RECALLS 7 NP1 C.

2050

Situation: You are a public health consultant tasked D. 2060

with implementing a comprehensive community
Situation: Prevention includes a wide range of
development program in a rural area with various
activities aimed at reducing risks or threats of
social, economic, and environmental challenges.
health.
Your goal is to ensure that your strategies align with
the 17 Sustainable Development Goals (SDGs) 6. Nurse Marco is visiting a family with a child who
adopted by the United Nations. recently became a paraplegic. He suggests some home
modifications to accommodate the child’s disability. What
1. Your program aims to ensure healthy lives and
level of family-focused intervention the nurse has
promote well-being for all, at all ages. Which SDG aligns
suggested?
with this objective?
*
*
1 point
1 point
A. Quaternary prevention
A. SDG 1
B. Secondary prevention
B. SDG 2
C. Tertiary prevention
C. SDG 3
D. Primary Prevention
D. SDG 5
7. Which of the following programs is an example of
2. If your program aims to promote sustained, inclusive,
secondary prevention?
and sustainable economic growth, full and productive
employment, and decent work for all, which SDG should *
it align with?
1 point
*
A. An exercise program for persons who had stroke
1 point
B. A community-wide nutrition program at fast food
A. SDG 7 establishments
B. SDG 8 C. Immunization of persons exposed to infectious
disease with immunoglobulin G within 2 weeks of
C. SDG 9
exposure.
D. SDG 12
D. Health education on safe water supply
3. You want to ensure the community has access to
8. As a result of an outbreak of influenza in Barangay
clean water and sanitation. Which SDG should guide
Maligaya, Nurse Marco encourages the residents of the
your efforts?
community to receive the influenza vaccine. Which level
* of prevention is being used?

1 point *

A. SDG 2 1 point

B. SDG 3 A. Tertiary prevention

C. SDG 6 B. Multifactorial prevention

D. SDG 9 C. Primary prevention

4. Your program includes initiatives to combat climate D. Secondary prevention

change. Which SDG aligns with this focus?
9. Nurse Marco explains to the mother the general
* needs of a family for adequate nutrition, rest, and
physical activity. Which level of prevention does this
1 point
describe?
A. SDG 7
*
B. SDG 10
1 point
C. SDG 13
A. Quaternary prevention
D. SDG 15
B. Primary prevention
5. By which year are the Sustainable Development
C. Tertiary prevention
Goals (SDGs) set to be achieved globally?
D. Secondary prevention
*
10. Nurse Marco also encounters a female patient who
1 point
reported chest discomfort and shortness of breath. He
A. 2030 placed the patient on oxygen, electrocardiogram, and
had his blood gases drawn. What level of preventive
B. 2040 care is this patient receiving?
* A. 1, 3, 5

1 point B. 2, 4, 5

A. Health promotion C. 1, 2, 5

B. Secondary prevention D. 2, 3, 4

C. Tertiary prevention 15. Nurse Dana stated that a definitive diagnosis of

leprosy is obtained through _________.
D. Primary prevention
*
Situation: The Department of Health has vowed to
end Neglected Tropical Diseases (NTDs) by 2030. In 1 point
the Philippines, the NTDs that are prevalent include
A. Blood examinations
leprosy and rabies. One of the strategies to address
this goal is through the conduct of HEALTH B. Tuberculin testing
EDUCATION program.
C. Skin smears/biopsies
11. Public Health Nurse Dana is educating a group of
residents in Community X about RABIES. A participant D. Nasal smears
asks, “How can you get the virus?” The Nurse explains
Situation: Nurse Rei is a staff nurse in the Maternity
that the virus can be transmitted by which source?
Ward of Government Hospital. While working as a
* staff nurse, she also pursues graduate studies for a
master’s degree in nursing. She plans to conduct a
1 point study in her unit.
A. Saliva 16. Nurse Rei understands that the main objective in
conducting research in nursing is to __________.
B. Blood
*
C. Urine
1 point
D. Stool
A. Develop the nursing profession
12. She emphasized that the bites, which are
responsible for nearly 99 percent of human rabies B. Improve nursing care
infections, are those of the infected __________.
C. Ensure accountability for nursing practices
*
D. Document the cost effectiveness of nursing care
1 point
17. Nurse Rei decides to do a phenomenological study.
A. Monkeys What is the characteristic of a phenomenological study?
B. Dogs *
C. Bats 1 point
D. Cats A. Was initially developed by anthropologist to study the
way a human being react within or experiencing a
13. Nurse Dana explains that there are situations which
natural setting.
increase the risk of rabies. These are ________.
B. Enables the investigator to discover the theory from
*
systematically obtained data.
1 point
C. Provides an in-depth description of the phenomenon
A. Stray dogs of interest to theninvestigator

B. Unprovoked bites D. Examines maternal experience as they are lived and

understood as reality as human beings
C. Animals display unusual behavior
18. Nurse Rei is aware that the phenomenological
D. All of these
method of research is ________.
14. In another health education session, Nurse Dana
*
explains about LEPROSY. Which of the following should
be included? 1 point

1. Leprosy is curable A. That is uses primary and secondary sources

2. Not all leprosy patients are infectious B. A description of events from the past

3. Leprosy is hereditary C. That truth is a lived experience

4. Casual contact with a patient causes leprosy D. That is involves field work

5. Regular and adequate treatment is essential 19. To collect data for her study, Nurse Rei interviews six
patients who has experienced complications during
*
pregnancy and after delivery. She interviews the patient
1 point two or three times until the point of saturation has been
reached. To what does the term "saturation" in qualitative 4. Be thorough, accurate, and objective.
research refer to?
5. Use only approved abbreviations.
*
*
1 point
1 point
A. Sample size
A. 1, 2, 3, 4, and 5
B. Subject exhaustion
B. 1, 3, and 5
C. Data repetition
C. 2, 3 and 4
D. Researcher exhaustion
D. 2, 4, and 5
20. Nurse Rei drafts a title for her proposed study. Which
24. Public health nurses must know that all records have
of the following would be the appropriate title for her
a lifecycle and retention scheduling. Clinical records
study?
must be retained in the health care facility for:
*
*
1 point
1 point
A. "Caring Behaviors of Nurses Toward Maternity
A. Anytime with client’s permission
Patients with Complications"
B. Ten years from last date of service
B. "Lived Experiences of Maternity Patients with
complications" C. Two years from date of client’s last visit
C. "Quality of life of Maternity Patients with D. Five years from date of client admission
Complications"
25. Controlled Substances such as drugs dispensed and
D. "Competencies of Nurses in the Maternity Unit as administered, order and inventory records must be kept
Perceived by Patients" in the health care facility for how many years?
Situation: In any setting of nursing practice *
including community health, records management
such as documentation and record keeping, is 1 point
important.
A. Six months
21. Documentation is a critical component to the delivery
B. One year
of healthcare. It is a tool which serves many purposes.
Which of the following is NOT included? C. Five years

* D. Three years

1 point Situation: Nurse Amanda is in charge of record

keeping in the health center
A. Create a permanent record for the patient’s future
care 26. Which of the following is NOT a step of record
keeping?
B. Provide material for discussion
*
C. Plan and evaluate a patient’s treatment
1 point
D. Ensures continuity of care
A. Structuring
22. When recording the home visit, it is important for the
public health nurse to _____. B. Storing

* C. Securing

1 point D. Easy disposal

A. Document the visit only when there are significant 27. In the community setting which is the essential
changes record about the patient?

B. Follow the agency format for recording and *

documentation
1 point
C. Complete the charting every Friday of the week
A. Treatment record
D. Use phrases in outline form
B. Tally sheet
23. The nurse should document intelligently and clearly.
There are ways to help protect against an allegation of C. Chart
falsifying a medical record. These are the following: D. Kardex
1. Date, time, and sign every entry. 28. Which of the following is the purpose of record
2. Make entries soon after care is given. keeping?

3. Written legibly. *
1 point the mother indicates correct understanding of the
vaccination schedule?
A. Quantify medication usage
*
B. Historical background
1 point
C. Archive
A. "My baby should receive the first dose at 2 months
D. Quality health care
old."
29. Records are IMPORTANT in health care for
B. "The Hepatitis B vaccine is given in a single dose
* only."

1 point C. "The first dose should be given within 24 hours after

birth."
A. Counting hospital bills
D. "My baby will receive the first dose together with the
B. Evidence of health care MMR vaccine."
C. Quantifying services provided 34. Which of the following is the next appropriate
schedule for the Hepatitis B vaccine?
D. For the physician to read
*
30. What is the ultimate purpose of record keeping?
1 point
*
A. At 3 weeks of age
1 point
B. At 6 weeks of age
A. Safeguard information
C. At 10 weeks of age
B. Archive
D. At 14 weeks of age
C. History
35. During meals, the pregnant client with Hepatitis B
D. Store information
dislodges her IV line and bleeds on the surface of the
Situation: A pregnant client tests positive for the over-the-bed table. It would be most appropriate for the
Hepatitis B virus. nurse to instruct a housekeeper to clean the table with:

31. The client asks the nurse if she will be able to *

breastfeed the baby as planned after delivery. Which
1 point
therapeutic response would the nurse communicate to
the client? A. Alcohol
* B. Acetone
1 point C. Ammonia
A. “You will not be able to breastfeed the baby until 6 D. Bleach
months after delivery.”
Situation: Health Education on HIV-AIDS has been
B. “Breastfeeding is not advised, and you should massive in the years prior, yet patients and their
seriously consider bottle-feeding the baby.” relatives still have a number of queries and
misconceptions about it. Marie, a young mother of
C. “Breastfeeding is not a problem, and you will be able
34, has been recently diagnosed with the disease.
to breastfeed immediately after birth.”
36. Nurse Ana is educating Marie about HIV
D. “Breastfeeding is allowed if the baby receives
transmission. Which of the following bodily fluids is
prophylaxis treatment at birth and scheduled
considered NOT a significant carrier of HIV due to very
immunizations.”
low concentrations of the virus?
32. A hepatitis B screen is performed on a postpartum
*
client, and the results indicate the presence of antigens
in the maternal blood. Which intervention would the 1 point
nurse anticipate to be prescribed to protect the neonate?
A. Urine
*
B. Cerebrospinal fluid
1 point
C. Semen
A. Obtaining serum liver enzymes
D. Menstrual blood
B. Administering hepatitis vaccine
37. Marie is aware that there is mother-to-child
C. Supporting breastfeeding every 5 hours transmission of HIV. She becomes concerned and asks
the nurse when it specifically happens. The nurse
D. Repeating hepatitis B screen in 1 week
answered that it can occur in the following
33. A nurse is conducting health teaching for a new circumstances, EXCEPT _____.
mother regarding the Hepatitis B immunization schedule
*
for her newborn. Which of the following statements by
1 point
A. During breastfeeding C. Virus

B. During casual contact D. Parasite

C. At the time of delivery 43. To confirm a diagnosis of poliomyelitis, specific

diagnostic tests are used to detect the presence of the
D. In utero
virus. What is one of the primary diagnostic methods
38. Marie asks the nurse, “what kind of transmission used to identify poliovirus?
occurs between a mother who is HIV-positive and her
*
infant?” Nurse Ana answered:
1 point
*
A. Blood smear
1 point
B. Urinalysis
A. Vertical transmission
C. Stool culture
B. Diagonal transmission
D. Chest x-ray
C. Horizontal transmission
44. The Oral Polio Vaccine (OPV) is given in a specific
D. Airborne transmission
dosage to ensure its effectiveness. What is the standard
39. Marie has CD4 lymphocyte count below 200 dosage for OPV?
cells/mm3. She then asks what that means. The nurse
*
answered:
1 point
*
A. 0.5 mL
1 point
B. 1 mL
A. That is within normal limits
C. 2 drops
B. She is in Stage 3 or AIDS
D. 5 drops
C. It is slightly below normal, nothing to worry about
45. The nurse is educating a parent about the
D. It is worrisome, but immediate attention is not
poliomyelitis vaccination schedule for their child. Which
necessary
statements about the Oral Polio Vaccine (OPV) and
40. The nurse counsel Marie that the prevention of HIV Inactivated Polio Vaccine (IPV) are correct?
infection that is not usually realistic is which one of the
1. OPV is administered as 2 drops orally.
following?
2. IPV should be administered intramuscularly in the
*
deltoid muscle for infants.
1 point
3. The first dose of IPV is given at 3 ½ months of age.
A. HIV testing
4. OPV should be administered at 2 months, 4
B. Behavioral interventions to reduce risk months, and 6-18 months.

C. Total abstinence 5. IPV is administered intramuscularly in the

anterolateral thigh for infants.
D. Linkage to a treatment center
*
Situation: Cassandra is suspected of having
poliomyelitis after recent travel to an endemic area. 1 point

41. Poliomyelitis is known for its specific modes of A. 1,3,4

transmission. Which of the following is the primary mode
B. 1,2,5
of transmission for poliomyelitis?
C. 2,3,5
*
D. 1,3,5
1 point
Situation: As the rainy season begins, Nurse Jenny
A. Direct contact with respiratory droplets
and her team are on high alert for a rise in Dengue
B. Airborne particles Fever cases.

C. Fecal-oral route 46. What is the causative agent of dengue fever?

D. Vector-borne transmission *

42. What is the causative agent of poliomyelitis? 1 point

* A. Fomite

1 point B. Vector

A. Bacteria C. Bacteria

B. Fungus D. Virus
47. Which of the following strategies would be effective A. 1,2,3 and 4
in reducing the incidence of dengue infection?
B. 1,2,5 and 6
*
C. 2,3,4 and 5
1 point
D. 2,4,5 and 6
A. Healthy nutritious food
52. The WHO reveals that the NUMBER ONE cause of
B. Burning of leaves and garbage death from chronic diseases worldwide, using the 2015
estimate, is _______.
C. Destruction of breeding place of vectors
*
D. Adequate rest and sleep
1 point
48. Bleeding is the most critical complication of dengue
infection. When should the patient be monitored for A. Tuberculosis
signs of bleeding?
B. Diabetes Mellitus
*
C. Ischemic Heart Disease
1 point
D. Pneumonia
A. 4th to 7 days
53. In the Philippines, which is the TOP Killer according
B. At the onset of symptoms to the Department of Health (2009 data)?

C. 2nd to 3rd day *

D. 1st day 1 point

49. What information about dengue fever should the A. Asthma

nurse communicate to the community?
B. Cancer
*
C. Tuberculosis
1 point
D. Cardiovascular Diseases
A. It is always life threatening.
54. When studying chronic diseases, the multifactorial
B. It could be deadly but preventable. etiology of illness is considered. What does this imply?

C. It responds well to antibiotics. *

D. The incubation period is variable. 1 point

50. Which diagnostic test can help confirm the diagnosis A. Single organism that causes the disease, such as
of dengue fever? cholera, must be studied in more detail.

* B. Focus should be on the factors or combinations and

levels of factors contributing to disease.
1 point
C. The rise in infectious and communicable disease
A. Rumpell-Leede
must be the main focus.
B. Mantoux
D. Genetics and molecular structure of disease is
C. Elisa paramount.

D. Widal 55. Determinants of health to address the development

of cancer in a community include:
Situation: According to the World Health
Organization (WHO), there are major causes of non- 1. Proximity of the community to chemical plants that
communicable disease that pose challenges to the emit poisonous gases.
live and health of millions of people and threaten
2. High percentage of tobacco use among the
economic and social development of countries.
residents.
51. Which of the following are the four chronic diseases
3. Prevailing diet high in processed food and fat.
referred to by WHO?
4. Availability of the health facilities.
1. Cardiovascular Disease
5. Old age.
2. Cancer
*
3. Dementia
1 point
4. Arthritis
A. 3,4 and 5
5. Diabetes Mellitus
B. 1,2 and 3
6. Chronic Obstructive Lung Disease
C. 1,3 and 4
*
D. 2,4 and 5
1 point
Situation: In the community where Nurse Aj works, 61. Which assessment finding is indicative of the
there are many individuals with obesity who are diagnosis of hypertension?
experiencing various heart conditions.
*
56. What initiative should Nurse Aj implement to reduce
1 point
the incidence of risk factors, particularly obesity?
A. Family members with high blood pressure
*
B. Elevation of blood cholesterol level
1 point
C. Stressful work environment
A. Wellness and fitness program
D. Consistent elevation of blood pressure
B. Obesity is natural body response
62. Identify the MOST appropriate diagnostic
C. Tell them to go the gym
examination that confirms the incidence of hypertension
D. They have to undergo strict dietary regimen among residents.

57. What should the nurse emphasize in her health *

teachings?
1 point
*
A. Chest x-ray
1 point
B. Ultrasound
A. Jogging a mile a day
C. Electrocardiogram
B. No need to diet
D. BP monitoring
C. Vigorous exercise
63. Which medication will be prescribed to control and
D. Weight reduction maintain the blood pressure of patients at normal level?

58. Nurse Aj should advise patients on the following, *

except:
1 point
*
A. Lidocaine
1 point
B. Amlodipine
A. Cut down on salt intake
C. Epinephrine
B. More fruits and vegetable
D. Furosemide
C. Eat regular meals
64. Nurse Dave had observed that most patients with
D. Eat more saturated fats hypertension stop taking their medications and heard
them saying "I feel good already" Which is the
59. To avoid complications from heart disease, the nurse
APPROPRIATE nursing diagnosis?
advises the patient to regularly check their blood:
*
*
1 point
1 point
A. Impaired gas exchange
A. Cholesterol
B. Anxiety
B. Nitrogen
C. Knowledge deficit
C. Type
D. Ineffective coping
D. Oxygenation
65. During the conduct of his health teachings to the
60. Nurse Aj should incorporate the following in his
patients, which should the nurse emphasize to maintain
health teachings, EXCEPT:
blood pressure at normal level?
*
1. Smoke in moderation
1 point
2. Exercise regularly
A. Less saturated fat
3. Consume less salt
B. Weight within normal limits
4. Maintain normal weight
C. Exercise regularly
5. Less stress
D. More fats in the diet.
*
Situation: Nurse Dave is assigned to manage the
1 point
Non Communicable Disease Prevention and Control.
She is alarmed by the increased number of residents A. 2,3,4,5
who are having Hypertension.
B. 1,2,3,4

C. 1.2.4.5
D. 1,3,4, C. Universal Health Care

* D. Generics Drug Act

1 point Situation: Filariasis is a parasitic disease present in

the Philippines, primarily affecting tropical and
Option 1
subtropical regions.
Situation: Nurse Bea reviews all pertinent laws that
affect public health nursing.
71. During a community health session, a nurse explains
66. RA 9173 is otherwise known as the Philippine
that filariasis is caused by parasitic worms like
Nursing Act of 2002. Which is the primary aim of this
Wuchereria Bancrofti, which primarily invade the:
law?
*
*
1 point
1 point
A. Respiratory system
A. To enhance the competence of professional nurses
B. Gastrointestinal system
B. To regulate practice of professional nursing in the
country C. Urinary tract

C. To facilitate mobility of nurses to other countries D. Lymphatic system

D. To promote well-being of health workers 72.Which organism is recognized as the vector for
filariasis?
67. The nurse closely monitors the work she delegated
to the barangay health worker. She is legally guided by *
this principle
1 point
*
A. Aedes aegypti
1 point
B. Wuchereria bancrofti
A. Respondeat superior
C. Aedes poecilus
B. The good Samaritan
D. Anopheles
C. Res ipsa loquitor
73. Raphael’s wife took him to the doctor's clinic for a
D. Jurisprudence test to determine the presence of filariasis. Which
diagnostic test is he most likely to undergo?
68. This law promotes the wellbeing and living conditions
of health workers especially those from the government *
managed facilities
1 point
*
A. Immunochromatographic test (ICT)
1 point
B. Nocturnal blood examination
A. Continuing professional development
C. Stool exam
B. Magna Carta for health workers
D. Urinalysis
C. Philippine qualifications framework
74. If an individual is in the acute phase of filariasis, what
D. Local government code symptoms might you expect to see?

69. It mandates the compulsory immunization of children *

below 8 years old
1 point
*
A. Lymphangitis, lymphadenitis, epididymitis
1 point
B. Hydrocele, lymphedema, elephantiasis
A. PD 996
C. Orchitis, hydrocele, elephantiasis
B. RA 11223
D. Lymphangitis, lymphedema, orchitis
C. RA 9173
75. A patient with filariasis presents with severe swelling
D. RA 10912 of the extremities due to lymphatic obstruction. What is
the medical term for this condition?
70. This law allows every Filipino to avail of affordable
medicines *

* 1 point

1 point A. Gigantism

A. Local Government Code B. Elephantiasis

B. Primary Health Care C. Lymphedema

D. Hydrocele B. the scope of nursing practice to be expanded into
areas formerly reserved for other disciplines.
Situation: Public health nurse Evelyn wants to
increase her knowledge and familiarity with the C. nursing responsibility to be more specifically defined
elements of research publication.
D. liability within the practice of nursing to be decreased

Situation: Correct administration of right

76. Nurse Evelyn is analyzing a research article. What medications with right dose to the right client is the
section in the article can she expect to find the research nurse's responsibility in the management of client's
question and study purpose? health needs. Nurse Cha is preparing various
medications for her clients in the ward.
*
81. Nurse Cha goes to the room of Mrs. Jaime who is
1 point
lying in bed. After checking the client's identity, the nurse
A. Discussion gives her the medications. Mrs. Jaime tells the nurse
that she "has a hard time swallowing tablets and is afraid
B. Results she might choke". Which nursing action is MOST
APPROPRIATE?
C. Methods
*
D. Introduction
1 point
77. Nurse Evelyn is looking for a description of the type
of measurement used in the study. She will find this A. Ask the client to assume sitting position
section of the article?
B. Put the tablet in banana for easy swallowing
*
C. Pound the tablet and mix in client's soup or juice
1 point
D. Tell the client the pills are small and should be taken
A. Conclusion on time.
B. Introduction 82. In the next room is Mrs. Mercado, 52 years old, with
an order for instillation of otic drops. Nurse Cha checks
C. Results
the client's identity then asks Mrs. Mercado to lie on her
D. Methods side, opposite the ear to be medicated. When
administering the otic drops nurse Chenny straightens
78. A brief explanation of data collection and analysis the ear canal by pulling the pinna in which CORRECT
procedure is found in which section of direction:
the article? *
* 1 point
1 point A. Upward and forward
A. Abstract B. Upward and backward
B. Conclusion C. Downward and backward
C. Discussion D. From side to side
D. Introduction 83. Mrs. Mercado has to receive SUBCUTANEOUS of
79. Nurse Evelyn wants to go over the list of references epinephrine. For thin clients like Mrs. Mercado, Nurse
used in the study which can be found Cha should ensure that the medication is correctly
administered. After checking the client's identity, she
____________. prepares the skin then lifts skin fold at the injection site
and injects medication at which angle?
*
*
1 point
1 point
A. at the end of the article
A. 45 degrees
B. in the results section
B. 90 degrees
C. as part of the literature review
C. 50 degrees
D. in the introduction
D. 30 degrees
80. Nurse Evelyn believes that research is significant to
the nursing profession, hence, the study results should 84. An iron preparation is to be injected intramuscularly
be disseminated. This is because research allows to Mrs. Gavino. Nurse Cha safely administered the drug
_________. using the Z-track technique. technique are true
EXCEPT:
*
*
1 point
1 point
A. a specialized body of knowledge to be generated for
use in health care delivery. A. The skin is pulled sideways is injected at a 45 degree
B. The zigzag path seals the needle track trapping the 89. The board of nursing has brought action against a
medication in the muscle nurse’s license based upon violation of

C. This method allows medication to be injected slowly a regulation. What is TRUE about this scenario?
to disperse evenly in muscle tissue
*
D. This technique is best when medication is irritating to
1 point
tissue
A. Rules and Regulations are internal to the Board, not
85. Nurse Cha will do a skin test for Aidan. She uses a
the nurse.
tuberculin syringe with gauge 25 needle and performs
the intradermal procedure CORRECTLY when she: B. Rules and regulations are only suggested standards
or care and do not have to be followed.
*
C. These rules and regulations have the force of law.
1 point
D. Violation of a rule and regulation is not the same as
A. Pinches and moves skin test for sideways and inject
violation of the nursing Practice Act.
medication slowly
90. The patient, injured at work, was seen by the factory
B. Massages the injection site immediately after
occupational nurse. The nurse treated the wound and
withdrawing the needle
instructed the patient to get a tetanus antitoxin injection
C. Aspirates after inserting needle to check for bleeding at the City Health Center. The patient failed to follow
instructions, developed tetanus, and subsequently filed a
D. Holds skin taut insert needle bevel up at 10 to 15
suit against the nurse. What is the most likely result of
degree angle
the ensuing trial? The nurse is __________.
Situation: A nurse is a trained professional who
*
provides care to people who are ill, injured, or in
need of medical support. 1 point

86. A nurse must follow laws that protect public health, A. liable, because there was no follow-up to ensure that
safety, and welfare. Which law is the nurse following? the patient receive the injection

* B. not liable for damages, because the nurse has a right

to expect that instructions will be followed.
1 point
C. liable, because tetanus is easily treatable after
A. Code of Ethics
diagnosis
B. Standards of Practice
D. not liable, because tetanus is a reportable disease
C. Continuing Professional Development and the health center should have insisted the treatment.

D. Nursing Practice Act Situation: Nurse Erica is fully aware that being a
public health nurse her work is guided by ethico-
87. Which situation supports the charge of malpractice moral principles.
against a professional nurse?
91. Which is the 'MAIN' goal of ethical practice of the
* nursing profession including the community setting?
1 point *
A. A failure on the part of the nurse to establish a 1 point
therapeutic relationship with the patient.
A. To protect the nurse and co workers
B. A failure on the part of the nurse to ensure that
patients only receive care for which they could pay. B. To prevent reprimand from physicians

C. A failure on the part of the nurse to exercise C. For the patients family satisfaction
reasonable and prudent care in treating a patient.
D. Centered on the welfare of clients and protect their
D. A failure on the part of the nurse to allay a patient’s rights
fears about an upcoming procedure.
92. As public health nurse Nurse Erica makes sure all
88. What does the court consider in determining the the supplies and medicines needed for the care of the
nurse’s liability for standards of care? community are available. This is an example of the
principle of
*
______________.
1 point
*
A. Professional education, experience, and specific
conduct. 1 point

B. Professional experience, but not education or A. Justice

conduct.
B. Respect
C. Professional conduct, but not experience or education
C. Fair treatment
D. Professional education, but not experience or
D. Beneficence
conduct.
93. Select nurses action in keeping with principle of C. Vitex negundo
confidentiality
D. Psidium guajava
*
98. Nurse Rico is conducting a lecture on medicinal
1 point plants under RA 8423. A participant asks about an herbal
remedy for antifungal skin conditions. Which of the
A. Hides identity of patient
following plants should the nurse highlight, and why?
B. Shares information from patients chart in public
*
C. Keeps all matters about the patient as a secret
1 point
D. Discusses the case of patient with others
A. Akapulko, because it contains chrysophanic acid.
94. Nurse Erica is always guided by the principle of
B. Tsaang Gubat, because it has antimicrobial effects.
beneficence in all that she does to all her patients.
Which of the following nursing action is aligned with C. Bayabas, because it can prevent fungal spore
principle of beneficence. germination.

* D. Niyog-Niyogan, because it has anti-parasitic

properties.
1 point
99. Nurse Ella is preparing to include niyog-niyogan in a
A. Equal and fair allocation of resources to all
deworming program. During a training session, what
B. Getting informed consent precaution should the nurse emphasize to avoid
complications?
C. Keep records of patients from public viewing
*
D. Promoting patient safety at all times
1 point
95. Nurse Erica tap all the newly hired nurses to be
members of her new project. She is observing the ethical A. Use only the leaves for decoction to avoid toxicity.
principle of __________.
B. Administer the seeds in low doses to prevent
* gastrointestinal side effects.

1 point C. Ensure the seeds are boiled to neutralize toxins

before ingestion.
A. Justice
D. Recommend it for children under 5 years old for
B. Autonomy efficacy.
C. Nonmaleficence 100. Nurse Elisha is leading a barangay health
education session and is asked about the use of
D. Respect
bayabas (guava). Which of the following uses is NOT
Situation: Nurse Bianca is conducting a seminar on supported by evidence-based practice for bayabas?
the Philippine Institute of Traditional and Alternative
*
Health Care (PITAHC) under RA 8423.
1 point
96. One participant asks about the use of Sambong.
Which of the following scenarios demonstrates the A. As an antiseptic for wound care
correct use of sambong as an herbal medicine?
B. As a mouthwash for oral infections
*
C. As an antidiarrheal for acute gastroenteritis
1 point
D. As a treatment for fungal skin infections
A. A 45-year-old hypertensive patient using sambong as
a diuretic for blood pressure control. RECALLS 7 NP2

B. A 60-year-old patient with dysuria due to urinary tract SItuation: Nurse Joel is collecting data from a newly
infection taking sambong to alleviate symptoms. admitted patient, Mrs. Christine, who is pregnant
with twins. She has a healthy 3-year-old child who
C. A 30-year-old with a history of kidney stones using was delivered at 38 weeks. She also revealed that
sambong for its litholytic property. she does not have a history of abortion nor fetal
demise. Her last menstrual period began February 7,
D. A 25-year-old asthmatic using sambong for
2017 and ended February 12, 2017.
bronchospasm relief.
1. What is the GTPAL for Mrs. Christine?
97. During a barangay health program, a mother with
joint pain due to gout asks about herbal remedies. Which *
medicinal plant approved under RA 8423 should the
nurse recommend, and what is its mechanism of action? 1 point

* A. G = 1, T = 1 , P = 1, A = 0, L = 1

1 point B. G = 2, T = 0 , P = 0, A = 0, L = 1

A. Peperomia pellucida C. G = 3, T = 2 , P = 0, A = 0, L = 1

B. Blumea balsamifera D. G = 2, T = 1 , P = 0, A = 0, L = 1
2. Mrs. Christine asks “When will be my expected date of A. Brown fat.
delivery (EDD)?” Based on her knowledge of Naegeles’
B. Glucose.
Rule, which should be the CORRECT answer of Nurse
Joel? C. Glycogen.
* D. Lanugo.
1 point 7. Drying the infant immediately after birth helps prevent
heat loss from what mechanism?
A. November 14, 2017
*
B. October 14, 2017
1 point
C. October 19, 2017
A. Conduction
D. November 19, 2017
B. Convection
3. A pregnant client reports morning sickness, nausea
and vomiting, missed periods, and breast tenderness. C. Evaporation
Which of these would be classified as a presumptive
sign of pregnancy? D. Radiation

* 8. After assisting with a vaginal delivery, what would the

nurse do to prevent heat loss via conduction in the
1 point newborn?
A. Fetal outline felt by examiner *
B. Positive pregnancy test. 1 point
C. Breast tenderness. A. Wrap the newborn in a blanket.
D. Fetal heart tones detected by Doppler. B. Close the doors to the delivery room.
4. A 10-week pregnant client asks the nurse how to C. Dry the newborn with a warm blanket.
determine if she’s truly pregnant. Nurse Priscila is
correct if he explains that a positive sign of pregnancy is: D. Place the newborn on a warm crib pad.

* 9. To prevent heat loss from convection, which action

should Nurse Calvin do?
1 point
*
A. Enlarged breasts.
1 point
B. Presence of fetal heart tones detected by Doppler.
A. Dry the neonate quickly
C. Positive pregnancy test.
B. Keep the neonate away from air conditioning vents
D. Presence of Quickening
C. Pre-warm the bed
5. A patient asks Nurse Yor about the signs and
symptoms of pregnancy. Nurse Yor is correct if she D. None of the above
states:
10. When performing nursing care for a neonate after
* birth, which intervention has the highest nursing priority?

1 point *

A. "The first perception of fetal movement that you have 1 point

felt at 16th to 20th week of gestation is a probable sign
A. Give the vitamin K injection
of pregnancy."
B. Give the initial bath
B. "The compressibility and softening of the lower uterine
segment that occurs about the 6th week is a probable C. Obtain a dextrostix
sign."
D. Cover the neonate’s head with a cap
C. “The examiner palpating fetal movement at 18 weeks
is a probable sign." Situation: The nurse has admitted a client
diagnosed with gestational hypertension who is in
D. "Pigmentation changes such as linea nigra and labor.
melasma are considered probable signs of pregnancy."

Situation: A neonate is born by primary cesarean

section at 36 weeks gestation. The temperature in 11. Which of the following are present in pregnancy-
the birthing room is 21 degree celsius. induced hypertension?

6. When the couple touches the newborn's shoulders, *

the skin feels warm. The nurse explains that the best 1 point
insulator for the newborn is:
A. Hypertension, proteinuria, and edema.
*
B. Hypertension, gestational diabetes, and edema.
1 point
C. Hypertension, seizure, and proteinuria. B. Those with medical conditions such as anemia

D. Proteinuria, edema, and seizure. C. Those younger than 20 years and older than 35 years

12. The nurse monitors the client closely for which D. Those who just had a delivery within the past 15
complication of gestational hypertension? months

* 17. Freedom of choice in one of the policies of the

Family Planning Program of the Philippines. Which of
1 point
the following illustrates this principle?
A. Seizures
*
B. Hallucinations
1 point
C. Placenta previa
A. Information dissemination about the need for family
D. Altered respiratory status planning

13. Nurse Alex is preparing a plan of care for client B. Support of research and development in family
Sophia with pre-eclampsia and documents that if client planning methods
Sophia progresses from preeclampsia to eclampsia,
C. Adequate information for couples regarding the
Nurse Alex should take which first action?
different methods
*
D. Encouragement of couples to take family planning as
1 point a joint responsibility

A. Administer oxygen by face mask. 18. The nurse provides instructions to Maria who will
begin taking oral contraceptives. Which statement by the
B. Clear and maintain an open airway client indicates the need for further teaching?
C. Administer magnesium sulfate intravenously *
D. Assess the blood pressure and fetal heart rate 1 point
14. Nurse Alex is administering magnesium sulfate to A. "I will take one pill daily at the same time every day."
another client experiencing severe preeclampsia. What
intervention would the nurse implement during the B. "If I miss a pill, I must take it as soon as I remember."
administration of magnesium sulfate for this client?
C. "I will not need to use an additional birth control
* method after I start these pills."

1 point D. "If I miss two pills, I will take them both as soon as I
remember, and then two pills the next day."
A. Schedule a daily ultrasound to assess fetal
movement. 19. She has regular menstrual cycles of 28 days and
wants to know when she is most fertile. When is she
B. Schedule a nonstress test every 4 hours to assess most likely to be fertile based on the typical menstrual
fetal well-being. cycle?
C. Assess the client's temperature every 2 hours *
because the client is at high risk for infection.
1 point
D. Assess for signs and symptoms of labor since the
client's level of consciousness may be altered. A. Days 9-16

15. Which of the following signs would alert Nurse Alex B. Days 22-28
to administer calcium gluconate?
C. Days 1-5
*
D. Days 17-21
1 point
20. There are two research projects under study. The
A. Urine output of 30ml/hr first is entitled "Effects of Nurses Contraceptive
Counseling on Unwanted Birth" and the second is
B. Respiratory rate of 35cpm entitled "Effects of Unwanted Birth on the Incidence of
Child Abuse.” Which of the following choices is true
C. Blood pressure of 130/80 mmHg
regarding these two studies?
D. Absent of patellar reflexes
*
Situation: Maria, a 32-year-old mother of five in rural
1 point
Mindanao, wants to use contraceptives offered for
free at the barangay health center. A. Both research problems have the same dependent
variable
16. Which of the following women should be considered
as special targets for family planning? B. Both research problems have the same independent
variable
*
C. The Independent variable in the first research
1 point
problem is used as dependent. variable on the second
A. Those who have two children or more study
D. The dependent variable in the first research problem *
is used as independent variable in the second one
1 point
Situation: The nurse is performing an
A. Painful sex
assessment on a female client who is suspected
of having mittelschmerz. B. Painful menstruation
21. Which subjective finding supports the possibility of C. Painful ovulation
this condition?
D. Painful pareunia
*
Situation: Nurse Jun is educating Ms. Baby, a 25-
1 point year-old woman, about her menstrual cycle. Ms.
Baby is concerned about the regularity, duration,
A. Experiences pain during intercourse
and flow of her periods. She wants to understand
B. Has pain at the onset of menstruation what is considered normal and when she should
seek medical advice.
C. Experiences profuse vaginal bleeding
26. Nurse Jun is educating Ms. Baby on the normal
D. Has sharp pelvic pain during ovulation
duration of a menstrual cycle. What is the average
22. When teaching clients to determine the time of length of a menstrual cycle in most women?
ovulation by taking the basal temperature, the nurse
*
explains that the change in the basal temperature during
ovulation is shown in which of the following 1 point
observations? The temperature_____________.
A. 21 days
*
B. 28 days
1 point
C. 35 days
A. Drops markedly and remains lower
D. 40 days
B. Rises markedly and remains high
27. Nurse Jun explains to Ms. Baby that the duration of
C. Drops slightly and then rises again menstrual bleeding can vary. What is the average range
for the number of days a woman may experience
D. Rises suddenly and then falls down
menstrual bleeding?
23. After ovulation has occurred, the nurse teaches
*
women in the fertility clinic that the ovum is through to
remain viable for many HOURS? 1 point

* A. 1-3 days

1 point B. 4-6 days

A. 24 to 36 C. 7-10 days

B. 12 to 18 D. 11-14 days

C. 48 to 72 28. Nurse Jun reviews the typical amount of menstrual

flow with Ms. Baby. What is the average amount of
D. 1 to 6
menstrual flow during a period?
24. The nurse performs an assessment on Mrs.
*
Mangaban. Which of the findings would be indicative of
endometriosis? Select all that apply. 1 point

1. Spotting after intercourse A. 10-30 mL

2. Menorrhagia B. 30-80 mL

3. Persistent dysmenorrhea C. 80-100 mL

4. Mass felt on palpation. D. 100-150 mL

5. Dyspareunia 29. Nurse Jun discusses with Ms. Baby the normal
characteristics of menstrual odor. What should Ms. Baby
6. Yellow purulent discharge
understand if her menstrual blood has an odor similar to
* marigold?

1 point *

A. 2, 3 and 4 1 point

B. 3, 4 and 5 A. Presence of bacterial infection

C. 1, 2 and 3 B. Normal hormonal changes

D. 4, 5 and 6 C. Excessive menstrual flow

25. What is dyspareunia? D. Recent dietary changes

30. Nurse Jun educates Ms. Baby about normal B. Multigravida patients have shorter labor.
characteristics of menstrual blood. Which of the following
C. Cervical lengthening was longer.
statements about the color of menstrual blood is
accurate? D. Induction of labor was done.
* 35. The mechanisms involved in fetal delivery is:
1 point *
A. Menstrual blood is typically bright red in color. 1 point
B. Menstrual blood is usually dark red or brown in color. A. Descent, extension, flexion, external rotation
C. Menstrual blood is yellowish in color. B. Descent, flexion, internal rotation, extension, external
rotation
D. Menstrual blood color varies from white to pink.
C. Flexion, internal rotation, external rotation, extension
Situation: Danica, a multiparous patient is admitted
due to labor pains which started an hour ago. During D. Internal rotation, extension, external rotation, flexion
the vaginal examination, the nurse noted the
complete dilatation of the cervix and effacement is Situation: Nurse Josephine is educating a
100 percent. The patient is in true labor pains. postpartum mother about the concept of lochia and
puerperium.
31. The nurse is caring for Danica with a
precipitous labor. What information would the nurse 36. For uterine assessment after delivery, position the
provide to the client regarding this type of labor? patient supine so that the height of the uterus is not
influenced by an elevated position. Observe the
* abdomen for contour, to detect distention, and for the
appearance of striae or a diastasis. Where will you begin
1 point
to place your hand?
A. Induction may be necessary.
*
B. The onset of contractions is gradual.
1 point
C. The labor may last less than 3 hours.
A. fundus of the uterus
D. A lengthy period of pushing may be necessary.
B. just above the symphysis pubis
32. Patient Josephine was referred to the physician,
C. at the umbilicus
routine blood examinations were taken. After reviewing
the serum electrolyte levels, an order of isotonic D. side of the abdomen
intravenous (IV) infusion was prescribed. Which IV
solution should the nurse prepare? 37. The nurse is performing an assessment on a mother
who just delivered a healthy newborn. When checking
* the uterine fundus the nurse should expect to note that
the fundus is positioned at which location?
1 point
*
A. 5 percent dextrose in water
1 point
B. 0.45 percent sodium chloride solution
A. To the right of the abdomen
C. 10 percent dextrose in water
B. At the level of the umbilicus
D. 3 percent sodium chloride solution
C. Above the level of the umbilicus
33. Nurse Jordyn reads the physician's prescription to
administer methylergonovine maleate (Methergin) D. One fingerbreadth above the symphysis pubis
intramuscularly after delivery. The rationale for giving this
medication is which of the following? 38. A postpartum nurse caring for a client who delivered
vaginally 2 hours ago palpates the fundus and notes
* the character of the lochia. Which characteristic of the
lochia would indicate to the nurse that the client's
1 point
recovery is normal?
A. Reduces the amount of lochia drainage.
*
B. Prevents postpartum hemorrhage
1 point
C. Decreases uterine contractions.
A. Pink-colored lochia
D. Maintains normal blood pressure.
B. White-colored lochia
34. Patient Danica asks why her labor is much shorter
C. Serosanguineous lochia
compared to previous deliveries. Which of the following
is the BEST RESPONSE? D. Dark red-colored lochia
* 39. Which statement by the patient indicates a need for
further teaching?
1 point
*
A. Onset of contraction was gradual.
1 point 44. A common drug given to stop the rapid growth of a
hydatidiform mole is:
A. "I should expect to see lochia for up to 6 weeks after
delivery." *

B. "Lochia should be a yellowish color after the first few 1 point

days."
A. Methotrexate
C. "The color of lochia should progress from red to pink
B. Meperidine
to white."
C. Mifepristone
D. "If the lochia reverses in color, I should contact my
doctor." D. Misoprostol
40. A 28-year-old primiparous woman, 2 days 45. Which of the following discharge instructions must be
postpartum, is exhibiting passive behavior, expressing given to a woman who has just undergone suction and
fatigue and stating, "I can't seem to do anything right." curettage for gestational trophoblastic disease?
Which phase of puerperium is most likely being
exhibited? *

* 1 point

1 point A. “Visit your physician after one year for a follow-up

examination to find out if there is still a possibility that get
A. Taking-in phase pregnant.”
B. Taking-hold phase B. “Women who have had a molar pregnancy must avoid
sexual intercourse for a year or two.”
C. Letting-go phase
C. “HCG levels usually return to normal 48 hours after
D. Giving-up phase
evacuation.”
Situation: Gestational Trophoblastic disease or
D. “Use a reliable contraceptive method for 12 months.”
abnormal proliferation of the trophoblastic villi tend
to occur most often to women who have a low Situation: Placenta Previa and Abruptio Placentae
protein intake, women older than 35 years old, and are two serious obstetric conditions involving
in women of Asian heritage. abnormalities in placental location or separation.
41. The characteristic manifestation of gestational 46. A client at 36 weeks gestation arrives at the
trophoblastic disease is: emergency department with painless, bright red vaginal
bleeding. The nurse suspects which complication?
*
*
1 point
1 point
A. Uterus tends to expand slower than a normal
pregnancy A. Placenta previa
B. Lower abdominal quadrant pain B. Abruptio placentae
C. Hyperemesis Gravidarum C. Uterine rupture
D. An HCG level of 400,000 IU D. Vasa previa
42. Assessment of client diagnosed to have hydatidiform 47. The nurse is assessing a patient with placenta previa
mole would include: who has experienced vaginal bleeding. Which of the
following findings requires immediate intervention?
*
*
1 point
1 point
A. Falling blood pressure with increased cardiac rate
A. Blood color is bright red
B. Absence of fetal heart sounds
B. Fetal heart rate is 130 bpm
C. Diaphoresis
C. The patient reports no pain
D. Delusions
D. Blood pressure decreases from 120/80 to 80/60
43. Which of the following is NOT an expected
mmHg
assessment for a client with H-mole?
48. A pregnant woman is admitted with a tentative
*
diagnosis of placenta previa. The nurse implements
1 point orders to start an IV infusion, administer oxygen, and
draw blood for laboratory tests. The client’s
A. Rapid increase in uterine size
apprehension is increasing, and she asks the nurse what
B. Excessive nausea and vomiting is happening. The nurse tells her not to worry, that she
is going to be all right, and that everything is under
C. Slow abdominal enlargement control. What is the best interpretation of the nurse’s
statement?
D. Vaginal bleeding
* inches. What other physical characteristics are expected
in a child of this age?
1 point
*
A. Adequate, because the preparations are routine and
need no explanation 1 point

B. Effective, because the client’s anxieties would A. Weight doubled from birth weight
increase if she knew the danger involved
B. Height increase of 1 inch per month
C. Questionable, because the client has the right to
C. Anterior fontanel closed
know what treatment is being given and why
D. No need for daytime naps
D. Incorrect, because only the healthcare provider
should offer assurances about management of care 53. Nurse Ember Lily is reviewing the growth of a 2-year-
old toddler. Which statement is not accurate for this age?
49. A perinatal home care nurse has just assessed the
fetal status of a client with a diagnosis of partial *
placental abruption of 20 weeks' gestation. The
client is experiencing new bleeding and reports less 1 point
fetal movement. The nurse informs the client that the
A. Weight gain slows down compared to infancy
obstetrician will be contacted for possible hospital
admission. The client begins to cry quietly while B. Head circumference increases about 1 inch
holding her abdomen with her hands. She murmurs,
"No, no, you can't go, my little man." The nurse C. Anterior fontanel is still open
would recognize the client's behavior as an indication D. Height increase is about 3 inches per year
of which psychosocial reaction?
54. Nurse Ember Lily is monitoring a 10-year-old child's
* growth and development. What physical growth pattern
1 point is expected for this age group?

A. Fear of hospitalization *

B. Fear of loss and the death of the fetus 1 point

C. Grief due to potential loss of the fetus A. Growth spurts of 6 inches per year

D. Cognitive confusion as a result of shock B. Weight gain of 10 pounds per year

50. The bleeding in placenta previa is contrasted to that C. Height increase of 2 inches per year
of abruption placenta is such a way that: D. Loss of all primary teeth by age 10
* 55. Nurse Ember Lily is discussing puberty with a group
1 point of adolescents. Which statement about puberty is not
true?
A. Bleeding in abruptio placenta is painful while bleeding
in placenta previa is painless *

B. Bleeding in abruptio placenta is internal while 1 point

bleeding in placenta previa external A. Menstrual periods occur about 2.5 years after the
C. There is more blood loss in abruption placenta onset of puberty

D. There is more blood loss in placenta previa B. Body mass reaches adult size

Situation: Nurse Ember Lily is conducting a C. Puberty starts at the same age for everyone
developmental assessment on various pediatric D. Sebaceous and sweat glands become fully functional
patients. She is reviewing their growth and
developmental milestones to ensure they are on
track and providing guidance to their parents.
Situation: Nurse Aliyah is reviewing pediatric clients
with gastrointestinal disorders.

51. Nurse Ember Lily is assessing a 6-month-old infant.

Which finding is not typical for an infant of this age?
56. During assessment, the mother of a 5-year-old
* reports that her daughter is experiencing constipation
and ribbon-like stools. The nurse recognizes this as a
1 point symptom of which condition?
A. Height increases by 1 inch per month *
B. Birth weight has tripled 1 point
C. Posterior fontanel has closed A. Aganglionic Megacolon
D. Nocturnal sleep pattern lasts 9 to 11 hours B. Volvulus
52. During a well-child visit, Nurse Ember Lily notes that C. Intussusception
a 2-year-old toddler has a head circumference of 19
D. Hernia 61. Nurse Bud is assessing a newborn with an orofacial
defect. He notes that the maxillary and median nasal
57. Which dietary recommendation is most appropriate
processes have failed to fuse. This condition is identified
for a child post-operatively for Hirschsprung’s disease?
as:
*
*
1 point
1 point
A. High-fiber, low-calorie diet
A. Cleft palate
B. Gluten-free, low-fat diet
B. Cleft lip
C. Low-fiber, high-calorie, high-protein diet
C. Palatine tonsil
D. Dairy-free, high-fiber diet
D. Maxillary fusion
58. During health teaching of a patient with celiac
62. A client has just given birth to a newborn who has a
disease, which statement indicates a correct
cleft lip and palate. When planning to talk with the
understanding of gluten sources?
client, Nurse Bud recognizes that the client needs to
* first work through which emotion before maternal
bonding can occur?
1 point
*
A. "Oats are always safe as they do not contain gluten."
1 point
B. "Small amounts of rye are safe in a gluten-free diet."
A. Guilt
C. “All dairy products must be eliminated to control
symptoms." B. Grief

D. "Rice and quinoa are excellent gluten-free C. Anger

alternatives."
D. Depression
59. Nurse Aliyah is providing health teaching for the
63. What is the MOST APPROPRIATE response of the
parents of a child diagnosed with intussusception.
nurse to the mother’s question as to when the child will
During the session, one parent asks about nursing
be ready for a cleft palate repair? Cleft palate repair is
interventions. Which of the following is inappropriate for
usually done ____
the nurse to perform?
*
*
1 point
1 point
A. When a large-holed feeding bottle is ineffective for his
A. Monitor for the passage of normal, brown stool,
feeding
indicating the condition has resolved.
B. When the child is completely weaned from bottle
B. Monitor for signs of perforation or shock (fever,
feeding
tachycardia, changes in level of consciousness,
respiratory distress). C. Prior to the development of speech

C. Explain the surgical procedure and obtain informed D. After the child has been toilet trained
consent.
64. Nurse Bud is assigned to care for an infant on the
D. Provide guidance and emotional support. first postoperative day after a surgical repair of a cleft lip.
Which nursing intervention is appropriate when caring
60. A friend of the parents of a newborn with a
for this child’s surgical incision?
diagnosis of congenital tracheoesophageal fistula
contacts the home health nurse with an offer to *
help. Which is the best nursing action at this time
1 point
to address the needs and rights of the family?
A. Rinsing the incision with sterile water after feeding
*
B. Cleaning the incision only when serous exudate forms
1 point
C. Rubbing the incision gently with a sterile cotton-tipped
A. Inform the friend to directly contact the family and
swab
offer assistance to them.
D. Replacing the Logan bar carefully after cleaning the
B. Request that the friend come to the client's home
incision
during the next home health visit.
65. On the 2nd postoperative day after repair of a
C. Report the friend's call to the nurse manager for
cleft palate, what should the nurse use to feed a
referral to the client's social worker.
toddler?
D. Assure the friend that there is no need for assistance
*
since the nurse is visiting daily.
1 point
Situation: Nurse Bud is assigned in caring for
patients with cleft lip and palate. A. cup
B. straw 70. The nurse is caring for a hospitalized child with
a diagnosis of rheumatic fever who has developed
C. rubber-tipped syringe
carditis. The mother asks the nurse to explain the
D. large-holed nipple meaning of carditis. On which description of this
complication of rheumatic fever would the nurse
Situation: Rheumatic fever (RF) and Rheumatic plan to base a response?
Heart Disease (RHD) remain significant public health
concerns in the Philippines, particularly among *
children and young adults.
1 point
66. Nurse Ruby is assessing a child admitted with a
A. Involuntary movements affecting the legs, arms, and
diagnosis of rheumatic fever. Which significant
face
question would the nurse ask the child's parent
during the assessment? B. Inflammation of all parts of the heart, primarily the
mitral valve
*
C. Tender, painful joints, especially in the elbows, knees,
1 point
ankles, and wrists
A. "Has your child had difficulty urinating?"
D. Red skin lesions that start as flat or slightly raised
B. "Has your child been exposed to anyone with macules, usually over the trunk, and that spread
chickenpox?" peripherally

C. "Has any family member had a sore throat within the Situation: Ryzza Mae, head nurse at the OB-DR
past few weeks?" Ward, is planning to have an in-service training for
25 staff nurses. Based from needs assessment, the
D. "Has any family member had a gastrointestinal training will be on lactation for 3 days.
disorder in the past few weeks?"
71. In order to make the activity a success, which of the
67. Nurse Ruby is teaching parents about rheumatic following resources would be MOST important?
fever. Which of the following is appropriate health
teaching? *

* 1 point

1 point A. Number of speakers

A. Symptoms subside in a few days with antimicrobial B. Location of venue

therapy only.
C. Number of participants
B. Untreated Group A beta-hemolytic streptococcal
D. Budget Allocation
infections can lead to rheumatic fever.
72. Which of the following resources should be
C. Parents can manage their child without seeking
MATERIAL/SUPPLY?
professional healthcare.
*
D. Symptoms will resolve without treatment once
infection resolves. 1 point

68. For making the diagnosis of rheumatic fever, the A. Bond Paper
Jones criteria requires which of the following conditions?
B. Sound system
*
C. food and drinks
1 point
D. tables and chairs
A. One major and one minor manifestations
73. Based from the studies, which among the following is
B. Two major or one major and two minor manifestations the MOST needed resource of nurses in order to atend
in-service training programs?
C. Two major and one minor manifestations
*
D. Two minor manifestations
1 point
69. Nurse Aiko is reviewing diagnostic tests for
rheumatic fever. Which laboratory test assists in A. Clothes
confirming the diagnosis?
B. Time
*
C. Drinks
1 point
D. Notebooks
A. Immunoglobulin levels
74. Evaluation of the training is an important form of
B. Red blood cell count feedback in order to improve future offerings. Which of
the following should be given MOST emphasis?
C. White blood cell count
*
D. Anti-streptolysin O titer
1 point
A. Taste and amount of food served. A. Stand while holding on to furniture.

B. Discipline of participants. B. Crawl short distances.

C. Convenience of the venue. C. Roll over from back to abdomen.

D. Knowledge and skills gained. D. Sit up without assistance.

75. When asking mothers to become real models for 80. Nurse Ara assesses the oral cavity of a 6-month-old
demonstrating breasfeeding, the nurse’s MOST child and finds out that the tooth that buds first is the
important responsibility is which of the following? __________.

* *

1 point 1 point

A. Word of thanks A. Lower central incisor

B. Stipend/honorarium B. Upper central incisor

C. Priority care C. Upper lateral incisor

D. Free hospitalizaion D. Lower lateral incisor

Situation: Nurse Ara is assigned at the Under Five Situation: A current initiative of the Department of
Clinic. Mostly of her patients are infants, so she took Health (DOH) is the program called essential
the opportunity to have a mother’s class on the care intrapartal Newborn (EINC). This provides
of infants. meaningful measures to be undertaken by
healthcare professionals in doing immediate
76. Which of the following will Nurse Ara EMPHASIZE
intrapartal maternal care and newborn care
regarding the importance of play during infancy? Play
management and the following conditions apply.
enhances _______ development.
81. Nurse Julia is a member of the birthing team when
*
Jenny gave birth to her first born. Inside the delivery
1 point room Nurse Julia assisted the attending obstetrician. To
address the concerns of keeping the baby warm, her first
A. Cognitive step in obtaining thermal protection for the newborn is to.
B. Emotional *
C. Physical 1 point
D. Social A. Dry the baby thoroughly after the cord has been cut
77. Which among the infants would show signs that B. Dry the baby thoroughly immediately after giving birth
he/she is experiencing maternal deprivation?
C. Cover the baby with a clean, dry cloth after the cord
* has been cut
1 point D. Cover the baby with clean, dry cloth, immediately
after birth
A. Hyperactive
82. After providing necessary drying and warmth and
B. Overweight
support to the newborn. Nurse Julia observed other
C. prone to illness details as essential parts of the immediate care of a
normal newborn which includes:
D. responsive to stimuli
*
78. What should Nurse Ara include in the accident
prevention teaching plan for a mother with a 4-month-old 1 point
infant?
A. Deep suctioning of the airway to remove mucous
*
B. Removing used wet cloth, and covering the baby with
1 point clean, dry clot

A. Keep crib rails up to the highest position. C. Stimulation the baby by slapping the soles of the
baby's feet
B. Cover electric outlets with safety plugs.
D. Skin-to-skin contact by placing the baby over the
C. Remove poisonous substances from low areas. mother's chest
D. Remove small objects from the floor. 83. In applying essential newborn care (ENC), Nurse
79. When teaching a mother how to prevent accidents Richard keeps in mind that care of the umbilicus should
while caring for her 6-month-old infant, Nurse Ara should include:
emphasize that at this age, the infant can already do *
which of the following developmental milestone?
1 point
*
A. Cleaning with cooled, boiled water and leaving it
1 point uncovered
B. Covering with a Sterile compress 1 point

C. Cleaning with alcohol A. Patient fell from the bed

D. Applying antibiotic cream B. Refusal to go to the physical therapy session

84. The vitamin K is administered to the newborn for C. A visitor encourages a patient on bed rest to ambulate
which of the following reasons?
D. Nurse left before his duty ends
*
89. On which occasion would a nurse can be charged
1 point with negligence?

A. Newborns are susceptible to avitaminosis *

B. Newborns have no intestinal bacteria 1 point

C. Hemolysis of the fetal red blood cells destroys vitamin A. Giving the patient the wrong medication

D. The newborn's incapable of producing sufficient B. Giving competent care

vitamin K
C. Following standards of care
85. Practices like cord clamping and the traditional
D. Communicating with another health team
"milking" of the cord immediately post delivery have now
been proven to be non-beneficial. These can also result 90. What tasks can be delegated to his nursing assistant
in more harm and complications especially in pre-terms during his tour of duty?
and in the fragile blood vessels in the brain of the
newborn. Nurse Julia NOW modifies and introduces a *
new newborn care practice termed as:
1 point
*
A. Changing wound dressings
1 point
B. Administering analgesic drug
A. Routine Separation
C. Performing a physical assessment
B. "Unang Yakap"
D. Taking vital signs
C. Properly timed cord clamping
Situation: Nurse Nelly is caring for a patient with late
D. Partographing decelerations in the fetal heart rate monitor.

Situation: Lengleng, a unit manager, is assigned to 91. The nurse establishes an IV line, and then connects
evaluate applicants for the position in the OB unit. Mrs. Bea to an electronic fetal monitor. The fetal monitor
During the interview, the applicant was asked 5 strip shows an FHR deceleration occurring about: 30
questions. seconds after each contraction begins; the FHR returns
baseline after the contraction is over. This type of
86. When a patient is admitted to the OB ward with deceleration is caused by a.
complaints of dizziness and body weakness, this is an
example of? *

* 1 point

1 point A. Fetal head compression

A. Secondary source B. Umbilical cord compression

B. Primary source C. Uteroplacental insufficiency

C. Objective data D. Cardiac anomalies

D. Subjective data 92. With this type of deceleration, the nurse's first action
should be to:
87. What are the possible cases that need informed
consent? *

* 1 point

1 point A. Increase the IV flow rate

A. Administering skin testing B. Call the physician

B. Subjecting the patient to an invasive procedure C. Position the patient on her left side

C. Hair shampooing of patient D. Continue monitoring the FHR

D. Performing a laboratory procedure 93. The nurse, caring for a client in the active
stage of labor, is monitoring the fetal status and
88. The applicant was further asked about an incident notes that the monitor strip shows a late
report. Which of the following is a PRIORITY case for an deceleration. Based on this observation, which
incident report to be accomplished? action would the nurse take immediately?
* *
1 point A. Culture, educational attainment and position in
society.
A. Document the findings.
B. Congruency of nonverbal expressions with spoken
B. Prepare for immediate birth.
words.
C. Increase the rate of an oxytocin infusion.
C. Facial expression, posture, tone of voice and age.
D. Administer oxygen to the client via face mask.
D. Eye contact with all patients at all times regardless of
94. Six hours into labor, Mrs. Bea's conditions are race.
occurring every 2 minutes, and lasting 80 seconds. She
98. Demonstrating what he learned from school in terms
is diaphoretic, restless, and irritable, moaning that she
of obtaining feedback, Daniel’s APPROPRIATE
can't take it anymore. According to these assessment
response to Grace’s complaint, “My breasts are
findings, which stage or phase of labor is she in?
engorged and it is so painful, “ should be _______.
*
*
1 point
1 point
A. Latent phase
A. “Tell me about the pain. Is it tolerable, moderate or
B. Third stage. severe?”

C. Second stage B. “It is alright all breastfeeding mother feel the same as
you”
D. Transitional stage
C. “That’s a sacrifice that mothers should do for her
95. Which factor would be most helpful in assessing the babies”
adequacy of Mrs. Bea’s placental perfusion?
D. “Just continue breastfeeding, it will relieve you from
* your pain”.
1 point 99. Daniel also recalled her learning on how to
REFOCUS conversations. Thus, when Grace’s
A. The curation and intensity of her contraction
subsequent messages were, “I have this painful
B. Her ability to cope with the discomfort of labor engorged breasts and my mother-in-law wants me to
bottle feed instead of breastfeed”. What will be Daniel’s
C. The duration of the rest phases between contractions BEST answer using refocusing technique?
D. The effectiveness of her breathing techniques during *
a contraction
1 point
Situation: Daniel is a new nurse in the Obstetrics
Ward. She remembers her Clinical instruction saying A. “What were you saying about your mother-in-law?”
that a nurse must learn how to communicate well
B. “All mothers-in-law are just as helpful, so it will be
with her patients.
better to just accept her”
96. Daniel learned active listening. How will Daniel
C. “I think we were talking about breast engorgement
demonstrate this on her patient named Grace? He
which brought about.”
should ________.
D. “What did you do about the pain you felt on your
1. Listen to what Grace verbalizes and observe how she
breast?”
expresses her feelings
100. In the course of Daniel’s duty in the OB Ward, he
2. Demonstrate interest on what Grace is talking about
also learned that he has to adjust his style of
by avoiding her eyes.
communication for different types of patients. Thus,
3. Maintain a close body posture such as keeping arms Daniel should adjust to which of the following
crossed and clenching fist. characteristics of Grace? Select all that apply.

4. Tune out other thoughts and refrain from interrupting 1. Level of usual communication
Grace while she is talking
2. Pace of interaction
*
3. Display of emotions
1 point
4. Full development of topic
A. 1 and 2
*
B. 1 and 4
1 point
C. 3 and 4
A. 1, 2, 3, 4
D. 2 and 3
B. 1 and 2
97. Which of the following should not be considered by
C. 3 and 4
the nurse in interpreting nonverbal messages of a
patient? D. 1, 2, 3
* RECALLS 7 NP3
1 point
Situation - Ethical and moral issues are becoming a D. Clean the body and remove all the IV lines, tubes and
common scenario in practice setting so health care other appliances
providers have to be equipped with this competency.
5. When a nurse is in full support of a patient's care,
safety and personal rights throughout her hospital stay,
she is implementing what ethical principle?
1. In the clinical setting, when nurses are confronted with
ethical dilemmas the BEST practical guide she can use *
is?
1 point
*
A. Responsibility
1 point
B. Empathy
A. PRC oath for professionals
C. Advocacy
B. Code of ethics
D. Accountability
C. Theological Doctrine
Situation: Nurse Janina works in the medical unit of
D. Florence Nightingale Oath a tertiary hospital, where the majority of patients are
diagnosed with endocrine disorders.
2. Mr. JBM was admitted to the hospital complaining of
chest pain due to clogging in his coronary arteries. He is She is currently caring for the following patients:
diabetic hypertensive and considered by the physician to Juliet, a 54-year-old married woman with
be a high risk for cardiovascular surgery. What hyperthyroidism; Vanessa, 66-year-old with a
PRIORITY action should the members of the health suspected case of Cushing's syndrome; and Miles, a
team do in this situation? 48-year-old woman suffering from hypothyroidism.

* 6. During your physical assessment of patient Vanessa,

she displays a UNIQUE clinical manifestation that differs
1 point
from those of patients Juliet and Miles, characterized by
A. Consult the family members and let them give their ______
decision.
*
B. Proceed with the planned surgery, as this will save
1 point
the patient.
A. cyanosis, increasing growth of hands and feet
C. Consult the ethics committee on what to do with the
patient. B. anemia, weight loss and presence of acne

D. Discuss with Mr. JBM his health status and let him C. moon face purple striae on trunk and buffalo hump
decide.
D. moon face easy fatigability and peripheral edema
3. Mrs. Constancia, 77 y/o is suffering from dementia
7. Which of the following diagnostic tests do you expect
and demonstrates unruly behavior. When Nurse Dan
the physician NOT to order for patient Vanessa, who is
describes the patient in his shift report, as “That awful,
suspected of having Cushing's syndrome?
dirty old woman in Bed 14.” is an example of what
ethical behavior being employed by the nurse? *
* 1 point
1 point A. 24 hour urine cortisol level
A. Stigma B. C reactive Protein level
B. Ageism C. ACTH serum concentration
C. Gender Bias D. Computerized tomography of the brain, chest and
abdomen
D. Depersonalization
8. Which clinical manifestation should Nurse Janina
4. Mr. Mark, who is on an end-stage of life, has an order
watch for patient Juliet if she is suffering from
of “Do Not Resuscitate” and passes away in your shift.
hyperthyroidism?
He was declared dead by his physician at 8:30 AM.
What should be your PRIORITY nursing action in this *
situation?
1 point
*
A. Cold extremities
1 point
B. Increased weight
A. Prepare the death certificate for the physician to sign.
C. Decreased bowel movement
B. Allow the family to have private moments with the
deceased. D. Fine motor tremor

C. Request your nurse attendant to call the funeral parlor 9. Patient Miles, who has hypothyroidism, is prescribed
at once. which of the following medications?

*
1 point loss. What would warrant the nurse’s attention and
prompt for an immediate termination of the test?
A. Propranolol
*
B. Iodine
1 point
C. Iron pills
A. The urine specific gravity gradually increases.
D. Levothyroxine
B. The urine output decreases.
10. Which of the following should Patient Miles AVOID
while undergoing treatment for hypothyroidism? C. The patient’s blood pressure is below the baseline,
and continuously decreases.
*
D. 3% of the body weight is lost.
1 point
15. DI happens due to a decreased production of ADH.
A. Use of warm blankets
On the other hand, SIADH has an overproduction of
B. Light activities done at home ADH leading to hypertension, weight gain, crackles, as
well as edema. What nursing interventions are
C. Taking foods low in fiber appropriate for a nursing diagnosis of fluid volume
excess, except?
D. Exposure to cold temperature
*
Situation: A patient who suffered head trauma
suddenly experienced an increase in urine output, 1 point
exceeding 250 mL per hour along with a feeling of
intense thirst. A. Accurately replace fluid loss.

11. The nurse is caring for a patient with DI. Which of the B. Restrict fluid intake.
following doctor’s order would the nurse question?
C. Administer furosemide as prescribed.
*
D. Assess lung sounds for crackles.
1 point
Situation: Evelyn, a retired Barangay Health Worker,
A. Weigh the patient daily, using the same type of came to the OPD for her check-up for her diabetes
clothes and same weighing scale at the same time of the mellitus. She had been diabetic since she was 37
day. years old. She has been taking her maintenance
medications which she sometimes does not comply
B. Accurately monitor I&O. with.16. There are metabolic abnormalities in the
development of type 2 Diabetes. Which of the following
C. Restrict fluid intake.
is NOT included in these abnormalities?
D. Make sure to keep the patient hydrated
16. There are metabolic abnormalities in the
12. The physician ordered Desmopressin to be given to development of type 2 Diabetes. Which of the following
the patient. What is an important nursing consideration is NOT included in these abnormalities?
when administering this medication?
*
*
1 point
1 point
A. Inappropriate production of the liver
A. Slowly administer via IV since this is a vesicant.
B. Increased ability of the pancreas to produce insulin
B. Watch out for water intoxication.
C. Insulin resistance
C. Watch out for increased urine output.
D. Altered production of hormones by adipose tissues
D. Closely monitor the blood pressure for hypotension
17. Ms. Evelyn was admitted to the hospital for further
13. The nurse asked the student nurse about the clinical check-up. Which of the following diagnostic tests do you
manifestations of a patient with diabetes insipidus. The expect to be ordered by the diabetologist as an indicator
student nurse would be correct if she states the that the patient is compliant to her prescribed diet?
following, except:
*
*
1 point
1 point
A. Oral glucose tolerance test
A. Flat neck veins
B. Glycosylated hemoglobin level
B. Altered LOC
C. Finger glucose findings for one day
C. Skin tenting
D. Fasting blood glucose level
D. Crackles on both lungs
18. While Nurse Eric was completing her assessment,
14. A fluid deprivation test was ordered by the physician she discovered the following findings. Which of the
and the patient was deprived of fluid for 10 hours. The following should she refer immediately to the physician?
patient still excretes large volumes of urine and weight
*
1 point A. Magnesium

A. Tingling sensation of the hands and feet B. Atropine

B. Changes in the peripheral vision C. Sodium bicarbonate

C. Beginning ulceration of the left big toe D. Vasopressin

D. Fruity odor breath 23. Which of the following ECG rhythms warrant
immediate defibrillation?
19. Nurse Eric, the nurse in charge of patient Evelyn,
informed her physician that her serum glucose level is *
38mmol/L and quite unresponsive to verbal questioning.
1 point
The nurse suspects that she is starting to develop
Diabetes Ketoacidosis (DKA). Which of the following A. Ventricular tachycardia
manifestations is UNIQUE to this condition?
B. Ventricular fibrillation
*
C. Asystole
1 point
D. Atrial fibrillation
A. Shallow slow respirations
Situation: Client suffering from cardiovascular
B. Increased serum potassium disorders.
C. Rapid deep respirations 24. Which of the following nursing interventions is most
appropriate in the care of a patient who has venous
D. Decreased serum albumin
insufficiency?
20. Nurse Eric’s counseling role includes lifestyle
*
changes as well as pharmacologic regimen. Evelyn’s
family were interested to know information regarding 1 point
insulin. She differentiated an intermediate acting insulin
from that of short-acting which is _________. A. Elevating the legs

* B. Increasing the fluid intake

1 point C. Limiting the activity level

A. Regular onset is 2 hrs. Peak is 3 ½ hr., duration -7 D. Massaging the extremities

hrs., administered 20-30 min. before meal
25. A client's medical record states a history of
B. Regular onset is 2-4 hr., peak is 4-12 hr., duration is 8 intermittent claudication. In collecting data about this
hr., administered 20-30 min. after meal symptom, the nurse would ask the client about which
symptom?
C. Regular, onset is 1 ½ hr, peak is 3-4 hrs, duration is 6
hrs. administered 20-30 min after meal *

D. Regular onset is ½ - 1hr, peak is 2-3 hr., 4-6hr 1 point

duration administered 20-30 min. before meal
A. Chest pain that is dull and feels like heartburn

B. Leg pain that is sharp and occurs with exercise

Situation: Nurse April is managing patients with
C. Chest pain that is sudden and occurs with exertion
cardiac dysrhythmias and conduction problems.
D. Leg pain that is achy and gets worse as the day
progresses
21. Nurse April interprets the rhythm strip of a patient
Situation: Nurse Karen is assigned to care of clients
who underwent electrocardiogram. Which of the
with respiratory disorders.
following waves represent ventricular depolarization?
26. The client is scheduled for a bronchoscopy. Which of
*
the following is not necessary to be done by the nurse
1 point when preparing the client for the procedure?

A. P wave *

B. QRS complex 1 point

C. T wave A. Secure written consent.

D. ST segment B. Ask for allergy to seafoods or iodine.

22. Nurse April reads the ECG rhythm of a patient as C. Maintain NPO for 6 to 8 hours.
having torsades de pointes. Which of the following
D. Instruct client to remove dentures or bridges.
medications must she expect to be ordered
immediately? 27. The nurse is teaching the client how to manage a
nosebleed. Which of the following instructions would be
*
appropriate to give to the client?
1 point
*
1 point *

A. "Tilt your head backward' and pinch your nose." 1 point

B. "Lie down at and place an ice compress over the A. Loud wheezing
bridge of your nose."
B. Wheezing on expiration
C. "Blow your nose gently with your neck flexed."
C. Noticeably diminished breath sounds
D. "Sit down, lean forward, and pinch the soft portion of
D. Increased displays of emotional apprehension
your nose."
Situation: Nurse Leah is a compassionate and
28. Which of the following is the primary reason to teach
skilled nurse working in a busy medical ward
pursed-lip breathing to clients with emphysema?
specializing in gastrointestinal (GI) diseases. Today,
* she is caring for a 28-year-old patient admitted with
severe abdominal pain, chronic diarrhea, and weight
1 point
loss. After diagnostic tests, the patient is diagnosed
A. To promote oxygen intake. with Crohn’s disease.

B. To strengthen the diaphragm. 33. Nurse Leah is assessing a patient with suspected
Crohn’s disease. Which finding is most characteristic of
C. To strengthen intercostal muscles. Crohn’s disease?
D. To promote carbon dioxide elimination. *
29. Which of the following diets would be most 1 point
appropriate for a client with COPD?
A. Continuous inflammation limited to the mucosal layer
* of the colon.
1 point B. Bloody diarrhea with tenesmus.
A. Low fat, low cholesterol diet. C. Cobblestone appearance of the bowel with skip
lesions.
B. Bland, soft diet.
D. Pseudopolyps observed during colonoscopy.
C. Low sodium diet.
34. A patient asks Leah how Crohn’s disease differs from
D. High calorie, high protein diet.
ulcerative colitis. Which response by the nurse is most
30. When caring for a client with a chest tube and water- accurate?
seal drainage system, the nurse should implement which
*
of the following interventions?
1 point
*
A. “Crohn’s disease only affects the colon, while
1 point
ulcerative colitis affects the entire GI tract.”
A. Verify that the air vent on the water-seal drainage
B. “Crohn’s disease causes continuous inflammation,
system is capped when the suction is off.
while ulcerative colitis causes skip lesions.”
B. Milk the chest drainage tube at least every four hours
C. “Crohn’s disease can affect any part of the GI tract,
if excessive bleeding occurs.
while ulcerative colitis is limited to the colon.”
C. Ensure that chest tube is clamped when moving the
D. “Crohn’s disease is caused by stress, while ulcerative
client out of bed.
colitis is caused by diet.”
D. Make sure that the drainage apparatus is always
35. Leah is caring for a patient with Crohn’s disease who
below the client's chest level.
is refusing to take prescribed oral medications due to
31. The nurse reviews the most recent blood gas severe nausea. The patient states, “I can’t keep anything
results of a client diagnosed with asthma. The nurse down, and I don’t want to take those pills.” Despite the
notes a pH of 7.43, Pco2 of 31 mm Hg, and HCO3 patient’s refusal, Leah administers the medication by
of 21 mEq/L. Based on these results, the nurse crushing it and mixing it into the patient’s applesauce
determines that which acid-base imbalance is present? without their knowledge. Which legal or ethical principle
has Leah most likely violated?
*
*
1 point
1 point
A. Compensated metabolic acidosis
A. Negligence
B. Compensated respiratory alkalosis
B. Malpractice
C. Uncompensated respiratory acidosis
C. Battery
D. Uncompensated metabolic alkalosis
D. Breach of confidentiality
32. The nurse is performing a respiratory assessment on
a client being treated for an asthma attack. The Situation: Clients suffering from Peptic Ulcer
nurse determines that the client's respiratory status is Disease (PUD).
worsening based upon which finding?
36. Nurse Stephen is assessing a client diagnosed with C. Positive guaiac stool tests
Peptic Ulcer Disease (PUD). Which physical
D. Sudden, severe abdominal pain
examination should the nurse implement first?
Situation: Incident reports serve as official records
*
of unexpected events. They can be used as legal
1 point evidence in case of disputes, complaints, or
investigations.
A. Palpate the abdominal area for tenderness
41. The nurse administers digoxin 0.25 mg by mouth
B. Auscultate the client's bowel sounds in all four
rather than the prescribed dose of 0.125 mg to the client.
quadrants
After assessing the client and notifying the primary
C. Assess the tender area progressing to nontender health care provider (PHCP), which action would the
nurse implement first?
D. Percuss the abdominal borders to identify organs
*
37. Nurse Pamela is assessing a client suspected of
having a gastric ulcer. Which of the following 1 point
assessment findings supports the diagnosis of a gastric
A. Write an incident report.
ulcer?
B. Administer digoxin immune fab.
*
C. Tell the client about the medication error.
1 point
D. Tell the client about the adverse effects of digoxin.
A. Sharp pain in the upper abdomen after eating a heavy
meal 42. The nurse finds a client lying on the floor. The
nurse performs an assessment, assists the client
B. Complaints of epigastric pain 30 to 60 minutes after
back to bed, and completes an incident report.
ingesting food
Which would the nurse document on the incident
C. Presence of blood in the client's stool for the past report?
month
*
D. Reports of a burning sensation moving like a wave
1 point
38. The nurse is caring for a client who admits to a 15-
A. The client fell onto the floor.
year history of gastric ulcers. The nurse instructs this
client to take which of the following drugs for minor B. The client climbed over the side rails.
aches and pains?
C. The client was found lying on the floor.
*
D. The nurse was the only responder to the event.
1 point
43. After finding a client lying on the floor, the nurse
A. Acetaminophen (Tylenol) ensures the client's safety, completes an incident
report, and notifies the primary health care provider
B. Buffered aspirin
of the incident. Which action would the nurse
C. Plain aspirin implement next?

D. Ibuprofen (Motrin) *

39. One of your patients was diagnosed with PUD, 1 point

however, she was also found to be pregnant. Which of
A. Staple the incident report in the client's medical
the following will alarm you if prescribed to the patient?
record.
*
B. Document the client events and follow-up nursing
1 point actions.

A. Cimetidine C. Provide a copy of the incident report to the provider

and family.
B. Misoprostol
D. Document that a copy of the report was sent to risk
C. Omeprazole management.
D. None of the above Situation: Effective teamwork and collaboration in
nursing is achieved when individuals work together
40. The nurse is caring for a client with a
in harmony, processes and goals are aligned
diagnosis of peptic ulcer disease. When monitoring
towards achieving safe quality patient care.
the client for possible gastrointestinal perforation, the
nurse identifies the importance of what assessment 44. Which of the following actions is INAPPROPRIATE
data? for a nurse leader to apply in a work
* Setting?
1 point *
A. Slow, strong pulses 1 point
B. Increase in bowel sounds A. Ask staff members for their opinion on the matter.
B. Modifies his own behavior favoring the needs of 1 point
individual staff.
A. Apply soap to hands
C. Gives equal consideration to each staff members.
B. Wet hands with water
D. Plans and organizes group activities of staff
C. Scrub the hands for 20 seconds
members.
D. Rinse hands with clean water
45. A hospital administrator has implemented a change
in the method of assigning nurses to client care units. A 50. According to WHO guidelines, how long is the
group of registered nurses is resistant to the change, recommended duration for the entire procedure of
and the nursing administrator anticipates that the nurses handwashing?
will not facilitate the process of change. Which approach
is best for the administrator to take initially in *
dealing with the resistance?
1 point
*
A. 20 – 30 secs
1 point
B. 30 – 60 secs
A. Cancel the implementation of the change.
C. 40 – 60 secs
B. Implement the change first on a trial basis.
D. 15 – 20 secs
C. Delay implementing the change for a few weeks.
Situation: You are the ICU nurse handling high-risk
D. Encourage the nurses to verbalize feelings regarding cardiovascular patients and post-surgical cases.
the change. Prompt recognition of life-threatening signs is
critical.
Situation: Various clients will undergo different post
op positioning from various procedures.

46. After Pneumonectomy, a client is positioned: 51. A nurse assessing a client who reports persistent
lower back pain and a sensation of “beating” in the
* abdomen. Upon palpation, the nurse notes a pulsating
mass in the abdomen. Which of the following is the
1 point
nurse’s priority action?
A. Right side lying
*
B. Affected side
1 point
C. Left side lying
A. Notify the health care provider
D. Unaffected side
B. Apply deep pressure to assess the mass
47. While after Lobectomy, the client is positioned:
C. Measure abdominal girth
*
D. Reassure the client and continue monitoring
1 point
52. A client with left-sided heart failure is admitted with
A. Right side lying dyspnea and orthopnea. What additional sign is the
nurse most likely to find?
B. Affected side
*
C. Left side lying
1 point
D. Unaffected side
A. Hepatomegaly
48. After Liver Biopsy, The client is positioned:
B. Crackles in lung bases
*
C. Dependent edema
1 point
D. Jugular vein distention
A. Right side lying
53. A patient receiving nitroglycerin IV for chest pain
B. Supine
develops a BP of 70/30 mmHg. What is the nurse’s
C. Left side lying priority action?

D. Semi Fowlers *

Situation: A nurse is teaching a group of healthcare 1 point

workers the proper technique for handwashing in a
A. Stop the infusion immediately
clinical setting.
B. Elevate the foot of the bed
49. What is the first step of the handwashing process to
ensure proper hygiene and minimize the spread of C. Notify the provider and reduce the dose
infections?
D. Administer IV fluids rapidly
*
54. A client with pericardial effusion suddenly becomes 59. Which discharge instruction is most appropriate for a
dyspneic and restless. The nurse notes BP 80/50 patient with an abdominal aortic aneurysm (AAA) repair?
mmHg, muffled heart sounds, and jugular vein
*
distention. Which nursing action takes priority?
1 point
*
A. “Resume weightlifting in 1 week to regain strength.”
1 point
B. “Call the provider for back or abdominal pain.”
A. Elevate the head of the bed to 90 degrees
C. “Check blood pressure once a month.”
B. Administer high-flow oxygen via non-rebreather mask
D. “Take your blood pressure only when you feel dizzy.”
C. Prepare for emergency pericardiocentesis
60. The nurse is monitoring a client who received IV
D. Initiate a rapid IV fluid bolus
furosemide. Which finding requires immediate follow-up?
55. A client recently discharged after mitral valve
*
replacement returns to the clinic with complaints of
fatigue. Which finding is most concerning? 1 point
* A. Serum potassium 2.9 mEq/L
1 point B. Mild decrease in BP after ambulation
A. INR of 2.3 C. Urine output 200 mL after 2 hours
B. Irregular pulse D. Complaint of mild muscle cramp
C. Fever and chills Situation: You are the nurse caring for clients with
respiratory conditions and trauma. Quick
D. Mild fatigue
recognition of abnormal signs and proper patient
Situation: You are preparing patients for discharge education is key.
and monitoring for high-risk cardiac medication
effects.
61. The nurse is teaching a client with asthma about
56. Which client is most at risk for developing digoxin
proper inhaler use. Which statement indicates correct
toxicity?
technique?
*
*
1 point
1 point
A. A client with hyperkalemia
A. “I inhale before pressing the inhaler.”
B. A client taking a loop diuretic
B. “I hold my breath after inhaling the medication.”
C. A client with low BUN
C. “I exhale immediately after using it.”
D. A client with a high-potassium diet
D. “I don’t need to shake the canister.”
57. A client is being discharged after heart surgery.
62. The nurse is caring for a client with chest trauma
Which statement signals need for further teaching?
after a road traffic accident. Which finding requires
* immediate action?

1 point *

A. “I will avoid heavy lifting.” 1 point

B. “I can resume sex when I can climb two flights of A. Paradoxical chest movement
stairs.”
B. Chest pain when coughing
C. “I’ll take my medications only if I feel chest pain.”
C. Decreased breath sounds on one side
D. “I’ll walk daily as tolerated.”
D. Rib tenderness on palpation
58. A client on IV heparin infusion for atrial fibrillation has
63. Which client condition warrants placing them in High
an aPTT of 110 seconds. What is the nurse’s best
Fowler’s position?
action?
*
*
1 point
1 point
A. Post-lumbar puncture
A. Stop the infusion
B. Hypovolemic shock
B. Slow the infusion and reassess in 2 hours
C. Acute respiratory distress
C. Continue as ordered and monitor for bleeding
D. Severe dizziness
D. Document the result and recheck in the morning
64. A nurse is monitoring a client with asthma. Which 69. The nurse is teaching a client with chronic bronchitis
finding is most concerning? about energy conservation. Which statement indicates
effective learning?
*
*
1 point
1 point
A. Use of accessory muscles
A. “I will complete all household chores in one session.”
B. Audible wheezing
B. “I will rest frequently between activities.”
C. Sudden absence of wheezing
C. “I will avoid using assistive devices.”
D. Reports of chest tightness
D. “I will shower in very hot water to loosen mucus.”
Situation: You are caring for clients with respiratory
disorders requiring immediate assessment and 70. A client presents with sudden dyspnea, chest pain,
intervention. and hemoptysis after orthopedic surgery. Which is the
priority nursing action?
65. A postoperative client is receiving morphine. The
nurse notes a respiratory rate of 8/min and shallow *
breathing. What is the nurse’s priority action?
1 point
*
A. Place the client in High Fowler’s position and apply
1 point oxygen

A. Stop the morphine and administer naloxone B. Encourage coughing and deep breathing

B. Encourage deep breathing and coughing C. Administer PRN morphine for pain

C. Document findings and continue monitoring D. Notify the provider after completing vitals

D. Notify the healthcare provider after 30 minutes Situation: You are caring for patients with suspected
or confirmed intracranial pathologies. Quick
66. The nurse is reviewing arterial blood gases (ABGs)
recognition of neurological changes is critical to
of a client with COPD: pH 7.32, PaCO₂ 60 mmHg, HCO₃ prevent complications.
28 mEq/L. How should the nurse interpret these results?

*
71. A nurse is assessing a client with suspected
1 point increased intracranial pressure (ICP). Which finding is
A. Respiratory acidosis, partially compensated most concerning?

B. Respiratory alkalosis, uncompensated *

C. Metabolic alkalosis, compensated 1 point

D. Normal acid-base balance A. Sluggish pupillary reaction

67. A client is scheduled for bronchoscopy. Which finding B. Projectile vomiting

should the nurse report immediately before the C. Headache that improves with sleep
procedure?
D. Blood pressure 120/80 mmHg
*
72. A client with a brain tumor exhibits confusion,
1 point disorientation, and agitation. These symptoms are best
A. Oxygen saturation 94% described as:

B. Platelet count 45,000/µL *

C. Pulse 88/min 1 point

D. NPO status for 6 hours A. Lethargy

68. The nurse observes a chest tube drainage system B. Decreased LOC
with continuous bubbling in the water-seal chamber. C. Stupor
What is the best interpretation? Rest
D. Delirium
*
73. A client post-craniotomy has clear drainage leaking
1 point from the nose. What is the nurse’s priority action?
A. Normal functioning—no action required *
B. Indicates an air leak in the system 1 point
C. Chest tube obstruction A. Check the drainage for glucose
D. Impending tension pneumothorax B. Document the finding

C. Elevate HOB to 45 degrees

D. Apply nasal packing 1 point

74. A nurse is caring for a client after a lumbar puncture. A. Insert an oral airway
Which position is appropriate post-procedure?
B. Place the patient on their side
*
C. Restrain the patient’s arms
1 point
D. Offer oral fluids
A. High Fowler’s
80. A patient who had a diving accident presents with
B. Supine for several hours decerebrate posturing. What does this indicate?

C. Prone with head elevated *

D. Semi-Fowler’s with legs elevated 1 point

75. The nurse suspects a basilar skull fracture. Which A. Mild cerebral concussion
assessment finding supports this?
B. Brainstem injury
*
C. Spinal cord compression only
1 point
D. Epidural hematoma
A. Pupil constriction
Situation: You are monitoring neurological status in
B. Periorbital ecchymosis and mastoid bruising trauma and critical care patients. Accurate Glasgow
Coma Scale (GCS) assessment is essential for
C. Trismus
detecting changes in level of consciousness.
D. Otitis
81. A client opens their eyes only when called by name,
Situation: You are monitoring stroke and central uses inappropriate words when speaking, and withdraws
nervous system infection patients. Quick response from painful stimuli. What is the GCS score?
to neurological deterioration can save lives.
*
76. A nurse observes a stroke client becoming
1 point
increasingly lethargic with unequal pupils. What is the
most urgent intervention? A. 8

* B. 10

1 point C. 12

A. Prepare for intubation D. 14

B. Check blood glucose 82. Which GCS score represents the need for immediate
airway management?
C. Notify provider of signs of herniation
*
D. Apply oxygen via nasal cannula
1 point
77. A client in the ER has suspected meningitis. What is
the most appropriate nursing action? A. 15

* B. 13

1 point C. 9

A. Administer acetaminophen D. 7

B. Initiate seizure precautions 83. A client post-head injury opens eyes spontaneously,
is oriented, and obeys commands. What is the GCS
C. Apply warm compress to neck
score?
D. Start oral antibiotics
*
78. Which finding is an early sign of increased ICP in a
1 point
traumatic brain injury patient?
A. 13
*
B. 14
1 point
C. 15
A. Bradycardia and widened pulse pressure
D. 12
B. lessness and confusion
84. Which motor response on the GCS indicates the
C. Fixed, dilated pupils
worst neurological status?
D. Decerebrate posturing
*
79. A nurse is caring for a patient after a seizure
1 point
episode. Which action is a priority?
A. Withdrawal from pain
*
B. Flexion to pain (decorticate) 89. The nurse positions Mr. Santos to optimize ICP
management. Which position is most appropriate?
C. Extension to pain (decerebrate)
*
D. Localizes pain
1 point
85. A client has eyes closed but opens to pain, makes
incomprehensible sounds, and shows decorticate A. High Fowler’s (90°)
posturing. What is their GCS?
B. Supine with head flat
*
C. Side-lying with neck flexed
1 point
D. Head midline, HOB elevated 30°
A. 7
90. While performing a neurological assessment on Mr.
B. 8 Santos, a post–cardiac arrest patient in the ICU, the
nurse notes pupils measuring approximately 8 mm
C. 9
bilaterally, completely unresponsive to light, with absent
D. 10 corneal reflex and no spontaneous eye movements
despite maximal stimulation. Based on these findings,
Situation: the most accurate description of his pupillary status is:
Mr. Santos, a 62-year-old male, was admitted to the *
ICU after a fall from a ladder. A CT scan revealed a
subdural hematoma. He is intubated and on 1 point
mechanical ventilation. The ICP monitor shows
A. Fixed dilated
readings fluctuating between 22–28 mmHg. Current
orders include head elevation at 30°, strict fluid B. Sluggish reaction to light
balance, and IV mannitol as needed. The nurse
C. Anisocoric
observes that Mr. Santos has become increasingly
drowsy, with sluggish pupillary reactions, and D. Pinpoint pupils
occasional decerebrate posturing.
Situation: You are caring for clients with acute and
chronic kidney disease, many of whom are receiving
dialysis or are at risk for fluid and electrolyte
86. Which of the following ICP readings requires
imbalances.
immediate intervention?
91. A client with chronic kidney disease (CKD) has a
*
serum potassium of 6.3 mEq/L. Which intervention takes
1 point priority?

A. 14 mmHg *

B. 18 mmHg 1 point

C. 22 mmHg A. Administer sodium polystyrene sulfonate

D. 8 mmHg B. Teach the client about a low-potassium diet

87. The nurse notes that Mr. Santos’ blood pressure has C. Monitor for fatigue and muscle weakness
increased, his pulse has slowed, and respirations have
D. Place client on a cardiac monitor
become irregular. This is most indicative of:
92. Which urine output is most concerning in a client
*
receiving IV fluids post-op?
1 point
*
A. Neurogenic shock
1 point
B. Cushing’s triad
A. 50 mL/hr
C. Brain death
B. 40 mL/hr
D. Seizure activity
C. 20 mL/hr
88. Which medication from the orders should the nurse
D. 80 mL/hr
anticipate administering to reduce Mr. Santos’ ICP?
93. A client receiving hemodialysis is scheduled for
*
medications. What should the nurse do?
1 point
*
A. Mannitol
1 point
B. Lorazepam
A. Give all meds with food
C. Phenytoin
B. Hold meds until after dialysis
D. Morphine
C. Administer meds via dialysis port
D. Give oral meds immediately before session *

94. The nurse notices a thrill at the AV fistula site of a 1 point

hemodialysis patient. What does this indicate?
A. Metallic taste in the mouth
*
B. Increased urine output
1 point
C. Jaundice
A. Infection
D. Dry cough
B. Bleeding
100. A patient with renal calculi reports sudden, severe
C. Patency of the fistula flank pain and nausea. What is the nurse’s priority
action?
D. Need to reposition the limb
*
95. Which lab finding in a dialysis patient requires
immediate follow-up? 1 point

* A. Administer antiemetics

1 point B. Strain all urine

A. Potassium 5.8 mEq/L C. Give prescribed analgesics

B. Calcium 9.0 mg/dL D. Prepare for cystoscopy

C. Hemoglobin 10.8 g/dL RECALLS 7 NP4

D. Sodium 136 mEq/L Situation: You are caring for clients with thyroid and
adrenal disorders. Monitoring for medication
Situation: You are assigned to clients with renal
complications and hormonal imbalances is critical.
failure and post-procedure care. Your focus is to
prevent complications and manage fluid and 1. A client on propylthiouracil (PTU) reports fever
electrolyte imbalances. and sore throat. What is the best next action?

96. Which condition places a client at highest risk for 1 point

pre-renal acute kidney injury (AKI)?
A. Check TSH level
*
B. Discontinue PTU and get WBC count
1 point
C. Continue PTU and ice throat
A. Renal calculi
D. Teach about agranulocytosis risk
B. Prolonged hypotension
2. A client with Addison’s disease reports nausea,
C. Bladder outlet obstruction abdominal pain, and profound weakness after
missing two doses of hydrocortisone. Which action
D. Polycystic kidney disease
is priority?
97. Which dietary instruction is most appropriate for a
*
client with nephrotic syndrome?
1 point
*
A. Provide a high-protein snack
1 point
B. Obtain serum potassium level
A. High protein, low sodium
C. Prepare to administer IV hydrocortisone
B. High carbohydrate, high potassium
D. Monitor intake and output
C. Low protein, high calcium
3. Which teaching point is correct for a client with
D. High fat, low fiber
hyperthyroidism?
98. The nurse is monitoring a post-kidney biopsy patient.
*
Which finding requires immediate action?
1 point
*
A. Increase intake of high-iodine foods
1 point
B. Avoid caffeine and high-stimulant drinks
A. Mild back pain
C. Increase caloric intake by 50%
B. Hematuria
D. Restrict fluid intake to 1L/day
C. BP of 90/50mmHg
4. A client after thyroidectomy reports hoarseness
D. Small dressing spot
and difficulty speaking. What is the nurse’s best
99. Which symptom is expected in a patient with uremia response?
due to end-stage renal disease?
* 9. A client on an insulin pump has blood glucose of
60 mg/dL and feels shaky. What is the best first
1 point
action?
A. Reassure the client this is expected and
*
temporary
1 point
B. Notify the provider immediately of airway
obstruction A. Give 15 g of simple carbohydrate

C. Assess for neck swelling and stridor B. Turn off the insulin pump

D. Offer lozenges for throat irritation C. Notify the provider immediately

5. A client with Cushing’s syndrome has a blood D. Administer glucagon IM

glucose of 210 mg/dL and reports muscle weakness.
10. The nurse is teaching foot care to a client with
What is the most appropriate nursing action?
diabetes. Which statement indicates a need for
* further teaching?

1 point *

A. Encourage ambulation and low-protein diet 1 point

B. Restrict fluid and sodium intake A. “I’ll inspect my feet every day.”

C. Monitor glucose and potassium levels B. “I’ll go barefoot at home to strengthen my feet.”

D. Prepare to administer calcium supplements C. “I’ll trim toenails straight across.”

Situation: You are teaching diabetic patients about D. “I’ll wear well-fitting shoes.”
insulin therapy, glycemic patterns, and self-
Situation: You are caring for patients with acute
monitoring of blood glucose.
abdominal emergencies and gastrointestinal
6. A nurse is teaching a diabetic about the dawn disorders. Prompt recognition of complications is
phenomenon. Which statement shows correct essential.
understanding?
11. Which assessment finding is most concerning in
* a client with acute pancreatitis?

1 point *

A. “I’ll eat a snack before bed to prevent it.” 1 point

B. “I’ll measure my blood sugar at 3am.” A. Epigastric pain

C. “I’ll increase my insulin in the morning.” B. Grey-Turner’s sign

D. “I’ll work out before dinner.” C. Nausea and vomiting

7. Which insulin regimen most closely mimics D. Fever

normal pancreatic function?
12. Which of the following best indicates resolution
* of bowel obstruction?

1 point *

A. NPH insulin once daily at bedtime 1 point

B. Short-acting insulin only with meals A. Distended abdomen

C. Long-acting insulin once daily with rapid-acting at B. Absent bowel sounds

meals
C. Passage of flatus
D. Intermediate-acting insulin twice daily only
D. Increased pain
8. A diabetic client with retinopathy is learning about
13. A client post-cholecystectomy reports right
exercise. Which statement indicates correct
upper quadrant pain radiating to the shoulder and
understanding?
nausea. What is the nurse’s best initial action?
*
*
1 point
1 point
A. “I will avoid heavy weightlifting.”
A. Administer ordered opioid analgesic
B. “I can exercise vigorously without restriction.”
B. Assess for abdominal rigidity and rebound
C. “Exercise will reverse my vision loss.” tenderness

D. “I only need to exercise when my blood sugar is C. Apply a heating pad to the abdomen
above 250 mg/dL.”
D. Encourage deep breathing and coughing
14. A patient with cirrhosis has ascites and dyspnea. D. Encourage fluids to prevent dehydration
Which position best promotes comfort?
19. A client with hepatic encephalopathy is
* increasingly drowsy and has asterixis (flapping
tremor). The family asks why the client is receiving
1 point
lactulose. What is the nurse’s best explanation?
A. Supine with pillows under the knees
*
B. High Fowler’s with feet dependent
1 point
C. Prone with head elevated
A. “It helps stop bleeding from the liver.”
D. Side-lying with knees flexed
B. “It reduces fluid buildup in your abdomen.”
15. Which dietary teaching is appropriate for a client
C. “It decreases ammonia levels that affect brain
with a new ileostomy?
function.”
*
D. “It stimulates your liver to regenerate.”
1 point
20. A post-gastrectomy client develops dizziness,
A. “Eat high-fiber foods to regulate output.” tachycardia, and diaphoresis 20 minutes after
eating. What is the nurse’s priority action?
B. “Limit fluid intake to reduce stool output.”
*
C. “Chew food thoroughly and avoid high-fiber
foods initially.” 1 point

D. “Increase raw fruits and vegetables for bowel A. Encourage fluids during meals to improve
health.” digestion

16. A 55-year-old man with a history of alcoholism B. Place the patient in a recumbent position and
presents with hematemesis and melena. He is pale, monitor
diaphoretic, and hypotensive (BP 80/50 mmHg, HR
C. Give an immediate dose of insulin
122/min). What is the nurse’s priority intervention?
D. Offer a snack high in simple carbohydrates
*
Situation: You are the charge nurse in a busy
1 point
medical-surgical unit supervising a mixed team of
A. Insert a large-bore IV line and prepare for fluid registered nurses (RNs), licensed practical nurses
resuscitation (LPNs), and nursing assistants (NAs). Your priority is
to ensure safe delegation, ethical practice, and
B. Prepare the patient for colonoscopy proper patient education while handling time-
sensitive tasks.
C. Position the patient flat and keep NPO
21. A nursing assistant reports a blood pressure of
D. Administer an antiemetic
90/60 mmHg on a post-op client who is pale and
17. A patient with cirrhosis and esophageal varices diaphoretic. What is the nurse’s first action?
suddenly begins vomiting bright red blood. The
*
nurse notes confusion and a distended abdomen
with ascites. Which intervention is most important? 1 point
* A. Reassess the blood pressure manually.
1 point B. Document the finding in the chart.
A. Insert a nasogastric tube for gastric lavage C. Ask the NA to recheck it in 15 minutes.
B. Place the patient in a high Fowler’s position and D. Notify the provider immediately without
give oxygen reassessing.
C. Administer oral vitamin K to reduce bleeding 22. A nurse delegates feeding a stroke client with
dysphagia to an NA. Which instruction is most
D. Encourage fluids to maintain hydration
important?
18. A 43-year-old woman with peptic ulcer disease
*
complains of sudden, severe abdominal pain
radiating to the shoulder, with a rigid abdomen. Her 1 point
blood pressure is 90/60 mmHg, and pulse is 118/min.
What is the nurse’s best immediate action? A. “Feed them quickly to reduce fatigue.”

* B. “Keep them upright at 90 degrees during and after

feeding.”
1 point
C. “Offer thin liquids between each bite.”
A. Administer an antacid and reassess pain
D. “Use a straw for easier fluid intake.”
B. Insert a nasogastric tube and prepare for surgery
23. An LPN asks which tasks they can perform.
C. Give oral sucralfate to coat the stomach lining Which assignment is appropriate?
* D. Double-glove during all patient care.

1 point 28. A nurse educator teaches the principle of fidelity.

Which statement shows understanding?
A. Developing a new care plan for a client with
sepsis. *

B. Administering oral antibiotics to a stable client. 1 point

C. Performing the initial admission assessment. A. “I will respect my client’s right to refuse
treatment.”
D. Teaching a client about insulin self-
administration. B. “I will keep promises and follow through with care
I commit to.”
24. During rounds, you find a confused client
attempting to pull out their IV line. What is the best C. “I will ensure that resources are distributed
immediate nursing action? fairly.”

* D. “I will avoid harming my clients.”

1 point 29. Which teaching method is best for an older adult

with mild hearing loss?
A. Apply wrist restraints immediately.
*
B. Reorient the client and offer a distraction.
1 point
C. Document the incident only.
A. Providing written instructions in large print.
D. Assign a staff member to sit with the client.
B. Speaking rapidly to finish instructions quickly.
25. Which situation demonstrates advocacy?
C. Turning away from the client while speaking.
*
D. Increasing environmental noise for stimulation.
1 point
30. A client refuses a prescribed blood transfusion
A. Supporting a client’s decision to refuse
due to religious beliefs. Which is the nurse’s best
chemotherapy despite family pressure.
response?
B. Telling the client that the doctor’s orders cannot
*
be changed.
1 point
C. Encouraging a client to “just do what the doctor
says.” A. “You must accept this treatment to save your
life.”
D. Reminding a client that they have no right to
refuse life-saving treatment. B. “Tell me more about your concerns and beliefs.”

Situation: You are mentoring a new graduate nurse C. “I will explain why your family wants you to take
who struggles with ethical dilemmas, patient it.”
teaching, and infection control practices. Your role is
D. “You don’t have the right to refuse lifesaving
to guide safe practice and reinforce core nursing
care.”
principles.
Situation: You are leading an ethics seminar for
26. A client says, “I don’t want CPR if I stop
nurses, highlighting real clinical scenarios to help
breathing.” Which action is most appropriate?
staff correctly identify ethical principles.
*
31. A nurse allows a competent client to sign an
1 point informed refusal form after explaining all potential
consequences. Which principle is primarily upheld?
A. Document the client’s statement as a DNR order.
*
B. Inform the provider to discuss advance directives.
1 point
C. Encourage the client to reconsider.
A. Justice
D. Tell the family to decide what’s best.
B. Autonomy
27. Which infection control practice is correct when
caring for a client with C. diff.? C. Veracity

* D. Fidelity

1 point 32. A nurse documents all assessments truthfully

and refrains from altering records, even under
A. Use alcohol-based sanitizer after removing
pressure. This best reflects:
gloves.
*
B. Wear a mask when within 3 feet of the client.
1 point
C. Use soap and water handwashing after glove
removal. A. Veracity and fidelity
B. Beneficence and justice A. Justice

C. Autonomy and non-maleficence B. Privacy and confidentiality

D. Privacy and confidentiality C. Beneficence

33. While caring for two patients, one wealthy and D. Autonomy
one homeless, the nurse provides equal attention
38. A nurse positions side rails and keeps the bed in
and resources. Which principle applies?
the lowest position for a confused client. Which
* principle is demonstrated?

1 point *

A. Justice 1 point

B. Beneficence A. Beneficence

C. Autonomy B. Autonomy

D. Fidelity C. Justice

34. After giving the wrong medication, the nurse D. Fidelity

immediately informs the client and provider, then
39. During discharge teaching, the nurse notices the
completes an incident report. Which principle is
client is drowsy and defers teaching to a later time.
shown?
This respects which principle?
*
*
1 point
1 point
A. Non-maleficence
A. Justice
B. Autonomy
B. Fidelity
C. Veracity
C. Autonomy
D. Privacy
D. Non-maleficence
35. A nurse follows through with a promise to return
40. A nurse ensures each patient gets pain
with pain medication within 10 minutes. This
medication on time, regardless of how busy the shift
reflects:
is. Which ethical principle is at work?
*
*
1 point
1 point
A. Justice
A. Justice
B. Fidelity
B. Autonomy
C. Privacy
C. Privacy
D. Beneficence
D. Veracity
Situation: You are evaluating nursing practices
Situation: You are assigned to the psychiatric unit,
during an ethics audit in a tertiary hospital. Your
caring for clients with schizophrenia, mood
focus is to ensure nurses understand when multiple
disorders, and suicidal risk. You must prioritize
principles overlap.
safety while using therapeutic communication
36. A nurse explains risks and benefits of a clinical techniques.
trial and gives the patient time to decide. This
41. Which therapeutic communication technique is
demonstrates which principles?
used when a nurse says, “Tell me more about what
* happened before you felt anxious”?

1 point *

A. Fidelity and privacy 1 point

B. Veracity and autonomy A. Giving advice

C. Justice and beneficence B. Exploring

D. Non-maleficence and fidelity C. Belittling feelings

37. A nurse refuses to share a client’s HIV status D. Reassuring

with a friend who asks. Which ethical principle is
42. A client states, “I want to end my life.” What is
prioritized?
the nurse’s priority?
*
*
1 point
1 point
A. Ask, “Why do you feel this way?” B. 0.5–1.5 mEq/L

B. Confront the client about their choices C. 2.0–3.0 mEq/L

C. Ask directly if there is a specific plan D. >3.5 mEq/L

D. Offer to distract the client with an activity 48. Which behavior is characteristic of a manic
episode?
43. Which symptom is most associated with
command auditory hallucinations? *

* 1 point

1 point A. Withdrawn, decreased energy, low self-esteem

A. The client repeatedly washes hands B. Flight of ideas, decreased sleep, risky behavior

B. The client hears voices telling them to act C. Repetitive hand-washing and counting rituals

C. The client expresses irrational fear of strangers D. Tearfulness and social isolation

D. The client avoids eye contact and becomes mute 49. What is the primary nursing goal for a severely
depressed client?
44. A client says, “The TV is sending me secret
messages.” Which is the nurse’s best response? *

* 1 point

1 point A. Encourage group participation

A. “That’s impossible, the TV cannot do that.” B. Promote safety and assess suicide risk

B. “It seems like you feel concerned about the C. Discuss long-term employment goals
messages.”
D. Teach complex coping strategies
C. “We need to remove the TV from your room
50. Which food should a client on MAOI avoid?
immediately.”
*
D. “Why do you think the TV is sending messages?”
1 point
45. Which finding is considered a negative symptom
of schizophrenia? A. Fresh bananas
* B. Aged cheddar cheese
1 point C. Baked chicken breast
A. Hearing voices D. Rice and steamed vegetables
B. Flat affect Situation: You are assigned to clients with eating
disorders and mood disorders. Your priority is to
C. Grandiose delusions
recognize complications, promote safety, and
D. Disorganized speech reinforce therapeutic interventions.

Situation: You are caring for clients with bipolar 51. A client with bulimia nervosa most likely exhibits
disorder and major depression. Your role includes which physical finding?
medication management, suicide precautions, and
*
client teaching.
1 point
46. Which client statement indicates understanding
of lithium therapy? A. Low BMI and lanugo hair
* B. Dental erosion and parotid swelling
1 point C. Amenorrhea and osteoporosis
A. “I will double my dose if I feel manic.” D. Hyperpigmentation and alopecia
B. “I need to keep my salt and fluid intake 52. A nurse encourages a depressed client to join a
consistent.” morning group activity. This demonstrates which
therapeutic strategy?
C. “I should stop taking lithium if I feel tremors.”
*
D. “This drug will work instantly for my mood
swings.” 1 point
47. What is the therapeutic serum lithium level? A. Confrontation
* B. Behavioral activation
1 point C. Cognitive reframing
A. 0.1–0.4 mEq/L D. Systematic desensitization
53. Which is an expected finding in PTSD? *

* 1 point

1 point A. Disulfiram

A. Amnesia for identity and relationships B. Lorazepam

B. Recurrent intrusive memories and hypervigilance C. Haloperidol

C. Social detachment only D. Lithium

D. Delusions of persecution 59. A nurse notes a client smiling while reporting

sadness and hopelessness. This is known as:
54. Which statement by a client taking sertraline
requires further teaching? *

* 1 point

1 point A. Flat affect

A. “I may not feel better for several weeks.” B. Incongruent affect

B. “I should avoid abruptly stopping the C. Restricted affect

medication.”
D. Blunted affect
C. “It’s okay to take St. John’s Wort for added
60. A nurse teaching a group about stress explains
effect.”
that the fight-or-flight response initially causes:
D. “I might have some sexual side effects.”
*
55. A nurse is using motivational interviewing with a
1 point
client who abuses substances. Which statement
reflects this technique? A. Bradycardia and pupil constriction
* B. Increased HR, BP, and dilated pupils
1 point C. Increased digestion and urine output
A. “You must quit now or face the consequences.” D. Decreased blood glucose and muscle tension
B. “Tell me what you like and dislike about your Situation: You are caring for clients with
substance use.” schizophrenia and psychotic disorders. Your role
includes recognizing priority symptoms, preventing
C. “If you don’t stop, you could die.”
harm, and reinforcing medication adherence.
D. “You know using is wrong, don’t you?”
61. Which is the best response to a client
Situation: You are managing clients with withdrawal experiencing auditory hallucinations?
syndromes, suicide risk, and severe anxiety
*
episodes. Quick recognition and immediate safety
measures are essential 1 point
56. The nurse cares for a client in methamphetamine A. “I hear the voices too.”
withdrawal. Which symptom is expected?
B. “That’s not real, ignore them.”
*
C. “I know the voices seem real to you; what are
1 point they saying?”
A. Euphoria and hyperactivity D. “You need to focus on reality now.”
B. Severe depression and fatigue 62. Which assessment finding indicates
benzodiazepine toxicity?
C. Seizures and vomiting
*
D. Violent hallucinations
1 point
57. Which is a priority outcome for a suicidal client?
A. Hyperreflexia and hypertension
*
B. Respiratory depression and confusion
1 point
C. Tinnitus and blurry vision
A. Expressing reasons for living
D. Abdominal cramps and diarrhea
B. Demonstrating mood improvement in one week
63. A client with dementia suddenly becomes more
C. Verbalizing no plan for self-harm
confused at night. This is called:
D. Participating in recreational activities
*
58. Which medication is most likely prescribed for
1 point
acute alcohol withdrawal?
A. Echolalia
B. Perseveration 69. Which intervention is most appropriate for a
client with moderate anxiety?
C. Sundowning
*
D. Confabulation
1 point
64. A nurse is reinforcing teaching about buspirone.
Which statement indicates understanding? A. Use a calm voice and explore feelings

* B. Avoid discussion until anxiety subsides

1 point C. Provide written instructions only

A. “I can take it as needed for anxiety attacks.” D. Confront all irrational thoughts immediately

B. “It will start working in 1–2 days.” 70. Which sign is associated with alcohol withdrawal
rather than intoxication?
C. “I might feel dizzy but it’s not addictive.”
*
D. “I need to avoid grapefruit juice.”
1 point
65. Which finding indicates serotonin syndrome?
A. Slurred speech and unsteady gait
*
B. Bradycardia and hypotension
1 point
C. Tremors and hypertension
A. Hypothermia and depression
D. Pinpoint pupils and drowsiness
B. Muscle rigidity, high fever, and confusion
Situation: You are assigned to clients with mood
C. Bradycardia and excessive sleepiness
disorders, substance abuse issues, and risk for
D. Enlarged pupils and orthostatic hypotension harm to self or others. Early identification and safety
measures are essential.
Situation: You are addressing cognitive disorders
and side effects of psychotropic medications, 71. A client in lithium therapy develops diarrhea,
focusing on early complication detection and tremors, and confusion. What is the priority action?
therapeutic approaches.
*
66. A nurse notices a client with dementia fabricating
1 point
stories. This is known as:
A. Document and continue monitoring
*
B. Give an anti-diarrheal and fluids
1 point
C. Hold the lithium and notify the provider
A. Perseveration
D. Encourage a salty snack
B. Confabulation
72. Which behavior is expected in borderline
C. Flight of ideas
personality disorder?
D. Circumstantiality
*
67. Which therapeutic approach is best for a
1 point
paranoid client refusing food?
A. Rigid perfectionism
*
B. Intense, unstable relationships and fear of
1 point
abandonment
A. Offer food in sealed containers
C. Lack of remorse for wrongdoing
B. Force-feed for nutrition\
D. Detachment and restricted emotions
C. Ignore food concerns and focus on medication
73. Which client statement reflects improved coping
D. Restrict interaction until trust is gained after depression treatment?

68. A nurse suspects neuroleptic malignant *

syndrome (NMS). Which symptom supports this?
1 point
*
A. “I still don’t feel like doing anything.”
1 point
B. “I called a friend to go for a walk.”
A. Sudden severe hypertension and headache
C. “Nothing will ever change for me.”
B. High fever, muscle rigidity, altered consciousness
D. “I can’t make any decisions.”
C. Pinpoint pupils and respiratory depression
74. Which lab must be monitored for clients on
D. Flushed skin and diarrhea valproic acid?

*
1 point C. Symptomatic bradycardia

A. Liver function tests D. Supraventricular tachycardia

B. Renal function 80. Amiodarone is used during ACLS primarily for:

C. Electrolytes *

D. Thyroid function tests 1 point

75. A client taking clozapine develops fever and sore A. Refractory VF/pulseless VT
throat. What is the priority action?
B. Sinus bradycardia
*
C. Asystole with PEA
1 point
D. Narrow complex tachycardia
A. Administer acetaminophen and fluids
Situation: You are preparing emergency IV
B. Hold the medication and get a CBC medications in a code blue scenario and monitoring
for adverse reactions while managing arrhythmias
C. Reassure and continue treatment
and perfusion.
D. Schedule an outpatient follow-up
81. A nurse gives adenosine via peripheral IV. What
Situation: You are working in an ICU responding to is the most important nursing action?
multiple cardiac arrests. Your role includes
*
medication preparation, safe administration, and
understanding their effects during code situations. 1 point

76. During a cardiac arrest, the first-line medication A. Give slowly over 1–2 minutes
for asystole is:
B. Follow with a rapid 20 mL saline flush
*
C. Place the patient flat and delay monitoring
1 point
D. Use a small vein in the hand
A. Epinephrine
82. Which rhythm is adenosine primarily used to
B. Amiodarone treat?

C. Atropine *

D. Dopamine 1 point

77. Which statement best explains the action of A. Ventricular fibrillation

epinephrine during cardiac arrest?
B. Pulseless electrical activity
*
C. Supraventricular tachycardia (SVT)
1 point
D. Asystole
A. Increases vagal tone and decreases HR
83. Dopamine infusion at low doses primarily
B. Enhances myocardial contractility and peripheral causes:
vasoconstriction
*
C. Slows conduction through the AV node
1 point
D. Decreases myocardial oxygen demand
A. Beta-1 stimulation with increased HR
78. The recommended route for epinephrine during
B. Renal vasodilation and improved urine output
code if IV/IO access is unavailable is:
C. Coronary vasoconstriction
*
D. Bronchoconstriction
1 point
84. Which is the most common adverse effect of
A. Oral
high-dose norepinephrine infusion?
B. Endotracheal (ET) tube
*
C. Intramuscular deltoid
1 point
D. Subcutaneous
A. Severe hypotension
79. What is the primary indication for atropine during
B. Reflex bradycardia
a code?
C. Tissue necrosis at the IV site
*
D. Bronchospasm
1 point
85. Which electrolyte is most important to check
A. Ventricular fibrillation
before giving magnesium sulfate for torsades de
B. Pulseless electrical activity pointes?
* A. Check for kinks in the tubing or patient biting the
tube
1 point
B. Call the physician
A. Potassium
C. Turn off the ventilator alarm
B. Calcium
D. Increase sedation immediately
C. Sodium
Situation: You are managing patients with
D. Chloride
bradyarrhythmias, shock, and airway emergencies
Situation: You are assigned to respond to requiring rapid recognition and intervention.
emergency cardiac events in the ICU and to initiate
91. Which drug is first-line for symptomatic
life-saving interventions, including CPR,
bradycardia?
defibrillation, and medication administration.
*
86. A patient is found unresponsive with no pulse.
What is the nurse’s first action? 1 point

* A. Epinephrine

1 point B. Atropine

A. Check blood pressure C. Dopamine

B. Start chest compressions D. Adenosine

C. Give epinephrine 92. A patient has severe chest pain and becomes
unresponsive. What is the nurse’s next step after
D. Place an IV line
calling for help?
87. A client in the ICU suddenly has ventricular
*
tachycardia without a pulse. Which is the priority?
1 point
*
A. Get the crash cart
1 point
B. Check carotid pulse
A. Give amiodarone immediately
C. Give nitroglycerin
B. Defibrillate the client
D. Place the client in high Fowler’s position
C. Administer oxygen
93. A nurse is preparing to give epinephrine during a
D. Perform synchronized cardioversion
code. What is its main effect?
88. A nurse is preparing to give amiodarone during a
*
code. What is its main purpose?
1 point
*
A. Slows the heart rate and decreases contractility
1 point
B. Improves heart contractility and increases blood
A. Treat asystole
pressure
B. Control ventricular arrhythmias
C. Dilates blood vessels and lowers resistance
C. Increase heart rate in bradycardia
D. Blocks adrenaline effects on the heart
D. Raise blood pressure in shock
94. A patient with septic shock has low blood
89. Which rhythm is appropriate for synchronized pressure despite fluids. Which medication is
cardioversion? expected?

* *

1 point 1 point

A. Pulseless ventricular tachycardia A. Amiodarone

B. Supraventricular tachycardia with pulse B. Norepinephrine

C. Asystole C. Atropine

D. Ventricular fibrillation D. Adenosine

90. A patient has a low oxygen saturation while on a 95. After defibrillation, a patient regains pulse and
ventilator and the high-pressure alarm sounds. What consciousness. What is the next priority?
is the first action?
*
*
1 point
1 point
A. Remove the oxygen mask
B. Place the patient in a recovery position and RECALLS 7 NP5
reassess
Situation: You are responding to neurologic and
C. Give another shock immediately critical care emergencies, including stroke, airway
compromise, cardiac arrest, and post-resuscitation
D. Stop monitoring the rhythm
management in the ICU.
Situation: You are responding to ventilator alarms,
1. A patient with suspected stroke suddenly has trouble
airway emergencies, and sepsis while monitoring
breathing and low oxygen. What is priority?
patient outcomes post-resuscitation.
*
96. What is the main reason for giving magnesium
sulfate in the ICU? 1 point

* A. Place patient supine

1 point B. Prepare for intubation

A. Treat torsades de pointes C. Check blood glucose

B. Increase heart rate in bradycardia D. Start IV fluids rapidly

C. Treat anxiety 2. Which medication is used in asystole and pulseless

electrical activity (PEA) according to ACLS?
D. Increase blood pressure
*
97. Which is an early sign of sepsis in ICU patients?
1 point
*
A. Epinephrine
1 point
B. Amiodarone
A. Cold, clammy skin
C. Adenosine
B. Decreased urine output and confusion
D. Atropine
C. Slow bounding pulse
3. Which assessment finding shows norepinephrine is
D. High blood pressure
effective?
98. The nurse notices the ET tube has come out of a
*
ventilated patient. What should be done first?
1 point
*
A. Blood pressure improves to MAP ≥65 mmHg
1 point
B. Pulse oximetry falls to 85%
A. Call respiratory therapy
C. Heart rate decreases to 30 bpm
B. Bag-valve-mask ventilate the patient
D. Extremities turn pale and cool
C. Attempt to reinsert the tube immediately
4. A patient on mechanical ventilation suddenly has
D. Silence the alarm
absent breath sounds on one side and hypotension.
99. What does dopamine do at moderate doses in What should the nurse suspect?
shock?
*
*
1 point
1 point
A. Atelectasis
A. Lowers blood pressure
B. Tension pneumothorax
B. Improves heart rate and cardiac contractility
C. Pulmonary edema
C. Causes bronchospasm
D. Bronchospasm
D. Decreases kidney perfusion
5. Which ECG rhythm requires immediate
100. Which patient is the best candidate for rapid defibrillation?
sequence intubation?
*
*
1 point
1 point
A. Asystole
A. One who is already breathing normally
B. Pulseless ventricular tachycardia
B. One with severe airway compromise or
C. Sinus bradycardia
respiratory failure
D. First-degree AV block
C. One with stable vital signs on room air
Situation: You are assisting with invasive
D. One who refuses oxygen
procedures, managing airway emergencies, and
responding to arrhythmias and shock in critical 11. Which finding is most concerning in a patient with
patients. acute kidney injury (AKI)?

6. A patient has a sudden drop in blood pressure during *

central line insertion. What is the first action?
1 point
*
A. Urine output of 40 mL/hr
1 point
B. Serum potassium of 6.5 mEq/L
A. Apply high-flow oxygen
C. Mild peripheral edema
B. Place patient in Trendelenburg and check for air
D. BUN of 30 mg/dL
embolism
12. Which diet is appropriate for chronic kidney disease
C. Remove the line and apply pressure
(CKD)?
D. Call respiratory therapy
*
7. After giving adenosine for supraventricular tachycardia
1 point
(SVT), what rhythm change is expected initially?
A. High protein, low sodium, high potassium
*
B. Low protein, low sodium, low potassium
1 point
C. High protein, high sodium, low phosphorus
A. Immediate return to normal rhythm
D. No restriction as long as dialysis is done
B. Brief asystole then conversion to sinus rhythm
13. A patient on hemodialysis suddenly complains of
C. Ventricular fibrillation
dizziness and nausea. What is the nurse’s priority?
D. Permanent bradycardia
*
8. A patient with a tracheostomy accidentally removes
1 point
the tube and is in respiratory distress. What is the first
step? A. Place patient supine and slow the dialysis rate
* B. Give antiemetics immediately
1 point C. Discontinue dialysis permanently
A. Call the surgeon D. Encourage fluids
B. Use the bag-valve-mask over the stoma or mouth 14. A client misses two hemodialysis sessions and
presents with muscle weakness and ECG showing
C. Insert a nasogastric tube
tall peaked T waves. What is expected?
D. Wait for respiratory therapy
*
9. Which fluid is used first for hypovolemic shock?
1 point
*
A. Hypokalemia
1 point
B. Hyperkalemia
A. 0.9% Normal saline
C. Hypercalcemia
B. D5W
D. Hypophosphatemia
C. 0.45% Normal saline
15. Which is an early sign of peritoneal dialysis
D. 5% Albumin infection?

10. A patient with cardiac arrest has return of *

spontaneous circulation (ROSC). Which is the nurse’s
1 point
priority?
A. Cloudy effluent
*
B. Bloody effluent
1 point
C. Clear, yellow effluent
A. Discontinue monitoring because the arrest is over
D. Green-tinted effluent
B. Maintain oxygenation and check blood pressure
Situation: You are monitoring vascular access,
C. Give epinephrine again immediately
managing hemodialysis complications, and
D. Place patient flat and remove IV lines reinforcing patient education for home dialysis care.

Situation: You are assigned to clients with acute and 16. A nurse notes bleeding at the AV fistula site after
chronic kidney disease. Your priority is recognizing hemodialysis. What is the priority?
life-threatening electrolyte imbalances and
*
complications of renal replacement therapies.
1 point
A. Apply gentle pressure D. Iron dextran only

B. Call the nephrologist immediately 22. A patient with CKD is prescribed calcium acetate.
What is its purpose?
C. Elevate the arm above the heart
*
D. Remove the fistula needle
1 point
17. What should the nurse avoid with an AV fistula
arm? A. Lower potassium levels

* B. Increase iron absorption

1 point C. Bind phosphorus in the gut

A. Taking blood pressure D. Raise serum calcium levels

B. Placing a tourniquet 23. What is the priority nursing assessment before

starting hemodialysis?
C. Drawing blood samples
*
D. All of the above
1 point
18. Which finding in a dialysis patient suggests
disequilibrium syndrome? A. Serum amylase

* B. Lung sounds

1 point C. Vital signs and weight

A. Headache and confusion D. Pain scale

B. Hypotension and dizziness 24. A patient with peritoneal dialysis has outflow less
than inflow. What is the first nursing action?
C. Chest pain and palpitations
*
D. Joint pain and muscle cramps
1 point
19. Which fluid is commonly used to prime a dialysis
circuit? A. Stop the dialysis

* B. Turn the patient side to side

1 point C. Call the nephrologist

A. Lactated Ringer’s D. Add heparin to the solution

B. 0.9% Normal saline 25. What is a major complication of hemodialysis

needle dislodgment?
C. Dextrose 5% in water
*
D. 0.45% Normal saline
1 point
20. A patient on peritoneal dialysis reports severe
abdominal pain during inflow. What is the best A. Infection
response?
B. Air embolism
*
C. Severe hemorrhage
1 point
D. Hypokalemia
A. Increase dialysate flow rate
Situation: You are addressing symptoms related to
B. Warm the dialysate solution chronic uremia, evaluating hemodynamic changes
post-dialysis, and preventing life-threatening
C. Stop dialysis immediately
complications.
D. Add extra potassium to the solution
26. A patient on hemodialysis has severe itching
Situation: You are managing pharmacologic (uremic pruritus). Which is the best nursing action?
interventions and monitoring lab results to prevent
*
complications of end-stage renal disease (ESRD).
1 point
21. Which medication is often given to dialysis
patients to prevent anemia? A. Restrict fluids

* B. Give antihistamines as prescribed

1 point C. Apply ice packs

A. Epoetin alfa D. Encourage high-protein diet

B. Heparin 27. Which finding is expected after dialysis?

C. Warfarin *
1 point D. Slight bruising around site

A. Weight gain 33. Which dialysis patient is at highest risk for

hypotension during treatment?
B. Lowered blood pressure
*
C. Hyperkalemia
1 point
D. Edema increase
A. One who ate a large meal before dialysis
28. A patient on hemodialysis is ordered heparin
during treatment. What is its purpose? B. One who is slightly hypertensive

* C. One who had fluid overload corrected slowly

1 point D. One who is already volume-depleted

A. Reduce blood pressure 34. Which sign indicates successful AV fistula

function?
B. Prevent clotting
*
C. Increase potassium removal
1 point
D. Treat anemia
A. No bruit or thrill
29. Which is the most serious complication of
peritoneal dialysis? B. Weak radial pulse

* C. Palpable thrill and audible bruit

1 point D. Edema around the site

A. Hypotension 35. Which action prevents peritonitis in peritoneal

dialysis?
B. Peritonitis
*
C. Nausea
1 point
D. Constipation
A. Use of cold dialysate
30. A patient undergoing dialysis develops chest
pain. What should the nurse do first? B. Strict hand hygiene during exchanges

* C. Increasing dwell time

1 point D. Avoiding daily weight checks

A. Stop dialysis and notify the provider Situation: You are assigned to monitor fluid balance
and electrolyte status in dialysis clients and
B. Increase fluid removal
intervene for post-treatment complications.
C. Encourage deep breathing
36. Which symptom after dialysis indicates
D. Give antiemetics hypovolemia?

You are managing dialysis access and monitoring *

for vascular and metabolic complications, ensuring
1 point
patient safety and access function.
A. Flushed skin and bounding pulse
31. Which drug is commonly given to control high
phosphate in CKD? B. Dry mucous membranes and dizziness

* C. High blood pressure and edema

1 point D. Warm, moist skin

A. Calcium acetate 37. Which medication should be hold before

dialysis?
B. Furosemide
*
C. Epoetin alfa
1 point
D. Sevelamer
A. Antihypertensives
32. Which AV fistula assessment finding should be
reported immediately? B. Phosphate binders

* C. Vitamin D supplements

1 point D. Erythropoietin

A. Bruit present 38. Which patient statement about peritoneal

dialysis needs teaching?
B. Thrill present
*
C. Cool pale hand below the fistula
1 point C. Avoid discussing physical changes to prevent distress

A. “I need to keep my catheter clean and dry.” D. Ask family to wait outside during care

B. “If the fluid comes out cloudy, I will call the clinic.” 44. A dying patient has noisy “death rattle”
respirations. Which is the priority?
C. “I will skip daily weight checks to save time.”
*
D. “I should warm the solution before using it.”
1 point
39. Which lab result is expected in end-stage renal
disease? A. Suction the patient continuously

* B. Reposition the patient to a side-lying position

1 point C. Restrict all fluids

A. Metabolic alkalosis D. Place in Trendelenburg position

B. Low BUN and creatinine 45. What is a common psychological sign of

approaching death?
C. Hyperkalemia and metabolic acidosis
*
D. Hypophosphatemia
1 point
40. Which sign after peritoneal dialysis indicates
peritonitis? A. Sudden bursts of energy

* B. Refusal of food and withdrawal

1 point C. Increased talkativeness and socializing

A. Clear effluent and soft abdomen D. Insomnia with anxiety

B. Cloudy effluent and abdominal pain Situation: You are supporting family members of
dying patients and managing common end-of-life
C. Weight gain and hypertension
complications like agitation and organ failure.
D. Minimal drainage with clear fluid
46. Which statement by the nurse helps support a
Situation: You are providing end-of-life care in the grieving family?
ICU, focusing on physical changes and emotional
*
support for family members.
1 point
41. Which sign indicates circulation is failing in a
dying ICU patient? A. “It’s time to stop crying; you need to be strong.”

* B. “Would you like to hold their hand while I explain the

monitors?”
1 point
C. “Let’s remove all equipment right now so you don’t
A. Warm pink skin
see them like this.”
B. Mottled, cool extremities
D. “We will step out and give you no updates until the
C. Increased urine output end.”

D. Bounding peripheral pulses 47. Which urinary change indicates imminent death?

42. What respiratory pattern often occurs near *

death?
1 point
*
A. Output > 50 mL/hr
1 point
B. Tea-colored or absent urine output
A. Kussmaul respirations
C. Clear and high-volume urine output
B. Cheyne-Stokes respirations
D. Frequent urination every 30 minutes
C. Eupneic pattern
48. The nurse notes terminal restlessness in a dying
D. Apneustic respirations ICU patient. Which is the best intervention?

43. Which nursing action best supports family *

presence at the bedside?
1 point
*
A. Apply soft restraints
1 point
B. Administer prescribed low-dose morphine or sedative
A. Limit visitation to reduce emotional stress
C. Reorient the patient every 15 minutes
B. Allow family to stay as desired and explain changes
D. Turn on bright overhead lights
they see
49. What should the nurse say to a family member 1 point
who asks, “How much longer do they have?”
A. Randomized controlled trial
*
B. Correlational comparative study
1 point
C. Case study
A. “I can’t predict exactly, but I can explain what signs
D. Phenomenological study
we look for.”
55. Which tool is best to measure the dependent
B. “That’s private information I can’t share.”
variable?
C. “Everyone dies eventually; let’s focus on something
*
else.”
1 point
D. “They will pass exactly at midnight.”
A. Morse Fall Scale
50. A patient’s pulse becomes weak and irregular
near death. Which action is most important? B. Braden Scale
* C. Visual analog pain scale
1 point D. Apgar score
A. Begin chest compressions immediately Situation: You want to explore the impact of shift
work on nurses. The research title is:
B. Notify family and continue comfort care
“Night-shift nurses report lower sleep quality than
C. Start IV dopamine infusion
day-shift nurses in tertiary hospitals.”
D. Prepare for emergent intubation
56. What is the independent variable?
Situation: You are a nurse researcher studying falls
*
in hospitals. One of your proposed studies is titled:
“Older adult patients are at higher risk of falls 1 point
compared to younger adult patients in general
medical wards.”The goal is to determine which A. Level of sleep quality
factor influences fall risk and to guide fall-prevention
B. Nurse shift schedule
programs.
C. Hospital policies
51. In this study, what is the independent variable?
D. Patient acuity level
*
57. What is the dependent variable?
1 point
*
A. Fall risk
1 point
B. Patient age group
A. Sleep quality score
C. Type of hospital ward
B. Nurse shift rotation schedule
D. Type of footwear used
C. Type of hospital
52. What is the dependent variable?
D. Age of nurse
*
58. What is the population?
1 point
*
A. Number of patients admitted
1 point
B. Fall risk score/incidence
A. All nurses in the region
C. Hospital staffing pattern
B. Nurses in tertiary hospitals
D. Medication use
C. Only emergency nurses
53. What is the population?
D. Nursing students
*
59. Which tool measures sleep quality?
1 point
*
A. All hospital patients
1 point
B. Patients in general medical wards
A. Morse Fall Scale
C. Healthcare staff
B. PSQI (Pittsburgh Sleep Quality Index)
D. Nursing students
C. Perceived Stress Scale
54. Which research design is most appropriate?
D. Braden Scale
*
60. Which type of research design is used? D. GCS

* Situation: You are the charge nurse on a medical-

surgical unit during a busy shift. Four patients need
1 point
attention: (1) a patient with COPD reporting
A. Experimental with randomization shortness of breath, (2) a patient with blood glucose
320 mg/dL waiting for insulin, (3) a post-op
B. Descriptive comparative cholecystectomy patient with pain score 8/10, and
(4) a patient with stage 2 hypertension waiting for
C. Grounded theory
medications.
D. Case study
66. Which patient do you see first?
Situation: Your research team designs an
*
intervention study titled: “Effect of music therapy on
postoperative pain levels among orthopedic patients 1 point
compared to standard care.”
A. COPD patient with dyspnea
61. What is the independent variable?
B. Hyperglycemic patient
*
C. Post-op pain patient
1 point
D. Hypertensive patient
A. Type of orthopedic surgery
67. Which action for the COPD patient is most urgent?
B. Music therapy
*
C. Pain intensity
1 point
D. Length of hospital stay
A. Administer pain medication
62. What is the dependent variable?
B. Position in high Fowler’s
*
C. Provide orange juice
1 point
D. Offer emotional support
A. Pain score
68. Which task can be delegated to a nursing assistant?
B. Type of music
*
C. Patient age
1 point
D. Ward type
A. Blood glucose monitoring
63. Which research design best fits this study?
B. Adjusting oxygen flow
*
C. Pain assessment
1 point
D. Teaching breathing techniques
A. Randomized controlled trial
69. Which intervention for the hypertensive patient is
B. Ethnography correct?
C. Phenomenology *
D. Case report 1 point
64. What is the population? A. Encourage fluid restriction immediately
* B. Administer antihypertensives as ordered
1 point C. Place in Trendelenburg position
A. All post-op patients D. Give a high-sodium snack
B. Orthopedic post-op patients 70. Which documentation is a priority for the post-op
patient?
C. Physiotherapy staff
*
D. Nursing students
1 point
65. Which instrument measures pain intensity?
A. Surgical site drainage
*
B. Pain score and intervention
1 point
C. Family’s questions
A. Morse Fall Scale
D. Time of last meal
B. Numeric pain rating scale
Situation: A 65-year-old diabetic patient presents to
C. Apgar score
the ER with foot ulcers, fever 38.5°C, and BP 90/60
mmHg. Blood glucose is 420 mg/dL. The patient is A. Patient with unrelieved abdominal pain
confused and has poor peripheral pulses.
B. Patient requesting discharge teaching
71. What is the first priority?
C. Patient with NG tube to suction
*
D. Patient with minimal urine output
1 point
77. What does minimal urine output after surgery usually
A. Treat the fever indicate?

B. Start fluid resuscitation *

C. Administer sliding-scale insulin 1 point

D. Obtain wound culture A. Infection is present

72. What does confusion most likely indicate? B. Patient has renal failure

* C. Low perfusion or hypovolemia

1 point D. Catheter obstruction is expected

A. High anxiety 78. Which action is safe to delegate to a nursing

assistant?
B. Pain
*
C. Hypoperfusion
1 point
D. Neuropathy
A. Assess abdominal distention
73. Which wound assessment is most important?
B. Empty the urinary catheter bag
*
C. Evaluate NG tube placement
1 point
D. Perform discharge teaching
A. Wound color
79. Which teaching point is priority for the client with an
B. Wound odor
NG tube?
C. Wound size
*
D. Surrounding tissue perfusion
1 point
74. Which order should the nurse question?
A. Frequent hand hygiene
*
B. Avoidance of chewing gum
1 point
C. Need to maintain tube placement and suction
A. IV normal saline bolus
D. Taking laxatives to prevent constipation
B. Sliding scale insulin
80. What is the best documentation for the client with
C. High-dose corticosteroids pain?

D. Wound culture before antibiotics *

75. Which complication is most likely? 1 point

* A. “Patient seems uncomfortable”

1 point B. “Patient complains of pain”

A. Retinopathy C. “Pain score 8/10, analgesic given, reassessment

planned in 30 min”
B. Sepsis
D. “Gave morphine”
C. Osteoarthritis
Situation: You are working in the ED with multiple
D. Cushing’s syndrome trauma clients after a bus accident: (1) a client with
suspected cervical spine injury and shallow
Situation: You are assigned to four post-operative
respirations, (2) a client with an open femur fracture
patients after abdominal surgeries. One client has an
bleeding heavily, (3) a client with abdominal pain
NG tube connected to suction, one has a urinary
rating 7/10, and (4) a client with minor scalp
catheter draining minimal urine, one reports
lacerations.
increasing abdominal pain unrelieved by analgesics,
and one is requesting discharge teaching about 81. Which client do you assess first?
wound care.
*
76. Which patient should you assess first?
1 point
*
A. Cervical spine injury client
1 point
B. Femur fracture client 87. What is the best immediate nursing action for the
thyroidectomy client?
C. Abdominal pain client
*
D. Scalp laceration client
1 point
82. Which intervention is priority for the femur fracture
client? A. Assess airway and prepare suction

* B. Give pain medication

1 point C. Notify dietary services

A. Give pain medication D. Place on side-lying position

B. Apply direct pressure to the wound 88. Which nursing intervention can be delegated?

C. Elevate the head of the bed *

D. Perform neurological checks 1 point

83. Which client is stable and can wait? A. Changing diabetic foot dressing

* B. Monitoring for bleeding post-thyroidectomy

1 point C. Repositioning pneumonia client for lung expansion

A. Cervical spine client D. Teaching insulin injection

B. Femur fracture client 89. Which lab result needs urgent review in the
thyroidectomy patient?
C. Abdominal pain client
*
D. Scalp laceration client
1 point
84. Which team member is best for splint application
under supervision? A. Calcium level 7.0 mg/dL

* B. Potassium level 4.0 mEq/L

1 point C. Sodium level 139 mEq/L

A. Experienced nursing assistant D. WBC 9,000/mm³

B. Student nurse 90. Which pain management plan is appropriate for the
chronic back pain client?
C. Respiratory therapist
*
D. Charge nurse only
1 point
85. What is most important to document for the cervical
spine injury client? A. Administer opioids every hour as requested

* B. Encourage heat therapy and scheduled pain meds

1 point C. Provide only non-pharmacological interventions

A. Pain score and medication D. Suggest immediate surgical referral

B. Neuro status and airway management Situation: You are managing clients with
cardiovascular conditions: (1) chest pain radiating to
C. Patient’s emotional response
jaw and unrelieved by rest, (2) client with irregular
D. Time of arrival heart rate and dizziness, (3) client on furosemide
with leg cramps, (4) client requesting discharge
Situation: On a medical-surgical floor, you have instructions after angioplasty.
patients with different conditions: (1) pneumonia on
IV antibiotics, (2) post-thyroidectomy client reporting 91. Which client do you see first?
hoarseness, (3) diabetic with foot ulcers awaiting
*
dressing change, (4) client with chronic back pain
requesting additional opioids. 1 point

86. Which patient needs priority assessment? A. Chest pain client

* B. Irregular HR client

1 point C. Furosemide client

A. Pneumonia client D. Angioplasty client

B. Post-thyroidectomy client 92. What is the first action for chest pain?

C. Diabetic foot ulcer client *

D. Chronic back pain client 1 point

A. Administer oxygen and call rapid response 98. Which finding in the appendectomy client requires
further evaluation?
B. Provide reassurance only
*
C. Send for X-ray
1 point
D. Perform discharge teaching
A. Fever 38.3°C
93. What electrolyte imbalance is suspected with leg
cramps on furosemide? B. Nausea

* C. Mild abdominal discomfort

1 point D. Pain controlled with oral analgesics

A. Hypernatremia 99. Which documentation is priority for the SOB client?

B. Hyperkalemia *

C. Hypokalemia 1 point

D. Hypercalcemia A. Oxygen saturation and respiratory rate

94. Which teaching is most important post-angioplasty? B. Discharge readiness

* C. Last bowel movement

1 point D. Pain score

A. Avoiding showers for 1 month 100. Which task can be delegated to the nursing
assistant?
B. Report chest pain or bleeding immediately
*
C. No physical activity for life
1 point
D. Avoid all medications unless prescribed by ER doctor
A. Assessing wound dehiscence
95. Which intervention for irregular HR and dizziness is
priority? B. Discharge teaching

* C. Obtaining vital signs for stable patients

1 point D. Deciding oxygen flow rate changes

A. Start cardiac monitoring and check vitals

B. Provide snacks for energy

C. Give diuretics

D. Perform extensive teaching

Situation: In a surgical ward, you are assigned to: (1)

a post-hip replacement client with sudden shortness
of breath, (2) a client 24 hrs post-appendectomy with
low-grade fever, (3) a client with abdominal wound
dehiscence, and (4) a client asking about discharge
paperwork.

96. Which patient needs immediate attention?

1 point

A. Post-hip replacement client with SOB

B. Appendectomy client with low-grade fever

C. Wound dehiscence client

D. Discharge client

97. What is the first action for wound dehiscence?

1 point

A. Cover wound with sterile saline dressing

B. Apply abdominal binder tightly

C. Give pain medication and wait

D. Instruct client to cough for airway clearance