TEST I

HAND WASHING

Situation: Initiation of practices to prevent the transmission of microorganisms is generally a nursing responsibility and is based on a comprehensive assessment of the client.

1. When you are performing surgical hand hygiene, you must keep hands _____a. Above elbows c. At a 45 – degree angleb. Below elbows d. In a comfortable position

2. You are providing an educational session to a group of young people. You prepare an instruction list for them regarding the correct procedure for medical hand hygiene. Which instructions do you include on the list?a. Turn on the water. Allow the warm water to wet the hands. Apply soap to the hands and rub them

vigorously. Keep hands pointed upward. Rinse the hands. Dry the hands using a paper towel. Turn the water faucet off with the paper towel.

b. Turn on the water. Allow the warm water to wet the hands. Apply soap to the hands and rub them vigorously. Keep hands pointed downward. Rinse the hands. Dry the hands using a paper towel. Turn the water faucet off with the paper towel.

c. Turn on the water. Allow the warm water to wet the hands. Apply soap to the hands and rub them vigorously. Keep hands pointed upward. Rinse the hands. Dry the hands using a paper towel. Turn the water off with the clean hands.

d. Turn on the water. Allow the warm water to wet the hands. Apply soap to the hands and rub them vigorously. Keep hands pointed downward. Rinse the hands. Dry the hands using a paper towel. Turn the water off with the clean hands.

3. What is the most important aspect of hand hygiene?a. Time b. Soap c. Water d. Friction

4. Place the following PPE in order of donning _____a. Gloves, eye protection, mask, and gown c. Gown, mask, eye protection, and glovesb. Mask, gloves, gown, and eye protection d. Eye protection, gloves, mask, and gown

5. At which time should you removePPE?a. Inside client’s room c. At doorwayb. Outside client’s room d. Outside client’s room or at doorway

COLOSTOMY

Situation: A client has a colostomy because of colon cancer. You are teaching him colostomy care.

1. To review, you ask him, “When should you empty the colostomy bag?” You know your teaching is effective when hestates _____a. “Every time I see stool in the bag I should empty it.”b. “I should empty the bag at least three times a day.”c. “I should empty the bag when it’s about one – third or one – half full.”d. “I’ll let my wife empty it. She doesn’t mind.”

2. It is important for you to teach him to care for the skin around the stoma by _____a. Avoiding the use of soap and other irritating agentsb. Rinsing with hydrogen peroxide and applying a gauze padc. Pouring saline over the stoma and wiping away the fecal matterd. Washing the area gently with soap and water before applying an appliance

3. You also teach him how to apply the colostomy bag. How much skin should remain exposed between the stoma and the ring of the bag?a. One – eight inch c. One – half inchb. One – fourth inch d. One inch

4. He asks you, “Will I ever be able to swim again?” Your best response would be _____a. “Yes, you should be able to swim again, even with the colostomy.”b. “You should avoid immersing the colostomy in water.”c. “No, you should avoid getting the colostomy wet.”d. “Don’t worry about that. You will be able to live just like you did before.”

5. You know your dietary teaching is effective when hestates, “It is important that I eat _____

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a. Food low in fiber so that there is less stool.”b. Bland foods so that my intestines do not becomeirritated.”c. Everything I ate before the operation andavoiding foods that cause gas and foul – odor.”d. Soft foods that are more easily digested and absorbedby my large intestine.”

F O C U S: Discharge instructions for a client who has been operated on for colorectal cancer include irrigating the colostomy.

1. When do you plan to teach him to irrigate a colostomy?a. The stool starts to become formedb. He can lie on the side comfortablyc. The abdominal incision is closed and contamination is no longer a dangerd. The perineal wound heals and he can sit comfortably on the commode

2. When preparing to teach him to irrigate a colostomy, you should plan to perform the procedure _____a. Several hours before visitorsb. Prior to eating food in the morningc. After he accepts the alteration in body imaged. When he would usually have had a bowel movement

3. When observing a return demonstration of a colostomy irrigation, you know that further teaching is required if he _____a. Clamps off the flow of fluid when feeling uncomfortableb. Lubricates the tip of the catheter prior to inserting it into the stomac. Discontinues the insertion of fluid after only 500 mL of fluid has been instilledd. Hangs the irrigation bag on the bathroom door clothes hook during fluid insertion

4. You know your teaching is effective when he states he’ll contact the physician if _____a. He notices a loss of sensation to touch in the stomab. He has difficulty inserting the irrigation tube into the stomac. He experiences abdominal cramping while the irrigant is infusingd. He expels flatus while the return is running out

5. When comparing the procedures of a colostomy irrigation and an enema, you understand an intervention that is unique to a colostomy irrigation is _____a. Positioning the client for evacuation of the bowelb. Lubricating the catheter tip with a water – soluble jellyc. Using a cone – shaped tip for the end of the instillation catheterd. Clearing the tubing of air before insertion of the irrigating solution

THERAPEUTIC DIETS

Situation: You are brushing up on the most commonly asked therapeutic diets in the NLE.

1. You are aware that a client can be placed on a clear liquid diet for a maximum of how many days?a. 1 b. 2 c. 3 d. 4

2. A client is placed on a low – residue diet before bowel surgery. You teach him that it is necessary to _____a. Lower the bacterial count in the GI tract c. Prevent irritation of the intestinal mucosab. Limit production of flatus in the intestine d. Reduce the amount of stool in the large bowel

3. What is the best snack for a client requiring increased potassium?a. Pear b. Apple c. Orange d. Banana

4. A vegan is at risk for which nutritional deficiency?a. Vitamin B3 b. Vitamin B6 c. Vitamin B9 d. Vitamin B12

5. Diet therapy for urinary calculi of calcium phosphate would probably be _____a. High calcium and phosphorus, acid – ash c. Low calcium and phosphorus, acid – ashb. High calcium and phosphorus, alkaline – ash d. Low calcium and phosphorus, alkaline – ash

F O C U S: A client is placed on a 2 – gram – sodium diet.

1. How much added salt is allowed per day?a. ½ tbs b. ½ tsp c. ¼ tbs d. ¼ tsp

2. Which food group is lowest in sodium?a. Meats c. Fresh fruitsb. Dairy products d. Fresh vegetables

3. You teach him that salt – substitutes cannot be used in the diet because _____a. A person’s body tends to retain fluid when a salt substitute is included in the dietb. Limiting salt substitutes in the diet prevents a build – up of waste products in the blood

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c. Salt substitutes contain potassium, which must be limited to prevent abnormal heartbeatsd. A substance in the salt substitute interferes with the transfer of fluid across capillary membranes, resulting

in anasarca

4. The food label says “sodium – free”. What does it mean?a. Sodium is less than 3 g per serving c. Sodium is less than 5 g per servingb. Sodium is less than 3 mg per serving d. Sodium is less than 5 mg per serving

5. The food has 500 mg of sodium per serving. The same food prepared “light in sodium” would have:a. 375 mg of sodium c. 150 mg of sodiumb. 250 mg of sodium d. 100 mg of sodium

THERAPEUTIC COMMUNICATION

1. Paranoid patient tells the nurse on psyche unit “The food is poisoned.” What’s the appropriate response of the nurse?a. “The dietitian prepares the food. They won’t put anything that will harm the patient.”b. The other patients eat the same food and no ill effects are noted.c. “Have you found anything unusual in the food?”

SUCTIONING

Situation: You have decided to perform nasopharyngeal suctioning for a conscious client who is unable to cough up and expectorate secretions.

1. Before doing this procedure, you should place him in which position?a. Semi – Fowler with the neck hyper extended c. Semi – Fowler with the head turned to one sideb. Lateral facing to you d. Lateral facing away from you

2. You should make an approximate measure of the depth for the insertion of the catheter. As such, you should measure the distance between _____a. The tip of his nose and the umbilicus c.The tip of his nose and the suprasternal notchb. The tip of his nose and the xiphoid process d. The tip of his nose and the earlobe

3. While doing this procedure, you can avoid trauma to the mucous membrane by _____a. Putting on the sterile gloves c. Applying no suction while inserting the catheterb. Lubricating the catheter tip d. Wiping off the catheter with sterile gauze

4. Which action is safe?a. Insert the catheter approximately 20 cm while applying suctionb. Allow 20 – 30 sec intervals between each suction and limit suctioning to a total of 15 minc. Gently rotate the catheter while applying suctiond. Apply suction for 5 sec while inserting the catheter and continue for another 5 sec before withdrawing

5. Which finding would most likely indicate that the procedure is effective?a. Respirations unlabored c. Decreased mucus productionb. Hollow sound on chest percussion d. Breath sounds clear on auscultation

F O C U S: You are preparing to suction an adult’s tracheostomy tube.

1. Which set of personal protective equipment (PPE) would you wear to perform this procedure?a. Gown, mask, and sterile gloves c. Mask, gown, and a capb. Goggles, mask, and sterile gloves d. Mask, sterile gloves, and a cap

2. What is the recommended pressure setting for suctioning his tracheostomy tube?a. 40 – 60 mm Hg c. 100 – 120 mm Hgb. 60 – 80 mm Hg d. 120 – 140 mm Hg

3. You should hyperoxygenate his lungs using a manual resuscitation bag basically because he doesn’t have copious amounts of secretions and thus you should compress it _____a. 1 – 3 times, as he inhales c. 1 – 3 times, as he exhalesb. 3 – 5 times, as he inhales d. 3 – 5 times, as he exhales

4. What is the maximum amount of time you should suction his tracheostomy tube?a. 10 seconds b. 15 seconds c. 25 seconds d. 30 seconds

5. You should use intermittent suction primarily to help prevent _____a. Stimulating his cough reflex c. Dislodging his tracheostomy tubeb. Depriving him of sufficient oxygen supply d. Obstructing the catheter with secretions

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ASSESSMENT

1. Which of the following times is ideal to assess a client’s respirations?a. Immediately after taking his body temperatureb. Immediately after taking his pulse rate c. Immediately after taking his blood pressured. Anytime during the assessment

2. Which of the following components should receive the highest priority before a physical assessment?a. Physical preparation of the clientb. Preparation of the environment

c. Psychological preparation of the client d. Preparation of the equipment

3. Utilizing the SOAP charting, the nurse would record her nursing diagnosis under which of the following? a. S – Subjective

b. O – Objectivec. A – Assessmentd. P – Planning

4. In assessing adult vital signs, the nurse performs which of the following techniques?a. Inspection, Palpation, Percussionb. Palpation, Percussion, Auscultation

c. Percussion, Auscultation, Inspectiond. Auscultation, Inspection, Palpation

5. Which method for assessing temperature is the least accurate?a. Oral b. Rectal

c. Axillary d. Tympanic

6. Which type of nursing diagnosis is one in which evidence about a health problem is incomplete or unclear which requires more data either to support or to refute it?a. Wellness diagnosis b. Risk nursing diagnosis

c. Actual diagnosisd. Possible nursing diagnosis

7. Which statement describes what a nursing diagnosis does?a. It provides a systemic, rational method of planning and providing nursing careb. It facilitates a comprehensive nursing care by identifying the health problem and validating the contributing factorc. It includes assessment, diagnosis, planning, implementation, and evaluationd. It provides a framework for nurse accountability and responsibility

DISCHARGE

1. Which of the following times is ideal to begin discharge planning?a. 24 hours after dischargeb. The day before discharge

c. At the time of admissiond. When the patient desires

2. Before discharge, Mang Nash sister will demonstrate how to use the glucometer correctly. This is an example of what kind of objective:

a.Cognitive b. Long term c. Effective d. Psychomotor

3. Before Rose is discharged she will be able to explain the pathophysiology of her illness and the different foods to be avoided. This is an example of which learning objective?

a. Management b. Psychomotor c. Affective d. Cognitive

4. Most nurses regard this as conventional recording of the date, time, and mode by which the patient leaves a healthcare unit but this record includes importantly, directs of planning for discharge that starts soon after the person is admitted to a healthcare institution. It is accepted that collaboration or multidisciplinary involvement (of all members of the health team) in discharge results in comprehensive care. What do you call this?a. Discharge Summary c. Medicine and Treatment Recordb. NursingKardex d. Nursing Health History and Assessment Worksheet

SATA ON CHARTING

1. Which of the following qualities are relevant in documenting client care?1. accuracy and conciseness2. thoroughness and currentness3. systematic and orderly4. legibly, properly dated and signed5. use of locally accepted abbreviation

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a. 2, 3, 4 and 5b. 1, 2, 3 and 4

c. 1, 2, 3 and 5d. 1, 3, 4 and 5

2. While the nurse was doing her rounds, she discovered that a client is lying on the floor. Which of the following statements should appear in the documentation?Select all that apply:

A. The client is found on the floorB. The client probably fell from the bedC. The vital signs have been checked

D. The doctor has been notifiedE. The client is now in a safe environment

HANDLING HAZARDOUS MATERIALS

1. What could be used to minimize electrical hazard in the hospital?a.Frayed cordb.Two pronged plug

c. Three pronged plugd. Open wirings

2. The most common hazard associated with electricity in a procedure room isa. Fire b. Burns c. Electric shock d. All of the above

3. Which of the following is a lead poisoning prevention discharge instruction?A. Use cold water for drinking.B. Prevent washing of clothes using washing machine.C. No sharing of clothes with siblings.D. Avoid undergoing multiple invasive procedures.

Rationale: Water that comes out of the tap warm or hot can contain much higher levels of lead.

TUBE FEEDINGS

Situation: You are preparing to administer enteral tube feedings.

1. You are preparing to administer continuous feedings. The formula should be administered using _____a. Infusion pump c. Intravenous filterb. Gravity drip d. Three – way stop – cock

2. What is the correct position for administering enteral tube feedings?a. Keep the head of the bed flat c. Place him in a left – lying positionb. Elevate the head of the bed 30 – 45º d. Raise the foot of the bed 10 - 20º

3. You determine that the nasogastric tube is properly positioned after obtaining which pH reading?a. 4 b. 6 c. 7 d. 8

4. He is to receive 200 mL of tube feedings every 4 hours. You check for his gastric residual before administering the next scheduled feeding and obtain 40 mL of gastric residual, what is your most appropriate nursing intervention?a. Withhold the feeding and then recheck the residual after 1 hourb. Dispose of the residual and continue with the feedingc. Delay feeding him for 1 hour and then recheck the residuald. Re – administer the residual to him and continue with the feeding

5. He has developed diarrhea, cramps, and abdominal distention. All but which are appropriate nursing interventions?a. Make sure to change the feeding apparatus every 24 hrb. Use a higher volume of formula because the formula may be too hypotonicc. Slow the administration rated. Use a diluted formula gradually increasing the volume and concentration

TPN

Situation: You are caring for a client who’s receiving parenteral nutrition.

1. What is the lowest amount of glucose considered safe and not caustic to small veins that will also provide adequate TPN when administering TPN through a peripheral IV line?a. 5% b. 10% c. 15% d. 17%

2. You notice that the bag of TPN solution has been infusing for 24 hours but has 300 mL of solution left. What would be your most appropriate nursing action?a. Continue the infusion until the remaining 300 mL is infusedb. Change the filter on the tubing and continue with the infusion

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c. Notify the physician and obtain orders to alter the flow rate of the solutiond. Discontinue the current solution, change the tubing, and hang a new bag of TPN solution

3. You note that the bag of TPN solution has become empty. You call the pharmacy, but the next bag will not be delivered for another 30 minutes. You hang which solution until the TPN arrives?a. D5W b. D10W c. D50NS d. D5NS

4. Which observation best indicates he is having the desired therapeutic effects from TPN?a. He has regular bowel movements c. He is gaining weightb. He maintains blood sugars in the normal range d. He has normal urine output

5. If the TPN were abruptly discontinued, you would expect him to exhibit _____a. Tinnitus, vertigo, blurred vision c. Diaphoresis, confusion, tachycardiab. Fever, malaise, anorexia d. Hyperpnea, flushed face, diarrhea

F O C U S:

Peripheral Line

basilic or cephalic vein

used for 1 – 2 weeks

dextrose concentration in the solution is 10% (to avoid irritation of blood vessel walls, phlebitis, and sclerosis)

Central Line

subclavian or jugular vein

used for > 2 weeks

dextrose concentration in the solution is > 10%

Central Venous Access Devices (CVADs)

Triple lumen catheter → “common”

18 G middle lumen used for TPN infusion

used when TPN needed ≤ 4 weeks

Peripherally inserted central catheter (PICC) → “increasingly popular”

inserted into peripheral vein and advanced to superior vena cava

used when TPN needed > 4 weeksBLOOD TRANSFUSION

F O C U S: Blood Group and Rh Type Compatibilities

Blood Group Can be donor for Can be recipient ofO O, A, B, AB OA A, AB O, AB B, AB O, B

AB AB O, A, B, AB

Rh Type Can be donor for Can be recipient of+ + +, –– +, – –

Universal Donor → _____

Universal Recipient → _____

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Situation: You have received an order to transfuse a client with one unit of packed red blood cells (RBCs).

1. You should use an IV access device of which size?a. 18 G b. 21 G c. 23 G d. 25 G

2. You are aware that the tubing is manufactured with which of the following?a. A microdrip chamber c. An in – line filterb. An air vent d. Tinting that protects blood from exposure to light

3. You would obtain which IV solution to hang with the unit of blood?a.Ringer’s lactate c.5% dextrose in 0.45% sodium chlorideb.5% dextrose in 0.9% sodium chloride d.0.9% sodium chloride

4. You must check the name on the label of the blood with the name on his _____a. Wristband c. Medical chartb. Wristband in the presence of another nurse d. Medication administration record (MAR)

5. You should stay with him for how long when the unit of blood is hung?a. 5 minutes b. 15 minutes c. 30 minutes d. 45 minutes

F O C U S: Transfusion Reaction

Type CauseHypersensitivity antibodies in donor blood

Febrile nonspecificHemolytic blood incompatibility

1st→ STOP transfusion

2nd→ KVO with infusion of normal saline (0.9% Na Cl)

Assess client and measure VS as often as every 5 minutes

Situation: You are preparing to administer a unit of packed red blood cells (RBCs) on a client.

1. You and another nurse have confirmed that it is the correct blood for him. Immediately prior to starting the blood transfusion, you should assess which of the following?a. Vital signs c. Hemoglobin levelb. Skin color d. Creatinine clearance

2. What is the average time for infusing a unit of packed red blood cells (RBCs)?a. 30 minutes b. 1 – 2 hours c. 2 – 4 hours d. 4 – 6 hours

3. Shortly after the transfusion is started he complains of lower back pain. Which transfusion reaction is he probably experiencing?a. Hypersensitivity c. Hemolyticb. Febrile d. Bacterial

4. The blood bag and a urine specimen are sent to the laboratory. The reason for sending a urine specimen to the laboratory is to test for _____a. Specific gravity c. Carboxyhemoglobinb. Free hemoglobin d. Disseminated intravascular coagulation

5. You document the event according to hospital policy and do which action with the remainder of the blood that has not been transfused?a. Discards the blood in the appropriate biohazard bagb. Returns the blood to the blood bankc. Sends the blood to the chemistry laboratory for analysisd. Sends the blood to the infection control department

TYPES OF IVFs

Situation: You are preparing to start an intravenous infusion on a newly admitted client.

1. Which area should you try first?a. Back of the hand c. Inner aspect of the forearmb. Inner aspect of the elbow d. Outer aspect of the forearm

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2. Before inserting the needle into a vein, you would apply a tourniquet on his arm to accomplish which of the following?a. Distend the veins c. Immobilize the armb. Stabilize the veins d. Occlude arterial circulation

3. When should you remove it?a. When the skin has been cleansedb. As soon as the needle is in veinc. As soon as the needle is positioned under the skind. When the needle has been secured with tape

4. You have successfully inserted the needle into a vein. A few hours later, while assessing his intravenous insertion site, you note that the area is swollen, cool, pale, and causes him discomfort. You document which complication of intravenous therapy?a. Local infiltration b. Phlebitis c. Infection d. Air embolism

5. Which action should you take first?a. Discontinue the intravenous infusionb. Apply a warm, moist compress to the intravenous sitec. Check the intravenous infusion for patencyd. Apply an ice pack to the intravenous site

ISOLATION PRECAUTION

Situation: The Hospital Infection Control Practices Advisory Committee (HICPAC) of the CDC presented new guidelines for isolation precautions in hospitals in 1996. These guidelines designate two tiers of precautions: Tier 1: Standard Precautions and Tier 2: Transmission – Based Precautions.

1. Isolation Precautions break the chain of infection by interfering with which link?a. Etiologic Agent c. Mode of Transmissionb. Portal of Exit d. Susceptible Host

2. Which 2 phrases are true about Airborne Precautions?I. Less than 5 micronsII. More than 5 micronsIII. Remains in the airIV. Settles to the floor

a. I III b. II III c. I IV d. II IV

3. Which 2 phrases are true about Droplet Precautions?I. Less than 3 feetII. More than 3 feetIII. Wear a mask at all timesIV. Wear a mask only when working within 3 feet of the client

a. I III b. II III c. I IV d. II IV

4. Which type of mask is appropriate for you to use when caring directly for clients placed on Airborne Precautions?a. Gas mask c. N – 95 maskb. Surgical mask d. Any mask as long as you can breathe normally

5. When caring for a client with diphtheria, you know that which type of precautions is required?a. Airborne Precautions c. Contact Precautionsb. Droplet Precautions d. Standard Precautions

F O C U S: You are admitting an immunocompromised client with cancer.

1. You would consider implementing neutropenic precautions when white blood cell (WBC) count is _____a. 10,500/mm3 b. 7,650/mm3 c. 6,000/mm3 d. 2,000/mm3

2. You understand precautionary measures necessary when you admit him to which room?a. A semiprivate room with a client who has pneumoniab. A private room with contact isolationc. A private room with protective isolationd. A private room with no isolation precautions

3. You should be aware that “Risk for Infection” is high when white blood cell (WBC) count is _____a. Normal b. Low c. Moderate d. High

4. You recognize that which is the most reliable early indicator of infection in a neutropenic client?a. Fever b. Chills c. Tachycardia d. Tachypnea

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5. During evening visitation, a visitor brings in a fruit basket. What is your best action?a. Allow him to keep the fruitb. Place the fruit next to the bed for easy access by himc. Offer to wash the fruit for himd. Remove the fruit from his room

NURSING PROCESS

Situation: The nursing process has unique characteristics that enable responsiveness to the changing health status of the client.

1. Which range of applications does the nursing process have?a. Narrow b. Exact c. Distinct d. Broad

2. Which type of assessment is used to collect data about a specific problem that has been identified in an earlier assessment?a. Initial assessment c. Time – lapsed reassessmentb. Focus assessment d. Emergency assessment

3. Which type of nursing diagnosis is one in which evidence about a health problem is incomplete or unclear which requires more data either to support or to refute it?a. Wellness diagnosis c. Actual diagnosisb. Risk nursing diagnosis d. Possible nursing diagnosis

4. Which is the “product” developed during the planning phase of the nursing process?a. Nursing care plan c. Nursing historyb. Nursing diagnoses d. Nursing notes

5. You do which task in the implementing phase of the nursing process?a. Determines the client’s health status c. Measures goal achievementb. Identifies available resources d. Puts the nursing care plan into action

IMCI

1. Which of the following is not a danger sign?A. Convulsions B. Inability to drink or breastfeed C. lethargy D. difficulty breathing

2. The first child who is 13 months has fast breathing, using IMCI parameters he has:A. 40 breaths per minute or more B. 50 breaths per minute or more

C. 30 breaths per minute or moreD. 60 breaths per minute or more

3. The following follow up questions will be used if the child presents with history or feels hot or with temperature of 37.50C and above, except for:

A. If fever is present, then for how long?B. If more than 7 days, has fever been present everyday?C. Has the child had measles for the past 6 months? D. Does the child have stiff neck?

4. On assessment, her cornea is cloudy with extensive mouth ulcers. Mrs.Alcantara exclaims she can’t get her to eat anything and she is deeply worried about her child. Mio’s condition is classified as:

A. Severe complicated measles B. Measles with eye or mouth complicationsC. MeaslesD. Complicated measles

5. The main parameter in classifying a child under the pink row of ear problems is:A. Pus seen draining form the ears for more than 14 days.B. Severe pain in the ear.C. Tender swelling behind the ear . D. Ear discharges for less than 14 days with fever.

ETHICS

1. Based on the Code of Ethics for Filipino Nurses, what is regarded as the hallmark of nursing responsibility and accountability?

A. Health, being a fundamental right of every individualB. Accurate documentation of actions and outcomesC. Human rights of clients, regardless of creed and genderD. The privilege of being a registered professional nurses

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2. A nurse is asked to keep the client’s cancer progression from family members indefinitely. This will require the nurse to withhold information from the client’s spouse, who frequently accompanies the client to the theory of Kantianism?

a. The nurse persuades the client to tell the family because it is the right thing to dob. The nurse considers multiple ethical principles and supports the client in telling the family, as should

be done universally is such a situationc. The nurse remembers the ethical rule of truth telling and decides to tell the client’s spouse is secretd. The nurse considers multiple ethical principles and does not tell the family, because client confidentiality is of primary importance

3. After the physician explains the surgery to the client, the nurse provides the client with information about surgery, answers the client’s questions, and allows the client to agree or refuse to have surgery. Which of the following ethical principles is best described by the nurse’s actions?

a. Nonmaleficence b. Beneficence c. Truth telling d. Autonomy

4. The nurse informs a young, healthy client that the scarce amount of flu vaccine will be given to older clients and those with immunosuppressed responses first. Which of the following ethical principles is best described by the nurse’s statement?

a. Beneficence b. Autonomy c. Justice d. Nonmaleficence

5. The nurse returns to the client’s room in exactly four hours to administer the next dose of pain medication as promised. Which of the following ethical rules is best demonstrated by the nurse?

a. Justice b. Nonmaleficence c. Fidelity d. Confidentiality

RESEARCH

1. Deriving a propositional statement from theory involves the logical reasoning process called;A. Deductive B. Conceptualization

C. InductionD. Critical analysis

2. “A set of shared understandings and assumptions about reality and the world” is a definition forA. A concept

B. A conceptual frameworks C. A practice discipline D. A paradigm

3. The conclusions of a study are based on theA. Findings of the study C. Implications of the studyB. Review of the literature D. Recommendations for future research

4. A new public health nurse would like to collect data on common problems encountered by diabetic patients in the community. In this survey, she selects only the diabetic patients in the community. In this survey, she selects only the diabetic residing in the different barangays of the community where she was assigned. This is an example of what type of sampling?

a. Purposive b. Cluster c. Systematic d. Stratified

5. Which of the following items distinguishes true experimental research from quasi- experimental research?A. Size exampleB. The use of a nonprobability sampleC. Random assignments of subjects to groupsD. The introduction of an experimental treatment

COMMUNICATION

1. Before making an initial contact with the clients, the nurse decides to review their individual medical records. This phase of the nurse – patient relationship could best be referred to as the:a. Pre – interaction phaseb. Orientation phase

c. Working phased. Termination phase

2. In demonstrating the method for deep breathing exercises, the nurse places the hands on the client’s abdomen to explain diaphragmatic movement. This technique involves the use of which element of communication?a. Messageb. Feedback

c. Appropriatenessd. Channel

3. Communication can be verbal and non – verbal. Examples of non – verbal communication in nurse – client relationship are the following except:a. using a sign language interpreter like a family memberb. signsc. restlessnessd. symptoms

4. Interpersonal communication is least threatening during what type of relationship?a. Intimateb. Social

c. Professionald. Personal

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5. Which of the following nursing interventions would be most appropriate for facilitating communication with a client who has hearing impairment?a. When speaking, stand to one side of the client and direct the voice directly into the client’s earb. Stand close to the client and speak as loudly as possiblec. Stand in front of the client and speak slowly and clearlyd. Ask only questions that the client can answer with a “yes” or “no” response

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