It has to go in a custom footer (not html module) to work*. The source, which also has some interesting thoughts on the desirability of disabling right click, is below: *Using in a custom footer:replace all code in xslt box with this: ]]>


Saturday, October 28, 2006

Saguisag to file motion to sanction vs Brion

Saguisag to file motion to sanction vs Brion

Lawyer Rene Saguisag is set to file a motion to sanction against Labor Secretary Arturo Brion before the Court of Appeals (CA) for delaying the oath-taking of nurses who passed the controversial board examinations in June, ABS-CBN News reported Saturday.

Saguisag said that Brion must be held accountable for his decision to stop the oath-taking despite the appellate court’s ruling on the issue.

On October 13, the court’s First Division ordered the Professional Regulation Commission to swear in the over 17,000 new nurses who passed the leakage-tainted Nursing Licensure Examination (NLE), almost two months after a restraining order from the CA stopped the oath-taking.

The appelate court ruled, however, that the 1,687 board passers would have to retake Tests 3 and 5 of the five-part NLE.

Some 2,000 to 3,000 board passers, along with their parents, were already gathered at the PRC auditorium when Chairwoman Leonor Tripon-Rosero announced the cancellation of the oath-taking ceremonies.

Rosero made the announcement after Brion said that the court's decision was not yet final and executory.

Saguisag said that even though the board passers finally took their oaths on Friday the CA should not let Brion get away with the damage he has inflicted on the nurses and their parents.

Nurses wake at dawn to take oath, move on

Nurses wake at dawn to take oath, move on

By Leila Salaverria
Last updated 02:56am (Mla time) 10/28/2006

Published on page A1 of the October 28, 2006 issue of the Philippine Daily Inquirer

LIZA Rastrollo, a 48-year-old mother, rose up well before dawn, left her Laguna home at 4:30 a.m. and arrived at the offices of the Professional Regulation Commission in Manila hours before the gates opened. She just wanted to make sure there would be no more hitch in her taking the Florence Nightingale pledge.

Four months of anxiety and recriminations ended yesterday for Rastrollo and the thousands of other passers of the scandal-smeared nursing board examination.

Cheering, clapping and hugging each other, they finally took their oaths to become full-fledged members of the nursing profession.

The cheering inside the PRC auditorium hadn’t died when Dante Ang, head of the Presidential Commission on Filipino Overseas Workers, injected a sour note.

In an interview with the Inquirer, Ang said that in his recent meetings with officials of the United States National Council of State Boards of Nursing (NCSBN), they told him that if a similar leakage had happened in the United States as what occurred during the nursing licensure examination here in June, they would have ordered a retake of the whole exam.

In fact, Ang said NCSBN president Faith Fields had told him that a nursing board exam in one US state was also wracked by a leakage scandal and the NCSBN ordered a retake of the whole exam to solve the problem.

The NCSBN administers the US National Council Licensure Examination (NCLEX). Passing the NCLEX would qualify a Filipino nurse for jobs in US hospitals and health centers.

Around 80 percent of NCLEX examinees come from the Philippines.

Ang’s remarks may well have sounded irrelevant to Rastrollo and to Gringo San Diego, 20, an accountant’s son and the topnotcher of the controversial June tests.

“I’m very, very happy because now we can move on,” said San Diego, who was among the 4,000 new nurses who took their oaths in batches at the PRC compound yesterday.

“Our plans were disrupted during our four months of waiting. At least, now we can make them happen,” he said.

End of agony

San Diego dreams of someday working in a US hospital.

The young Pampango said he would begin reviewing for the NCLEX but that before going abroad, he wanted to work for at least a year in a Philippine hospital.

“We are all very happy that finally their agony is over,” said school dean Antonio Lim, who attended the oath-taking of 85 new nurses in Tacloban City.

First batch

Yesterday’s first batch of 200 oath-takers at the PRC office in Manila swore their allegiance to the nursing profession and its principles at the PRC auditorium at 8:30 a.m. The 30-minute ceremony included a prayer and a message from the Board of Nursing chair.

The integrity of the June exam came under a cloud after disclosures that questions to Tests III and V had been leaked to reviewees in Baguio and Manila.

This led to the stopping twice of the oath-taking of the 17,821 who were initially announced to have passed, and to changes in the list of passers.

Integrity of the exam

The Court of Appeals first stopped the oath-taking following a petition filed by some nursing college professors and graduates, who questioned the PRC’s decision to recompute the scores in a bid to nullify the effects of the leakage.

The petitioners said they wanted to preserve the exams’ integrity and supported a retake, but the PRC maintained that a retake was unnecessary.

The scandal also split the ranks of the passers.

On Oct. 13, the appellate court invalidated the PRC’s recomputation of grades and ordered the retake of Tests III and V of the exam by the 1,687 graduates who had been added to the list of passers after the recomputation.

Nationwide uproar

The court also ordered the reinstatement to the list of passers of 1,186 graduates whose names were removed from the list following the recomputation.

The scandal kicked off a nationwide uproar and prompted calls for Malacañang to step in. It later designated Labor Secretary Arturo Brion to handle the bomb.

On Wednesday, after a conciliation meeting attended by opposing parties, the CA said there was no legal impediment to the oath-taking.

Cheers in the auditorium

Many, like Rastrollo, came to the PRC offices in Manila hours before they opened.

By 7:30 a.m., the line of people in white nurses’ uniforms that had formed outside the PRC’s gates along Paredes Street in Sampaloc had snaked for several hundred feet, reaching all the way to España.

The oath-taking, administered by the BON, was done in batches and on a first-come, first-served basis because the auditorium could only hold about 200 to 300 people.

When the first batch of oath-takers was asked to stand up prior to reading their oaths, many of them gave howls of joy.

Challenge to new nurses

Cheers and clapping erupted after they completed their oaths. Some hugged each other while others shook hands.

“At last,” said Rastrollo, a mother of two nursing students and who used to be a housewife before she decided to take up nursing. She arrived at the PRC at 5:45 a.m.

Calling on the passers to reflect on the doubts that had been cast on their competence, BON chair Eufemia Octaviano told the first batch of oath-takers:

continue reading on:

Nurse Licensure Examination Results additional 1,184 new passers

Nurse Licensure Examination Results

The Philippine Star 10/27/2006

The Professional Regulation Commission (PRC) announces that as per decision of the Court of Appeals an additional 1,184 examinees passed the Nurse Licensure Examination given by the Board of Nursing in the cities of Manila, Baguio, Cagayan de Oro, Cebu, Davao, Iloilo, Legazpi, Lucena, Tacloban, Tuguegarao and Zamboanga last June 2006. The results of examination with respect to two (2) examinees were withheld pending final determination of their liabilities under the rules and regulations governing licensure examinations.

The oathtaking and registration of successful examinees will start on Friday, October 27, 2006. Those who will register are required to bring the following: duly accomplished Oath Form or Panunumpa ng Propesyonal, current Community Tax Certificate (cedula), 2 pieces passport size picture (colored with white background and complete nametag), 1 piece 1" x 1" picture (colored with white background and complete nametag), 2 sets of metered documentary stamps, and 1 short brown envelope with name and profession; and to pay the Initial Registration Fee of P600 and Annual Registration Fee of P450 for 2006-2009. Successful examinees should personally register and sign in the Roster of Registered Professionals.

Following is the list of Successful Applicants:

Continue reading...

Additional 1,184 nursing exam passers listed

Additional 1,184 nursing exam passers listed


The Professional Regulation Commission (PRC) announced yesterday that, as per decision of the Court of Appeals, an additional 1,184 examinees passed the Nurse Licensure Examination given by the Board of Nursing in the cities of Manila, Baguio, Cagayan de Oro, Cebu, Davao, Iloilo, Legazpi, Lucena, Tacloban, Tuguegarao, and Zamboanga last June.

The results of examination with respect to two examinees were withheld pending final determination of their liabilities under the rules and regulations governing licensure examinations.

Meanwhile, thousands of new nurses heaved a sigh of relief and cheered one another after completing their oath in ceremonies at the PRC office in Manila yesterday, a day after the Court of Appeals issued a decision allowing the board passers to take their pledge as nurses.

Two weeks after the postponement of their oath-taking, successful examinees in their impeccably white uniforms went to the PRC even earlier than 6 a.m. and finally took their pledge four months after the scandal-tainted Nursing Licensure Examinations last June.

The Alliance of New Nurses (ANN) said about 15,000 board passers took their oath. Some 17,000 who also passed the board had already taken their oath last Aug.18.

"Finally, we can move on," said Gringo San Diego, the exams’ topnotcher, who attended the oath-taking of the third batch of successful examinees at 9:30 a.m.

San Diego led the recitation of the "Nightingale Pledge," the nursing creed in honor of Florence Nightingale, founder of the nursing profession.

Continue reading ....

* the list of the new passers is found in Manila Bulletin section B-7. So grab your copy now!*

Nurses finally take oath

Nurses finally take oath
By Sheila Crisostomo
The Philippine Star 10/28/2006

After months of agonizing over their fate, those who passed the June licensure test for nursing can finally "move on."

Yesterday, thousands of board passers took their oath at Professional Regulation Commission (PRC) offices across the country, ending months of speculation and anxiety.

"At last it’s over. I dreamt of this for a long time. Now, I can move on," said 20-year-old Faith Infanta, of Barangay Caalibang-bangan, Cabanatuan City, Nueva Ecija.

Passers have asked those seeking a retake of the June licensure test for nursing to give up and respect the decision of the Court of Appeals (CA), allowing them to take their oath.

"I just hope they’ll let us go on with our life and pursue our dreams. This issue has been stalling us for several months now. We want to move on," said Renato Aquino, president of the Alliance of New Nurses (ANN).

Faith was one of the passers who rushed to the PRC central office in Manila from his hometown to take his oath.

Going through school was a struggle for Faith. The meager income of his carpenter-father was not enough for his needs and if not for his 75-year-old maternal grandmother Marina Reduque, he would have not fulfilled his dream.

"From grade school to college, my Lola was providing for me. He is also helping my cousins. Actually, six of my cousins also finished nursing because of her. She has a family of her own but she does not hesitate to help us," he told The STAR.

In college, Faith worked part-time in the editorial staff of a local newspaper in Nueva Ecija and as a researcher. He also sold bags, pillows, t-shirts and automatic load for cellular phones.

In a small company in Cabanatuan, he worked as an "office assistant" even without pay, but he had free use of company computers for his school work.

Despite these seeming distractions, Faith graduated cum laude from the Wesleyan University of the Philippines in Cabanatuan City to the delight of his Lola.

So when the leakage controversy broke out, Faith’s grandmother was also devastated. "She knows how hard I worked to be able to finish nursing with honors. We were really disappointed but we did not lose hope that everything will be all right."

Faith plans to work in a local hospital for two to three years before taking his chance in a foreign hospital.

"I intend to help my two siblings and other cousins in their studies. It’s actually a tradition in our clan – to help one another get a diploma. I also want to ease the burden of my Lola. I know that’s the only way that I can do that," he added.

For Grace Urquiaga, 39, of Loyola Grand Villas in Quezon City, being a nurse is her "Plan B" to ensure a bright future for her children Isabel, 11; Karla, 10; and Paco, 1.

Grace has been a stewardess for an international airline for 19 years now, but she felt she had to do more for her kids to get a good education.

"It’s actually my daughters who motivated me. One time, when they came home from school, they asked me where Princeton University and MIT (Massachusetts Institute of Technology) are. They said they want to study there. I was shocked," she recalled.

Grace surmised that her daughters got that idea from their classmates at Woodrose School at the Ayala Alabang Village in Muntinlupa.

Her daughters could have popped that question out of the blue, without really knowing its meaning. But their mother took it seriously and enrolled in a nursing course.

"Actually even before, I wanted a service-oriented job. I wanted to become a doctor but I ended up as a stewardess. Now with nursing, I’ll be able also to fulfill my dream," she said.

But migrating or working abroad is not in her immediate plans yet. Grace prefers that her children spend their growing up years in the Philippines.

Continue reading on :

Nursing Practice (Integrated Exam) with Answer Keys

Nursing Practice (Integrated Exam)

Here's something for all the Filipino Nursing Students.

Answer keys are found after the last item of exam. Due to time constraints, I will not be able to provide you with rationales.

Kindly post comments if there are any misleading answers.

Thank you..


Answer Keys will be reposted soon..
Thanks to the comments...
The errors to the answer keys were unintentional..

Degree of Question’s Difficulty

(3) – Difficult question
(2) – Average question
(1) – Easy question

Situation 1: Mr. Santiago has a long history of smoking; he is currently diagnosed with COPD. He is admitted for a pulmonary work up.

1. His arterial blood gas results are PO2 of 85, PCO2 of 40 and HCO3 of 24. Which of the following should be initiated? (3)
a. Administer O2 at 2L to prevent him from becoming hypoxic.
b. No action is necessary; this is within normal range for a COPD client.
c. Anticipate the development of metabolic acidosis and administer Na HCO3.
d. Position him in high Fowler’s and anticipate him to need assisted ventilation
2. He finds that after smoking or exercise, he experiences difficulty of breathing, headaches and nausea. These are symptoms of: (2)
a. Increased level of carbon dioxide
b. Decreased level of arterial oxygen
c. Decreased level of carbon dioxide
d. Very rapid breathing and metabolic acidosis
3. To encourage proper breathing exercises, which of the following should the nurse teach? (1)
a. Encourage pursed lip breathing
b. Inhalation should be 2 to 3x that of exhalation
c. Encourage high abdominal breathing using the muscles of the diaphragm
d. Inhale through the mouth and out through the nose.
4. Which set of blood gases would indicate respiratory acidosis? (2)
a. pH 7.0; PCO2 42mmHg; HCO3 21mEq/L
b. pH 7.46; PCO2 38mmHg; HCO3 28mEq/L
c. pH 7.35; PCO2 44mmHg; HCO3 25mEq/L
d. pH 7.32; PCO2 48mmHg; HCO3 22mEq/L
5. He is to receive an IV of Lactated Ringer’s, 1000 cc to run for 8 hours. The drip factor is 10 gtt/cc. How many drops per minute should you regulate the IV? (1)
a. 24 gtt/min
b. 12 gtt/min
c. 21 gtt/min
d. 30 gtt/min

Situation 2: Nurse Jeddah is the staff nurse assigned in the Medical Ward of a secondary hospital.

6. The physician ordered reverse isolation for Mr. Perez with second degree burns. While performing reverse isolation technique, Nurse Freud should understand that: (2)
a. it is not necessary to use sterile linen if the linen has been properly washed.
b. only some persons who come in direct contact with the client need to wear gloves andmask
c. sterile gown and gloves must be worn while caring for Mr. Perez
d. it is not necessary to wear a mask
7. During the stage of diuresis, there is resorption of fluid into the intravascular compartment and increase urinary output. Which electrolyte imbalance is most frequently associated with this stage? (3)
a. hypernatremia, hyperkalemia, carbonic acid deficit
b. hyponatremia, hyperkalemia, bicarbonate excess
c. hyponatremia, hypokalemia, bicarbonate deficit
d. hypernatremia, hypokalemia, carbonic acid excess
8. The priority nursing care for patient suffering from stroke during acute phase is to: (3)
a. maintain respiratory and cardiac functions
b. prevent contracture and deformities
c. maintain optimal nutrition
d. provide sensory stimulation
9. The nurse in the clinic would assess a 4-month-old who is in acute respiratory distress when which of the following is observed? (2)
a. resting respiratory rate of 35 breaths/min
b. flaring of nares
c. diaphragmatic respiration
d. bilateral breath sounds
10. In assessing patient for signs of impending respiratory failure, an early symptom that the nurse should look for is: (1)
a. Kussmaul’s respiration
b. cyanosis
c. tachypnea
d. bradypnea

Situation 4: Nurse Kitchie is caring to clients with tuberculosis at San Lazaro Hospital

11. Which of the following symptoms is common in clients with tuberculsosis? (1)
a. Mental status changes
b. Increased appetite
c. Dyspnea on exertion
d. Weight loss
12. Nurse Kitchie obtains a sputum specimen from a client for laboratory study. Which of he following laboratory techniques is most commonly used to identify tubercle bacilli in sputum? (1)
a. Dark-field illumination
b. Sensitivity Testing
c. Acid – fast staining
d. Agglutination
13. A client has a positive Mantoux test. Nurse Kitchie correctly interprets this reaction to mean that the client has: (2)
a. active tuberculosis
b. had contact with Mycobacterium tuberculosis
c. developed a resistance to tubercle bacilli
d. developed passive immunity to tuberculosis
14. Nurse Kitchie should teach clients that the most common route of transmitting tubercle bacilli from person to person is through contaminated: (1)
a. dust particles
b. droplet nuclei
c. water
d. eating utensils
15. The client is to be discharged home with a community health nursing follow – up. Of the following interventions, which would have the highest priority? (2)
a. Offering the client emotional support
b. Teaching the client about the disease and treatment
c. Coordinating various agency services
d. Assessing the clients environment for sanitation

Situation 4 Mang Tomas with advanced chronic obstructive pulmonary disease (COPD) reports steady weight loss and being “is too tired from just breathing to eat, is admitted in the hospital.

16. Which of the following physical assessment findings would Nurse Pepsi expect to find for Mang Tomas? (2)
a. Increased anteroposterior chest diameter
b. Underdeveloped neck veins
c. Collapsed neck veins
d. Increased chest excursions with respiration
17. Which of the following nursing diagnoses would be most appropriate when planning nutritional interventions? (1)
a. Altered Nutrition: Less than body requirements r/t fatigue
b. Activity Intolerance r/t dyspnea
c. Weight loss related to COPD
d. Ineffective breathing pattern r/t alveolar hypoventilation
18. Nurse Pepsi’s priority goal for Mang Tomas is: (2)
a. Maintaining functional ability
b. Minimizing chest pain
c. Increasing carbon dioxide levels in the blood
d. Treating infectious agents
19. Which of the following diets would be most appropriate for Mang Tomas? (2)
a. Low fat, low cholesterol
b. Bland, soft diet
c. High calorie, high CHON
d. Low sodium diet
20. When developing a discharge plan to manage the care for Mang Tomas, Nurse Pepsi should anticipate that the client will do which of the following? (3)
a. Develop infections easily
b. Maintain current status
c. Require less supplemental oxygen
d. Show permanent improvement

Situation 5: Tuberculosis (TB) has been declared a global emergency in 1993 by the WHO.

21. TB ranks sixth in the leading causes of morbidity. Nurse Miranda recognizes that the most hazardous periods for development of clinical disease is: (1)
a. 1 year
b. 2 ½ years
c. 3 months
d. 6 months
22. Which of the following statements is the primary preventive measure for PTB? (2)
a. Provide public health nursing and outreach services
b. BCG vaccination of newborn, infants and grade 1 or school entrants
c. Make available medical, laboratory and x –ray facilities
d. Educate the public in mode of spread and methods of control
23. The source of infection in PTB is through which of the following? (1)
a. Contamination of potable water
b. Direct connection with injected persons
c. Crowded living patterns
d. Sexual intercourse
24. In TB control program, DOH has specific objectives, one on prevention is another program focused on children. Which one below is the program? (1)
a. Sputum collection and examination
b. Tuberculin for skin testing
c. EPI for BCG vaccine
d. Maternal and child health nursing
25. BCG is given to protect the baby from infection at what age? (1)
a. At birth
b. At 1 month
c. At 2 month
d. At 9 month

Situation 6: The national objectives for maintaining the health of all Filipinos is a primary responsibility of the Department of Health.

26. The Department of Health Program has a mission which includes all of the following, except: (1)
a. Ensure accessibility
b. Quality of health care
c. Improve quality of life
d. Health for all Filipinos in the year 2020
27. Which of the following are primary strategies to achieve health goals? (1)
a. Assurance of health care
b. Development of national standards and objectives
c. Support to local health system development
d. All of the above
28. Which of the following statements best describes the DOH vision? (1)
a. Ensure accessibility
b. Achievement of quality health care for all
c. Health for all Filipinos
d. Promotion of health education
29. Which of the following is the mission of the DOH? (1)
a. Promote healthy lifestyle
b. Ensure accessibility and quality of health care
c. Reduce morbidity and mortality
d. Improve general heath status of the people
30. Which of the following is not a primary strategy to achieve health goals? (1)
a. Support of local health system
b. Development of national standards for health
c. Assurance of health care for all
d. Funding from non – government organizations

3Situation 7: Asthma results in diffuse obstructive and restrictive airway disease of inflammation and bronchoconstriction. With increasing pollution in our environment, both children and adults are now affected with asthma.

31. As a nurse you know that there are many elements that provoke the attack. Which among the elements is a common allergen to both the children and adult patients? (1)
a. Cigarette smoke
b. Dust – mite
c. Perfume
d. Flowers
32. If a child has asthma, what nursing diagnosis can you make that will direct your nursing intervention? (2)
a. Parental anxiety r/t respiratory distress in child
b. Child fear r/t asthma
c. Impaired breathing mechanisms r/t bronschospasm
d. Fatigue r/t respiratory distress
33. As a nurse, what body organs and sense can you utilize in rural areas that can crudely assess presence of asthma in children? (2)
a. heart, eyes and ears
b. eyes and mind
c. eyes, ears and touch
d. ears and heart
34. In case of asthmatic attack, what position can a nurse advise patients to take? (1)
a. Semi – fowler’s
b. Sitting
c. Lying down in bed
d. Prone lying
35. Of what use is the Peak Expiratory Low Rate (PEFR) as a monitoring device for nurses? (3)
a. Guide to respiratory therapy with medications
b. Help in planning of an appropriate therapeutic regimen
c. Monitor breathing capacity
d. Know adequate transfer of gases across alveolar capillaries

Situation 8: Fear and anxiety are conditions that bring about acid-base imbalances.

36. What is the primary nursing responsibility when a patient presents respiratory distress? (2)
a. Get ready with complete ECG cart at the side
b. Life-threatening measures are readied
c. History taking and keen assessment of respiratory problem
d. Positioning and oxygen therapy on hand
37. When a patient is fearful and anxious, what is the condition indicative of? (3)
a. Respiratory alkalosis
b. Metabolic acidosis
c. Metabolic alkalosis
d. Respiratory acidosis
38. When a patient shows manifestation of an acid-base imbalance, what is the nursing responsibility? (2)
a. Explain procedure and protocol of care
b. Take arterial blood gases every hour
c. Assess respiratory and neurologic status every 2-4 hours
d. Administer medication to help ventilation
39. Chow, 2-year-old has difficulty of breathing without any previous cause. What can a nurse do at this very moment? (2)
a. Positional nursing care – head part higher
b. Administer oxygen and fluids
c. Hook to mechanical ventilation
d. Monitor intake and output
40. If Chow asks for food and drink, which among the following will you give him? (3)
a. Soft drinks
b. Ice cream
c. Hot milk and crackers
d. Warm congee

Situation 9: “Acute Respiratory Infection (ARI) especially pneumonia leads as the cause of illness and death among Filipino children”, claims the Department of Health.

41. Which of the following is the main factor that contributes to the problem of getting sick of pneumonia among children below 5 years old? (3)
a. Poor follow-up compliance to treatment
b. Lack of advocates to gain local government support
c. Inability of health worker to refer immediate treatment
d. Failure of mother to recognize early signs and symptoms
42. What is the program mandated to reduced mortality of acute respiratory illness? (1)
a. Pneumonia control program
b. Stop pneumonia
c. Control of ARI (CARI)
d. “Ask, Look and Listen”
43. Which classification of pneumonia has the child if 3 or more danger signs are present? (2)
a. Severe
b. Pneumonia
c. No Pneumonia
d. Very severe
44. When the child is to receive antibiotic, where should the first dose be given? (1)
a. In the school
b. In the health center
c. In the home
d. In the referral system
45. Which of the following is your topic for health teaching to mothers of children with pneumonia? (2)
a. Breastfeeding
b. Family planning
c. Use of Assess Card
d. Play therapy

Situation 10: The Tochan family is in crisis situation. Mr. Tochan, 60-year-old has emphysema and is in ZMDH. He was admitted last September 5, 2006. His wife Vina, 50-year-old is taking care of her husband in the hospital. He is under close observation with O2 inh/NC @ 2LPM.

46. Upon auscultation, rales are heard in Mr. Tochan’s left lower lung segment. One of the orders in the care and treatment of Mr. Tochan was postural drainage once a day. To perform the procedure it would involve placing Mr. Tochan on: (2)
a. back with a pillow under his hips
b. left side with a pillow under his hips
c. right side with a pillow under his hips
d. abdomen with a pillow under his chest
47. Mr. Tochan’s condition resulted in COPD. His blood pH is 7.33 and he is restless. Accordingly, her nursing care plan should include: (3)
a. increasing his O2 flow rate
b. removing his secretions from his respiratory tract
c. limiting his fluid intake
d. administering hypnotics as ordered
48. Most of the time Mr. Tochan is allowed to rest. At 12 noon CBC & ABG were done. The results showed PaO2 - 92%, PCO2 - 46, RBC- 4.8 mx10, WBC - 11000, Hgb.-12g/dl. The best nursing action would be: (2)
a. monitor Mr. Tochan
b. Increase O2 inh
c. call the MD
d. start an antibiotic
449. He complained of inability to produce sputum. “I feel I have something in my lungs that I need to cough out.” Nurse Pia would be most helpful if she: (2)
a. calls the physician
b. administer mucolytic
c. give health teaching
d. limit fluid intake
50. Chest physiotherapy and deep breathing exercises were encouraged for Mr. Tochan. When is the most appropriate time to perform such procedure? (1)
a. after lunch, before napping
b. before breakfast
c. after breakfast, before am care
d. time element is not important

Situation 11: At around 7:30 am the following day, Nurse Pia endorsed Mr. Tochan to Nurse Vega as having a temperature reading of 38.8ºC/ax. She also endorsed that he’d been restless during the night.

51. The most appropriate nursing action would be: (3)
a. check vital signs
b. call the physician
c. administer cooling measures
d. administer antipyretics
52. One of the nurses came at the bedside of Mr. Tochan and states: “You look like you are having difficulty of breathing.” The nurse’s statement is: (3)
a. appropriate because difficulty of breathing is expected from COPD
b. appropriate because it states what the nurse is observing
c. inappropriate because the nurse made a conclusion without validating
d. inappropriate because the nurse should wait for the client to speak first
53. Later that day, Mr. Tochan had bouts of productive cough. The most effective infection control is for the nurse to: (1)
a. monitor the temperature
b. push oral fluids
c. have the client cover his mouth when coughing
d. do not allow visitors for the client
54. In respiratory infection, the sputum is highly contagious. In the chain of infection the sputum is: (1)
a. portal of entry
b. infectious agent
c. reservoir
d. portal of exit
55. The following conversation took place at Mr. Tochan’s bedside while the morning shift nurse was making her rounds:
Nurse: “Mr. Tochan, I will be teaching you deep breathing exercises.”
Tochan: “I would prefer that we wait for my wife. She knows what to do.”
Nurse: “You should not rely on your wife. I will show you how to do it effectively.”
The nurse’s last statement is: (2)
a. displaying a value of judgment
b. appropriate because it encourage independence
c. the client must realize that the wife has other things to do
d. inappropriate because patients are always right

Situation 12: The Department of Health promotes use of herbal drugs. As a public health nurse, you implement the program on traditional medicine in the community.

56. To promote the use of herbal medicines, which of the following projects would you encourage the people in the community to do? (1)
a. Backyard herbal gardening
b. Plant a tree today
c. Save Mother Earth
d. Clean and Green
57. Which of the following herbal plants is used for respiratory problems such as asthma, cough and fever? (1)
a. Lagundi
b. Sambong
c. Niyog-niyogan
d. Yerba Buena
58. Which of the following aromatic herbs for body pain, rheumatism and arthritis is used by older persons? (1)
a. Sambong
b. Yerba Buena
c. Carmona-rosa
d. Alusimang Bato
59. Which of the following herbal plants is used for mild non-insulin dependent diabetes mellitus? (1)
a. Alusimang Bato
b. Bawang
c. Carmona-rosa
d. Ampalaya
60. In the use of herbal medicines, which of the following statement is incorrect? (2)
a. Avoid the use of insecticides as these may leave poison on plants
b. Use only the part of the plant being advocated
c. In preparation, use a clay pot and cover it while boiling at low heat
d. Follow accurate dose of suggested preparation

Situation 13: Mr. Ang Lee has chronic cough and dyspnea. Her physician made a diagnosis of Acute Pulmonary Emphysema.

61. He has dyspnea with mild exertion. What is the probable cause of this? (2)
a. Impaired diffusion between the alveolar air and blood
b. Thrombic obstruction of pulmonary arterioles
c. Decrease tone of the diaphragm
d. Lowered oxygen carrying capacity of the RBC
62. Which of the following tissue changes is a characteristic of emphysema? (2)
a. Overdistention, inelasticity and rupture of alveoli
b. Accumulation of pus in the pleural space
c. Filling of air passage by inflammatory alveoli
d. Accumulation of fluids in the pleural sac
63. While waiting for the resident-on-duty to perform the physical examination, Mr. Lee would be most comfortable in which position? (1)
a. Sitting on edge of bed
b. Lying flat on bed
c. Reclining in his left side
d. Supine with head elevated
64. The primary objective of your nursing care management for him is to improve her quality of life. Which of the following would not be included in your therapeutic approach? (3)
a. Prevention of infection
b. Prompt treatment of infection
c. Providing supportive care
d. Maintenance of a conducive environment
65. Which of the following hygienic care would be most appropriate for Mr. Lee? (2)
a. Proper care of finger and toenails
b. Not allowing him to have daily baths
c. Checking the VS every four hours
d. Providing oral care at least three times a day

5Situation 14: Mrs. Meow, 46-year-old with asthmatic attack is admitted in the medical ward of Rico Hospital.

66. Your finding in your assessment would include the following, except: (1)
a. Ability only to speak a few words without taking a deep breath
b. Tachycardia, cool and moist skin
c. Air hunger and presence of wheezing sounds
d. Tachycardia, warm and moist skin
67. With your assessment, which of these symptoms would you expect to develop later? (2)
a. Nasal flaring
b. Lips pursed in an effort to exhale
c. Cyanosis
d. Use of accessory muscles for breathing
68. Which has the fewer tendencies to precipitate or trigger asthmatic attack? (1)
a. Air pollution
b. Cold weather
c. Changes in climate
d. Mold, house dust
69. The least of nursing care that you would do with Mrs. Meow is to: (2)
a. Give Bricanyl tablet to ease breathing
b. Keep his back always dry
c. Keep the siderails up at all times
d. Force fluids to liquefy the secretions
70. The most comfortable position for Mrs. Meow to assume during asthmatic attack is: (1)
a. Sitting
b. Orthopneic
c. Fowler’s
d. Supine

Situation 15: Mr. Kaldero, age 38, is referred to the local hospital clinic after his tuberculin skin test was found to be positive. He is admitted for further diagnosis and evaluation. Medications ordered for Mr. Cordero are 300 mg Isoniazid (INH) p.o. daily, 300 mg Rifampicin p.o. daily, 100 mg Pyridoxine (Vitamin B6) p.o. daily, regular diet and bed rest.

71. Which would most likely confirm Mr. Kaldero’s diagnosis of tuberculosis? (1)
a. Creatinine kinase test
b. Chest x-ray
c. Sputum smear and culture
d. White blood cell count
72. Which clinical manifestations would the nurse expect in a patient with TB? (2)
a. Hemoptysis and weight gain
b. Productive cough and afternoon elevated temp
c. Dry cough and blood streaked sputum
d. Night sweats and urticaria
73. Which nursing activity would be most therapeutic while Mr. Kaldero is on bed rest? (2)
a. Encouraging family and friends to visit 3x a day
b. Assisting him in walking to the lounge
c. Assisting him with ROM exercises
d. Encouraging him to visit other patients
74. Possible adverse effects of Isoniazid therapy include: (2)
a. Peripheral neuritis, tachycardia, and insomnia vertigo
b. Fever and GI dysfunction
c. Hepatic dysfunction, headache and
d. Hepatic dysfunction and kidney damage
75. After a week in the hospital, Mr. Kaldero is ready for discharge. When providing discharge instructions, the nurse should discuss all of the following, except:
a. The plan for regular follow-up care
b. The possible adverse effects of his medications
c. The need to discontinue INH if nausea occurs
d. The need to cover his nose and mouth when coughing

Situation 16: Reason Blade, R.N., is the staff nurse on duty at the Medical Ward of Aquinas University Hospital.

76. In Bed No. 1 is Mr. Monterey, a 50-year-old client with asthma. Your nursing management for him is: (2)
a. Administer Alevaire inhalation to soften secretions
b. Force fluids
c. Administer Bricanyl
d. Give fruit juice
77. To ease his breathing, which position would make him most comfortable? (1)
a. Dorsal recumbent
b. Sim’s
c. Orthopneic
d. Fowler’s
78. Mr. Tatad, who is in Bed No. 3 is suffering from COPD. You informed him that the most effective bronchodilator is: (2)
a. Lukewarm lemonade
b. Deep breathing
d. Steam inhalation
d. Mild mucolytic agent
79. What diet is best recommended for him considering his existing Valsalva maneuver problem? (2)
a. Full liquid diet
b. Bland diet
c. High in fiber and bulk
d. Soft, high in protein
80.Which of the following will not promote effective clearing of Mr. Tatad’s tracheobronchial secretions? (2)
a. Assuming postural drainage
b. Administering Alevaire medications
c. Doing deep breathing exercises every 2 hours
d. Doing coughing technique effectively

Situation 17: In a developing country like the Philippines, accumulation of fluid in the pleural cavity commonly results from tuberculosis.

81. Anatomically, the inner part of the thoracic cavity is lined by the parietal membrane, while the membrane that envelops the lung is called: (1)
a. visceral membrane
b. cell membrane
c. plasma membrane
d. pulmonary membrane
82. Mang Jose is prepared for CTT. Nurse A would know that CTT stands for: (2)
a. Chest Tube Thoracostomy
b. Central Thoracic Test
c. Critical Terminal Treatment
d. Close Tube Thoracostomy
83. The correct position of Mang Jose to assume during CTT is: (1)
a. supine position
b. sitting on a chair, leaning on the back rest
c. high fowler’s with arm of affected side above the head
d. side lying on high fowler’s at the side of the bed
84. During the rounds, Nurse A noticed that the chest tube was accidentally removed by the client. The best appropriate nursing action Nurse A should take is: (3)
a. shout for help
b. reinsert the chest tube immediately
c. apply vaselinized sterile gauze and pressure dressing and notify surgeon immediately
d. ignore it, the client can reinsert it by himself
685. Nursing responsibilities in caring for patients with CTT are the following except: (3)
a. ensure that the drainage bottle is at the level of the patient’s chest
b. monitor water-seal drainage bottle to ensure fluid level is above drain tube
c. coil tubing carefully to avoid kinking
d. prepare two clamps at bedside and take with patient when brought out of the room

Situation 18: Calamares, 25-year-old, employee was brought to the ER because of severe allergic reaction. She complained of difficulty of breathing. Oxygen inhalation 3L was ordered stat. Intravenous solution started.

86. Which of the following physiologic needs has the highest priority for Calamares? (1)
a. Fluid
b. Nutrition
c. Oxygen
d. Low Temperature
87. A symptomatic patient like Calamares would consider which of the following as her most important needs? (2)
a. Relief from her health problem
b. Assistance with family and financial responsibilities
c. Understanding of her personal concern
d. Solution for the office problem
88. Illness prevention activities are generally designed to help client attain which of the following? (2)
a. Promote habits related to good health
b. Identify disease symptoms
c. Manage stress
d. Hospitalization
89. Nurse Lavigña provided Calamares and her family with information regarding the client’s care. This constitute as: (1)
a. Patient advocate role
b. Surrogate role
c. Educator role
d. Counselor role
90. Which of the following is the most important precautionary measure in administering oxygen inhalation to be observed that will benefit the client in particular and hospital in general? (2)
a. Setting up a bottle of sterile water to humidify the oxygen before it is administered to client
b. “Crack” the oxygen tank before it is wheeled/brought to client’s room
c. Lubricate the tip of the catheter with mineral oil that is water soluble
d. Hang a “No Smoking” sign on the oxygen tank and a similar warning at the door.

Situation 19: Mr. Murdocks, a 65-year-old retired steel mill worker, is admitted to the unit with dyspnea-upon-exertion. He has a long history of smoking. Initial assessment findings include barrel chest, ankle edema, persistent cough with copious sputum production and variable wheezing on expiration.

91. Mr. Murdocks’ ankle edema and respiratory problems should make the nurse suspect hypertrophy of which heart chamber? (2)
a. Left atrium
b. Right atrium
c. Left ventricle
d. Right ventricle
92. The physician orders an Aminophylline IV drip for Mr. Murdocks. The nurse should be alert for which sign of drug toxicity? (2)
a. Depression
b. Lethargy
c. Tachycardia
d. Cyanosis
93. ABG measurements reveal a ph of 7.25, PaCO2 of 52 mmHg and a HCO3 level of 25 mEq/L. The result indicates what acid-base imbalance? (2)
a. Respiratory alkalosis, uncompensated
b. Respiratory acidosis, uncompensated
c. Metabolic alkalosis, compensated
d. Metabolic acidosis, compensated
94. Mr. Murdocks is unable to exhale efficiently and becomes short of breath. The best nursing intervention would be, to teach him: (1)
a. Pursed lip breathing
b. Coughing technique
c. Postural drainage
d. Relaxation technique
95. The physician orders postural drainage. Which statement about postural drainage is most accurate? (2)
a. Postural drainage uses gravity to augment mucociliary clearing mechanisms and drain retained secretions
b. All patients with COPD are positioned the same way during postural drainage
c. Postural drainage involves rhythmic clapping of the chest wall with cupped hands
d. postural drainage is effective only when performed for 1 hour or longer

Situation 20: Marisse, a BSN student was assigned in the medical ward. She is to administer medication under the supervision of her clinical instructor.
96. When administering drugs, the nurse compares the label of the drug container with the medicine card correctly except: (2)
a. Before removing the container from the drawer or shelf
b. As the amount of drug ordered is removed from it
c. Before resuming the container to the storage
d. Before directly administering the drug
97. What is the best way of identifying the right client ideally? (1)
a. Check the medicine tickets against the client’s identification
b. Nurse speaks the name of the client
c. Nurse ask the client’s relative to state the full name
d. Nurse consults the physician
98. If the doctors orders q8h, what does this mean? (1)
a. The medication should be given during the waking hours
b. The medication should be given round the clock
c. Both a and b
d. None of the above
99. The expectorant guiafenesin (Robitussin) 300 mg p.o. has been ordered. The bottle is labeled 100mg/5mL. How many mL should be given? (2)
a. 13 mL
b. 14 mL
c. 15 mL
d. 16 mL
100. The physician orders: Administer Ampicillin 50 mg. oral suspension p.o q6 hours for 7 days. Stock dose is 125 mg/5mL in 30 mL bottle. How many bottles of the medication will you request? (3)
a. 5 bottles
b. 4 bottles
c. 3 bottles
d. 2 bottles

/end of nursing practice (integrated examination)
This material may not be published, broadcast, rewritten or redistributed.
Thank you.


Commission on Graduates of Foreign Nursing Schools (CGFNS International) Statement Regarding VisaScreen® Eligibility of Philippine Nurses Taking the Professional Regulation Commission's (PRC's) June 2006 Nursing Licensing Exam

PHILADELPHIA, PA — OCTOBER 26, 2006 — The Board of Trustees of the Commission on Graduates of Foreign Nursing Schools (CGFNS International) met October 22-23, 2006 and considered whether Philippine nurses who have passed the Professional Regulation Commission's (PRC) June 2006 nursing licensing exam are eligible for VisaScreen® Certification.

The Board directed its staff and counsel to review and assess whether the licensure process followed in light of the challenged results of the June 2006 exam is "comparable" with that required for nurses licensed in America, as required by U.S. law. CGFNS will then make a final determination of whether passers of the June 2006 exam are eligible for VisaScreen® certification. CGFNS expects to reach a final decision on the question of comparability in the near future. Any VisaScreen® applications that CGFNS receives from June 2006 passers will be accepted but deferred for a final decision until this assessment process is complete. If the assessment concludes that the license is not comparable, the VisaScreen® application from a June 2006 passer will be denied.

Friday, October 27, 2006

Palace hoping CA ruling will end nursing controversy

Palace hoping CA ruling will end nursing controversy
Last updated 07:28pm (Mla time) 10/27/2006

MALACAÑANG is hoping that a Court of Appeals ruling allowing the oath-taking of the nursing board passers can lead to a final resolution of the issue, a senior official said Friday.

But at the same time, Executive Secretary Eduardo Ermita said a final report on who should retake the exams could still change the complexion of the case.

"They have to follow what the Court of Appeals [had] ordered. Of course, we are going by the rule of law all the time, but you will notice that] there is a caveat that says that in the event that the final report determines who should undergo a retake of the exams because they attended the final sessions of the review centers [the source of the leakage], then there's still a recourse," Ermita told reporters at the Ninoy Aquino International Airport (NAIA) after seeing off President Gloria Macapagal-Arroyo who went to China for a week-long state visit.

Last October 13, the court ruled that those who had passed the board exams before the Professional Regulation Commission (PRC) recomputed the scores following the discovery of a leakage in some portions of the test could take their oaths.

This meant the reinstatement of 1,186 examinees whose names were removed following the recomputation.

The court also ordered a retake of Tests 3 (medical-surgical nursing) and 5 (psychiatric nursing) for the 1,687 examinees who were added to the list of passers after scores were recomputed.

But on October 16, Malacañang stopped the oath-taking, saying it was not yet final and executory.

The appellate court reached a decision on the oath-taking Thursday after conciliation talks with parties concerned.

Lira D. Fernandez

China interested in hiring RP nurses

China interested in hiring RP nurses
By Alcuin Papa
Last updated 09:17pm (Mla time) 10/27/2006

MANILA -- China is interested in hiring around 500 Filipino nurses to teach there, the Commission on Higher Education (CHEd) said on Friday.

CHEd Chair Carlito Puno said that two big nursing schools in China have expressed interest in hiring Filipino nurses. “I can’t disclose yet the names of these schools pending the signing of an agreement between our government through CHEd and the China government through its education ministry,” Puno said.

He said that China has “high regard” for the country's nurses as compared with its own nurses. “China admitted that the quality of their nursing education is not good compared with those of other countries such as Philippines. China’s nursing graduates could barely pass the National Licensure Examination,” he said.

Puno announced the news as a result of his recent visit to China where he met with 41 education ministers from all over the world to discuss trends and improvements in cross-border education programs.

He also said the country will be sending to China next year the first batch of 1,000 nursing students who will share their knowledge with their counterparts on nursing care and hospital work.

“This (student exchange) is part of a cross-border education program between our country and the education ministry of the China government that would be formalized soon between the two governments,” Puno said.

Puno said that those who will be sent to China for a one-year tour-of-duty in the student exchange program are 4th year nursing students from two prestigious schools in the country.

“These nursing students will spend their last year of practicum in different hospitals in China. "That’s the initial agreement that has still to be signed by both governments. CHEd is already considering two top schools where the 4th year nursing students would be tapped to be sent to China ,” Puno explained.

Puno also expressed confidence that the nursing profession in the country will continue to produce more competent and qualified nurses in the future.

“Despite the leakage controversy wreaking havoc in our nursing profession, some countries are still interested to share and impart knowledge with us. This is a very positive development for our Filipino nurses who should also try to go to other countries other than the United States and Europe,” he said.

Puno believes that the controversy over the licensure exams leakage that hit the Philippine nursing education in 2006 will “die down naturally.” “I’m hoping the issue will be resolved soon and let our new nurses move on with their life and future,” he said.

On Friday, the Philippine Regulation Commission (PRC) started to administer the oath to those who passed the last nursing board exams last June.

Out of around 43,000 examinees, 41.24 percent or 17,323 passed.

PRC New Registration Schedules

PRC New Registration Schedules

October 30, 2006
  • Cawilan, Shrinkie- Dapitalla, Art Vincent
  • Daproza, Joelyn- Doniego, Ian Allison
October 31, 2006
  • Donoso, Fernando III A- Flores, Arnold
  • Flores, Beverly L.- Guaring, Catherine V.
November 2, 2006
  • Guarra, Shiela G.- Lacap, Annah Aurea D.
  • Lacastesantos, Jasmin T.- Mabaquiao, Denette B.
November 3, 2006
  • Mabasa, Mercedes J.- Melancolico, Cherry Lou R.
  • Melendez, Ana Rosa Katrina L.- Olaisman, Alexander S.
November 6, 2006
  • Olay, Stepehen G.- Peralta, Jeffrey S.
  • Peralta, Christine Joy C.- Reuyan, Melissa B.
November 7, 2006
  • Revelar, Rey J.- Santiago, Nerissa R.
  • Santiago, Noliber T.- Taladoc, Racky C.
November 8, 2006
  • Taladro, Nadelyne A.- Valencia- Hernia, Janette C.
  • Valenciano, Galen Bryan P.- Zuñiga, Zis R.
Joan's Notes: Schedules are subject to change without prior notice so please check with PRC once in a while.



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In the court's decision, it said that the 1,687 examinees who were believed to have benefited from the leaked questions of Tests 3 and 5 should retake the NLE.

The court also ordered the PRC to include in the retake the 1,186 examinees who were removed from the list of board passers after the grades were recomputed.


Of about 40,000 nursing graduates who took the exam, more than 17,000 passed the five-part exams last June. But the CA ordered 1,687 who passed to retake Tests III (on medical surgical nursing) and V (on psychiatric nursing). They were the examinees who attended the last coaching sessions in three review centers in Baguio City and Metro Manila where the leaked questions were discovered to have circulated.





Starts December 3, 2006 (Daily Schedule)

For more info, please call or visit:
742- 0022 ** 741- 1336 **
0906- 2225227 ** 0921- 9526710

See you in the Review Class!


Court allows oath taking by more than 15,000 nurses

Court allows oath taking by more than 15,000 nurses

MANILA -- An amicable settlement of sorts was reached Thursday by parties in the suit seeking to nullify the June 2006 nursing licensure examination due to a leakage.

Labor Secretary Arturo Brion initiated conciliatory talks to allow more than 15,000 nursing graduates who passed the exams to take their oaths.

The agreement was reached during the mediation proceedings held at the hearing room of Associate Justice Vicente Veloso of the Court of Appeals (CA) First Division.

Veloso said the appellate court has no intention of issuing any more injunctions stopping the oath taking of nurses.

"We have no intention to stop the exercise of the rights of those who passed. Those who can take the oath is now embodied in our ruling," Veloso said.

Present in the meeting were officials from Professional Regulation Commission (PRC), Board of Nursing, Office of the Solicitor General, counsels for petitioners, respondents and interveners.

The CA called the parties for conciliatory talks and mediation in a resolution issued last October 25 based upon the recommendation of Brion.

In his letter submitted to the appellate court, Brion urged the CA to consider the use of mediation approach in resolving the controversy involving the leakage.

With the settlement, there is no more legal impediment for the oath taking of the nursing graduates who were among the 41.24 percent of board takers who passed the exam out of 42,000 before the leakage became public.

Last October 13, the CA junked the petition of the Rene Luis Tadle, president of the University of Sto. Tomas (UST) College of Nursing Faculty Association, to halt the oath-taking of new nurses, pending the result of an investigation regarding the leakage of the June 11 and 12 nursing licensure exams.

The CA decision called for a selective retake of the nursing licensure exam among those whose names were merely added to the list of successful examinees.

This after the appellate court declared null and void the assailed Resolution 31 of the PRC approving the Board of Nursing's initial formula for the recomputation of the results in the exam tainted by the leakage anomaly.

The resolution invalidated portions of the nursing examinations due to leakage. Some 42,600 students took the nursing exam but only 17,821 passed the tests.

The CA ordered the Board of Nursing and PRC to restore the names of the 1,186 successful examinees and include them again in the list of 41.24 percent who actually passed the exams, before the recomputation.

It also allowed the oath taking and issuance of licenses to all of the 41.24 percent successful examinees who were untainted by the leakage scandal.

The leakage has caused the US National Council of State Boards of Nursing Inc. (NCSBN) to put off its plan to include the Philippines among its international testing centers, according to a top official of the NCSBN.

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PRC still independent as far as CA is concerned’ -- sources

‘PRC still independent as far as CA is concerned’ -- sources

By Tetch Torres
Last updated 12:52pm (Mla time) 10/27/2006

NOTWITHSTANDING an executive order issued by President Gloria Macapagal-Arroyo placing the Professional Regulation Commission (PRC) under the Department of Labor and Employment (DoLE), the Court of Appeals (CA) still sees the commission as an independent body.

This is because, according to two court sources privy to the deliberations on the leak-tainted June nursing licensure examinations, the PRC’s independence is mandated by Republic Act 9173 or the Philippine Nursing Act of 2002, which a mere executive order cannot amend, much more supersede.

On October 13, the appeals court ruled for the selective retake by 1,687 examinees of those portions of the licensure exam tainted by leaked questions, thus paving the way for other board passers to take their oaths as new nurses.

A conciliatory meeting was subsequently held Thursday between stakeholders in the nursing board controversy during which the appellate court gave the go-ahead for the oath-taking of more than 15,000 board passers.

During the meeting, however, the DoLE maintained that the oaths should not be administered until the appeals court has ruled on the appealed filed by the University of Sto. Tomas’ Rene Tadle.
But the court said there was no longer any legal impediment to the oath-taking despite the conflicting positions of the DoLE and PRC.

"Under Republic Act 9173 or the Philippine Nursing Act of 2002, [the] PRC is an independent body and all its decision[s are] final. I don't think a mere executive order can amend a republic act," one of the court sources said.

The other source explained that “it is basic in law” that the executive branch only implements the law while Congress has the exclusive authority to make or amend laws.

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Court allows nurses to take oath starting today

Court allows nurses to take oath starting today

By Alcuin Papa, Leila Salaverria
Last updated 03:01am (Mla time) 10/27/2006

Published on page A1 of the October 27, 2006 issue of the Philippine Daily Inquirer

THOUSANDS of examinees who passed the June nursing licensure exam that was marred by a leakage can now take their oath as professional nurses, the Court of Appeals said yesterday.

Associate Justice Vicente Veloso said there was no legal impediment to the oath-taking, but the lawyer of the University of Santo Tomas nursing faculty, which is pushing for a retake of the exam, said they might go to the Supreme Court to finally settle the leakage issue.

“Those who can take the oath are now embodied in our ruling,” Veloso said. “We have no intention to stop the exercise of the rights of those who passed.”

The Professional Regulation Commission (PRC) has provided the appellate court with the names of those who will take the oath.

“We are happy but not very, very happy because of the 1,687 who were being required to retake the tests,” PRC Chair Leonor Rosero said when asked about the appellate court’s decision.
Rosero said the oath-taking, which will begin today at all PRC offices nationwide, would allow the passers to practice their chosen profession. “Now they can move on and join the nursing profession. That is what we want for them,” she said.

Of the 42,006 who took the board exams on June 11 and 12 at 11 test centers across the country, some 17, 000 passed.

The appellate court came up with the decision after more than five hours of conciliation talks with parties concerned.

In attendance were representatives of the PRC, the Board of Nursing (BON), Office of the Solicitor General, and some of the petitioners who have asked the Court of Appeals to reconsider its decision of Oct. 13.

The Court of Appeals ruled then that those who passed the board exam conducted outside Metro Manila and Baguio and those who registered at but did not attend the “final coaching” sessions at three review centers suspected of leaking questions could take their oath as nurses.

The court ordered a retake of Tests III (medical-surgical nursing) and V (psychiatric nursing) for 1,687 examinees who were added to the list of passers after the PRC recomputed the test scores.
It also ordered the reinstatement to the list of passers of the 1,186 graduates whose names were removed following the re-computation.

Labor Secretary Arturo Brion, who has been tasked by President Gloria Macapagal-Arroyo with resolving the controversy, stopped the PRC on Oct. 16 from administering the oath.
Brion said he wanted to avoid further complicating the situation of examinees in light of the possible filing of a motion for reconsideration. Several groups have since filed a motion for reconsideration asking the court to stop the oath-taking.

Brion, who was supposed to hold conciliation talks with concerned parties so as to discourage them from delaying the retake of the exams by filing a motion for reconsideration, was not at the meeting yesterday.

He is on official trip to Japan, where he is attending a maritime industry conference.
Pia Bersamin, lawyer of the UST nursing faculty, said the meeting between the stakeholders and the Court of Appeals did not resolve anything.

“The meeting did not address the issues that we raised,” a frustrated Bersamin told the Inquirer, referring to the cheating.

“Nothing was resolved with finality. We disagree with the decision to move ahead with the oath-taking because we want the issues to be resolved first,” she said.

Bersamin said the selective retake by some 1,600 nursing graduates of the board exam did not address the issue of the leakage.

She said board passers should not blame the petitioners for “stalling” the oath-taking.

“It was not us who ordered the TRO on the oath-taking and it was not us who made the mistakes in the handling of the issue. They should blame the PRC for that. Our point is to uphold the integrity of the nursing profession. We keep focusing on individual rights but we keep forgetting the common good,” she said.

No basis for retake

Renato Valdecantos, PRC commissioner, said the appellate court’s decision yesterday “sustains our position on the matter that there is no basis to require a retake.”

“This (oath-taking) is one way of putting closure to this unfortunate incident. The other side can go all the way to the Supreme Court. But in the meantime there is no more restraining order and we can go ahead with the oath-taking,” Valdecantos said.

He said the PRC, after due proceedings, could revoke the licenses of those found to have “knowingly benefited from the leakage.”

Valdecantos said it was up to the executive branch, through the National Bureau of Investigation (NBI), to determine those culpable of the leakage.

Selective retake in December

For his part, Renato Aquino of the Alliance of New Nurses, which is opposed to a retake, said he was “very happy” with the appellate court’s decision on the oath-taking.

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Thursday, October 26, 2006

Appeals court lets nurses take oath

Appeals court lets nurses take oath
By Jomar Canlas, Reporter

THE Court of Appeals said on Thursday that the 17,000 who passed the nursing board exam and who were on the original list of passers issued by the Professional Regulation Commission (PRC) could take their oath as soon as possible.

During mediation proceedings held by the court, Associate Justice Vicente Veloso, who wrote the ruling, asked the PRC and the Department of Labor and Employment to consider the court’s ruling of October 13 as “immediately executory.”

The PRC said it would conduct the oath-taking on Friday or Monday.

Veloso questioned why the oath-taking of the 17,000 nursing board passers who make up 41.24 percent of the original list was being held up.

The court said that the ruling would be considered implemented since the temporary restraining order stopping the oath-taking had lapsed.

Veloso said the PRC was an independent body that has the authority to implement the oath-taking.

“…To take an oath is an individual right. No one can stop the oath-taking,” Veloso said.

He required the PRC to provide the court with the list of the additional passers who should be allowed to take their oath.

In the meantime, the main petitioner to the case will question Veloso’s opinion that the court’s ruling is immediately executory.

Pia Bersamin, lawyer for the petitioner UST College of Nursing, said they still have a motion for reconsideration pending with the court’s First Division. She said it was not a conciliation at all, because they do not agree with Veloso’s view.

Bersamin said that if needed, they will challenge the declaration of Veloso before the Supreme Court.
“We are open to all options including the Supreme Court to stop the oath-taking. The case before the Court of Appeals is not yet final and executory, because there is still a pending motion for reconsideration,” Bersamin said.

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US nursing officials receive gov’t assurances

President Arroyo yesterday assured the US National Council of State Boards of Nursing (NCSBN) that the government is moving to restore the integrity of the professional licensure examinations after the leakage in the June nursing tests.

The President met with US nursing officials led by Faith Fields in Malacañang amid government efforts to convince them to consider the Philippines as an accredited venue for the American licensure examinations for nurses.

Mrs. Arroyo said she was aware of the negative impact of the recent nursing exam scandal particularly on Filipino nurses seeking employment abroad, adding the government would not condone any irregularity.

"We were able to identify those who were involved in the nursing exam leakage and we are bent on filing criminal charges," the President told officials involved in the nursing state boards in the United States.

Fields, president of the NCSBN, said the international community is closely monitoring the developments in the nursing leakage issue and the government’s investigation.

"We are very interested to see that you handle the crisis and I think it’s something that you don’t want to waste opportunity to make your own system better. But how you handle is really up to the Philippines," she said in an interview with reporters at the Palace.

Fields, however, admitted that Manila’s application for inclusion on the list of international testing centers of the US National Commission on Licensure Examination (NCLEX) has been put on hold following the leakage scandal.

"Obviously it has affected (the application) because we were set to make a decision on that when the leakage occurred. We decided to back off to get the results of how you handle that," she said.

Despite the tainted nursing exams last June, Fields maintained that American nursing boards remain confident in the nursing education system in the Philippines.

"We are still hopeful and confident of our partnership in terms of nursing education. We want to keep up the training and employment opportunities for your Filipino nurses in the United States," she told the President.

During the meeting, the President also assured the visiting US nursing officials about government’s resolve to upgrade the quality of the country’s nursing educational system, hospital facilities and standards.

"Nursing education needs enhancement and we are focused on it. We are spending money to support our local hospitals and upgrade their level from secondary to tertiary," she told the NCSBN team.

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Confidence in RP nursing education system remains high

Despite the controversy generated by the "leakage" in nursing licensure examination this year, American confidence in the country's nursing educational system remains high, according to officials of an organization involved in nursing state boards in the United States.

Faith Fields and Ruth Ann Terry, president and treasurer respectively of the National Council of State Boards of Nursing (NCSBN), told President Gloria Macapagal-Arroyo during their courtesy call on her in Malacanang Wednesday morning that nursing boards in all 50 American states remain confident of a continued partnership with the Philippines which supplies 80 percent of nurses in the United States.

"We are still hopeful and confident of our partnership in terms of nursing education. We want to keep up the training and employment opportunities for your Filipino nurses in the United States," they told the President.

The President, for her part, assured the visiting US nursing officials that the Philippine government is determined to upgrade the quality of the country's nursing educational system, hospital facilities and standards.

She said the education institutions in the country are adapting a ladderized education system in training nursing students and graduates.

The government, according to the President, has already allocated funds to support local government hospitals.

"Nursing education needs enhancement and we are focused on it. We are spending money to support our local hospitals and upgrade their level from secondary to tertiary," she told the NCSBN team.

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100 items Comprehensive Exam

Choose the BEST answer

1. The nurse enters the room as a 3 year-old is having a generalized seizure. Which intervention should the nurse do first?
A) Clear the area of any hazards
B) Place the child on the side
C) Restrain the child
D) Give the prescribed anticonvulsant

2. A client has just returned to the medical-surgical unit following a segmental lung resection. After assessing the client, the first nursing action would be to
A) Administer pain medication
B) Suction excessive tracheobronchial secretions
C) Assist client to turn, deep breathe and cought
D) Monitor oxygen saturation

3. A nurse from the surgical department is reassigned to the pediatric unit. The charge nurse should recognize that the child at highest risk for cardiac arrest and is the least likely to be assiged to this nurse is which child?
A) Congenital cardiac defects
B) An acute febrile illness
C) Prolonged hypoxemia
D) Severe multiple trauma

4. Which of the following would be the best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes?
A) Give written pre and post tests
B) Ask questions during practice
C) Allow another diabetic to assist
D) Observe a return demonstration

5. The nurse is assessing a 2 year-old client with a possible diagnosis of congenital heart disease. Which of these is most likely to be seen with this diagnosis?
A) Several otitis media episodes in the last year
B) Weight and height in 10th percentile since birth
C) Takes frequent rest periods while playing
D) Changing food preferences and dislikes

6. The nurse is reassigned to work at the Poison Control Center telephone hotline. In which of these cases of childhood poisoning would the nurse suggest that parents have the child drink orange juice?
A) An 18 month-old who ate an undetermined amount of crystal drain cleaner
B) A 14 month-old who chewed 2 leaves of a philodendron plant
C) A 20 month-old who is found sitting on the bathroom floor beside an empty bottle of diazepam (Valium)
D) A 30 month-old who has swallowed a mouthful of charcoal lighter fluid

7. A 23 year-old single client is in the 33rd week of her first pregnancy. She tells the nurse that she has everything ready for the baby and has made plans for the first weeks together at home. Which normal emotional reaction does the nurse recognize?
A) Acceptance of the pregnancy
B) Focus on fetal development
C) Anticipation of the birth
D) Ambivalence about pregnancy

8. Upon examining the mouth of a 3 year-old child, the nurse discovers that the teeth have chalky white-to-yellowish staining with pitting of the enamel. Which of the following conditions would most likely explain these findings?
A) Ingestion of tetracycline
B) Excessive fluoride intake
C) Oral iron therapy
D) Poor dental hygiene

9. Which of the following should the nurse teach the client to avoid when taking chlorpromazine HCL (Thorazine)?
A) Direct sunlight
B) Foods containing tyramine
C) Foods fermented with yeast
D) Canned citrus fruit drinks

10. The nurse is discussing dietary intake with an adolescent who has acne. The most appropriate statement for the nurse is
A) "Eat a balanced diet for your age."
B) "Increase your intake of protein and Vitamin A."
C) "Decrease fatty foods from your diet."
D) "Do not use caffeine in any form, including chocolate."

11. The nurse is caring for a child who has just returned from surgery following a tonsillectomy and adenoidectomy. Which action by the nurse is appropriate?
A) Offer ice cream every 2 hours
B) Place the child in a supine position
C) Allow the child to drink through a straw
D) Observe swallowing patterns

12. The nurse is caring for a client with acute pancreatitis. After pain management, which intervention should be included in the plan of care?
A) Cough and deep breathe every 2 hours
B) Place the client in contact isolation
C) Provide a diet high in protein
D) Institute seizure precautions

13. The nurse is caring for a client with trigeminal neuralgia (tic douloureaux). To assist the client with nutrition needs, the nurse should
A) Offer small meals of high calorie soft food
B) Assist the client to sit in a chair for meals
C) Provide additional servings of fruits and raw vegetables
D) Encourage the client to eat fish, liver and chicken

14. A client treated for depression tells the nurse at the mental health clinic that he recently purchased a handgun because he is thinking about suicide. The first nursing action should be to
A) Notify the health care provider immediately
B) Suggest in-patient psychiatric care
C) Respect the client's confidential disclosure
D) Phone the family to warn them of the risk

15. The initial response by the nurse to a delusional client who refuses to eat because of a belief that the food is poisoned is
A) "You think that someone wants to poison you?"
B) "Why do you think the food is poisoned?"
C) "These feelings are a symptom of your illness."
D) "You’re safe here. I won’t let anyone poison you."

16. A client has just been admitted with portal hypertension. Which nursing diagnosis would be a priority in planning care?
A) Altered nutrition: less than body requirements
B) Potential complication hemorrhage
C) Ineffective individual coping
D) Fluid volume excess

17. The nurse in a well-child clinic examines many children on a daily basis. Which of the following toddlers requires further follow up?
A) A 13 month-old unable to walk
B) A 20 month-old only using 2 and 3 word sentences
C) A 24 month-old who cries during examination
D) A 30 month-old only drinking from a sippy cup

18. Which of the following conditions assessed by the nurse would contraindicate the use of benztropine (Cogentin)?
A) Neuromalignant syndrome
B) Acute extrapyramidal syndrome
C) Glaucoma, prostatic hypertrophy
D) Parkinson's disease, atypical tremors

19. A 15 year-old client with a lengthy confining illness is at risk for altered growth and development of which task?
A) Loss of control
B) Insecurity
C) Dependence
D) Lack of trust

20. The nurse is caring for a client with cirrhosis of the liver with ascites. When instructing nursing assistants in the care of the client, the nurse should emphasize that
A) The client should remain on bed rest in a semi-Fowler's position
B) The client should alternate ambulation with bed rest with legs elevated
C) The client may ambulate and sit in chair as tolerated
D) The client may ambulate as tolerated and remain in semi-Fowlers position in bed

21. In providing care to a 14 year-old adolescent with scoliosis, which of the following will be most difficult for this client?
A) Compliance with treatment regimens
B) Looking different from their peers
C) Lacking independence in activities
D) Reliance on family for their social support

22. The nurse is preparing to perform a physical examination on an 8 month-old who is sitting contentedly on his mother's lap. Which of the following should the nurse do first?
A) Elicit reflexes
B) Measure height and weight
C) Auscultate heart and lungs
D) Examine the ears

23. Which of these principles should the nurse apply when performing a nutritional assessment on a 2 year-old client?
A) An accurate measurement of intake is not reliable
B) The food pyramid is not used in this age group
C) A serving size at this age is about 2 tablespoons
D) Total intake varies greatly each day

24. The nurse is assessing a client with delayed wound healing. Which of the following risk factors is most important in this situation?
A) Glucose level of 120
B) History of myocardial infarction
C) Long term steroid usage
D) Diet high in carbohydrates

25. Which of the following nursing assessments indicate immediate discontinuance of an antipsychotic medication?
A) Involuntary rhythmic stereotypic movements and tongue protrusion
B) Cheek puffing, involuntary movements of extremities and trunk
C) Agitation, constant state of motion
D) Hyperpyrexia, severe muscle rigidity, malignant hypertension

26. A client with HIV infection has a secondary herpes simplex type 1 (HSV-1) infection. The nurse knows that the most likely cause of the HSV-1 infection in this client is
A) Immunosuppression
B) Emotional stress
C) Unprotected sexual activities
D) Contact with saliva

27. The nurse measures the head and chest circumferences of a 20 month-old infant. After comparing the measurements, the nurse finds that they are approximately the same. What action should the nurse take?
A) Notify the health care provider
B) Palpate the anterior fontanel
C) Feel the posterior fontanel
D) Record these normal findings

28. At a routine clinic visit, parents express concern that their 4 year-old is wetting the bed several times a month. What is the nurse's best response?
A) "This is normal at this time of day."
B) "How long has this been occurring?"
C) "Do you offer fluids at night?"
D) "Have you tried waking her to urinate?"

29. A client was admitted to the psychiatric unit after refusing to get out of bed. In the hospital the client talks to unseen people and voids on the floor. The nurse could best handle the problem of voiding on the floor by
A) Requiring the client to mop the floor
B) Restricting the client’s fluids throughout the day
C) Withholding privileges each time the voiding occurs
D) Toileting the client more frequently with supervision

30. The nurse is caring for a client with a sigmoid colostomy who requests assistance in removing the flatus from a 1 piece drainable ostomy pouch. Which is the correct intervention?
A) Piercing the plastic of the ostomy pouch with a pin to vent the flatus
B) Opening the bottom of the pouch, allowing the flatus to be expelled
C) Pulling the adhesive seal around the ostomy pouch to allow the flatus to escape
D) Assisting the client to ambulate to reduce the flatus in the pouch

31. The nurse is teaching parents of an infant about introduction of solid food to their baby. What is the first food they can add to the diet?
A) Vegetables
B) Cereal
C) Fruit
D) Meats

32. When counseling parents of a child who has recently been diagnosed with hemophilia, what must the nurse know about the offspring of a normal father and a carrier mother?
A) It is likely that all sons are affected
B) There is a 50% probability that sons will have the disease
C) Every daughter is likely to be a carrier
D) There is a 25% chance a daughter will be a carrier

33. When teaching a client with chronic obstructive pulmonary disease about oxygen by cannula, the nurse should also instruct the client's family to
A) Avoid smoking near the client
B) Turn off oxygen during meals
C) Adjust the liter flow to 10 as needed
D) Remind the client to keep mouth closed

34. The nurse is caring for a post-op colostomy client. The client begins to cry saying, "I'll never be attractive again with this ugly red thing." What should be the first action by the nurse?
A) Arrange a consultation with a sex therapist
B) Suggest sexual positions that hide the colostomy
C) Invite the partner to participate in colostomy care
D) Determine the client's understanding of her colostomy

35. A schizophrenic client talks animatedly but the staff are unable to understand what the client is communicating. The client is observed mumbling to herself and speaking to the radio. A desirable outcome for this client’s care will be
A) Expresses feelings appropriately through verbal interactions
B) Accurately interprets events and behaviors of others
C) Demonstrates improved social relationships
D) Engages in meaningful and understandable verbal communication

36. A 7 year-old child is hospitalized following a major burn to the lower extremities. A diet high in protein and carbohydrates is recommended. The nurse informs the child and family that the most important reason for this diet is to
A) Promote healing and strengthen the immune system
B) Provide a well balanced nutritional intake
C) Stimulate increased peristalsis absorption
D) Spare protein catabolism to meet metabolic needs

37. The parents of a 7 year-old tell the nurse their child has started to "tattle" on siblings. In interpreting this new behavior, how should the nurse explain the child's actions to the parents?
A) The ethical sense and feelings of justice are developing
B) Attempts to control the family use new coping styles
C) Insecurity and attention getting are common motives
D) Complex thought processes help to resolve conflicts

38. A school nurse is advising a class of unwed pregnant high school students. What is the most important action they can perform to deliver a healthy child?
A) Maintain good nutrition
B) Stay in school
C) Keep in contact with the child's father
D) Get adequate sleep

39. A client continually repeats phrases that others have just said. The nurse recognizes this behavior as
A) Autistic
B) Ecopraxic
C) Echolalic
D) Catatonic

40. A client is admitted for hemodialysis. Which abnormal lab value would the nurse anticipate not being improved by hemodialysis?
A) Low hemoglobin
B) Hypernatremia
C) High serum creatinine
D) Hyperkalemia

41. The nurse is caring for a 7 year-old child who is being discharged following a tonsillectomy. Which of the following instructions is appropriate for the nurse to teach the parents?
A) Report a persistent cough to the health care provider
B) The child can return to school in 4 days
C) Administer chewable aspirin for pain
D) The child may gargle with saline as necessary for discomfort

42. The nurse is caring for a 14 month-old just diagnosed with Cystic Fibrosis. The parents state this is the first child in either family with this disease, and ask about the risk to future children. What is the best response by the nurse?
A) 1in 4 chance for each child to carry that trait
B) 1in 4 risk for each child to have the disease
C) 1in 2 chance of avoiding the trait and disease
D) 1in 2 chance that each child will have the disease

43. The nurse is performing an assessment on a client with pneumococcal pneumonia. Which finding would the nurse anticipate?
A) Bronchial breath sounds in outer lung fields
B) Decreased tactile fremitus
C) Hacking, nonproductive cough
D) Hyperresonance of areas of consolidation

44. During seizure activity which observation is the priority to enhance further direction of treatment?
A) Observe the sequence or types of movement
B) Note the time from beginning to end
C) Identify the pattern of breathing
D) Determine if loss of bowel or bladder control occurs

45. Which of the following statements describes what the nurse must know in order to provide anticipatory guidance to parents of a toddler about readiness for toilet training?
A) The child learns voluntary sphincter control through repetition
B) Myelination of the spinal cord is completed by this age
C) Neuronal impulses are interrupted at the base of the ganglia
D) The toddler can understand cause and effect

46. A client complaining of severe shortness of breath is diagnosed with congestive heart failure. The nurse observes a falling pulse oximetry. The client's color changes to gray and she expectorates large amounts of pink frothy sputum. The first action of the nurse would be which of the following?
A) Call the health care provider
B) Check vital signs
C) Position in high Fowler's
D) Administer oxygen

47. The nurse is caring for a client with benign prostatic hypertrophy. Which of the following assessments would the nurse anticipate finding?
A) Large volume of urinary output with each voiding
B) Involuntary voiding with coughing and sneezing
C) Frequent urination
D) Urine is dark and concentrated

48. An anxious parent of a 4 year-old consults the nurse for guidance in how to answer the child's question, "Where do babies come from?" What is the nurse's best response to the parent?
A) "When a child asks a question, give a simple answer."
B) "Children ask many questions, but are not looking for answers."
C) "This question indicates interest in sex beyond this age."
D) "Full and detailed answers should be given to all questions."

49. A 3 year-old child is treated in the emergency department after ingestion of 1ounce of a liquid narcotic. What action should the nurse do first?
A) Provide the ordered humidified oxygen via mask
B) Suction the mouth and the nose
C) Check the mouth and radial pulse
D) Start the ordered intravenous fluids

50. The charge nurse on the eating disorder unit instructs a new staff member to weigh each client in his or her hospital gown only. What is the rationale for this nursing intervention?
A) To reduce the risk of the client feeling cold due to decreased fat and subcutaneous tissue
B) To cover the bony prominence and areas where there is skin breakdown
C) So the client knows what type of clothing to wear when weighed
D) To reduce the tendency of the client to hide objects under his or her clothing

51. In teaching parents to associate prevention with the lifestyle of their child with sickle cell disease, the nurse should emphasize that a priority for their child is to
A) Avoid overheating during physical activities
B) Maintain normal activity with some restrictions
C) Be cautious of others with viruses or temperatures
D) Maintain routine immunizations

52. The nurse understands that during the "tension building" phase of a violent relationship, when the batterer makes unreasonable demands, the battered victim may experience feelings of
A) Anger
B) Helplessness
C) Calm
D) Explosive

53. A parent has numerous questions regarding normal growth and development of a 10 month-old infant. Which of the following parameters is of most concern to the nurse?
A) 50% increase in birth weight
B) Head circumference greater than chest
C) Crying when the parents leave
D) Able to stand up briefly in play pen

54. The nurse has been assigned to these clients in the emergency room. Which client would the nurse go check first?
A) Viral pneumonia with atelectasis
B) Spontaneous pneumothorax with a respiratory rate of 38
C) Tension pneumothorax with slight tracheal deviation to the right
D) Acute asthma with episodes of bronchospasm

55. The nurse is assessing a 4 year-old for possible developmental dysplasia of the right hip. Which finding would the nurse expect?
A) Pelvic tip downward
B) Right leg lengthening
C) Ortolani sign
D) Characteristic limp

56. A 2 year-old child has recently been diagnosed with cystic fibrosis. The nurse is teaching the parents about home care for the child. Which of the following information is appropriate for the nurse to include?
A) Allow the child to continue normal activities
B) Schedule frequent rest periods
C) Limit exposure to other children
D) Restrict activities to inside the house

57. The nurses on a unit are planning for stoma care for clients who have a stoma for fecal diversion. Which stomal diversion poses the highest risk for skin breakdown
A) Ileostomy
B) Transverse colostomy
C) Ileal conduit
D) Sigmoid colostomy

58. A client is unconscious following a tonic-clonic seizure. What should the nurse do first?
A) Check the pulse
B) Administer Valium
C) Place the client in a side-lying position
D) Place a tongue blade in the mouth

59. The nurse is teaching a client who has a hip prostheses following total hip replacement. Which of the following should be included in the instructions for home care?
A) Avoid climbing stairs for 3 months
B) Ambulate using crutches only
C) Sleep only on your back
D) Do not cross legs

60. A nurse who travels with an agency is uncertain about what tasks can be performed when working in a different state. It would be best for the nurse to check which resource?
A) The state nurse practice act in which the assignment is made
B) With a nurse colleague who has worked in that state 2 years ago
D) The Nursing Social Policy Statement within the United States
C) The policies and procedures of the assigned agency in that state

61. Parents of a 7 year-old child call the clinic nurse because their daughter was sent home from school because of a rash. The child had been seen the day before by the health care provider and diagnosed with Fifth Disease (erythema infectiosum). What is the most appropriate action by the nurse?
A) Tell the parents to bring the child to the clinic for further evaluation
B) Refer the school officials to printed materials about this viral illness
C) Inform the teacher that the child is receiving antibiotics for the rash
D) Explain that this rash is not contagious and does not require isolation

62. What principle of HIV disease should the nurse keep in mind when planning care for a newborn who was infected in utero?
A) The disease will incubate longer and progress more slowly in this infant
B) The infant is very susceptible to infections
C) Growth and development patterns will proceed at a normal rate
D) Careful monitoring of renal function is indicated

63. While teaching a client about their medications, the client asks how long it will take before the effects of lithium take place. What is the best response of the nurse?
A) Immediately
B) Several days
C) 2 weeks
D) 1 month

64. The nurse is caring for a 12 year-old with an acute illness. Which of the following indicates the nurse understands common sibling reactions to hospitalization?
A) Younger siblings adapt very well
B) Visitation is helpful for both
C) The siblings may enjoy privacy
D) Those cared for at home cope better

65. Following a cocaine high, the user commonly experiences an extremely unpleasant feeling called
A) Craving
B) Crashing
C) Outward bound
D) Nodding out

66. One reason that domestic violence remains extensively undetected is
A) Few battered victims seek medical care
B) There is typically a series of minor, vague complaints
C) Expenses due to police and court costs are prohibitive
D) Very little knowledge is currently known about batterers and battering relationships

67. When making a home visit to a client with chronic pyelonephritis, which nursing action has the highest priority?
A) Follow-up on lab values before the visit
B) Observe client findings for the effectiveness of antibiotics
C) Ask for a log of urinary output
D) As for the log of the oral intake

68. When a client is having a general tonic clonic seizure, the nurse should
A) Hold the client's arms at their side
B) Place the client on their side
C) Insert a padded tongue blade in client's mouth
D) Elevate the head of the bed

69. The nurse is teaching a client with dysrhythmia about the electrical pathway of an impulse as it travels through the heart. Which of these demonstrates the normal pathway?
A) AV node, SA node, Bundle of His, Purkinje fibers
B) Purkinje fibers, SA node, AV node, Bundle of His
C) Bundle of His, Purkinje fibers, SA node , AV node
D) SA node, AV node, Bundle of His, Purkinje fibers

70. Clients with mitral stenosis would likely manifest findings associated with congestion in the
A) Pulmonary circulation
B) Descending aorta
C) Superior vena cava
D) Bundle of His

71. In assessing the healing of a client's wound during a home visit, which of the following is the best indicator of good healing?
A) White patches
B) Green drainage
C) Reddened tissue
D) Eschar development

72. The nursing intervention that best describes treatment to deal with the behaviors of clients with personality disorders include
A) Pointing out inconsistencies in speech patterns to correct thought disorders
B) Accepting client and the client's behavior unconditionally
C) Encouraging dependency in order to develop ego controls
D) Consistent limit-setting enforced 24 hours per day

73. A client has received her first dose of fluphenazine (Prolixin) 2 hours ago. She suddenly experiences torticollis and involuntary spastic muscle movement. In addition to administering the ordered anticholinergic drug, what other measure should the nurse implement?
A) Have respiratory support equipment available
B) Immediately place her in the seclusion room
C) Assess the client for anxiety and agitation
D) Administer prn dose of IM antipsychotic medication

74. The nurse asks a client with a history of alcoholism about the client’s drinking behavior. The client states "I didn’t hurt anyone. I just like to have a good time, and drinking helps me to relax." The client is using which defense mechanism?
A) Denial
B) Projection
C) Intellectualization
D) Rationalization

75. The nurse is teaching a smoking cessation class and notices there are 2 pregnant women in the group. Which information is a priority for these women?
A) Low tar cigarettes are less harmful during pregnancy
B) There is a relationship between smoking and low birth weight
C) The placenta serves as a barrier to nicotine
D) Moderate smoking is effective in weight control

76. The nurse is caring for a client with end stage renal disease. What action should the nurse take to assess for patency in a fistula used for hemodialysis?
A) Observe for edema proximal to the site
B) Irrigate with 5 mls of 0.9% Normal Saline
C) Palpate for a thrill over the fistula
D) Check color and warmth in the extremity

77. Which therapeutic communication skill is most likely to encourage a depressed client to vent feelings?
A) Direct confrontation
B) Reality orientation
C) Projective identification
D) Active listening

78. The nurse walks into a client's room and finds the client lying still and silent on the floor. The nurse should first
A) Assess the client's airway
B) Call for help
C) Establish that the client is unresponsive
D) See if anyone saw the client fall

79. What is the best way for the nurse to accomplish a health history on a 14 year-old client?
A) Have the mother present to verify information
B) Allow an opportunity for the teen to express feelings
C) Use the same type of language as the adolescent
D) Focus the discussion of risk factors in the peer group

80. A new nurse on the unit notes that the nurse manager seems to be highly respected by the nursing staff. The new nurse is surprised when one of the nurses states: "The manager makes all decisions and rarely asks for our input." The best description of the nurse manager's management style is
A) Participative or democratic
B) Ultraliberal or communicative
C) Autocratic or authoritarian
D) Laissez faire or permissive

81. A 2 year-old child is being treated with Amoxicillin suspension, 200 milligrams per dose, for acute otitis media. The child weighs 30 lb. (15 kg) and the daily dose range is 20-40 mg/kg of body weight, in three divided doses every 8 hours. Using principles of safe drug administration, what should the nurse do next?
A) Give the medication as ordered
B) Call the health care provider to clarify the dose
C) Recognize that antibiotics are over-prescribed
D) Hold the medication as the dosage is too low

82. The nurse is performing a developmental assessment on an 8 month-old. Which finding should be reported to the health care provider?
A) Lifts head from the prone position
B) Rolls from abdomen to back
C) Responds to parents' voices
D) Falls forward when sitting

83. The nurse is participating in a community health fair. As part of the assessments, the nurse should conduct a mental status examination when
A) An individual displays restlessness
B) There are obvious signs of depression
C) Conducting any health assessment
D) The resident reports memory lapses

84. The nurse caring for a 14 year-old boy with severe Hemophilia A, who was admitted after a fall while playing basketball. In understanding his behavior and in planning care for this client, what must the nurse understand about adolescents with hemophilia?
A) Must have structured activities
B) Often take part in active sports
C) Explain limitations to peer groups
D) Avoid risks after bleeding episodes

85. When assessing a client who has just undergone a cardioversion, the nurse finds the respirations are 12. Which action should the nurse take first?
A) Try to vigorously stimulate normal breathing
B) Ask the RN to assess the vital signs
C) Measure the pulse oximetry
D) Continue to monitor respirations

86. In order to enhance a client's response to medication for chest pain from acute angina, the nurse should emphasize
A) Learning relaxation techniques
B) Limiting alcohol use
C) Eating smaller meals
D) Avoiding passive smoke

87. The primary nursing diagnosis for a client with congestive heart failure with pulmonary edema is
A) Pain
B) Impaired gas exchange
C) Cardiac output altered: decreased
D) Fluid volume excess

88. After talking with her partner, a client voluntarily admitted herself to the substance abuse unit. After the second day on the unit the client states to the nurse, "My husband told me to get treatment or he would divorce me. I don’t believe I really need treatment but I don’t want my husband to leave me." Which response by the nurse would assist the client?
A) "In early recovery, it's quite common to have mixed feelings, but unmotivated people can’t get well."
B) "In early recovery, it’s quite common to have mixed feelings, but I didn’t know you had been pressured to come."
C) "In early recovery it’s quite common to have mixed feelings, perhaps it would be best to seek treatment on an outclient bases."
D) "In early recovery, it’s quite common to have mixed feelings. Let’s discuss the benefits of sobriety for you."

89. Clients taking which of the following drugs are at risk for depression?
A) Steroids
B) Diuretics
C) Folic acid
D) Aspirin

90. The nurse is assessing a client on admission to a community mental health center. The client discloses that she has been thinking about ending her life. The nurse's best response would be
A) "Do you want to discuss this with your pastor?"
B) "We will help you deal with those thoughts."
C) "Is your life so terrible that you want to end it?"
D) "Have you thought about how you would do it?"

91. The nurse is caring for a client 2 hours after a right lower lobectomy. During the evaluation of the water-seal chest drainage system, it is noted that the fluid level bubbles constantly in the water seal chamber. On inspection of the chest dressing and tubing, the nurse does not find any air leaks in the system. The next best action for the nurse is to
A) Check for subcutaneous emphysema in the upper torso
B) Reposition the client to a position of comfort
C) Call the health care provider as soon as possible
D) Check for any increase in the amount of thoracic drainage

92. The nurse is caring for a newborn who has just been diagnosed with hypospadias. After discussing the defect with the parents, the nurse should expect that
A) Circumcision can be performed at any time
B) Initial repair is delayed until ages 6-8
C) Post-operative appearance will be normal
D) Surgery will be performed in stages

93. A client has been receiving lithium (Lithane) for the past two weeks for the treatment of bipolar illness. When planning client teaching, what is most important to emphasize to the client?
A) Maintain a low sodium diet
B) Take a diuretic with lithium
C) Come in for evaluation of serum lithium levels every 1-3 months
D) Have blood lithium levels drawn during the summer months

94. When an autistic client begins to eat with her hands, the nurse can best handle the problem by
A) Placing the spoon in the client’s hand and stating, "Use the spoon to eat your food."
B) Commenting "I believe you know better than to eat with your hand."
C) Jokingly stating, "Well I guess fingers sometimes work better than spoons."
D) Removing the food and stating "You can’t have anymore food until you use the spoon."

95. A client develops volume overload from an IV that has infused too rapidly. What assessment would the nurse expect to find?
A) S3 heart sound
B) Thready pulse
C) Flattened neck veins
D) Hypoventilation

96. A neonate born 12 hours ago to a methadone maintained woman is exhibiting a hyperactive MORO reflex and slight tremors. The newborn passed one loose, watery stool. Which of these is a nursing priority?
A) Hold the infant at frequent intervals.
B) Assess for neonatal withdrawl syndrome
C) Offer fluids to prevent dehydration
D) Administer paregoric to stop diarrhea

97. While planning care for a preschool aged child, the nurse understands developmental needs. Which of the following would be of the most concern to the nurse?
A) Playing imaginatively
B) Expressing shame
C) Identifying with family
D) Exploring the playroom

98. A depressed client who has recently been acting suicidal is now more social and energetic than usual. Smilingly he tells the nurse "I’ve made some decisions about my life." What should be the nurse’s initial response?
A) "You’ve made some decisions."
B) "Are you thinking about killing yourself?"
C) "I’m so glad to hear that you’ve made some decisions."
D) "You need to discuss your decisions with your therapist."

99. The nurse is caring for 2 children who have had surgical repair of congenital heart defects. For which defect is it a priority to assess for findings of heart conduction disturbance?
A) Artrial septal defect
B) Patent ductus arteriosus
C) Aortic stenosis
D) Ventricular septal defect

100. The nurse is caring for a post myocardial infarction client in an intensive care unit. It is noted that urinary output has dropped from 60 -70 ml per hour to 30 ml per hour. This change is most likely due to
A) Dehydration
B) Diminished blood volume
C) Decreased cardiac output
D) Renal failure


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