TIME START: TEST 1: 1. Which nutrient deficiency is associated with the development of Pellagra, Dermatitis and Diarrhea? A.

Vitamin B1 B. Vitamin B2 C. Vitamin B3 D. Vitamin B6 2. Among the following foods, which has the highest amount of potassium per area of their meat? A. Cantaloupe B. Avocado C. Raisin D. Banana 3. Jose Miguel is a little bit nauseous. Among the following beverages, Which could help relieve JMs nausea? A. Coke B. Sprite C. Mirinda D. Orange Juice or Lemon Juice 4. The vomiting center is found in the A. Medulla Oblongata B. Pons C. Hypothalamus D. Cerebellum 5. According to her, A nurse patient relationship is composed of 4 stages : Orientation, Identification, Exploitation and Resolution A. Roy B. Peplau C. Rogers D. Travelbee 6. A patients chart is what type of data source? A. Primary B. Secondary C. Tertiary D. Can be A and B 7. John has a fever of 38.5 Deg. Celsius. It surges at around 40 Degrees and go back to 38.5 degrees 6 times today in a typical pattern. What kind of fever is John having? A. Relapsing B. Intermittent

TIME END: C. Remittent D. Constant 8. Which of the following is responsible for deep and prolonged inspiration A. Medulla oblongata B. Pons C. Carotid bodies D. Aortic bodies 9. The primary respiratory center A. Medulla oblongata B. Pons C. Carotid bodies D. Aortic bodies 10. How many minutes are allowed to pass if the client had engaged in strenuous activities, smoked or ingested caffeine before taking his/her BP? A. 5 B. 10 C. 15 D. 30 11. Too narrow cuff will cause what change in the Clients BP? A. True high reading B. True low reading C. False high reading D. False low reading 12. The suggested time per hand on handwashing using the time method is A. 5 to 10 seconds each hand B. 10 to 15 seconds each hand C. 15 to 30 seconds each hand D. 30 to 60 seconds each hand 13. How many ml of liquid soap is recommended for handwashing procedure? A. 1-2 ml B. 2-3 ml C. 2-4 ml D. 5-10 ml 14. If a client has been taking cold or hot food or fluids or smoking, the nurse should wait for how many minutes before taking temperature orally A. 5 minutes B. 7 minutes C. 15minutes

D. 30 minutes 15. She is the first one to coin the term NURSING PROCESS She introduced 3 steps of nursing process which are Observation, Ministration and Validation. A. Nightingale B. Johnson C. Rogers D. Hall TEST II. PHARMACO 1. When caring for a client experiencing an acute gout attack, the nurse anticipates administering which medication? a. allopurinol (Zyloprim) b. colchicines c. prednisone (Deltasone) d. propoxyphene hydrochloride (Darvon) 2. The nurse must instruct a client with glaucoma to avoid taking OTC drugs like? a. Antihistamines. b. NSAIDs. c. Antacids. d. Salicylates. 3. Methotrexate, the most widely used antimetabolite in cancer chemotherapy does not penetrate the central nervous system (CNS). To treat CNS disease this drug must be administered: a. Intravenously. b. Subcutaneously. c. Intrathecally. d. By inhalation. 4. Nurse Jeff is teaching a client with chronic renal failure (CRF) about medications. The client questions the purpose of aluminum hydroxide (Amphojel) in her medication regimen. The nurse best response would be: a. it will reduce serum calcium b. it decreases serum phosphate c. it increases urine output d. it control gastric acid secretion 5. A 47-year-old client was put in Quinidine (a drug that decreases myocardial excitability) to prevent atrial fibrillation. He also has kidney disease. The nurse is aware that this drug, when given to a client with kidney disease, may a. cause hypotension b. produce mild bradycardia c. be very toxic even in small doses d. cause cardiac arrest

TEST III. 1. Which disease was declared through Presidential Proclamation No. 4 as a target for eradication in the Philippines? A. Poliomyelitis B. Measles C. Rabies D. Neonatal tetanus 2. During prenatal consultation, a client asked you if she can have her delivery at home. After history taking and physical examination, you advised her against a home delivery. Which of the following findings disqualifies her for a home delivery? A. Her OB score is G5P3. B. She has some palmar pallor. C. Her blood pressure is 130/80. D. Her baby is in cephalic presentation. 5. Which biological used in Expanded Program on Immunization (EPI) is stored in the freezer? A. DPT B. Tetanus toxoid C. Measles vaccine D. Hepatitis B vaccine 4.During the physical examination of a young child, what is the earliest sign of xerophthalmia that you may observe? A. Keratomalacia B. Corneal opacity C. Night blindness D. Conjunctival xerosis 5. The public health nurse is responsible for presenting the municipal health statistics using graphs and tables. To compare the frequency of the leading causes of mortality in the municipality, which graph will you prepare? A. Line B. Bar C. Pie D. Scatter diagram TEST IV. 1. The nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to A. restrict fluid intake to 1 qt (1,000 mL)/day. B. drink liquids only with meals. C. don't drink liquids 2 hours before meals. D. drink liquids only between meals. 2. A 16-year-old client received a severe head injury in a motor vehicle accident. Hes admitted to the neurologic unit and subsequently develops neurogenic diabetes

insipidus. The physician prescribes vasopressin (Pitressin), 5 units subcutaneously twice a day. When vasopressin is given subcutaneously, it begins to act within: A. 5 minutes. B. 1 hour. C. 2 hours. D. 4 hours. 3. A client admitted for a hysterectomy has a secondary diagnosis of Menieres disease. Which of the following nursing interventions should the nurse include in the clients care plan to decrease the effects of tinnitus? A. Reduce the amount of glucose and cholesterol in the diet. B. Encourage the client to listen to the radio with earphones. C. Encourage a weight reduction diet. D. Administer antihypertensive medications as ordered. 4.The physician orders blood coagulation tests to evaluate a clients blood clotting ability. The nurse knows that such tests are important in assessing clients at risk for thrombi. Higher risk is associated with a history of atrial fibrillation, infective endocarditis, prosthetic heart valves, or myocardial infarction (MI). Which test is used to determine a clients response to oral anticoagulant drugs? A. B. C. D. Bleeding time Platelet count Prothrombin time (PT) Partial thromboplastin time (PTT)

D. Seventh month 3. When is the serum estrogen level highest in the menstrual cycle? A. 3rd day B. 13th day C. 14th day D. End of menstrual cycle 4. The mother asks, What does it means if her maternal serum alpha feto protein is 35 ng/ml? The nurse should answer A. It is normal B. It is not normal C. 35 ng/ml indicates chromosomal abberation D. 35 ng/ml indicates neural tube defect 5. Who's Theory of labor pain that states that PAIN in labor is cause by FEAR A. Bradley B. Simpson C. Lamaze D. Dick-Read

TEST VI. 1. Which of the following is included in the health teachings among clients receiving Valium?: A. Avoid foods rich in tyramine. B. Take the medication after meals. C. It is safe to stop it anytime after long term use. D. Double up the dose if the client forgets her medication. 2. A client tends to be insensitive to others, engages in abusive behaviors and does not have a sense of remorse. Which personality disorder is he likely to have? A. Narcissistic B. Paranoid C. Histrionic D. Antisocial 3. The superego is that part of the psyche that: A. Uses defensive function for protection. B. Is impulsive and without morals. C. Determines the circumstances before making decisions. D. The censoring portion of the mind. 4. Freud explains anxiety as: A. Strives to gratify the needs for satisfaction

5. Which of the following exercises would the nurse advise the client to avoid after a lumbar laminetcomy? a. Knee-to-chest lifts b. Hip tilts c. Sit-ups d. Pelvic tilts

TEST V. 1. The nurse plans to teach Michiel about colostomy irrigation. As the nurse prepares the materials needed, which of the following item indicates that the nurse needs further instruction? A. Plain NSS / Normal Saline B. K-Y Jelly C. Tap water D. Irrigation sleeve 2. Placenta is the organ that provides exchange of nutrients and waste products between mother and fetus. This develops by A. First month B. Third month C. Fifth month

and security B. Conflict between id and superego C. A hypothalamic-pituitary-adrenal reaction to stress D. A conditioned response to stressors 5. A 10 year old child has very limited vocabulary and interaction skills. She has an I.Q. of 45. She is diagnosed to have Mental retardation of this classification:

A. tardive dyskinesia B. Pseudoparkinsonism C. akinesia D. dystonia TEST VII. 1. Florence nightingale is born in A. Germany B. Britain C. France D. Italy 2. Founded the second order of St. Francis of Assisi A. St. Catherine B. St. Anne C. St. Clare D. St. Elizabeth

A. Profound B. Mild C. Moderate D. Severe 6. Situation: A 27 year old writer is admitted for the second time accompanied by his wife. He is demanding, arrogant talked fast and hyperactive. Initially the nurse should plan this for a manic client: A. set realistic limits to the clients behavior B. repeat verbal instructions as often as needed C. allow the client to get out feelings to relieve tension D. assign a staff to be with the client at all times to help maintain control 7. An activity appropriate for the client is: A. table tennis B. painting C. chess D. cleaning 8. A client on Lithium has diarrhea and vomiting. What should the nurse do first: A. Recognize this as a drug interaction B. Give the client Cogentin C. Reassure the client that these are common side effects of lithium therapy D. Hold the next dose and obtain an order for a stat serum lithium level 9. A teenage girl is diagnosed to have borderline personality disorder. Which manifestations support the diagnosis? A. Lack of self esteem, strong dependency needs and impulsive behavior B. social withdrawal, inadequacy, sensitivity to rejection and criticism C. Suspicious, hypervigilance and coldness D. Preoccupation with perfectionism, orderliness and need for control 10. The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting:

3. Anastacia Giron-Tupas was the first Filipino nurse to occupy the position of chief nurse in this hospital. A. St. Paul Hospital B. Iloilo Mission Hospital C. Philippine General Hospital D. St. Lukes Hospital 4. He was called the father of sanitation. A. Abraham B. Hippocrates C. Moses D. Willam Halstead 5. What country did Florence Nightingale train in nursing? A. Belgium B. US C. Germany D. England

THE MORE PREPARED YOU ARE TO TAKE THE TEST, THE MORE CONFIDENT YOU WILL BE THE MORE CONFIDENT YOU ARE, THE MORE YOU ARE ABLE TO CHALLENGE THE FEAR OF BEING UNPREPARED

TEST 1: RECALL ROUND 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. C. Vitamin B3 A. Cantaloupe A. Coke A. Medulla Oblongata B. Peplau B. Secondary C. Remittent B. Pons A. Medulla oblongata D. 30 C. False high reading C. 15 to 30 seconds each hand C. 2-4 ml * If a liquid soap is to be used, 1 tsp [ 5ml ] of liquid soap is recommended for handwashing procedure. D D. Hall

adequate hydration, reduces the amount of bulk ingested with meals, and aids in preventing rapid gastric emptying. There is no need to restrict the amount of fluids, just the time when the client drinks fluids. Drinking liquids with meals increases the risk of dumping syndrome by increasing the amount of bulk and stimulating rapid gastric emptying. Small amounts of water are allowable before meals. 2. B. When vasopressin is given subcutaneously it begins to act within 1 hour. Its duration of action is 2 to 8 hours. 3. B. Listening to the radio with earphones is one way to override the buzzing sound in the ears caused by tinnitus. Diet regulation may affect the occurrence of attacks of Menicres but not the effects of tinnitus. The client wouldnt take antihypertensive medications for this disorder. 4. C. PT determines a clients response to oral anticoagulant therapy. This test measures the time required for a fibrin clot to form in a

29. 30. TEST II.

citrated plasma sample after calcium ions and tissue thromboplastin are added, and compares this time with the fibrin clotting time in a Answer: B. Explanation: The physician usually prescribes colchicine for a client experiencing an acute gout attack. This drug decreases leukocyte motility, phagocytosis, and lactic acid production, thereby reducing urate crystal deposits and relieving inflammation. Allopurinol is used to decrease uric acid production in clients with chronic gout. Although corticosteroids are prescribed to treat gout, the nurse wouldnt give them because they must be administered interarticularly to this client. Propoxyphene, a narcotic, may be used to treat osteoarthritis. 5.

1.

control sample. Anticoagulant dosages should be adjusted, as needed, to maintain PT at 1r to 2r times the control value. PTT determines the effectiveness of heparin therapy and helps evaluate bleeding tendencies. Roughly 99% of bleeding disorders are diagnosed from PT and PTT values. Bleeding time indicates how long a small puncture wound takes to stop bleeding. The platelet count reveals the number of circulating platelets in venous or arterial blood. Ans: C sit-ups are not recommended for the client who has had a lumbar laminectomy, because these exercises place too great a stress on the back. Knee-to-chest lifts, hip tilts, and pelvic tilt exercises are recommended to strengthen back and abdominal muscles. TEST V 1. A. Plain NSS / Normal Saline

2.

Answer: A. Explanation: Antihistamines cause pupil dilation and should be avoided with glaucoma

3.

Answer: C. Explanation: With intrathecal administration chemotherapy is injected through the theca of the spinal cord and into the subarachnoid space entering into the cerebrospinal fluid surrounding the brain and spinal cord. The methods in options A, B, and D are ineffective because the medication cannot enter the CNS.

4.

Correct Answer: B. Rationale: It decreases serum phosphate. Aluminum binds phosphates that tend to accumulate in the patient with chronic renal failure due to decreased filtration capacity of the kidney. Antacids such as Amphojel are commonly used to accomplish this.

* The colon is not sterile, nor the stomach. Tap water is used in enema irrigation and not NSS. Although some clients would prefer a distilled, mineral or filtered water, NSS is not always necessary. KY Jelly is used as the lubricant for the irrigation tube and is inserted 3-4 inches into the colostomy pointing towards the RIGHT. Irrigation sleeve is use to direct the flow of the irrigated solution out of the stomach and into the bedpan or toilet. 2. B. Third month * The placenta is formed at around 3 months. It is a latin word for PANCAKE because of

5.

Correct Answer: D. Rationale: Kidney disease interferes with metabolism and excretion of Quinidine, resulting in higher drug concentrations in the body. Quinidine can depress myocardial excitability enough to cause cardiac arrest. TEST III.

it's appearance. It arises from the trophoblast from the chorionic villi and decidua basalis. It functions as the fetal lungs,kidney, GI tract and an endocrine organ. 3. B. 13th day

1. Answer: (B) Measles Presidential Proclamation No. 4 is on the Ligtas Tigdas Program. 2. Aswer: (A) Her OB score is G5P3. Only women with less than 5 pregnancies are qualified for a home delivery. It is also advisable for a primigravida to have delivery at a childbirth facility. 3. Answer: (C) Measles vaccine Among the biologicals used in the Expanded Program on Immunization, measles vaccine and OPV are highly sensitive to heat, requiring storage in the freezer. 4. Answer: (D) Conjunctival xerosis The earliest sign of Vitamin A deficiency (xerophthalmia) is night blindness. However, this is a functional change, which is not observable during physical examination.The earliest visible lesion is conjunctival xerosis or dullness of the conjunctiva due to inadequate tear production. 5.Answer: (B) Bar A bar graph is used to present comparison of values, a line graph for trends over time or age, a pie graph for population composition or distribution, and a scatter diagram for correlation of two variables. TEST 4 1. D. A client who experiences dumping syndrome after a subtotal gastrectomy should be advised to ingest liquids between meals rather than with meals. Taking fluids between meals allows for

* There are only 3 days to remember in terms of hormonal heights during pregnancy. 3,13 and 14. During the 3rd day, Serum estrogen is the lowest. During the 13th day, Serum estrogen is at it's peak while progestrone is at it's lowest and this signifies that a mature oocyte is ready for release. At 14th day, Progesterone will surge and this is the reason why there is a sudden increase of temperature during the ovulation day and sudden drop during the previous day. This will not stimulate the release of the mature egg or what we call, OVULATION. 4. C. 35 ng/ml indicates chromosomal abberation * The normal maternal alpha feto protein is 38-45 ng/ml. Less 38 than this indicates CHROMOSOMAL ABBERATION [Down,Klinefelters] and more than 45 means NEURAL TUBE DEFECTS [Spina Bifida]. Remember the word CLINICAL NURSE. C for chromosomal abberation for <38>N for neural tube defect for >45. C<38>45 Clinic Nurse.

5. D. Dick-Read * Believe it or not, this is an actual board question. Grantley Dick-Read is just one person. Usually a two name theory means two theorist. He published a book in 1933 "CHILDBIRTH WITHOUT FEAR". He believes that PAIN in labor is caused by FEAR that causes muscle tension, thereby halting the blood towards the uterus and causing decreased oxygenation which causes the PAIN.

TEST 6 1. Answer: (B) Take the medication after meals. Antianxiety medications cause G.I. upset so it should be taken after meals. A. This is specific for antidepressant MAOI. Taking tyramine rich food can cause hypertensive crisis. C. Valium causes dependency. In which case, the medication should be gradually withdrawn to prevent the occurrence of convulsion. D The dose of Valium should not be doubled if the previous dose was not taken. It can intensify the CNS depressant effects. 2. Answer: (D) Antisocial These are the characteristics of an individual with antisocial personality. A. Narcissistic personality disorder is characterized by grandiosity and a need for constant admiration from others. B. Individuals with paranoid personality demonstrate a pattern of distrust and suspiciousness and interprets others motives as threatening. C. Individuals with histrionic have excessive emotionality, and attention-seeking behaviors. 3. Answer: (D) The censoring portion of the mind. The critical censoring portion of ones personality; the conscience. A. This refers to the ego function that protects itself from anything that threatens it.. B. The Id is composed of the untamed, primitive drives and impulses. C. This refers to the ego that acts as the moderator of the struggle between the id and the superego. 4. Answer: (B) Conflict between id and superego Freud explains anxiety as due to opposing action drives between the id and the superego. A. Sullivan identified 2 types of needs, satisfaction and security. Failure to gratify these needs may result in anxiety. C. Biomedical perspective of anxiety. D. Explanation of anxiety using the behavioral model. 5. Answer: (C) Moderate The child with moderate mental retardation has an I.Q. of 35-50 Profound Mental retardation has an I.Q. of below 20; Mild mental retardation 50-70 and Severe mental retardation has an I.Q. of 20-35. 6. Answer: (A) set realistic limits to the clients behavior The manic client is hyperactive and may engage in injurious activities. A quiet environment and consistent and firm limits should be set to ensure safety. B. Clear, concise directions are given because of the distractibility of the client but this is not the priority. C. The manic client tend to externalize hostile feelings, however only non-destructive methods of expression should be allowed D. Nurses set limit as needed. Assigning a staff to be with the client at all times is not realistic. 7. Answer: (D) cleaning The clients excess energy can be rechanelled through physical activities that are not competitive like cleaning. This is also a way to dissipate tension. A. Tennis is a competitive activity which can stimulate the client. 8. Answer: (D) Hold the next dose and obtain an order for a stat serum lithium level Diarrhea and vomiting are manifestations of Lithium toxicity. The next dose of lithium should be withheld and test is done to validate the observation. A. The manifestations are not due to drug interaction. B. Cogentin is used to manage the extra pyramidal symptom side effects of antipsychotics. C. The common side effects of Lithium are fine hand tremors, nausea, polyuria and polydipsia 9. Answer: (A) Lack of self esteem, strong dependency needs and impulsive behavior These are the characteristics of client with borderline personality. B. This describes the avoidant personality. C. These are the characteristics of a client with paranoid personality D. This describes the obsessive compulsive personality Answer: (B) Pseudoparkinsonism Pseudoparkinsonism is a side effect of antipsychotic drugs characterized by mask-like facies, pill rolling tremors, muscle rigidity A. Tardive dyskinesia is manifested by lip smacking, wormlike movement of the tongue C. Akinesia is characterized by feeling of weakness and muscle fatigue D. Dystonia is manifested by torticollis and rolling back of the eyes

TEST 7 1. D. Italy * Florence Nightingale was born in Florence, Italy, May 12, 1820. Studied in Germany and Practiced in England.

2.

3. 4. 5.

C. St. Clare * The poor clares, is the second order of St. Francis of assisi. The first order was founded by St. Francis himself. St. Catherine of Siena was the first lady with the lamp. St. Anne is the mother of mama mary. St. Elizabeth is the patron saint of Nursing. C. Philippine General Hospital C. Moses C. Germany