WHAT YOU SHOULD KNOW BEFORE THE PNLE

JULY 2012 PNLE PEARLS OF SUCCESS

PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH
(PALMER)

POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE
*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students
on the possible topics that might be part of the upcoming July 2012 PNLE
PROFESSIONAL ADJUSTMENT/ NURSING JURISPRUDENCE

A. Patients Bill of Rights

The patient has the right to considerate & respectful care,
irrespective of socio-economic status.
The patient has the right to obtain from his physician
complete current information concerning his diagnosis,
treatment and prognosis in terms the patient can reasonably
be expected to understand.
The patient has the right to receive from his physician
information necessary to give informed consent prior to start
of any procedure and or treatment (except in emergencies).
The patient has the right to refuse treatment / life-giving
measures, to the extent permitted by law and to be informed
of the medical consequence of his action.
The patient has the right to every consideration of his
privacy concerning his own medical care program. Case
discussion, consultation, examination and treatment are
confidential and should be conducted discreetly.
The patient has the right to expect that all communication
and records pertaining to his care should be treated as
confidential.
The patient has the right that within its capacity, a hospital
must make reasonable response to the request of patient for
services.
The patient has the right to obtain information as to any
relationship of the hospital to other health care and to other
health care and educational institutions in so far as his care
is concerned.
The patient has the right to refuse or participate in such
research projects.
The patient has the right to expect reasonable continuity of
care.
The patient has the right to examine and receive an
explanation of his bill regardless of source of payment.
The patient has the right to know what hospital rules and
regulations apply to his conduct as a patient.

B. Nursing as a Profession
Nursing is a profession. A profession possesses the following
primary characteristics:
Education, requires an extended education of its
members, as well as basic liberal foundation.
Theory, has a theoretical body of knowledge leading to
defined skills, abilities and norms.
Service
Autonomy
Code of ethics
Caring

C. Organization of the Board of Nursing

The Board is composed of a Chairperson and six (6)
members
That the membership to the Board shall represent the
three (3) areas of nursing, namely: nursing education,
nursing service and community health nursing.
The Chairperson and Members of the Board shall
possess the following qualifications:
Be a natural born citizen and resident of the Philippines
Be a member of good standing of the accredited
professional organization of nurses;
Be a registered nurse and holder of a master's degree in
nursing, education or other allied medical profession
conferred by a college or university duly recognized by
the Government: Provided, That the majority of the
members of the Board shall be holders of a master's
degree in nursing: Provided, further, That the Chairperson
shall be a holder of a master's degree in nursing;
Have at least ten (10) years of continuous practice of the
profession prior to appointment: Provided, however, That
the last five (5) years of which shall be in the
Philippines; and
Not have been convicted of any offense involving moral
turpitude

The Board shall supervise and regulate the practice of
the nursing profession and shall have the following
powers, duties and functions: CIMECPRP
Conduct the licensure examination for nurses;
Issue, suspend or revoke certificates of registration for
the practice of nursing;
Monitor and enforce quality standards of nursing practice
in the Philippines.
Ensure quality nursing education
Conduct hearings and investigations to resolve
complaints against nurse practitioners
Promulgate a Code of Ethics
Recognize nursing specialty organizations in
coordination with the accredited professional
organization
Prescribe, adopt issue and promulgate guidelines,
regulations, measures and decisions as may be necessary
for the improvements of the nursing practice

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.

D. Licensure Examination

In order to be admitted to the examination for nurses, an
applicant must, at the time of filing his/her application,
establish to the satisfaction of the Board that:
He/she is a citizen of the Philippines, or a citizen or
subject of a country which permits Filipino nurses to
practice within its territorial limits on the same basis as
the subject or citizen of such country: Provided, That the
requirements for the registration or licensing of nurses in
said country are substantially the same as those
prescribed in this Act;
He/she is of good moral character; and
He/she is 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.

In order to pass the examination, an examinee must
obtain a general average of at least seventy-five
percent (75%) with a rating of not below sixty
percent (60%) in any subject.
An examinee who obtains an average rating of seventy-
five percent (75%) or higher but gets a rating below sixty
WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY 2012 PNLE PEARLS OF SUCCESS

PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH
(PALMER)

POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE
*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students
on the possible topics that might be part of the upcoming July 2012 PNLE
percent (60%) in any subject must take the examination
again but only in the subject or subjects where he/she is
rated below sixty percent (60%).
In order to pass the succeeding examination, an examinee
must obtain a rating of at least seventy-five percent
(75%) in the subject or subjects repeated.

A special/temporary permit may be issued by the Board
to the following persons subject to the approval of the
Commission and upon payment of the prescribed fees:
Licensed nurses from foreign countries/states whose
service are either for a fee or free if they are
internationally well-known specialists or outstanding
experts in any branch or specialty of nursing;
Licensed nurses from foreign countries/states on
medical mission whose services shall be free in a
particular hospital, center or clinic; and
Licensed nurses from foreign countries/states employed
by schools/colleges of nursing as exchange professors
in a branch or specialty of nursing;

The Board shall have the power to revoke or suspend the
certificate of registration/professional license or cancel
the special/temporary permit of a nurse upon any of the
following grounds:
Person convicted by final judgment of any criminal
offense involving moral turpitude or any person guilty of
immoral or dishonorable conduct or any person declared
by the court to be of unsound mind
For unprofessional and unethical conduct;
For gross incompetence or serious ignorance;
For malpractice or negligence in the practice of nursing;
For the use of fraud, deceit, or false statements in
obtaining a certificate of registration/professional license
or a temporary/special permit;
For violation of this Act, the rules and regulations, Code of
Ethics for nurses and technical standards for nursing
practice, policies of the Board and the Commission, or the
conditions and limitations for the issuance of the
temporarily/special permit; or
For practicing his/her profession during his/her
suspension from such practice;

E. Nursing Education and Practice

A member of the faculty in a college of nursing teaching
professional courses must:
Be a registered nurse in the Philippines;
Have at least one (1) year of clinical practice in a field of
specialization;
Be a member of good standing in the accredited
professional organization of nurses; and
Be a holder of a master's degree in nursing, education, or
other allied medical and health sciences conferred by a
college or university duly recognized by the Government
of the Republic of the Philippines.
In addition to the aforementioned qualifications, the dean
of a college must have a master's degree in nursing.
He/she must have at least five (5) years of experience in
nursing.

A person occupying supervisory or managerial positions
requiring knowledge of nursing must:
Be a registered nurse in the Philippines;
Have at least two (2) years experience in general nursing
service administration;
Possess a degree of Bachelors of Science in Nursing, with
at least nine (9) units in management and administration
courses at the graduate level; and
Be a member of good standing of the accredited
professional organization of nurses;
Provided, That a person occupying the position of chief
nurse or director of nursing service shall, in addition to
the foregoing qualifications, possess:
At least five (5) years of experience in a supervisory or
managerial position in nursing; and
A master's degree major in nursing


F. Laws Affecting Nursing Profession

PD 442 Labor Code
PD 651 Birth registration following delivery (all health
workers shall identify and encourage the
registration of all births within 30 days
following delivery)
PD 825 Anti- improper garbage disposal
PD 856 Code of Sanitation
PD 996 Compulsory immunization for all children
below eight (8) years old against six (6)
immunizable diseases
EO 51 Milk Code
RA. 1136 Tuberculosis Law
RA. 3573 Reporting communicable Disease
RA. 4073 Liberalized the treatment of Leprosy
RA. 6425 Dangerous Drug Act the sale, administration,
delivery, distribution and transportation of
prohibited drugs is punished by law.
RA. 6675 Generics Act of 1988 this promotes, requires
and ensures the production of an adequate
supply, distribution, use an acceptance of
drugs and medicines identified by their generic
names.
RA. 7160 Local Government Code
RA. 7170 Organ Donation Law
RA. 7277 Magna Carta for Disabled persons
RA. 7305 Magna Carta for Public Health workers
RA. 9257 Expanded Senior Citizen Act of 2003
RA. 7600 Rooming In and Breast feeding Act
RA. 7610 Anti-Child Abuse Law
RA. 8172 Asin Law / Iodize Salt Law
RA. 8423 Traditional and Alternative Medicine Act
RA. 8504 Philippine AIDS Prevention and Control Act
RA. 8976 Food Fortification Act
RA. 9173 The Nursing Act of 2002

G. Inform Consent
Requisites for Validity of Informed Consent
Written permission is best and legally accepted.
To ensure that the client understand the nature of the
treatment including the potential complications and
disfigurement (explained by AMD)
Signature is obtained with the clients complete understanding
of what to occur.
- adult sign their own operative permit
- obtained before sedation
For minors, parents or someone standing in their behalf,
gives the consent.
Note: for a married emancipated minor parental consent is not
needed anymore, spouse is accepted
For mentally ill and unconscious patient, consent must be
taken from the parents or legal guardian
WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY 2012 PNLE PEARLS OF SUCCESS

PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH
(PALMER)

POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE
*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students
on the possible topics that might be part of the upcoming July 2012 PNLE
If the patient is unable to write, an X ia accepted if there is
a witness to his mark
Secured without pressure and threat
A witness is desirable nurse, physician or authorized
persons.
When an emergency situation exists, no consent is necessary
because inaction at such time may cause greater injury.
(permission via telephone/cellphone is accepted but must be
signed within 24hrs.)


H. Living Will
It is a legal declaration of a persons intentions upon
death.
The nurse should note the soundness of the patients
mind and that there was free from fraud or undue
influence and that the patient was above 18 years or of
age.
The patient should write that the will was signed by the
testator, that the witnesses were all present at the same
time and signed the will I the presence of the testator.
Advance Directive
Signed request to be allowed to die when life can be
supported only mechanically or by heroic measures
Includes the decision to accept or refuse any treatment,
service or procedure used to diagnose or treat his/her
physical or mental condition and decisions to provide

Health Care Proxy
The patient designates a health care representative,
usually a member of the family, a friend or a family
physician to make decisions for him/her when he/she is
unable, due to physical or mental incapacity, accept or
refuse treatment, service or procedure used to diagnose
or treat his/her physical or mental condition and
decisions to provide, withhold or withdraw life sustaining
measures

I. Negligence

NEGLIGENCE refers to the commission or omission of
an act, pursuant to a duty, that a reasonably prudent
person in the same or similar circumstance would or
would not to, and acting or the non-acting of which is the
proximate cause of injury to another person to his
property.
Elements of Negligence:
Existence of a duty on the part of the person charged
Failure to meet the standard of due care
Harm resulting from failure to meet the standard
Specific examples of Negligence:
Failure to report observations to attending Physicians
Failure to exercise the degree of diligence which the
circumstances of the particular case demands
Mistaken Identity
Wrong medicine, wrong concentration, wrong route,
wrong dose
Defects in the equipment such as stretchers and
wheelchairs may lead to falls thus injuring the patients
Errors due to family assistance





Doctrine of Negligence
1. RES IPSA LOQUITOR
the things speak for itself - the injury is enough proof of
negligence
2. RESPONDEAT SUPERIOR
Let the master answer for the acts of the subordinate
The liability is expanded to include the master as well as the
employee
3. FORCE MAJEURE
Irresistible force; unforeseen or inevitable event
No person shall be responsible for those events which cannot be
foreseen
Ex. Flood, fire, earthquake

J. Malpractice
Doing acts or conducts that are not authorized or licensed
or competent or skilled to perform, resulting to injuries or
non-injurious consequences
Stepping beyond ones authority
RN exceeding the scope of nursing practice & does an
MDs job.

K. Torts
Assault is a unjustifiable attempt to touch another
person or even the threat of doing so
Battery is the actual carrying out of the threatened
physical contact
Defamation of character occurs where a person
discusses another individual in terms that diminish
reputation. Libel is written defamation. Slander is oral
Defamation
False Imprisonment it is making someone wrongfully
feel that he or she cannot leave the place.

L. Restraints
Restraints are protective devices used to limit the physical
activity of a client or to immobilize a client or an
extremity.
R-equires physicians order; consent
E-mergency, get MDs order ASAP
S-hortest duration, least restrictive type
T-o protect pt. and others
R-enew order every 24 hours
A-ssess every 15 to 30 minutes and document
I-ndividualized supervision
N-ever used as a punishment
T-otal documentation
S-eclusion as last step

M. Crimes
Conspiracy to commit a crime:
Principals- are those who take a direct part in the
execution of the act, whos directly force or induce others
to commit it; or who cooperate in the commission of the
offense by another act without which it would not have
been accomplished.
Accomplices- are those who, not being principals,
cooperate in the execution of the offense by previous and
simultaneous act.
Accessories- are those who, having the knowledge of the
commission of the crime. Assisting the offender to profit
from the crime either by disposing the body, concealing
or assisting in escape of the principal of the crime.

WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY 2012 PNLE PEARLS OF SUCCESS

PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH
(PALMER)

POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE
*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students
on the possible topics that might be part of the upcoming July 2012 PNLE
Degree of the acts of execution:
Consummated- when all the elements necessary for its
execution and accomplishment are present.
Frustrated- when the offender performs all the acts or
execution which will produce the felony as a consequence
but which nevertheless, do not produce it by reason of
causes independent of the will of the perpetrator.
Attempted- when the offender commences the
commission of the same directly by overt acts, and does
not perform the acts which shall produce the felony.



LEADERSHIP AND MANAGEMENT

A. Leadership Style

Authoritarian leadership style or autocratic leader
keeps strict, close control over followers by keeping
close regulation of policy and procedures given to
followers.
Democratic leadership style consists of the leader
sharing the decision-making abilities with group
members by promoting the interests of the group
members and by practicing social equality.
Laissez faire style is sometimes described as a
"hands off" leadership style because the leader
delegates the tasks to their followers while providing
little or no direction to the followers

Transactional Leadership Transformational
Leadership
Focuses on management
task
Identify common values
Caretaker Is committed
Uses trade-offs to meet
goals
Inspires other with vision
Shared values not identified Has a long term vision

Examines causes Looks at effect
Uses contingency reward Empowers other



RESEARCH

A. Types of Research

Basic / Pure Research, it is done for the intellectual pleasure
of learning to search for knowledge for its own sake and
eventually filter down the result into real life situation.
Applied Research, seeks for practical application of
theoretical or abstract knowledge. The truth is adapted to
every situation.
Action Research, the process involves the study of certain
problem and from that experience, decisions, actions and
conclusion are drawn.
Correlational Research, involves the systematic
investigation of relationship between or among variables.
Experimental, an objective, systematic, highly controlled
investigation for the purpose of predicting and controlling
phenomena in nursing practice.
Non Experimental, the researcher collects data without
introducing any treatment or making any changes.
Quasi Experimental, is like experimental research because
it actively introduces some form of treatment or manipulation
of an independent variable.
Quantitative Research, a formal, objective, systematic
process in which numerical data are used to obtain
information about the world.
Qualitative Research, systematic, interactive, subjective
approach used to describe life experiences and give them
meaning.
Phenomenological Research, begin with accumulation of
evidence when little topic is known or when studying new
topic it involves gathering of fresh perspective.
Grounded Theory Research, the primary purpose of
grounded theory research is to develop a theory. The
concepts and theories discovered through this research
approach are derived directly from the data.
Ethnographic Research, a tool for studying cultures
Narrative Research, Focus on story as the object of inquiry,
to determine how individuals make sense of events in their
lives.


B. Differences Between Conceptual and Theoretical
Model


Conceptual Model or
Paradigm


Theoretical Model or
Framework
It is a pre-theoretical basis
from which substantive
theories may be derived
It proposes a framework
derived from theories
It is highly abstract It is less abstract
Concept are related and
multidimensional
Concepts are narrowly
bounded, specific and explicitly
interrelated.
It provides a perspective for
science
It postulates relationship.
It is descriptive, explanatory or
predictive.
It is derived from systematic
observation and intuition.
It is constructed from available
theories and findings of
empirical research.
It is developed through the
process of intuition
It is develop through the
process of induction and
deduction.
It must be evaluated through
logical grounds and cannot be
empirically tested.
It permits empirical tests.


C. Variables

Independent Variables (CAUSE), These are factors
that are being manipulated by the researcher and the
focus of the inquiry.
Dependent Variable (EFFECT), This is the factor or
variable that is affected or influenced by the
independent variable.
Intervening Variable (MEDIATOR), This is a factor or
variable that exists between the independent and the
dependent variable.
Moderator Variable, This is a variable that affects the
strength or direction of the relationship between the
independent and the dependent variables.
WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY 2012 PNLE PEARLS OF SUCCESS

PART 4: PROFESSIONAL ADJUSTMENT, LEADERSHIP&MANAGEMENT AND RESEARCH
(PALMER)

POSSIBLE TOPICS ON PALMER FOR THE UPCOMING JULY 2012 PNLE
*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students
on the possible topics that might be part of the upcoming July 2012 PNLE

Examples
IV Independent Variables
DV Dependent Variable


Self-Concept, Personal and Professional Characteristics of Staff
Nurses (IV) in Relation to Patients Satisfaction Index (DV)

Thermoregulation of Infants (DV ) utilizing Mineral Water
Container and Droplight (IV)


D. Hypothesis
Simple Hypotheses predicts the relationship
between one independent variable and one dependent
variable.
Example: Performance in the College of Nursing is
related to success in the nurses licensure exam.

Complex Hypotheses predicts the relationship
between two or more independent variables and two
or more dependent variables.
Example: Heredity, home environment and quality
of instruction are related to intelligence,
motivation and performance of school.

Directional/Predictive Hypotheses specifies the
direction of relationship between the variables being
studied.
Example: People who smoke are more prone to
lung cancer than those who do not smoke.

Non Directional Hypotheses predicts only that
there is a relationship between the variables being
studied but does not specify what it is.
Example: There is a difference in the level of
anxiety of pre-operative patients who receive pre-
operative instruction than those who do not
receive such instruction.

Statistical / Null Hypotheses is an assumption that
there is no difference between the studied variables.
Example: There will be no correlation between
liberalization attitudes and completion of a course
in human sexuality.

Research Hypotheses this is also referred to as
substantive or declarative hypotheses or statement of
expected relationship between variables.
Example: There is a significant relationship
between maternal heroin addiction and birth
weight of infants.


E. Sampling Technique

Simple Random Sampling the selection of sample is
done by chance. e.g Lottery draw
Stratified Random Sampling population is
subdivided into areas, section then random sample as
are taken from each.
Systematic Sampling consist of taking every nth
person in a school, community telephone directory.
Cluster Sampling small sample is taken from
various section of a total population.
Convenience or Accidental Sampling data is
collected from anyone most conveniently available.
Snowball or Network Sampling involves subjects
suggesting or referring other subjects who meet the
researchers criteria.
Judgmental or Purposive Sampling researcher
selects and studies a specific number of a special group
that represent the target population with regards to
certain characteristics such as age, sex or economic
status.
Cross-cultural Sampling conducted in a variety of
cultural settings.
Longitudinal Sampling given group of subjects are
studied for an extended period of time
Cross-sectional Sampling subjects are observed at
only one point in time.
Quota Sampling identifies the strata of the
population and determines the proportion of elements.