PART 1 PAGE 1

PART 2 PAGE 35
PART 3 PAGE 66
PART 4 PAGE 99
PART 5 PAGE 126

For more nursing reviewers, contact ebookwholeseller@yahoo.com 09394837323 1

 100 ITEMS

Endocrine
1. Fluid management in
patient with SIADH
should include?

a. Rapid IV fluid infusion

b.Fluid restriction
c. Increasing oral fluid intake
d. Administering glucose-containing IV fluids

Answer. B

Treatment is geared toward reducing water retention.

A, c, and d. Administration of fluids only increases water intoxication.

Source: Lippincott’s Review series Medical Surgical Nursing.p.279

2.The patient receiving PTU should be instructed to immediately stop the medication and call the
physician if which of the following occurs?

a. Diarrhea
b. Palpitation
c. Fever
d. Weight gain

Answer. C

Fever may be indicative of infection, and infection may be caused by agranulocytosis.

A and b. Diarrhea and palpitations are symptoms of hyperthyroidism.
D. weight gain is a common consequence of decreasing thyroid hormone levels.

Source: Lippincott’s Review series Medical Surgical Nursing.p.279

3. Which of the following statements regarding analgesic therapy for a hypothyroid patient is
correct?

a. Increased dosage will be needed because the patient is overweight.

b. Analgesics are not needed because the patient already is lethargic.
c. Decreased dosages will be needed due to prolonged drug degradation rate.
d. Increased dosages will be needed because of the hypermetabolic drug state.

Answer. C

A hypothyroid patient has increased sensitivity to all drugs because of altered metabolism and
excretion, depressed metabolic rate and respiratory status.
a. weight is not a factor.
b. Failure to administer analgesics when appropriate may cause unnecessary suffering.
d. Increased dosages may lead to overdose.

Source: Lippincott’s Review series Medical Surgical Nursing. p.279

4. In the postoperative parathyroidectomy patient, “hungry bone” syndrome is manifested by

For more nursing reviewers, contact ebookwholeseller@yahoo.com 09394837323 2

 a. Carpopedal spasm
b. Weakness
c. Back pain
d. Polyuria

Answer. A

In “hungry bone” syndrome, the bones take up calcium at an accelerated rate, leading to
hypocalcemia. Carpopedal spasm is a symptom of hypocalcemia caused by neuromuscular
irritability.
B and c Weakness and back pain are unrelated to calcium balance.
d. Polyuria is a symptom of hypercalcemia.

Source: Lippincott’s Review series Medical Surgical Nursing. P.279

5. Preoperative care for a patient receiving long term glucocorticoid therapy should include:

a. Holding the glucocorticoid because the patient is NPO.

b. Administering an increased dose parentally
c. Administering the usual dose intramuscularly.
d. Administering the usual dose with a sip of water

Answer. B

During periods of stress, such as surgery, glucocorticoid dosages must be increased.

A, c, and d. Decreased or usual doses may cause adrenal insufficiency.

Source: Lippincott’s Review series Medical Surgical Nursing. P.279

6. Which of the following would be the least reliable evaluation outcome criterion demonstrating
compliance with a therapeutic regimen for diabetes?

a. The patient has glycosylated hemoglobin drawn every 3 months.

b. The patient displays puncture marks on his or her fingertips.
c. The patient maintains weight within 5lb of his or her ideal weight.
d. The patient’s blood glucose values measured during office visits remain within an acceptable range.

Answer. D

The office-measured blood glucose value indicates the level at only one point in time and is
influenced by many factors.
a. Glycosylated hemoglobin are influenced by medications, diet, and life-style
b. Puncture marks on the fingers indicate performance of SMBG (self monitoring blood
glucose).
c. Rapid weight change can be caused by missed insulin doses or excessive caloric intake.

Source: Lippincott’s Review series Medical Surgical Nursing. P.279

7. Which of the following represents the best advice to give a diabetic patient about eye
examination?

a. Examination should be scheduled every year

b. Examination should be scheduled every 2 years.
c. Changes in vision do not necessitate immediate medical attention.
d. Examinations should be performed by an optometrist.

Answer. A

For more nursing reviewers, contact ebookwholeseller@yahoo.com 09394837323 3

 The current standards of care published by the American Diabetes Association recommend
annual eye examinations by the ophthalmologist. The standards also recommend aimmediate
evaluation of any visual changes.
b. Annual examinationa are recommended.
c. Any visual change merits immediate evaluation
d. An ophthalmologist, not an optometrist,is the appropriate health-care proffetional for this
examination.

Source: Lippincott’s Review series Medical Surgical Nursing. P.280

8. When planning care for a diabetic patient with end-satge renal disease, the nurse should expect
that the patient’s insulin requirements most likely would:

a. Increase
b. Remain the same
c. Decrease
d. Fluctuate greatly

Answer. C

Renal failure prevents the kidneys from degrading insulin normally; as a result, insulin is available
longer.
A and b. This increased availability means that an increased or same dose of insulin
may cause hypoglycemia.
d. Renal failure, by itself, does not cause increased fluctuation of insulin doses.

Source: Lippincott’s Review series Medical Surgical Nursing. P.280

9. Which of the following situations would not interfere with sympathetic nervous system responses
to hypoglycemia?

a. Administration of beta blocker

b. Use of a continuous insulin infusion device
c. Longstanding (15 years’ duration) Type I diabetes mellitus.
d. Administration of a calcium channel blocker

Answer. D

Calcium channel blockers do not affect sympathetic nervous system (SNS) activity.
a. Beta blockers block SNS activity
b. Anyone using a continuous insulin infusion devise has continuous insulin available, which
may blunt SNS activity.
c. A person with a long history of diabetes may have autonomic SNS neuropathy.

Source: Lippincott’s Review series Medical Surgical Nursing. P.280

10. Altered LOC commonly accompanies hyperglycemic hyp[erosmolar nonketotic coma (HHNC).
Which of the following nursing diagnoses reflects the pathophysiologic process accounting for this
complication?

a. Altered Nutrition: Less Than Body Requirements

b. Impaired Gas Exchange
c. Fluid Volume Deficit
d. Fluid Volume Excess

Answer. C

For more nursing reviewers, contact ebookwholeseller@yahoo.com 09394837323 4

 Plasma hyperosmolality resulting from Fluid Volume Deficit causes decreased LOC.
A and b. Neither Impaired Gas Exchange nor Altered Nutrition is linked directly to altered LOC
although they both may be involved in the progression of this syndrome.
D. Fluid Volume Excess is not implicated in this complication.

Source: Lippincott’s Review series Medical Surgical Nursing. P.280

Respiratory System

11. Mr. Roberts, a 34-year-old accountant, called the nurse at the outpatient clinic and reported the
following: He had a cold last week, but was feeling better today and so went jogging, as is his
usual routine. After a short run, however, he became very short of breath and felt tightness in his
chest. He reported no sore throat, fever, or productive cough. Based on this information elicited
by way of telephone assessment, the nurse could surmise that Mr. Roberts’ symptoms are
related to

a. Asthma
b. Pneumoconioses
c. Bronchitis
d. Pneumonia

Answer. A

The reported symptoms and lack of symptoms are characteristic of asthma.

The previous viral infection may have made the patient more prone to bronchial spasms in
response to exercise or cold temperatures.
B. The patient’s occupation as an accountant would decrease the likelihood of pneumoconiosis.

C and d. The patient’s lack of productive cough or fever would decrease the probability of either
bronchitis or pneumonia.

Source: Lippincott’s Review series Medical Surgical Nursing. P.138

12. An 18-year-old woman came to the physician’s office complaining of general malaise,fever, and a
hacking cough. In completing a nursing assessment, which of the following would the nurse
expect to find with pneumonia?

a. Conjunctivitis and nasal swelling

b. Tonsillar exudates and pain on swallowing
c. Bronchial breath sounds over lung field with consolidation
d. Productive cough with excess mucous production

Answer. C

Bronchial breath sounds are commonly found over the lung fields with infiltration and
consolidation in pneumonia
A. Eyes and nose symptoms aren’t typical in pneumonia
B. Tonsillar exudates and pain on swallowing are cardinal symptoms of streptococcal sore throat
caused by infectio of the pharynx
D Cough associated with pneumonia is typically hacking and nonproductive.

Source: Lippincott’s Review series Medical Surgical Nursing. P.138

13. During hospitalization for a pulmonary embolism, Ms. Stone, aged 75, was being prepared for
discharge. The nursing diagnosis, Knowlegde Deficit, was identified as a primary concern for
focus by the nursing staff to increase Ms. Stone’s progress at home. This diagnosis would be
based on the patient’s need to know which of the following self-care activities?

For more nursing reviewers, contact ebookwholeseller@yahoo.com 09394837323 5

 a. Reduce walking to only necessary activities around the house
b. Maintain peripheral circulation with leg exercises
c. Soak feet nightly in warm water to increase circulation.
d. Avoid bending to pick up objects.

Answer. B

Leg exercises are important in reducing the risk of further thrombus development
A reduction of walking is contraindicated.
C Soaking the feet is not necessary to increase circulation and is inappropriate, especially in an
older person because of its drying effect on skin.
D No physiologic contraindication to bending is associated with this medical diagnosis

Source: Lippincott’s Review series Medical Surgical Nursing. P.138

14. Mrs. Smith, aged 64, has been diagnosed with COPD. Although she was hospitalized several
times in the last yaer for acute respiratory failure, she is presently in stable condition. The primary
focus of care in the long-term nursing care of Mrs. Smith would be to

a. Decrease activity to conserve functional lung tissue.

b. Increase th frequency of postural drainage to every 2 hours while awake
c. Increase the RV.
d. Improve and maintain pulmonary ventilation and gas exchange.

Answer. D

The underlying pathology of COPD affects the lungs’ ability to ventilate and exchange O2 and
CO2. Ventilation and gas exchange are directly dependent on each other. An effective
relationship between the two parameters is absolutely necessary for effective physiologic and
mental functioning.
a. Decreasing activity level will not conserve functional lung tissue. Rather, reatment should
aim to increase activity while implementing work modification
techniques.
b. Postural drainage performed every 2 hours would be necessary since no evidence links
her problem to retained secretions.
c. The goal would be to decrease rather than increase RV, which usually is high in COPD.

Source: Lippincott’s Review series Medical Surgical Nursing. P.138

15. Mrs. Smith’s condition changed over a period of days, and her arterial blood studies now indicate
she is again in acute respiratory failure. The primary nursing intervention mos commonly required
in the care of patients with COPD who are in acute respiratory failure is to

a. Establish initial stage of activity

b. Discourage patient from sitting in Fowler’s position in order to reduce work load of he heart
c. Remove bronchial secretions, and manage oxygen therapy
d. Plan with family for home care.

Answer. C

Acute respiratory failure results from inadequate gas exchange in the lungs. Increasing the
availability of oxygen and assisting with secretion removal will improve ventilation.
a. A patient experiencing acute respiratory failure should usually not be started on an
activity program: conservation of energy is critical at this stage.
b. The patient most likely will find that semi-Fowler’s or Fowler’s position facilitates
breathing

For more nursing reviewers, contact ebookwholeseller@yahoo.com 09394837323 6

 d. Planning for home care is important- but not at this stage; the patient’s level of self-care deficit
is unknown at this point.

Source: Lippincott’s Review series Medical Surgical Nursing. P.138-139

16. Mrs. Smith has been treated aggressively for acute respiratory failure and has improved over the
past 4 weeks. She experienced anxiety about being prepared for discharge. The nurse who cares
for her should help her develop ways to cope with her chronic obstructive lung disease by:

a. Encouraging the family to take increased responsibility for the patient’s care
b. Discouraging the patient from performing activities of daily living if they make her tired
c. Teaching the patient relaxation techniques and breathing retraining exercises
d. Protecting the patient from knowing the prognosis of her disease.

Answer. C

Relaxation techniques and breathing retraining will help a patient with COPD maximize energy
supplies and effectively use available oxygen
a and b. A COPD patient should be encouraged to be as independent as possible within
physiologic capabilities; total care encourages deterioration.
d. Knowledge of the disease process may help the patient better understand how she can
make the most of her life.

Source: Lippincott’s Review series Medical Surgical Nursing. P.139

17. Mr. Brown, a 40-year-old man employed in a steel plant, was referred to the outpatient clinic at
the local hospital from work with a tentative diagnosis of pneumonia. The nurse who initially
examines Mr. Brown should be aware of the clinical manifestations of pneumonia. Nursing
diagnoses would include which of the following?

a. Fluid Volume Deficit related to vomiting and diarrhea

b. Pain related to chest pain radiating to the left shoulder and arm
c. Hyperthermia related to sudden onset of chills with a rising fever and chest pain
d. Ineffective Breathing Patterns related to slow, shallow respiration with point tenderness at a
rib site.

Answer. C

Chills, fever and pain result from inflammation of the terminal airways and alveoli caused by
bacterial, viral, or fungal infection.
A, b and d. These signs and symptoms are not associated with pneumonia.

Source: Lippincott’s Review series Medical Surgical Nursing. P.139

18. Mrs. Stone has just undergone chest surgery for a right lower lobectomy. The nurse planning
Mrs. Stone’s postoperative care should include which of the following?

a. Encourage coughing to mobilize secretions.

b. Ensure that the thoracotomy tube is attached to open chest drainage
c. Restrict IV fluids for 24 hours
d. Prevent coughing to assure incision integrity.

Answer. A

The patient should be encouraged to cough to raise and expectorate sputum. Splinting the
incision during coughing is recommended to minimizw discomfort.
b. Thoracotomy tubes are always attached to closed sealed drainage to reexpand lung tissue
and prevent pnuemothorax

For more nursing reviewers, contact ebookwholeseller@yahoo.com 09394837323 7

 c. IV fluid infusion is indicated following surgery because the patient will not be able to tolerate
oral fluids for a time.Restricting fluids would encourage dehydration
d. Coughing is indicated to mobilize secretions

Source: Lippincott’s Review series Medical Surgical Nursing. P.139

19. The partial pressure of oxygen in arterial blood(PO2) is proportional to the concentration of O2
because it is mixed with the other gases. Keeping this fact in mind, at discharge from a Denver
hospital that is at an altitude of approximately 5000 feet, whish of the following is an expected
discharge criterion for a person without COPD?

a. pH 7.3
b. PaO2 65 to 75 mmHg
c. PaO2 45 to 55 mmHg
d. PaO2 80 to 100 mmHg

Answer. C

Atmospheric air comprises oxygen, nitrogen, carbon dioxide, and water. Inhled air is translated
into partial pressure of its components. At an altitude of 5000 feet, the partial pressure of arterial
O2 is 65 to 75 mmHg. The pH remains the same regardless of the altitude.

Source: Lippincott’s Review series Medical Surgical Nursing. P.140

20. The neurocontrol of ventilation rests in several areas of the nervous system. The primary control
of inspiration and expiration occurs in the

a. Baroreceptors
b. Medulla oblongata
c. Alveoli
d. Pons

Answer. B
The rhythmicity of breathing in controlled by respiratory centers located in the medulla oblongata
of the brain. These inspiratory and expiratory centers control the rate and depth of respiration to
meet the body’s metabolic demands.
a. Located in the aortic arch and carotid bodies, barorecepors respond to increase and
decrease in arterial blood pressure and cause reflex hypoventilation and hyperventilation
c. The alveoli contain stretch receptors that mediate overdistension of the lung
d. The pons houses the pneumotaxic center, which is thought to stimulate the expiratory
medullary center.

Source: Lippincott’s Review series Medical Surgical Nursing. P.140

NOTE: THIS IS A SAMPLE ONLY, TO READ THE NEXT 480 ITEMS, PURCHASE THE

WHOLE EBOOK FROM ebookwholeseller@yahoo.com or ebookwholeseller@gmail.com

contact 09394837323 / 09166695394

ONLY 50 PESOS!

OTHER PEOPLE SELL THIS FOR 150 PESOS, THINK ABOUT IT

For more nursing reviewers, contact ebookwholeseller@yahoo.com 09394837323 8

 OTHER REVIEWERS AND BOOK/EBOOKS ARE AVAILABLE, JUST INQUIRE

PNLE REVIEWERS

1. BOARD EXAM COMPILATION BOOK 1(500 ITEMS WITH ANSWER AND RATIO, 50 PESOS)

2. BOARD EXAM COMPILATION BOOK 2 (500 ITEMS WITH ANSWER AND RATIO, 50 PESOS)

3. BOARD EXAM COMPILATION BOOK 3 (500 ITEMS WITH ANSWER AND RATIO, 50 PESOS)

4. COMPREHENSIVE PNLE 800 ITEMS PRACTICE BOOKLET WITH ANSWERS (50 PESOS)

5. UP MANILA EXAM DRILLS AND PREBOARD (1,300 ITEMS WITH ANSWERS, 100 PESOS)

6. REVIEW CENTERS TRANSCRIBED QUESTIONNAIRES (1,OOO ITEMS WITH ANSWERS

AND RATIO---ONLY 300 PESOS)

ALL OF THIS FOR ONLY 500 PESOS! (SAVE 100 PESOS)

NOTE, PAST BOARDS COMPILATION IS FROM 2007-2009 PNLE

Visit my ads at http://ebookwholeseller.sulit.com.ph

PAYMENTS ACCEPTED:
Payment Via:

Since my items are ebooks, shipment is via email to your email

address

MODES OF PAYMENTS ACCEPTED:

> GCASH to 09166695394

> SMARTMONEY to 5299-6709-6894-6102

> eload or share a load to my globe number 09166695394 (for small

purchases)

> pasaload or eload to my smart number 09394837323 ( for small

purchases)

For more nursing reviewers, contact ebookwholeseller@yahoo.com 09394837323 9