1. The nurse knows which of the following indicates protein deficiency?a. Hypoalbuminemia and pot bellyb. Koionychia (spoon-shaped nails)c. Beefy red tongued.d. Bleeding gums

2. Before administering a tube feeding the nurse knows to perform which of the following assessments?a. The GI tract including bowel sound, last BM and distentionb. The clients neurologic status, especially gag reflexc. The amount of air in the stomachd. The formula used directly from the refrigerator

3. An adult is being taught about a healthy diet. The nurse can offer:a. Milkb. Jelloc. Freshly squeezed orange juiced. Ice cream

5. An adult has received an injection of immunoglobulin. The nurse knows that the client will develop which of the following types of immunity:a. Active natural immunityb. Active artificial immunityc. Passive natural immunityd. Passive artificial immunity

6. BON Resolution No 432 S 2003 is:a. Guidelines for the implementation of Board Resolution No. 14 S 1999b. Implementing Rules and Regulations of RA 9173c. Special training on intravenous injection for nursesd. Adoption of a Guide to Evaluate Compliance with Standard for Safe Nursing Practice.

7. Its a type of non-probability sampling wherein the researcher identifies population strata and determines how many participants are needed for each stratuma. Quota Samplingb. Purposive Samplingc. Convenience samplingd. Simple stratified sampling

8. All but one are concepts of informed consent.a. It must be voluntary-without coercion or forceb. Patient must be competentc. Knowledgeable information should be providedd. It must be signed right after administration of pre-ops meds.

9. The following concepts of liability negligence are true, except?a. Deviation from standard of care is established.b. Duty is owed to the nursec. Financial, physical and emotional harm is establishd. Direct cause for failure to meet standard of care clearly established.

10. The nurse is caring for a client whose arterial blood gases indicate metabolic acidosis. The nurse knows that of the following, the least likely to cause metabolic acidosis is:a. cardiac arrestb. Diabetic ketoacidosisc. decreased serum potassium leveld. renal failure

11. The nurse is caring for a client who is receiving IV fluids, Which observation the nurse makes best indicates that the IV has infiltrated?a. Pain at the siteb. A change in flow ratec. Coldness around the insertion sited. Redness around the insertion site

12. A 27 y.o adult is admitted for treatment of Crohn's disease. Which information is most significant when the nurse assesses nurtritional health?a. Anthropometric measurementsb. bleeding gumsc. dry skind. facial rubor

13. ASA (aspirin) is being administered to a client. The nurse understands that the most common mechanism of action for nonnarcotic analgesic is their ability to:a. Inhibit prostaglandin systhesisb. After pain perception in the cerebellumc. Directly affect the central nervous systemd. Target the pain-producing effect of kinins

14. The nurse caring for an adult client who is receiving TPN will need to be monitored for which of the following metabolic complications?a. Hypoglycemia and Hypercalcemiab. Hyperglycemia and Hypokalemiac. Hyperglycemia and Kyperkalemiad. Hyperkalemia and Hypercalcemia

15. Total parenteral nutrition is ordered for an adult. Which nutrient is not likely to be in the solution? a. Dextrose 10%b. Trace mineralsc. Amino acidsd. Non of the above

16. A man has sprained his ankle. The physician would order cold applied to the injured area to.a. Reduce the body's temperatureb. Increase circulation to the areac. Aid in absorbing the edemad. Relieve pain and control bleeding.

17. An adult is to have a tepid sponge bath to lower his fever. What temperature should the nurse make the water?a. 65 Fb. 90 Fc. 110 Fd. 105 F

18. An adult has chronic lower back pain and receives hot pack three times a week. The nurse knows that the treatment is given for which of the following reasons?a. To help remove debris from the wound

b. To keep the client warm and raise his temperaturec. To improve the client's general circulationd. To relieve muscle spasm and promote muscle relaxation

19. An insane man got hold of a knife and stabbed a pregnant woman. His liability will be determined by virtue of :a. Justifying circumstancesb. Exempting circumstancesc. Mitigating circumstancesd. Aggravating circumstances

20. A crime in which all the elements necessary for its execution and accomplishment are present.a. Heinous crimeb. frustrated crimec. consummated crimed. attempted crime

21. Once criterion to assess the quality of a study is triangulation. This means.a. accuracy and consistency of informationb. soundness of evidencec. use of multiple sources for conclusionsd. consistency and stability of evidence over time

22. It is thought to be the most recent method or system in providing nursing carea. Case System methodb. primary nursing methodc. functional nursing methodd. team nursing method

23. A patient classification system where patients minimal theraphy and less frequent observationa. minimal care (category 1)b. moderate care (category 2)c. maximum care (category 3)d. intensive care (category 4)

24. The nurse is to apply a dressing to a stage II pressure ulcer. Which of the following dressing is best?a. Dry gauze dressingb. wet gauze dressingc. wet to dry dressingd. moisture vapor permeable dressing

25. The client has been placed in the trendelenburg position. The nurse knows the effects of this position to the client include which of the following.a. increase blood flow to the feetb. decrease blood pressurec. increase pressure on the diaphragmd. decrease intracranial pressure

26. A man who has been in an MVA is going into shock. Before placing the client in a modified trendelenburg position, the nurse should assess the client for:a. long bone fractureb. air embolusc. head injuryd. thrombophlebitis

27. The nurse enter a room and finds a fire.

Which is the best initial action?a. Evacuate any people in the room, beginning with the most ambultory and ending with the least mobileb. activating the fire alarm or call the operator, depending on the institutions systemc. get a fire extinguisher and put out the fired. close all the windows and doors and turn off any oxygen or electricity appliance.

28. A member of the board of nursing may be removed and/or suspended on the following grounds except:a. Toleration of irregularities in the licensure examinationb Violation of the Philippine Nursing Actc. Neglect of duty or incompetenced. Immoral unprofessional or dishonorable conduct

29. A tendency of the evaluator to inaacurately rate a group because of the belief that he/she has a very good cooperative group.a. hawthorne effectb. sunflower effectc. horn's effectd. halo effect

30. A type of probability sampling where the researcher selects random samples, successively from a larger to smaller units by either simple or stratified methods.a. Multi-stage samplingb. Systematic samplingc. purposive samplingd. snowballing sampling

31. The nurse is to open a sterile package from central supply. Which is the correct direction to open the first lap?a. Toward the nurseb. Away from the nursec. To the nurse's left or right handd. It does not matter as long as the nurse touches only the outside edge

32. The nurse knows which of the following is the proper technique for medical asepsis?a. gloving for all the client contactb. changing hospital linens weeklyc. using your hands to turn off the faucet after handwashingd. gowning to care for a 1 year old child w/ infections diarrhea

33. An adult ha a left, above the knee amputation two weeks ago. The nurse places him in a prone position tree times a day becausea. Prevents pressure ulcer on the sacrumb. helps the prosthesis to fit correctlyc. prevents flexion constracturesd. allow better blood flow to the heart

34. A woman is to have a pelvic exam. Which of the following should the nurse have the client do first?a. Remove all her clothes and her socks and shoesb. go to the bahtroom and void saving a samplec. assume a lithotomy position on the exam

tabled. assemble all the equipments needed for the examination

35. An adult is supine. Which of the ff. can the nurse to to prevent external rotation of the legs?a. put a pillow under the clients lower legsb. place a pillow directly under the client kneec. use a trochanter rool alongside the client's upper thighsd. lower the client's legs so that they ae below hips.

36. The following are elements of felony except?a. There must be an act of ommisionb. such act or omission must be done voluntarilyc. such act maybe done with or without intentd. such act or omission is punisable by law

37. To qualify as a dean of the college of nursing the applicants must have?a. At least 5 years of teaching and supervisionb. At least 10 years of clinical practivec. At least 3 years of being a clinical coordinatord. At least 2 years management units.

38. A research design where there is manipulation of independent variable but no random or control groupa. longitudinal designb. quasi-experimentalc. experimentald. cross-sectional

39. Four clients have signaled with the call bells for the nurse. Who should you see first?a. A client who needs to use the toiletb. A client who does not have his glasses or hearing aidec. A client who has just been given morphined. A client in a chair with a restraint vest on.

40. Which of the ff. should the nurse observe first?a. A client who has just returned from the ORb. A client whose call light is not workingc. A client with Alzheimer's diseased. A clietn who is receiving a heating pad treatment

41. Which of the ff. should the nurse deal first?a. A client who need her dressing changedb. A client who needs to be suctionedc. A client needs to be medicated for postoperative paind. A client who is incontinent and needs to be cleaned

42. One of the major ethical princles in research is beneficence that includes:a. Right to protection of protection from physical and psychological harmb. Right to full-disclosurec. Right to performance of sources goodd. Right to protection of participants form explotation.

43. He described humans as "wanting organism" that satisfly their basic needs in a

specific sequence?a. Frederick Herzbergb. Abraham Maslowc. BF Skinnerd. Victor Vroom

50. A client has been receiving an IV solution. What is an appropriate expected outcome for this client?a. Monitor fluid intake and output every 4 hoursb. The client remains free of signs and symptoms of phelibitsc. edema and warmth over the IV sited. Excess fluid volumn evidenced by weight gain

51. This theorist of management developed the 14 principles of management based on his experience.

a. Mary Follettb. Max Weberc. Henry Fayold. Kurt Lewin

52. The nurse prepares to palpate a clients maxillary sinues. For this procedure, where should the nurse place the hands?a. On the bridge of the noseb. below the eyebrowsc. below the cheekbonesd. over the temporal area

53. A client who receives general anesthesia returns from surgery. Postoperatively, which nursing diagnosis takes highest priority for this client?a. Pain related to the surgeryb. Fluid volume deficit related to fluid and blood loss from surgeryc. Impared physical mobility related to surgeryd. Risk for aspiration related to anesthesia

54. After a client receives an IM injection, he complains of a burning pain in the injection site. Which nursing action whould be best to take at this time?a. apply a cold compress to decrease swellingb. apply a warm compress to dilate the blood vesselsc. Massage the area to promote absorption of the drugd. Instruct the client to tighten his gluteal muscles to enhance absorption of the drug

55. These are mitigating circumstances that lessen the penalty, except:a. Under 18 and over 70b. No intention to commit so gravec. There wa sufficent provocationd. in contempt of authority

56. The nurse is monitoring options of effectiveness of drug theraphy, when should the nurse obtain a measurement of the blood sample through level.a. 1 hour before administering the next doseb. immediately before administering the next dosec. immediately after administering the next dosed. 30 mins. after administering the next dose

57. Which od the following options servers a framework for nursing education and clinical practice?a. Scientific breakthroughb. technological advancesc. theoretical modelsd. medical practices

58. Nursing care for a client includes removing elastic stocking once per day. What is the rationale for this interventions?a. TO increase blood flow to the heartb. to observe the lower extremitiesc. to allow the leg muscles to stretch and relaxd. To permit veins in the legs to fill with blood.

59. Hyperactive bowel sounds can result from all the following except.a. Paralytic ileusb. hungerc. intestinal obstructiond. diarrhea

60. The following characteristics speak of a leader except:a. Do the right thingb. focus on peoplec. develops visions and strategiesd. have a short-term views

61. This theory of management suggest that an employees work motivation is controlled by conditions in the external environment rather than by internal needs and desires.a. vroom's expectancy theoryb. skinner's operant theoryc. adam's equity theoryd. white competence theory

62. In Lydia Hall's theory, which of the ff. represents "core"?a. Nurturance and factors that are exclusive to nursingb. Therapeutic use of selfc. Focuses on nursing related to physicians orderd. All of the above.

63. A research that seeks to describe an existing problem situation and examine the underlying factors that contributes to the emergence of the problem:a. Explanatory researchb. Quantitative researchc. Exploratory researchd. Quantitative research

64. During blood transfusion, the patient manifest tacycardia, distended neck vein and increase CVP reading, the nurse shoulda. Obtain vital signsb. Call the physicianc. Stop the infusiond. Decrease the rate of infusion.

65. A nurse who is maintainin a private clinic in the community and renders service on materials and child health amont the neighborhood for a fee isa. primary care nurseb. an independent nurse practioner

c. nurse-midwifed. a nurse specialist

66. A client comes to the clinic for a diagnostic allergy testing. Why is intradermal injections used for such tsting.a. intradermal injection is less painfulb. intradermal drugs are easier to administerc. intradermal drug diffuse more rapidlyd. intradermal drugs diffuse more slowly

67. A client is placed in isolation. Client isolation techniques attempt to break the chain of infection by interfering with thea. Agentb. susceptible hostc. transmission moded. portal of entry

68. A research hypothesis that proposes that there is association or significant relationship between variables is called.a. null hypothesisb. directional hypothesisc. alternative hypothesisd. non-directional hypothesis

69. Which of the ff. laboratory test results is themost impt. indicator of malnutrition in a client with a wound?a. serum potassium levelb. albumin levelc. lymphocyte countd. differential count

70. Which detail of a clients drug theraphy is the nurse legally responsible for documenting?a. Peak concentration time of drugb. Safe ranges of the drugc. Clients socioeconomic datad. client's reaction to the drug

71. Which of the ff. statements about these nursing practice acts are true?a. These acts are not effective in the supervision or revocation of licensure of erring nursesb. These acts have been authorized by the accredited national nurses organizationc. These acts usually define the scope of nursing practiced. These acts describe the diffences between a registered nurse and a practice nurse

72. The following are true on a manager except?a. Are interested in efficiencyb. emphasize tactics, structure and systemc. motivate people to comply with standardsd. use person to person influence

73. The nurse is assessing tactile fremitus in a client with pneumonia. For this examination, the nurse hould use the:a. fingertipsb. ulnar surface of the handc. dorsal surface of the handd. finger pads

74. The ff. activities belong to the design phase in the research process, except?a. developing a time tableb. selecting the study design

c. determining sampling pland. conducting a pilot study

75. When inspecting a client's skin, the nurse finds a vesicle on the client's arm. Which description appliest to a vesicle?a. flat, nonpalpable and coloredb. solid, elevated and cicumscribedc. circumscribed, elevated, and filled with serous fluidd. elevated, pus-filled and circumscribed

76. Which nursing action is essential when providing continuous enteral feeding?a. elevating the head of the bedb. positioning the client on the left sidec. warming the formula before administering itd. hanging a full day's worth of formula at one time

77. After initial assessment of a client, findings reveals a body temp of 38.5 C, Consequently the clients blood pressure can be expected toa. Fluctuatesb. Remain the Samec. Increased. Decrease

78. The nurse assesses the skin turgor of an elderly client. When evaluating skin turgon, the nurse should remember that:a. Over hydration causes the skin to tentb. Dehydration causes the skin to appear edematous and spongyc. Inelastic turgor is a normal part of agingd. Normal skin turgon is moist and boggy.

79. Which of the ff. does not govern the practice of nursing?a. RA 7164b. RA 9173c. BON Resolution for Code of Ethicsd. Board Resolution Scope of Nursing Practice

80. A client with sever chest pain is brought to the emergency department. He tells the nurse, "I just have a little indigestion." Which of the following mechanisms is the client exhibiting?a. Denialb. Anxietyc. Repressiond. Confusion

81. These are "in-between factors" present in research environment that threaten the internal and external validity of a research study.a. Dependent variableb. Independent variablesc. Intervening variablesd. Criterion variable

82. The ff. are motivational factors according to Herzberg, except:a. Challenging aspects of the work itselfb. Added responsibilityc. Oppurtunities for personal growthd. Quality of supervision

83. The nurse measures the client's temperature at 102 F. What is the equivalent

centigrade temp?a. 39.1 Cb. 47.2 Cc. 38.9 Cd. 40.1 C

84. A client is placed on a low-sodium (500mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective?a. "I can eat a ham-and-cheese sandwich w/ potato chips for lunch"b. "I choose broiled chiken whith a baked potato for dinner"c. "I choose a tossed salad w/ sardines and oil and vinegar dressing for lunch"d. "Im glad i can still have chicken bouillon soup"

85. Why should an infant be quiet and seated upright when the nurse assess his fontaanels?a. The mother will have less trouble holding a quiet upright infantb. Lying down can cause the fontanels to recede, making assessment more difficult.c. The infant can breath more easily when sitting upd. Lying down and crying can cause the fontanels to buldge

86. Communicating and using the research findings is under what phase of the research process?a. Implementation phaseb. Dissemination phasec. Analysis and interpretation phased. Design phase

87. To give a Z-tract injection, the nuse measures the correct medication dose and draws a small amount of air into the syringe. What is the rationale for this action?a. Adding air decreases pain caused by the injectionb. Adding air prevents the drug from flowing back into the needle tractc. Adding air prevens the solution from entering a blood vesseld. Adding air ensures that client receives the entire dose.

88. Which of the ff. is true of Care System method?a. Autonomy and authority for the care of four to siz patients on a 24-h basisb. Assigning nurses to give total nursing care to a single patientc. Divison of labor which nurses are assigned to perform secific tasksd. Assigning a team to give total care to a selected group of clients

89. Which of the ff. best describes the action of the nurse who documents her nursing diagnosis?a. She documents and charts it whenever necessaryb. She can be accused of malpracticec. She does it reguarly as an impt. responsibilityd. She starts it only when the pt. is acutely ill

90. To help assess a clients cerabral function,

the nurse should ask:a. Have you noticed a change in your memory?b. Have you noticed a chnge in your muscle strength?c. Have you had any coodination problem?d. Have you had any problems with your eyes?

91. The nurse is evaulating a postoperative client for infection. Which sign of sympton would be most indicative for infection?a. The presence of an indwelling urinary catheterb. Rectal temperature of 100Fc. Red, warm , tender incisiond. WVC count of 8,000/UI

92. A patient classification system where patients need close attention and complete care in most activities and requires frequent and complex treatments and medicationsa. Minimal Care (category 1)b. Moderate Care (category 2)c. Maximum Care (category 3)d. Intensive Care (category 4)

93. What nursing diagnosis is commonly used to develop a plan of care for managing client's drug regimen?a. Noncomplienceb. Altered coping mechanismc. Anxietyd. Altered home maintenance

94. Which of the ff. provides that nurses be members of the national nurse organization?a. RA 877b. 1987 Code of Ethics approved by the house of delegates PNAc. Board Resolution No 1955 promulgated by the Board of Nursingd. RA 7164

95. The ff. are good sources of research problems except?a. Literatureb. Clininal experiencec. Daily news reportsd. existing theories

96. What is the common goal of discharge planning in all care settings?a. prolonging hospitalization until the client can function independentlyb. Teaching client how to perform self-care activitiesc. Providing the financial resources needed to ensure proper cared. Preventing the need for medical follow-up care.

97. The physician prescribe as IV infucion of 1000 ml D5W every 12 hours for a client. The IV setup delivers 15 gtt/ml. Approx. how many drops should be administered each minute?a. 18b. 21c. 24d. 27

98. Which of the following provides the material and human resources and building the structure to care out the activities of the

organization?a. Planningb. Organizingc. Commandd. Control

99. A client is scheduled to receive a blood transfusion. During the transfusion, the nurse should observer for which sign or symptoms of a transfusion reaction?a. Dizzinessb. Chillsc. Hypothermiad. Hyperreflexia

100. The client has an abdominal hysterectomy, 10 hours ago. Which position should the nurse teach the client to avoid?a. High Fowlersb. lateral recumbentc. Supined. Side lying