no responsibility for what happened during the manager’s absence

Answer: ARationale: The nurse-manager is accountable for what happens on the unit 24 hours per day, 7 days per week. If a serious problem occurs, the nurse-manager should be notified as soon as possible. The other choices don’t accurately reflect the accountability of the nurse-manager’s position.Source: NCLEX-RN Questions and Answers made Incredibly Easy, 2nd edition, 2003, page 777

15. The selection of a nursing care delivery system is critical to the success of a nursing area. Which factor is essential in the evaluation of a nursing care delivery system?a. Determining how planned absences, such as vacation time, will be scheduled so that all staff are treated fairlyb. Identifying who will be responsible for making client care decisionsc. Deciding what type of dress code will be implementedd. Identifying salary ranges for various types of staff

Answer: BRationale: Determining who has responsibility for making decision regarding client care is an essential element of all client care delivery systems. Dress code, salary, and scheduling planned staff absences are important to any organization but aren’t actually determined by nursing care delivery system.Source: NCLEX-RN Questions and Answers made Incredibly Easy, 2nd edition, 2003, page 779

16. The nurse –manager in the office of a group of surgeons has received complaints from discharged clients about inadequate instructions for performing home care. Knowing the importance of good, timely client education, the nurse should take which steps?a. Contact the nurses who work in the facility and tell them that client education should be implemented as soon as the clients are admitted to either the hospital or the outpatient surgical centerb. Review and revise the way client education is conducted in the surgeons’ officec. Because no serious damage was done to any of the clients, the nurse-manager can safely ignore their complaintsd. Work with the surgeons’ and nursing staff in the hospital and outpatient surgical center to evaluate current client education practices and revise as needed

Answer: DRationale: Client education is the responsibility of all nurses providing care to the client, and the nurse must work together to establish the best methods. The most appropriate response is to contact the nurse manager, not the nursing staff, at the facility. Evaluating client education in one setting only doesn’t consider the entire process and the staff providing it. No complaint should be ignored; patient education is an important nursing responsibility.Source: NCLEX-RN Questions and Answers made Incredibly Easy, 2nd edition, 2003, page 780

17. When the team approach is utilized in a management situation the subordinates should be aware that they should receive order from only one person. This principle is:a. Unity of command c. Centralizationb. Chain of command d. Channel of communication

Answer: ARationale: Unity of command is represented by the vertical solid line between positions on an organizational chart. It indicates one person has one bossSource: Guide to Nursing Management and Leadership by Ann Tomey, 6th edition, 2000, page 236

18. Which of the following would the nurse identify as an indication that the client understands the informed consent document?a. The client states that the physician has explained the procedure to himb. The nurse finds the informed consent form already signedc. The client can give return verbal explanation of the informed consent documentd. The client states that his wife read it and said it was okay

Answer: CRationale: The client needs top show an understanding of the informed consent document by giving an explanation in his own wordsSource: Illustrated Study Guide for the NCLEX-RN Exam by JoAnn Zerweck, 6th edition, page 615

19. The nurse enters data on a chart and discovers she has written on the wrong chart. How is this error best corrected?a. White out the wrong information and write over itb. Recopy the page with error so chart will be neatc. Draw a straight line through the error, initial and dated. Obliterate the error so it will not be confusing

Answer: CRationale: Errors in charting should never be obliterated, recopied, or covered with correction fluid. When the erroneous information is not legible, it raises questions as to what the person was trying to cover up.Source: Illustrated Study Guide for the NCLEX-RN by JoAnn Zerwekh, 6th edition, 2006,page 615

20. Performance improvement is an important component of continuous quality improvement. Which action should an effective nurse- manager take when conducting performance evaluations?a. Conduct performance evaluation in a group setting so input from peers and subordinates is considered when evaluating a staff member’s effectiveness.b. Provide feedback on strengths as well as areas for improvement and clarify what the staff member is expected to accomplish before the next performance evaluationc. Document areas for improvement in writing. Areas of strength don’t need to be documented because these areas are complementary and don’t describe actions the staff member must take to improved. Delegate responsibility for conducting performance evaluations to primary nurses whenever possible to help them grow professionally.

Answer: BRationale: An effective performance evaluation provides recognition of strengths, identifies areas for improvement, and clarifies performance expectations. Performance evaluation should be done in private, not in front of others. All components of a performance evaluation should be documented in writing. Although input from staff members can be useful in preparing

performance evaluations, delegating all responsibility to others is inappropriate. The nurse- manager is responsible for the performance of the staff.Source: NCLEX-RN Questions and Answers made Incredibly Easy, 2nd edition, 2003, page 784

21. The correct sequence of steps in the research process is:1. Selection and development of the tools/ techniques for collecting data2. Formulation of hypothesis3. Determining the research design or the approach suitable for the study4. Formulation of the problema. 1, 2, 3, 4 b. 4, 1, 2, 3 c. 4, 2, 3, 1 d. 1, 3, 4, 2

Answer: CRationale: The major steps in the research process listed in chronological order as follows: Formulation of the problem, formulation of the hypothesis, determining the research design or the approach suitable for the study, selection and development of the tools/techniques for collecting data.Source: Introduc When selecting your study sample. Which of the following activities should you do first?

22. When selecting your study sample. Which of the following activities should you do first?a. specify the sampling frameb. identify the target populationc. specify the criteria for selection of subjectsd. identify the available population

Answer: BRationale: In selecting study sample the researcher must first identify the target population. He/she must identify the common characteristics of the population.Source: Understanding Nursing Research by Carol Macnee, 2004, page 103 tion to Nursing Research by Lydia Venzon, 2004, page 36-37

23. You decided to use convenience sampling. This is an example of convenience sampling:a. selection with consent c. availability of subjectsb. simple selection d. first come, first selected basis

Answer: CRationale: In convenience sampling data are collected from anyone most conveniently available such as people on a street.Source: Introduction to Nursing Research by Lydia Venzon, 2004, page 53

24. You decided to use Prospective Longitudinal Sampling. Which of the following is an example of this?a. Growth of newborn 2 years ago to the presentb. Mastectomy patients are studied from operation to 3 years after dischargec. Asking high school students their choices of career after graduationd. Asking mothers their past experiences in giving birth

Answer: BRationale: In longitudinal sampling a given group of subjects are studied for an extended period of time, which can be retrospective (past) or prospective (future)

Source: Introduction to Nursing Research by Lydia Venzon, 2004, page 54

25. A type of sampling that starts with one participant or member of the population and uses that member’s contacts to identify other potential participants for the study is:a. cluster sampling c. snowball samplingb. convenience sampling d. purposive sampling

Answer: CRationale: Snowball sampling involves subjects suggesting or referring other subjects who meet the researcher’s eligibility criteria.Source: Introduction to Nursing Research by Lydia Venzon, 2004, page 53

26. A patient refuses to take his antibiotics because he believes that it’s not giving him any good. Which of the following actions of the nurse is MOST appropriate?a. Explains to the patient that he needs the medications for his recovery and clarify any misconceptionsb. Writes in the chart that the patient refuses to take his medicationc. Refer to the attending physician about his refusald. Ask the patient to sign the waiver of responsibility

Answer: ARationale: The nurse must explain all the appropriate measures that have to be done to the patient. If after the explanation, he still refuses to sign the consent form he should be made to fill out the release form to protect the hospital/personnel from any liability that may result from his refusal.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, p. 135

27. When conflict arises regarding management of patient care, which of the following should be upheld?a. Physician’s orders c. Patient’s rightsb. Preference of the family d. Institutional Policy

Answer: CRationale: when conflict arises regarding management of patient care, the patients’ right are upheld.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 83

28. The most common major risk to safety of unconscious patient in the hospital is:a. carbon dioxide poisoning c. fallsb. any poisoning d. insect bites

Answer: CRationale: The most common risk for unconscious patients is falls. For the protection of patient, padded siderails are provided and raised at all times.Source: Brunner and Suddarth’s Textbook of Medical-Surgical Nursing, 10th edition, 2004, page 1854

29. Devolution of the Health department of care is implemented in order to:a. bring services near to the people c. become self reliantb. empower local politician d. stop funding for national funds

Answer: ARationale: Local Government Code transfers responsibility for delivery of basic services and facilities of the national government to local government units to bring services near to the people.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 119

30. Which of the following is your vital role in cancer care?a. arrange for spiritual consultation c. maintain dignity of patientb. allow patient to get angry d. control shame and guilt

Answer: CRationale: The primary responsibility of the nurse to the patient is to give him/her the kind of care his/her needs regardless of his/her status.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 86

31. If the died without a will, the succession is called:a. holographic will b. testate c. heir d. intestate

Answer: DRationale: a person who dies leaving a will is said to have died testate, while one who dies without a will is said to have died intestate.Source: Professional Nursing in the Philippines by Lydia Venzon, 10th edition, 2005, page 190

32. This is treated as the most important attribute of a true Professional Nursea. competence and independent approach b. professional accountability c. self autonomy d. responsibility

Answer: ARationale: Nurses must acquire and develop the necessary competence. Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 82

33. The board may allow licensed nurses from foreign countries or state to practice nursing in the Philippines through special and temporary permit if they belong to the following categories EXCEPT:a. internationally-well specialist or outstanding experts in any branch of specialty of nursingb. nurses on medical mission whose services shall be free in a particular hospital, center or clinicc. employed by schools, colleges of nursing as exchange professors in a branch or specialty of nursingd. Balikbayan nurses who wants to practice nursing in order to earn credits for continuing professional education

Answer: BRationale: A special/temporary permit may be issued by the Board to the following persons:

Licensed nurses from foreign countries/states whose service are either for a fee or free; Licensed nurses from foreign countries/states on medical mission whose services shall be free in a particular hospital; and Licensed nurses from foreign countries/states employed by schools/colleges of nursing as exchange professors in a branch of specialty or trainingSource: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 10

34. The following are grounds for the suspension and revocation of certificates of registration/professional license or special/temporary permit; which one is NOT included?a. use of fictitious date in obtaining a professional licenseb. Commission of a serious negligencec. Unprofessional or unethical conductd. Not a member of the accredited professional organization

Answer: DRationale: The Nursing Board of the PRC shall have the power to revoke or suspend the certificate of registration of a nurse upon any of the ff. grounds: unprofessional and unethical conduct; gross incompetence or serious ignorance and the use of fraud, deceit, or false statements in obtaining a certificate of registration Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 16

35. Nursing is considered as rewarding and fulfilling career. Nursing is best described as a profession that;a. concerned with patientsb. concerned with proper organization of the wardc. assist the people towards self cared. helps to prevent disease and promote wellness

Answer: DRationale: As independent practitioners, nurses are primarily responsible for the promotion of health and prevention of illness.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 205

36. Which of the following are grounds for removal of suspension of the Board Members?1. Unprofessional, immoral or dishonorable conduct2. Continued neglect of duty3. Commission or toleration of irregularities in the licensure examination4. Gross incompetence or serious ignorance

a. 1,2,4 b. 2,3,4 c. 1,3,4 d. 1,2,3

Answer: DRationale: The President may remove or suspend any member of the Board after having been given the opportunity to defend himself/herself in a proper administrative investigation, on the following grounds: continued neglect of duty or incompetence; commission or toleration of irregularities in the licensure examination and unprofessional, immoral or dishonorable conduct.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 23-24

37. The Board has the mandate to determine whether an applicant for the licensure examination is qualified to take the said examination. Who among the following is NOT qualified under the provision of the law?

a. Nurse who finished BSN then proceeded to pursue a medical degreeb. Medical degree graduate who pursued nursing course for one year.c. Midwife graduate who took up nursing following the AHSE programd. BSN graduate of a ladderized BSN curriculum

Answer: BRationale: In order to be admitted to the examination for nurses an applicant must be a holder of a Bachelor’s Degree in Nursing from a college or university that complies with the standards of nursing education duly recognized by the proper government agency.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 11

38. Which TWO of the following courses of action would an examinee that got a general average of 76.8% but a rating of 59% in Curative-A need a take?1 Repeat the whole examination all over again2 Take only the subject where she got a rating below 60%3 Enroll in a refresher course in the subject that she failed4 Obtain a score of 75% in the repeated subjects

a. 1&2 b. 2&3 c. 1&3 d. 2&4

Answer: DRationale: An examinee who obtains an average rating of 75% or higher but gets a rating below 60% in any subject must take the examination again but only in the subject or subjects where he/she is rated below 60%. In order to pass the succeeding examination, an examinee must obtain a rating of at least 75 % in the subject or subjects repeated.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 13

39. Which of the following considered quasi-judicial powers of the Board?a. Conduct licensure examinationb. Recognize nursing specialty organizationc. Conduct hearing and investigations to resolve complaints against nursesd. Promulgate a Code of Ethics for nurses

Answer: CRationale: Conducting hearings and investigations to resolve complaints against nurse practitioners for unethical and unprofessional conduct and violations is a quasi-judicial power of the Board. Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 25-26

40. Some functions of the board are considered to be quasi-legislative. Which of the following functions belong to this category?a. Ensure quality nursing education by examining prescribed facilities of colleges of nursingb. Monitor and enforce quality standards of nursing education in the Philippinesc. Prescribe, adopt and promulgate guidelines, regulations, measures and decisions as maybe necessary for the improvement of the nursing practice.d. Issue, suspend and revoke certificates of registration for the practice of nursing

Answer: CRationale: Prescribe, adopt, issue and promulgate guidelines, regulations, measures and decisions as may be necessary for the improvement of the nursing practice and the

advancement of the profession are considered as quasi-legislative power of the Board.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 26

41. Which of the following areas should be represented by the members of the Board?1. Nursing education2. Nursing practice3. Community health Nursing4. Maternal & Child healthNursing

a. 1,2,3 b. 2,3,4 c. 1,3,4 d. 1,2,3,4

Answer: A Rationale: The board created under Section 3, Article III of the said Nursing Act shall be composed of a Chairperson and 6 members, representing the 3 areas of nursing, namely, nursing education, nursing service, and community health nursing.Source: Professional Nursing in the Philippines by Lydia Venzon, 10th edition, 2005, page 25

42. The following are qualifications of the Chairperson of the Board. Which one is NOT included?a. A natural born citizen and resident of the Philippinesb. Member of good standing of the Philippine Nurses Ass.c. Be a registered nurse and holder of a Master’s degree in Hospital Administrationd. Have at least ten years of continuous practice of the profession prior to appointment

Answer: CRationale: The chairperson shall be a holder of a Master’s degree in Nursing.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 22

43. Some patients have different health beliefs and practices, and Nesty is aware how these can be considered in the plan of care she and her team will prepare for the patients. Which theory is appropriate for these groups of patients?a. Transcultural theory c. Health System Theoryb. Adaptation Theory d. Self care Theory

Answer: ARationale: Transcultural theory is a humanistic and scientific mode of helping a client through specific cultural caring process (cultural values, beliefs and practices) to improve or maintain a health condition.Source: Fundamentals of Nursing by Josie Udan, 2nd edition, 2004, page 17Situation: The Board of Nursing has two vacant positions for members. The Philippine Nurses Association (PNA) has launched its search for nominees.

44. The PNA after having deliberated whom to nominate to PRC must have at least how many candidates for the two positions?a. two b. four c. Six d. Eight

Answer: C

Rationale: There shall be created a Professional Regulatory Board of Nursing, hereinafter referred to as the Board, to be composed of a Chairperson and 6 members. They shall be appointed by the President of the Republic of the Philippines from among 2 recommendees per vacancy, of the PRC, hereinafter referred to as the Commission, chosen and ranked from a list of 3 nominees, per vacancy.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 21

45. After 2 years in hospital nursing, Nesty decided to change career military nursing. She knows that the chief nurse in the military hospital is qualified if she has completed:a. Master’s degree in nursingb. General Staff Coursec. At least 9 units in management and administration courses at the graduate leveld. Masters Degree in Nursing and General Staff Course

Answer: DRationale: Qualification for chief nurse in the military hospital must have Masters Degree in Nursing and General Staff CourseSource: Professional Nursing in the Philippines by Lydia Venzon, 10th edition, 2005, page 53

46. Nesty should be working in collaboration with the members of the health team. Collaboration means:a. Cooperation b. Unityc. Concerted efforts of individuals and groups to meet the goald. Loyalty to the health team

Answer: CRationale: Collaboration means a collegial working relationship with another health care provider in the provision of patient care to meet the goal.Source: Fundamentals of Nursing Concepts, Process, and Practice by Barbara Kozier, 7th edition 2004, page 111

47. Which of the following pursues continuing professional education in emergency care order to be certified as a nurse specialist in critical care. Which of the following agencies are mandated by law to be formulated and develop the comprehensive specialty program?Board of nursing Accredited Professional Organization 1. Department of Health 2. Specialty Organizations

a. 1,2,3 b. 1,2,4 c. 1,3,4 d. 1,2,3,4

Answer: DRationale: In the Philippines the implementation of Board of Nursing Resolution No. 1903 of 1985 on CPE accreditation program for nurses became effective by 1998. Continuing education programs may be offered by: national professional nursing association such as PNA, LGN and ANSAP; professional organizations representing various nursing specialties; health agencies with specialties and employing agencies in the form of in-service training programs.

Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 158-160

Situation: Ms. Baluyot is the newly appointed manager of primary hospital in Sta. Fe. As a new Manager, she deems it appropriate that she gains competence in her professional responsibilities.

48. Ms. Baluyot knows that the fundamental responsibility of a nurse is in fourfold. Which is the most basic of these responsibilities?a. Promote Health c. Restoration of Healthb. Prevention of Illness d. Alleviation of Suffering

Answer: ARationale: As independent practitioners, nurses are primarily responsible for the promotion of health.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 205

49. Which of the following demonstrates the responsibility towards her profession?1. Participate in the development and implementation of standards of Nursing practice in her department.2.Ensures that the core competencies of her staff are enhanced.3. Participates in the activities of the local chapter of the PNA and ANSAP4. Lobbies for the implementation of the incentives and benefit system for Nurses and dependents as stipulated in the law.

a. 1,2,3 b. 2,3,4 c. 3,4 d. 1,2,3,4

Answer: DRationale: All of these demonstrate the responsibility of a nurse towards her profession. Nurses should assert the implementation of labor standards and lobby for favorable legislations to improve existing socio economic conditions of nurses. Nurses help to determine and implement desirable standards of nursing practice and nursing education. They must participate actively in the development and growth of the nursing profession. They are enjoined to members of the PNA and avail of the prevailing continuing education unit privilege. Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 85

50.When Ms. Baluyot is certain that Marie Flor, a new Nurse, is not competent in taking care of critically ill patient , she would not be ethical if she:

Discusses this concern with Marie Flor herselfAssigns another Nurse to the patientExplains to Marie Flor the nature of the condition of the patient and the need for a competent Nurse to handle the increased demand for careDiscusses to the other Nurse that Marie Flor is new and lacking in skills for the needs of the patient.

Answer: DRationale: Nurses should honor and safeguard the reputation and dignity of the members of nursing and other professions. They shall refrain from making unfair and unwarranted comments or criticisms on their competence, conduct, and procedure or do anything that will bring discredit to a colleague and to any member of the other professions.Source: Professional Nursing in the Philippines by Lydia Venzon, 9th edition, 2003, page 84

51. The nurse teaches a client how to prepare for a barium enema. Which statement by the client indicates a correct understanding of the teaching?a. “I’ll cleanse my bowel with laxatives and enemas before the test.”b. “I’ll receive a muscle relaxant during the test.”c. “I’ll drink a contrast medium during the test.”d. “I’ll stop eating red meat 3 days before the test.”

Answer: ARationale: Barium sulfate is administered rectally. To ensure that it adheres to the lower portion of the intestine, the area must be properly cleaned, using laxatives and enemas. A muscle relaxant isn’t administered during the test. Barium sulfate isn’t administered orally (C). The client is put on a liquid diet the night before the procedure and receives nothing by mouth the morning of the procedure.Source: Springhouse Review for NCLEX RN, 5th edition, 2002, page 605

52. The infusion site of your client is edematous and reddened. Your client is complaining of pain along the vein. What should you do FIRST?a. Check the IV solution and refer immediatelyb. Stop infusion and reinsert the IV immediatelyc. Place a warm compress over the IV sited. Slow down the IV infusion

Answer: BRationale: If an infiltration is present, stop the infusion and remove the catheter. Restart the infusion at another site.Source: Fundamentals of Nursing Concepts, Process, and Practice by Barbara Kozier, 7th

edition, 2004, page 1394

53. The nurse is performing a wound irrigation and dressing change. Which action, if taken by the nurse, would be a break in technique?a. Consistently facing the sterile field

b. Washing hands before opening the sterile setc. Opening the bottle of irrigating solution and pouring directly into a container on the sterile fieldd. Opening the sterile set so that the initial flap is opened away from the nurse

Answer: CRationale: After opening a sterile bottle the edge of the bottle is considered to be contaminated. The nurse should pour a little solution out first to wash away organisms on the lip of the opening and then pour from the same side of the bottle into the sterile container on the sterile field.Source: NSNA NCLEX-RN Review by Alice Stein, 4th edition, 2000, page127

54. To prevent complications of immobility, which activities would the nurse plan for the first postoperative day after a colon resection?a. Turn, cough, and deep breathe every 30 minutes around the clockb. Get the client out of bed and ambulate to a bedside chairc. Provide passive range of motion three times a dayd. It is not necessary to worry about complications of immobility on the first postoperative day.

Answer: ARationale: To prevent complications of immobility, the nurse should teach the client to turn, cough, and deep breathe every 30 minutes around the clock for the first postoperative day after a surgery.Source: Fundamentals if Nursing by Barbara Kozier, 7th edition, 2004, page 1068

55. The nurse has received a report on assigned clients. In planning the initial assessment of each client, what approach should be implemented?a. A thorough history of the hospitalization should be reviewed for trends in care, responses to therapy, and currency of medication orders.b. An assessment should be done to determine the client’s current status and the development of complications and to determine whether any changes in nursing care are necessaryc. A complete head-to-toe physical examination should be conducted with emphasis on current health care problemsd. All laboratory results for the past 24 hours should be reviewed to determine changes that have occurred in the client’s condition and to plan effective nursing care

Answer: BRationale: An initial focused assessment should be conducted to determine the client’s current status with regard to his primary health care needs. Source: Illustrated Study Guide for the NCLEX-RN by JoAnn Zerwekh, 6th edition, 2006,page 614

56. A client receives instructions about high-calcium foods. The client shows an understanding of these instructions by selecting which food as highest in calcium?a. Liver b. Yogurt c. Bran muffin d. Carrots

Answer: BRationale: Milk, milk products, and some green vegetables are good sources of calcium. The other options are lower in calcium.Source: Springhouse Review for NCLEX RN, 5th edition, 2002, page 590

57. The following are correct nursing actions when taking the radial pulse EXCEPT:a. put the palms downwardb. use the thumb to palpate the arteryc. use two to three fingertips to palpate the pulse at the inner wristd. assess the pulse rate, rhythm, volume, and bilateral equality

Answer: BRationale: A pulse is normally palpated by applying moderate pressure with the three middle fingers of the hand.Source: Fundamentals of Nursing Concepts, Process, and Practice by Barbara Kozier, 7 th

edition, 2004, page 498

58. The nurse is caring for a client who has a temperature of 105º F (40.5ºC). The physician orders the application of a cooling blanket. The nurse should know that which of the following statements is true about the use of a cooling blanket?a. Cold application will increase the metabolic rateb. Vital signs should be monitored every 8 hoursc. The client should remain in one position to conserve energyd. Skin hygiene and protection of body surface areas is essential

Answer: DRationale: Cold application lowers the metabolic rate and causes vasoconstriction in the area. Therefore, assessment of the skin, protection of the skin surfaces with oil, and repositioning are all temperature will be monitored continually with a rectal probe and blood pressure, pulse, and respirations will be monitored frequently.Source: NSNA NCLEX-RN Review by Alice Stein, 4th edition, 2000, page126

59. How does the school health nurse, working with sexually active teenagers, incorporate the concept of secondary prevention into practice?a. By setting up a birth control clinic in the school health officeb. By attending health curriculum meetings to ensure that contraceptive information is included in a unit on sexualityc. By teaching a group of parents about the problems of adolescent pregnancyd. By referring a pregnant adolescent for prenatal care

Answer: DRationale: The nurse knows that secondary prevention efforts are directed toward promoting early case findings so that prompt intervention can be instituted.Source: Illustrated Study Guide for the NCLEX-RN by JoAnn Zerwekh, 6th edition, 2006,page 614

60. As the nurse assists a client with breathing exercises, the client says, “I don’t feel any better. Why should I bother learning how to do these exercises?” How should the nurse respond?a. Tell the client that the physician ordered the exercisesb. Encourage the client to express feelingsc. Ask if the client would like to do the exercises at another timed. Inform the physician of the client’s statements

Answer: BRationale: A client who is upset with the treatment regimen should be given the opportunity to express feelings. The other options don’t provide this opportunity.Source: Springhouse Review for NCLEX RN, 5th edition, 2002, page 585

61. The physician orders an upper GI series for a client with GI complaints. The nurse teaches the client about the upper GI series. Which statement indicates that the client understands the instructions?a. “I’ll have a special instrument passed through my mouth into my stomach.”b. “I’ll take several tablets the night before the test.”c. “I’ll drink a contrast medium while X-rays are taken.”d. “I’ll have a CT scan taken after I’m injected with a radioactive substance.”

Answer: CRationale: In an upper GI series, the client swallows barium and has x-rays of the stomach taken. A, B, and D don’t apply to an upper GI series. A gastroscope is passed through the mouth into the stomach to observe the gastric mucosa to perform gastroscopy. The night before a gallbladder series, a client takes radiopaque tablets. A CT scan isn’t a component of an upper GI series.Source: Springhouse Review for NCLEX RN, 5th edition, 2002, page 582

62. Which statement by the nurse best indicates a correct understanding of “log rolling” when moving a client?a. One nurse may perform this task aloneb. Pillows are needed for positioning in order to provide supportc. The legs should be moved before the head is movedd. Keeping the neck in a straight position is the primary concern

Answer: BRationale: A pillow should be placed between the knees/legs for support while the client is

being turned. It takes two or three nurses to do log rolling. The whole spinal column should be kept straight and the entire body moved at once.Source: NSNA NCLEX-RN Review by Alice Stein, 4th edition, 2000, page126

63. Which of the following statements is TRUE about thoracentesis?a. NPO is required after the procedureb. The patient should remain immobile during the procedurec. The patient should remain flat on bed for at least 4 hours after the procedured. The procedure is contraindicated for COPD clients

Answer: BRationale: Make sure the patient is firmly supported. Remind the patient not to cough, deep breathe deeply or move suddenly during the procedure to avoid puncture of the visceral pleura or lung. Source: Nursing Procedures by Springhouse, 3rd edition, 2000, page 486

64. What is the most effective method for obtaining an accurate blood pressure reading from a client?a. Obtain a cuff that covers the upper one third of the client’s armb. Position the cuff approximately 4 inches above the antecubital spacec. Use a cuff that is wide enough to cover the upper two thirds of the client’s armd. Identify the Korotkoff sounds, and take a systolic reading at 10 mm Hg after the first sound

Answer: CRationale: To obtain an accurate reading in an adult, the blood pressure cuff should cover the upper two thirds of the client’s arm; it should be positioned approximately 2 inches above the antecubital space. The systolic reading is obtained with the first of Korotkoff sounds.Source: Illustrated Study Guide for the NCLEX-RN by JoAnn Zerwekh, 6th edition, 2006,page 614

65. The nurse suspects that a client is in severe pain even though he denies it and refuses pain medications. The nurse understands that he or she may be dealing with a person who:a. Uses stoicism as a psychological response to painb. Is angry and hostilec. Gets needs met by being a martyrd. Has a psychological need to punish himself

Answer: ARationale: Stoicism is a common psychological response to pain, particularly in some cultures. The remaining answers are assumptions that cannot be made with this amount of information.Source: Successful test-taking learning strategies for nurses by Marian Sides, 3rd edition, 1998, page 345

66. The nurse is teaching a client who is scheduled for a paracentesis. Which of the following statements, if made by the client to the nurse, indicates that teaching has been successful?a. “I will be in surgery for less than one hour.”

b. “I must not void prior to the procedure.”c. “the physician will remove 2-3 L of fluid.”d. “I will lie on my back and breathe slowly.”

Answer: CRationale: Fluid removed slowly to decrease ascites; can remove up to 4-6 L in sever casesSource: Kaplan NCLEX-RN, 2003-2004 edition, page 256

67. For which of the following signs should the nurse monitor the client during paracentesis?a. Hiccups b. incontinence c. fever d. syncope

Answer: DRationale: During paracentesis observe the client loosely for vertigo, faintness (syncope) diaphoresis, pallor, heightened anxiety, tachycardia, dyspnea and hypotension.Source: Nursing Procedures by Springhouse, 3rd edition, 2000, page 577-578

68. A nurse checks on a patient awaiting surgery the following morning and finds her alone quietly weeping. Which of the following would be the most appropriate initial response of the nurse?a. Leave the room quietly and close the patient’s doorb. Apologize for disturbing the patient and return to the room laterc. Sit with the patient silently and use therapeutic touchd. Ask the patient if there is a family member the patient would like to be with.

Answer: CRationale: Sitting with the patient and using touch therapeutically conveys the nurse’s interest in and concern for the patient, which will help to reduce the patient’s preoperative fears and anxieties. A and B convey a message of avoidance of the patient and offer no support to the patient. D is ineffective because the nurse is not offering himself or herself, but rather a family member to support the patient.Source: Successful test-taking learning strategies for nurses by Marian Sides, 3rd edition, 1998, page 255-256

69. The homecare nurse is performing chest physiotherapy on an elderly client with chronic airflow limitations (CAL). Which of the following actions should the nurse take first?a. Perform chest physiotherapy prior to mealsb. Auscultate the chest prior to beginning the procedurec. Administer bronchodilators after the procedure d. Percuss each lobe prior to asking the client to cough

Answer: BRationale: Identify areas of the lung that require drainage; auscultate chest at the end of procedure to determine effectiveness.Source: Kaplan NCLEX-RN, 2003-2004 edition, page 256

70. The nurse is instructing a group of middle-aged women anticipating mammography as part of a cancer screening program. Which of the following instructions should the nurse provide to the group members?a. “You should have nothing to eat or drink after midnight before your scheduled mammogram.”b. “You should not wear deodorant or talc of the day of your mammogram.”c. “An intravenous infusion will be started at a low flow rate just prior to your scheduled mammogram.”d. “You should not wear a bra or constrictive clothing for several hours following your mammogram.”

Answer: BRationale: Use of deodorants or talcs interferes with mammographic screening. No restriction of oral intake is necessary prior to diagnostic test. Although some women may experience minimal breast tenderness following mammography, there is no need to restrict wearing of undergarments or constrictive clothing posttest. IV fluids are neither indicated nor used for this diagnostic testing.Source: Successful test-taking learning strategies for nurses by Marian Sides, 3rd edition, 1998, page 397

71. Which one of the following actions by the nurse illustrates the principle that evaluation is an essential component in the achievement of effective pain relief?a. Administering pain medication to her client promptlyb. Practicing guided imagery with her clientc. Determining the quantity and quality of paind. Returning to the client 20 minutes after pain medication has been administered to assess effectiveness

Answer: DRationale: This nursing action evaluates the efficacy of the pain medication. The remaining answers illustrate assessment and intervention strategies.Source: Successful test-taking learning strategies for nurses by Marian Sides, 3rd edition, 1998, page 345

72. Which of the following is correct nursing action when collecting urine specimen from a client with indwelling urethral catheter?a. collect urine specimen from the urinary drainageb. detach the catheter from the connecting tubec. use sterile needle and syringe to aspirate urine specimen from the drainage portd. flush the catheter with sterile NSS before collection of urine specimen

Answer: CRationale: Sterile urine specimens can be obtained from closed drainage systems by inserting

a sterile needle attached to a syringe through a drainage port in the tubing.Source: Fundamentals of Nursing Concepts, Process, and Practice by Barbara Kozier, 7th

edition, 2004, page 769

73. What is the BEST position of the client who will undergo abdominal palpation?a. Supine b. dorsal recumbent c. genupectoral d. trendelenburg

Answer: ARationale: In assessing the abdomen assist the client to a supine position, with the arms placed comfortably at the sides.Source: Fundamentals of Nursing Concepts, Process, and Practice by Barbara Kozier, 7th

edition, 2004, page 594

74. A nurse is planning to teach a 4-day postoperative patient about care of his incision, in preparation for discharge. Which of these assessments of the patient should cause the nurse to postpone the teaching session?a. I’m anxious to go home to my family. I’m looking forward to a good home-cooked meal!”b. “It’s still a little sore where they did my surgery, but I manage pretty well.”c. “I’m feeling nauseated now. I think that antibiotic is making me feel sick to my stomach.”d. “I didn’t realize this incision would be so big. Do you think I’ll have a scar?”

Answer: CRationale: This patient has an increased need for communication with a health care provider by virtue of his surgical experience. However, the patient’s present nausea will prevent him from focusing completely on the important information being communicated. The nurse should postpone the interaction with the patient until he is feeling more physically able to share in the communication process.Source: Successful test-taking learning strategies for nurses by Marian Sides, 3rd edition, 1998, page 254

75. The nurse would likely restrict protein intake for which of the following patients?a. An elderly patient with stasis ulcers on heels and anklesb. A teenage patient recovering from abdominal surgeryc. A middle-aged patient with advanced cirrhosis of the liverd. An adult patient hospitalized for exacerbation of COPD

Answer: CRationale: Persons with liver failure require restriction of protein intake because nitrogen by-products of protein metabolism for ammonia, a toxin to the neuromuscular system. Patients in A and B would require increased protein intake to effect healing. The patient in D would benefit from increased protein intake to enhance general nutritional status.Source: Successful test-taking learning strategies for nurses by Marian Sides, 3rd edition, 1998,

page 367

Situation: A research study was undertaken in order to identify and analyze a disabled boy’s coping reaction to pattern during stress.

76. The study which is an in depth study of one boy is a:a. evaluative study c. cross-sectional studyb. case study d. longitudinal study

ANSWER: BRATIONALE: case study- an in-depth research study of a single individual, single unit or a single organization.Cross-sectional- is a research design that includes the collection of all data at one point in time.Longitudinal- is a research design that includes a collection of data over time.SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p396, 399Introduction to nursing research: quest for quality nursing by Lydia M. Venzon, p171

77. Which of these does not happen in a descriptive study?a. manipulation of variablesb. exploration of relationships between two or more phenomenac. investigation of a phenomenon in real life contextd. exploration of relationships between two or more phenomena

ANSWER: ARATIONALE: Manipulation of variable does no happen I descriptive study. It is done in experimental designs and quasi-experimental designs. A descriptive design functions to portray as accurately as possible some phenomenon in interest. Descriptive design is used to answer research questions that seek to describe. It describes and interprets what is, and reveals condition and relationship that exist or do not exist, practice that prevails or do not prevail, beliefs or point of view or attitudes that are held or not held, procedures that are continuing or otherwise effects that are being felt or trend that are developing. SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p198Introduction to nursing research: quest for quality nursing by Lydia M. Venzon, p94

78. The investigator also provides the nursing care of the subject. The investigator is referred to as a/an:a. advocate c. participant observerb. observer researcher d. caregiver

ANSWER: DRATIONALE: Caregiver- the caregiver role has traditionally includes those activities that assist the client’s physical and psychologically while preparing the client’s dignity. The required nursing action may involve full care complete dependent client, partial care for partially dependent client and supportive-educative care to assist clients in attaining the highest possible level of health and wellness. Caregiver encompasses physical, psychosocial, developmental,

cultural and spiritual levels.Advocate- The overall goal of the client advocate is to protect the clients’ rights. An advocate informs clients about their rights and provides them with information they need to make informed decision. Observer researcher- stands out in the phenomenon being studied and, as objectively as possible, records the acquired data.Participant observation- the researcher intentionally imbeds himself into the environment from which data will be collected and becomes a participant. From the perspective of the active participation in the experience and lives of those studied the researcher records observations, feelings, conversations and experiences regarding the phenomenon of interest.SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p156Introduction to nursing research: quest for quality nursing by Lydia M. Venzon, p117Fundamentals of nursing: concepts, process and practice, 7th ed., by Kozier, p10

79. To ensure the reliability of the study, the investigator’s analysis and interpretations were:a. subjected to an inter-observer agreementb. correlated with a list of coping behaviorc. scored and compared standard criteriad. subjected to statistical treatment

ANSWER: CRATIONALE: reliability of the measure reflects how definite we can be that the measure will yield the same data consistently if the actual or real variable stays the same. When quantitative data are collected using observation, the rate of agreement, or inter-rater agreement, tells us how consistent the observational measure was. Test-retest reliability or a Cronbach’s alpha coefficient is a statistics that tells us how consistently subjects respond to a set of items or questions. In all three cases, the goal in quantitative research is to use measures that will most consistently measure the variables of interest. SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p169

Situation: as a nurse you are expected to initiate or participate in conducting research studies to improve nursing practice. You have to be updated on the latest trends and issues affecting the profession and the best practices arrived at the profession.

80. You are interested to study the effects of meditation and relaxation on the pain experienced by cancer patients. What type variable is pain?a. dependent b. independent c. correlational d. demographic

ANSWER: ARATIONALE: A variable is a quality, property or characteristic of a person or thing to be studied that can be quantitatively measured. Choice A is correct answer. A dependent variable is the variable that is determined by, that is, depends upon, other variables in the study or in outcome variable of interest. Choice B, the independent variables are those variables in the study that are used to explain or predict the outcome of interest, that is, the independent variable. Other variable aside from independent, may affect the dependent variable. If not taken into account, this may confuse the interpretation of the study. This are called confounding variables which are sometimes called

extraneous and uncontrolled variables.SOURCE: Introduction to Nursing Research: quest for quality nursing by Lydia M. Venzon, p60 Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p58

81. You would like to compare the support system of the patient with chronic illness to those with acute illness. What type of research is this?a. Descriptive b. experimental c. correlational d. quasi-experimental

ANSWER: CRATIONALE: Choice C, correlational designs function to describe or to identify interrelationships among factors of interest. Because correlational designs describe the relationships, occasionally it is called descriptive correlational design. Descriptive designs function to portray a phenomenon of interest. Descriptive designs are used to answer research questions that seek to describe. Experimental design and quasi-experimental research designs functions to answer questions involving prediction and the effects of manipulation. SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p198, 200

82. In any research study where individual persons are involved, it is important that any informed consent for the study is obtained. The following are essential information about the consent that you should disclose to the prospective subject except:a. assurance of anonymity and confidentialityb. explanation of procedurec. consent to complete disclosured. description of benefits, risk and discomforts

ANSWER: ARATIONALE: Right to informed consent- informed consent has two components- recognition of self determination and thorough comprehension of the proposed participation. The freedom to choose that will do the vital part of human being. The right to self determination is firmly established in the constitution and in moral beliefs. Every code of ethics applicable to research studies states that free consent is prerequisite to any human involvement.All subjects must have clear, explicit information about every aspect of the research project- the procedure to be followed and the reasons; the exact nature of the participant’s role, including time and energy requirements, the risk and benefits involved; any anticipation or potential loss or dignity or autonomy; any anticipated pain or discomfort; psychological stress or embarrassment; and the way in which the data will be handled and reported. Full disclosure is necessary to informed consent.SOURCE: Introduction to nursing research: quest for quality nursing by Lydia M. Venzon, p130-132

Situation: As a beginner in research, you are aware that sampling is an essential element of a research process.

83. What does a sample group represent? a. control group b. general population c. universe d. study subjects

ANSWER: DRATIONALE: a sample is the smaller group, or subset of the group, of interest that is studied in the research.Control group- is a group of subjects who do not received an intervention so that the control group can be compared to those who received the intervention. General population- the entire group of individuals about whom the researcher is interested to study.SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p24, 200, 400

84. Random sampling ensures that subjects have: a. an equal chance of section c. been selected based on set criteriab. been selected systematically d. characteristic that match other samples

ANSWER: ARATIONALE: in a random sample, all the members of a population of interest must identified and listed and each member of a population is assigned to a number. Therefore to select a random sample, all the members of the sample frame must be part. After deciding how many members of the population will be in the study, the researcher uses some device, such as random number table or a computer program to select who will be in the study. The researchers arbitrarily pick a number from a random number table, which consist of rows and columns of numbers and then continuous in any direction of the table to select number. Because all possible numbers are represented in the table, it is by chance alone that the numbers of any particular member of the population be chosen. SOURCE: understanding nursing research: reading and using research in practice by Carol L. Macnee, p109-110

85. Which of the following sampling methods allows the use of any group of research subjects?a. convenience b. purposive c. systematic sampling d. random sampling

ANSWER: ARATIONALE: convenience sample- a sample that includes members of the population who can be readily found and recruited.Purposive sampling- is inclusion in a study of participants who are intentionally selected because they have certain characteristics that are related to the purpose of the study.Systematic random sampling- is an approach to selection of individuals for the study where the members of the population are identified and listed and then members are selected at a fixed interval from the list.Random sampling- is a sample in which every member of the population had an equal probability of being included. SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p395, 401, 402, 404

86. You decided to include 5 barangays in your municipality and chose a sampling method that would get representative samples from each barangay. What should be the appropriate method for you to use in this care? a. cluster sample b. stratified sampling c. systematic sampling d. random sampling

ANSWER: ARATIONALE: Cluster sampling- a small sample is taken from various sections of the population. Choice B, Stratified sampling- here, the population is subdivided into areas, sections, and then random samples are taken from each.Choice C, Systemic sampling- this consist of taking every nth person in school, community or telephone directory.Choice D, Random sampling- in this method, the selection of the sample is done by chance. SOURCE: Introduction to Nursing Research: quest for quality nursing by Lydia M. Venzon, p53

Situation: You are actively practicing nurse who just finished your graduate studies. You learn the value of research and would like to utilize the knowledge and skills gained in the application of research into nursing service. The following question applies to research.

87. Which of the following studies is based on quantitative research?a. A study examining the bereavement process in the spouses of the clients with terminal cancerb. A study examining client’s feelings before, during and after a bone marrow aspirationc. A study exploring factors influencing weight control behaviord. A study measuring the effects of sleeping deprivation

ANSWER: BRATIONALE: Quantitative research progresses through systematic, logical steps according to a specific plan to collect numerical information, often under conditions of considerable control, that is a nalyz4ed using statistical procedures. The quantitative approach is usually associated with positivism, philosophical doctrine that emphasizes the rational and scientific. Quantitative research is often viewed as “hard” science and uses deductive reasoning and the measurable attributes of human experiences.SOURCE: Fundamentals of Nursing: concepts, process and practice, 7th ed., by Kozier, p27

88. Which of the following studies is based on qualitative research?a. A study measuring differences in blood pressure before, during and after a procedure.b. A study examining client’s reactions to stress after open heart surgeryc. A study measuring nutrition and weight loss/gain in clients with cancerd. A study examining oxygen levels after endotreacheal suctioning

ANSWER: BRATIONALE: The qualitative approach is often associated with naturalistic inquiry, which explores the subjective and complex experiences of human beings. Qualitative research investigates “the human experiences as it is lived through careful collection and analysis of narrative, subjective materials”. Data collection and its analysis occur concurrently. Using the inductive method, data are analyzed by identifying themes and patterns to develop a theory or framework that helps explain the processes under observation.SOURCE: Fundamentals of Nursing: concepts, process and practice, 7th ed., by Kozoer, p28

89. An 85 years old client in a nursing home tells a nurse, “I signed the papers for the research study because the doctor was so insistent and I want him to continue taking care of me”. Which client right is being violated?a. right of self determination c. right to privacy and confidentialityb. right to full disclosure d. right not to be harmed

ANSWER: ARATIONALE: Right to be protected from harm- an informed consent is important to the research plan so that an appropriate balance exists between potential benefits of the research and the risk assumed by the parents of the subjects. This is called the risk-benefit ratio wherein the risk should outweigh by the benefits. Risk or harm is defined as the exposure of the subjects to the possibility of the injury beyond everyday situations. This includes physical, emotional legal financial and social harm. Minimal risk means that the risk of harm anticipated in the proposed research are not greater than those ordinarily encountered in daily life or during the performance of routine examinations or test.

Sometimes, the subject may experience undue anxiety if the instruments to be used are too sensitive as to evoke disturbing feelings. Debriefing is the process of disclosing to the subject all information that was previously withheld. It may even be necessary that provision for referral to counseling be included in the study protocol.

With the concern of the protection of human research subjects, factors that threaten bodily harm such as drug toxicity or those who threaten a subject’s self-esteem, self worth, values, privacy and religious freedom should be disclosed. Some risks may lasts beyond the study or may produce permanent damage, such as the use of drug or devices.SOURCE: Introduction to nursing research: quest for quality nursing by Lydia M. Venzon, p132

90. “A supposition or system of ideas that is proposed to explain a given phenomenon” best defines:a. a concept c. a theoryb. a conceptual framework d. a paradigm

ANSWER: CRATIONALE: A theory is an abstract explanation describing how different factors or phenomenon relate.A concept is a term or idea that has a specific meaning with the context of a general field of study; a notion that substitute for a definition with several words, or an abstraction that categorizes observation based on commonalities and differences. A paradigm is a kind of model framework for explaining or describing a theory that includes methods, laws, traditions, encompasses a set of philosophical assumptions.A conceptual framework is an underlying structure for building and testing knowledge that is made up of concepts and the relationship among the concept.SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p404, 395Introduction to nursing research: quest for quality nursing by Lydia M. Venzon, p172, 179

Situation: A nurse professor assigns a group of students to do data gathering by interviewing their classmates as the subject.

91. She instructed the interviewers not to tell the interviewees that the data gathering are for his own research project for publication. This teacher has violated the student’s right to:a. Disclosure b. not be harmed c. privacy d. self determination

ANSWER: ARATIONALE: Right to informed consent- informed consent has two components- recognition of self determination and thorough comprehension of the proposed participation. The freedom to choose that will do the vital part of human being. The right to self determination is firmly

established in the constitution and in moral beliefs. Every code of ethics applicable to research studies states that free consent is prerequisite to any human involvement.All subjects must have clear, explicit information about every aspect of the research project- the procedure to be followed and the reasons; the exact nature of the participant’s role, including time and energy requirements, the risk and benefits involved; any anticipation or potential loss or dignity or autonomy; any anticipated pain or discomfort; psychological stress or embarrassment; and the way in which the data will be handled and reported. Full disclosure is necessary to informed consent.SOURCE: Introduction to nursing research: quest for quality nursing by Lydia M. Venzon, p130-132

92. A nurse preceptor observes that many clients are being admitted in the ward for the post operative infections. She suggested to the students that they do a research on this topic. What research activity is this?a. sharing research results with colleaguesb. data collectionc. developing guidelines for patient cared. identifying clinical problem

ANSWER: DRATIONALE: Once the research topic is selected, the research problem should be formulated as specifically as possible. A problem should represent an action or change. It may be geared toward practical real-life situations or it may represent a theoretical situation that would expand nursing knowledge.SOURCE: Introduction to Nursing: Quest for quality nursing by Lydia Venzon, p40-41

93. Quantitative research involves numerical data. Which of the following is based on quantitative research?a. The effects of regular nurse visits to client’s bedside on the number of client’s call to the nurse.b. A study on the effects of the white uniform of hospital personnel on pediatrics patients.c. A study on benefits of pre-operative health instructions to clients feeling of anxiety.d. A study on the effects of touch on the client’s of isolation.ANSWER: BRATIONALE: Quantitative research progress through systematic, logical steps according to a specific plan to collect numerical information, often under conditions of considerable control, which is analyzed using statistical procedures. This quantitative approach is frequently associated with positivism or logical positivism, a philosophical doctrine that emphasizes the rational and scientific. Quantitative research is often viewed as “hard” science and uses deductive reasoning and measurable attributes of human experience. Choice B is the correct answer.SOURCE: Fundamentals of nursing: concepts, process and practice, 7th ed., by Kozier, p25-26

94. Before the nurse researcher starts her study, she analyzes how much time, many materials and people she will need to complete the research project. This analysis prior to beginning the study is called:

a. Validity c. feasibilityb. Researchability d. reliability

ANSWER: CRATIONALE: feasibility- pertains to the availability of time as well as the materials and human resources needed to investigate the research problem or question. Conducting studies involves the use of space, money, equipment, supplies, computers, subjects, research assistants and consultants.Validity in research reflects how accurately the measures yield information about the true or real variable being studied. A measure is valid if it measures correctly and accurately what is intended to measure.Researchability- means that the problem can be subjected to scientific investigation. Many significant problems that produce ambiguity and uncertainty in clinical situations may not be amenable to research.Reliability in research means that a measure can be relied on consistently to give the same result if the aspects being measured have not changed.SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p167, 169Fundamentals of Nursing: concepts, process and practice, 7th ed., by Kozier, p29

95. Data analysis is to be done and the nurse researcher wants to include measures of variability. These include the following except:a. Range b. Variance c. Mean d. Standard deviation

ANSWER: CRATIONALE: A measure of variability indicates the degree of dispersion or spread of data. These includes, range, variance and standard deviation.Range- is the extent or the spread of score from the highest to the lowest in a variable or value.Variance- is a statistic, that is, a number that can be used to show how much difference or variety exists in group of number.Standard deviation- is simply the square root of the variance, so it reflects the variety among all the numbers.Mean is a measure of central tendency. Mean- means the average of all the values for variables- that is, the sum the sum of all the values divided by the number of values summed.SOURCE: Understanding Nursing Research: reading and using research in practice by Carol L. Macnee, p61, 63, 66Introduction to nursing research: quest for quality nursing by Lydia M. Venzon, p181Fundamentals of Nursing: concepts, process and practice, 7th ed., by Kozier, p30

Situation: The use of massage and meditation to help decrease stress and pain have been strongly recommended based on documented testimonial.

96. Martha wants to study on the topic “The effects of massage and meditation on stress and pain.”, the type of research that best suits this topic is:a. basic research c. quantitative researchb. applied research d. qualitative research

ANSWER: ARATIONALE: Pure or basic research- the search for knowledge includes establishing

fundamental theories or relationship among facts, which are not intended for immediate use for real life situation. It is useful in advancing scientific knowledge or in furthering research.Choice B, applied research- this type of research involves seeking new applications of scientific knowledge in solving a problem, making a decision, developing or evaluating a program, procedure or products. Choice C, quantitative research- because quantitative studies uses numbers to represent variables of interest and then, often apply statistical tests to allow inference, we expect to see mostly number in the result of quantitative results. Choice D, qualitative research- this study’s purpose is to increase our understanding some aspects of experiences, so the results of qualitative studies describe what we found, usually by the gauge used by participants to support and clarify the meaning of those concept.SOURCE: Understanding Nursing Research: Reading and Using Research in Practice by Carol L. Macnee, p60Introduction to Nursing Research: quest for quality nursing by Lydia M. Venzon, p6-7

97. This type of research design that does not manipulate independent variable is:a. non-experimental design c. quantitative designb. quasi-experimental design d. experimental design

ANSWER: ARATIONALE: In a non-experimental research, it is easier to gain the cooperation of the study subjects in a non-experimental research. Study subjects are not exposed to unpleasant, unusual or even burdensome conditions. Choice B, quasi-experimental design lacks both control group and random assignment. It may not include two groups at all. Instead it may involve a series of observations, followed by an intervention and another series of observations. In this case there is a manipulation of the independent variable but no control group. Choice C, quantitative design also manipulates variables. Choice D experimental design always includes a control group and a random assignment to groups. A control group is a group who does not receive an intervention, so that the control group can be compared to those who do not receive the intervention. This design includes manipulation of independent variable, random assignment and control group; therefore, it is experimental.SOURCE: understanding nursing research: reading and using research in practice by Carol L. Macnee, p197, 200-201

98. Martha does review related literature for the purpose of:a. to identify if the problem can be replicatedb. gather data about what is already known or unknown about the problemc. answering the research questiond. determining statistical treatment of data

ANSWER: BRATIONALE: A literature review is a synthesis of the literature that describes what is known or has been studied regarding the particular research question or purpose.SOURCE: understanding nursing research: reading and using research in practice by Carol L. Macnee, p220

99. The client’s right to be protected when doing research using human subjects, Martha identifies this right as follows except:

a. right to self determination c. right to not to be harmedb. right to compensation d. right to privacy

ANSWER: BRATIONALE: Protecting human subjects means protecting their legal and moral rights. Attention must be given to the rights of informed consent, the right to refuse or withdrawal from participation, the right to privacy, to confidentiality or anonymity of data and to protection from harm.1. Right to informed consent- informed consent has two components- recognition of self determination and thorough comprehension of the proposed participation. The freedom to choose that will do the vital part of human being. The right to self determination is firmly established in the constitution and in moral beliefs. Every code of ethics applicable to research studies states that free consent is prerequisite to any human involvement.All subjects must have clear, explicit information about every aspect of the research project- the procedure to be followed and the reasons; the exact nature of the participant’s role, including time and energy requirements, the risk and benefits involved; any anticipation or potential loss or dignity or autonomy; any anticipated pain or discomfort; psychological stress or embarrassment; and the way in which the data will be handled and reported. Full disclosure is necessary to informed consent.2. The right to refuse or withdraw from participation- just as the person has the right to give consent; he has also the right to refuse. It should be clearly stated that their will be no recrimination of any of the subject’s refusal. He may have several reasons to withdraw. The subject may find his involvement tiring or more embarrassing than expected. His conditions may change. He may change his mind after further reflection or after consulting a friend or relative, or he may find his continuing participation inconvenient. The nurse should explore the reason for the subject’s refusal and should support his right to do so. The possibility of withdrawing however can minimize if, at the onset, the subject is given a careful and honest explanation of what to be done.3. Right to privacy- the right to privacy includes the privacy of one’s thought, opinions and physical presence, and the privacy of one’s records. The right to control the extent to which a person shares himself with others includes the freedom to decide the schedule and the general circumstances under which he will share his beliefs and attitudes with one another.Each subject should be consulted about his willingness to share his privacy.Arrange a convenient time and place for the subject and the investigator. Data collected from observation without the subject’s consent or knowledge is clearly violated of the right to privacy.4. Right to confidentiality and anonymity- research subject has the right to expect that the date obtained about them will be handled in confidentially. Data should be available only to research staff and should be reported anonymously. Remember that the subject gave consent for a specific propose only, which means that the data should not be used for any other reasons. It should not be made in public or available to others. 5. Right to be protected from harm- an informed consent is important to the research plan so that an appropriate balance exists between potential benefits of the research and the risk assumed by the parents of the subjects. This is called the risk-benefit ratio wherein the risk should outweigh by the benefits. Risk or harm is defined as the exposure of the subjects to the possibility of the injury beyond everyday situations. This includes physical, emotional legal financial and social harm. Minimal risk means that the risk of harm anticipated in the proposed research are not greater than those ordinarily encountered in daily life or during the performance of routine examinations or test. SOURCE: Introduction to nursing research: quest for quality nursing by Lydia M. Venzon, p130-132

100. What is considered the most current priority for nursing research?a. Improvements in patient care and outcomesb. Problems relating to nurse professional identityc. Content of nursing curriculad. Staffing and shortage problems

Answer: ARationale: In the nursing profession, research is undertaken to: Provide a scientific basis for the nursing profession Develop and evaluate new technique for delivering patient care that is attuned to patient’s health needs Develop tools for assessing the effectiveness of nursing interventions Provide solutions to problems concerning health maintenance, health delivery and health care. Help determine the areas of need relative to nursing practices such as patient- teaching and nurse- patient relationships.Source: Introduction to Nursing Research Quest for Quality Nursing. Venzon. Page 9- 10

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