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: http://javascript.about.com/library/blnoright.htm *Using in a custom footer:replace all code in xslt box with this: ]]>

QUICKLINKS : CHAT RULES / PINOYBSN FORUM

Friday, November 10, 2006

Labor chief questions oath-taking of nurse-flunkers

Labor chief questions oath-taking of nurse-flunkers


By Leila Salaverria, Jerome Aning
Inquirer
Last updated 09:33pm (Mla time) 11/09/2006


LABOR Secretary Arturo Brion on Thursday gave the Professional Regulation Commission (PRC) five days to explain why several students who did not pass the recent nursing board exams had been allowed to be inducted as nurses.

Brion issued the order after a panel of Department of Labor and Employment officials that he had formed to study the results of the leak-tainted tests found that some the original and recomputed scores of examinees had been altered.

“There were glaring discrepancies in the grades that the PRC needs to explain. Obviously there were manipulations,” said a member of the panel who asked not to be identified.

Brion did not go so far as to accuse the PRC of “grade-fixing,” as the panel had only examined the scores of about 400 examinees, or less than one percent of the 42,000 who took the tests.

According to the source, nearly half of the 400 examinees had scores in PRC’s original list that were different from the final list of passers that the commission issued after the leak controversy was resolved.


Continue reading on : http://newsinfo.inq7.net/breakingnews/nation/view_article.php?article_id=31619

Thursday, November 09, 2006

99 who took nurses exam in WV covered by selective retake order

99 who took nurses exam in
WV covered by selective retake order


BY CARLA GOMEZ

Ninety-nine examines who took the June Nursing Licensure Examination in Iloilo are among the 1,687 who had passed earlier but were directed to retake tests three and five, after a recent Court of Appeals ruling, Lily Ann Baldago, Professional Regulation Commission regional director, said yesterday.

Of those ordered to retake tests three and five, 40 are from Negros Occidental, Rodrigo Tinsay of the Association of Concerned Parents said.

Tinsay yesterday complained that no formal notification was sent to the students who have to retake tests three and five.

These examinees had already been told they had passed, so the reason for making them retake tests three and five should be explained to them, he said.

He also said that, although the deadline for processing their papers for the retake is today, the PRC office in Iloilo has not yet released the guidelines.

He said that, on such short notice, the retakers of the June NLE tests three and five should not be required to take them in December together with all the other NLE examinees.

They should given a little more time to prepare, he said, suggesting that perhaps their tests can be set for a month after December.

Baldago said nursing deans had been informed of those who would have to retake test three and five so they would be ready.

She already informed a representative of the Association of Concerned Parents that the 40 students from Negros who have to retake tests three and five can send a representative to the PRC office in Iloilo to get all their numbers for registration for the NLE today, Baldago said.

Continue reading on : http://www.visayandailystar.com/2006/November/09/topstory5.htm

Tuesday, November 07, 2006

R&A Seeks Additional Visas for RN and PTs

R&A Seeks Additional Visas for RN and PTs

Attorneys Robert L. Reeves and Joseph I. Elias

On November 1, 2006, immigrant visa numbers for Registered Nurses (RN) and Physical Therapists (PT) retrogressed for one year. The demand for the visas exceeded the supply creating a one-year backlog for immigrant visas. As of today, there are only visas available for RNs and PTs whose employers filed immigrant visa petitions on or before October 1, 2005.

In early 2005 Congress acted on a four to five-year visa backlog for RNs and PTs by allocating an additional 50,000 visas for RNs and PTs. By May 11, 2005, the additional visas were available. These 50,000 visas ran out on November 1, 2006. Many immigration practitioners and medical service providers were expecting the backlog to be at least four years. The fact that it appears to be a year-long backlog is somewhat of a relief, but is still unacceptable.

Reeves and Associates, hospitals, medical associations, individuals and immigration practitioners are lobbying Congress very hard for a solution to this visa crisis. Foreign RNs and PTs are providing crucial public health medical services because there are not enough U.S. workers to fill these positions. Medical facilities can not operate at full capacity and in some areas are not able to provide necessary/adequate health services due to the shortage. Patients literally have been turned away.

The 50,000 visas allocated in 2005 were a temporary fix—only a bandage. The different groups lobbying Congress for help realize this and are pushing for more long-term solutions. Some of our institutional clients have told us about their head-to-head meetings with Senators and Congressional Representatives pushing for reform. One promising Senate bill is being proposed in which RNs and PTs would not be subject to any visa cap until the Department of Labor determines there are sufficient workers in this field. The Department of Labor has already projected that U.S. RNs and PTs are graduating at a rate too low to keep up with demand for at least the next ten years.

Another proposal is to revise the manner in which visa numbers are counted. Currently, if an RN immigrates to the U.S. with their spouse and children, visa numbers are deducted for each of them from the visa pool. The proposed revision is to only deduct one visa number for each RN and allow the family members to immigrate without utilizing the visa numbers set aside for RNs.

In the last RN and PT visa crisis, Congress acted within a few short months. Now is the time for Congress to provide a quick and longer-term solution. Otherwise, Congressional representatives will have to provide an explanation to their constituents as to why they cannot receive adequate medical care. R&A is urging Congress to resolve the visa shortage by providing sufficient visas for our badly needed immigrant health care workers

http://www.asianjournal.com/?c=170&a=16839

A retake would have been wiser

MISSION IMPOSSIBLE
By Marit Stinus-Remonde
A retake would have been wiser


SOME years ago I enrolled in a province-based law school. To my great shock, several of my classmates, some mature professionals, cheated during the tests. They did it openly without shame and it seemed to be the most natural thing in the world.

Because of this experience the news of the leakage in the June 2006 nursing licensure examination (NLE) didn’t surprise me. If there is cheating at simple midterm exams, what more at a licensure exam where so much is at stake?

In the case of the NLE much is indeed at stake. It is common knowledge that many, if not a majority, of those who take up nursing do so not, because of a desire to nurse the sick, but because this is an almost fool-proof pass to greener pastures abroad. Parents compel their children to take up nursing even if the children have little if any interest in nursing. Fortunes are spent on tuition fees and review classes.

So who wants to flunk the licensure examination? Some brilliant review center owners found a way to make certain that their enrollees would be sure board passers.

Nursing, from the schools to the taking of the licensure examination, has become a business. Schools offering nursing courses—some of dubious quality—and review centers have mushroomed to accommodate the growing number of enrollees. It’s all about money and there is nothing wrong with this.

However, nursing, like any profession, has certain professional standards to live up to, so that hospitals that hire them are assured that they hire qualified personnel. This is why there is a licensure examination and why there is a Professional Regulation Commission and a Board of Nursing. Alas, these entities failed to do their part of the job. Two of five tests in the June exam were comprised. One test—the now infamous test 5, the test in psychiatric nursing—had 90 of its 100 questions leaked. Yet, the PRC actually included the test score in its recomputation of the overall examination results (“Did recomputation result in injustice?”) Manila Times, September 24). The PRC exercised its discretion and came up with a formula that can best be described as an effort to dilute the effect of the leakage. Instead of containing the damage of the leakage to tests 3 and 5 and to examinees that were at the review center where the leaked questions were reviewed, the PRC managed the scandal in a manner that affected the final grades of all examinees.

Continue reading on:
http://www.manilatimes.net/national/2006/nov/07/yehey/opinion/20061107opi4.html

New nursing board needs briefing, says labor chief

New nursing board needs briefing, says labor chief

LABOR Secretary Arturo Brion sought a meeting with the newly appointed members of the Board of Nursing yesterday to discuss a re-test that will be administered on Dec. 2 and 3 to graduates who passed the leak-ridden board exams in June.

“We have to discuss many things. I have not met with the new members up to now,” Brion said in a radio interview.

Malacañang had tasked Brion to oversee the Professional Regulation Commission, which supervises the Board of Nursing, in the wake of the test leak scandal.

But he said he was yet to be briefed on the new tests that some 1,687 examinees would have to take in December.

Previous members of the board quit over the scandal but the government announced their replacements only last month.

The Philippine Nurses Association nominated the five new board members to the commission, which in turn endorsed them to Malacañang.

The new board members were named after the Court of Appeals cleared the way for most of the exam passers to take their oath as new nurses.

Continue reading on : http://www.manilastandardtoday.com/?page=news3_nov7_2006

Monday, November 06, 2006

COMMUNITY HEALTH NURSING EXAMINATION PART I Answer Key

COMMUNITY HEALTH NURSING EXAMINATION PART I
By : Budek
http://pinoybsn.blogspot.com

Outline :

I. Epidemiology
II. Vital Statistics
III. FHSIS
IV. COPAR
V. Health Education


SITUATION : Epidemiology and Vital statistics is a very important tool that a nurse could use in controlling the spread of disease in the community and at the same time, surveying the impact of the disease on the population and prevent it’s future occurrence.

1. It is concerned with the study of factors that influence the occurrence and distribution of diseases, defects, disability or death which occurs in groups or aggregation of individuals.

A. Epidemiology
B. Demographics
C. Vital Statistics
D. Health Statistics

2. Which of the following is the backbone in disease prevention?

A. Epidemiology
B. Demographics
C. Vital Statistics
D. Health Statistics

3. Which of the following type of research could show how community expectations can result in the actual provision of services?

A. Basic Research
B. Operational Research
C. Action Research
D. Applied Research

4. An outbreak of measles has been reported in Community A. As a nurse, which of the following is your first action for an Epidemiological investigation?

A. Classify if the outbreak of measles is epidemic or just sporadic
B. Report the incidence into the RHU
C. Determine the first day when the outbreak occurred
D. Identify if it is the disease which it is reported to be

5. After the epidemiological investigation produced final conclusions, which of the following is your initial step in your operational procedure during disease outbreak?

A. Coordinate personnel from Municipal to the National level
B. Collect pertinent laboratory specimen to confirm disease causation
C. Immunize nearby communities with Measles
D. Educate the community in future prevention of similar outbreaks

6. The main concern of a public health nurse is the prevention of disease, prolonging of life and promoting physical health and efficiency through which of the following?

A. Use of epidemiological tools and vital health statistics
B. Determine the spread and occurrence of the disease
C. Political empowerment and Socio Economic Assistance
D. Organized Community Efforts

7. In order to control a disease effectively, which of the following must first be known?

1. The conditions surrounding its occurrence
2. Factors that do not favor its development
3. The condition that do not surround its occurrence
4. Factors that favors its development

A. 1 and 3
B. 1 and 4
C. 2 and 3
D. 2 and 4

8. All of the following are uses of epidemiology except:

A. To study the history of health population and the rise and fall of disease
B. To diagnose the health of the community and the condition of the people
C. To provide summary data on health service delivery
D. To identify groups needing special attention

9. Before reporting the fact of presence of an epidemic, which of the following is of most importance to determine?

A. Are the facts complete?
B. Is the disease real?
C. Is the disease tangible?
D. Is it epidemic or endemic?

10. An unknown epidemic has just been reported in Barangay Dekbudekbu. People said that affected person demonstrates hemorrhagic type of fever. You are designated now to plan for epidemiological investigation. Arrange the sequence of events in accordance with the correct outline plan for epidemiological investigation.

1. Report the presence of dengue
2. Summarize data and conclude the final picture of epidemic
3. Relate the occurrence to the population group, facilities, food supply and carriers
4. Determine if the disease is factual or real
5. Determine any unusual prevalence of the disease and its nature; is it epidemic, sporadic, endemic or pandemic?
6. Determine onset and the geographical limitation of the disease.

A. 4,1,3,5,2,6
B. 4,1,5,6,3,2
C. 5,4,6,2,1,3
D. 5,4,6,1,2,3
E. 1,2,3,4,5,6

11. In the occurrence of SARS and other pandemics, which of the following is the most vital role of a nurse in epidemiology?

A. Health promotion
B. Disease prevention
C. Surveillance
D. Casefinding

12. Measles outbreak has been reported in Barangay Bahay Toro, After conducting an epidemiological investigation you have confirmed that the outbreak is factual. You are tasked to lead a team of medical workers for operational procedure in disease outbreak. Arrange the correct sequence of events that you must do to effectively contain the disease

1. Create a final report and recommendation
2. Perform nasopharyngeal swabbing to infected individuals
3. Perform mass measles immunization to vulnerable groups
4. Perform an environmental sanitation survey on the immediate environment
5. Organize your team and Coordinate the personnels
6. Educate the community on disease transmission

A. 1,2,3,4,5,6
B. 6,5,4,3,2,1
C. 5,6,4,2,3,1
D. 5,2,3,4,6,1

13. All of the following are function of Nurse Budek in epidemiology except

A. Laboratory Diagnosis
B. Surveillance of disease occurrence
C. Follow up cases and contacts
D. Refer cases to hospitals if necessary
E. Isolate cases of communicable disease

14. All of the following are performed in team organization except

A. Orientation and demonstration of methodology to be employed
B. Area assignments of team members
C. Check team’s equipments and paraphernalia
D. Active case finding and Surveillance

15. Which of the following is the final output of data reporting in epidemiological operational procedure?

A. Recommendation
B. Evaluation
C. Final Report
D. Preliminary report

16. The office in charge with registering vital facts in the Philippines is none other than the

A. PCSO
B PAGCOR
C. DOH
D. NSO

17. The following are possible sources of Data except:

A. Experience
B. Census
C. Surveys
D. Research

18. This refers to systematic study of vital events such as births, illnesses, marriages, divorces and deaths

A. Epidemiology
B. Demographics
C. Vital Statistics
D. Health Statistics

19. In case of clerical errors in your birth certificate, Where should you go to have it corrected?

A. NSO
B. Court of Appeals
C. Municipal Trial Court
D. Local Civil Registrar

20. Acasia just gave birth to Lestat, A healthy baby boy. Who are going to report the birth of Baby Lestat?

A. Nurse
B. Midwife
C. OB Gyne
D. Birth Attendant

21. In reporting the birth of Baby Lestat, where will he be registered?

A. At the Local Civil Registrar
B. In the National Statistics Office
C. In the City Health Department
D. In the Field Health Services and Information System Main Office

22. Deejay, The birth attendant noticed that Lestat has low set of ears, Micrognathia, Microcephaly and a typical cat like cry. What should Deejay do?

A. Bring Lestat immediately to the nearest hospital
B. Ask his assistant to call the nearby pediatrician
C. Bring Lestat to the nearest pediatric clinic
D. Call a Taxi and together with Acasia, Bring Lestat to the nearest hospital

23. Deejay would suspect which disorder?

A. Trisomy 21
B. Turners Syndrome
C. Cri Du Chat
D. Klinefelters Syndrome

24. Deejay could expect which of the following congenital anomaly that would accompany this disorder?

A. AVSD
B. PDA
C. TOF
D. TOGV

26. Which presidential decree orders reporting of births within 30 days after its occurrence?

A. 651
B. 541
C. 996
D. 825

25. These rates are referred to the total living population, It must be presumed that the total population was exposed to the risk of occurrence of the event.

A. Rate
B. Ratio
C. Crude/General Rates
D. Specific Rate

26. These are used to describe the relationship between two numerical quantities or measures of events without taking particular considerations to the time or place.

A. Rate
B. Ratios
C. Crude/General Rate
D. Specific Rate

27. This is the most sensitive index in determining the general health condition of a community since it reflects the changes in the environment and medical conditions of a community

A. Crude death rate
B. Infant mortality rate
C. Maternal mortality rate
D. Fetal death rate

28. According to the WHO, which of the following is the most frequent cause of death in children underfive worldwide in the 2003 WHO Survey?

A. Neonatal
B. Pneumonia
C. Diarrhea
D. HIV/AIDS

29. In the Philippines, what is the most common cause of death of infants according to the latest survey?

A. Pneumonia
B. Diarrhea
C. Other perinatal condition
D. Respiratory condition of fetus and newborn

30. The major cause of mortality from 1999 up to 2002 in the Philippines are

A. Diseases of the heart
B. Diseases of the vascular system
C. Pneumonias
D. Tuberculosis

31. Alicia, a 9 year old child asked you “ What is the common cause of death in my age group here in the Philippines? “ The nurse is correct if he will answer

A. Pneumonia is the top leading cause of death in children age 5 to 9
B. Malignant neoplasm if common in your age group
C. Probability wise, You might die due to accidents
D. Diseases of the respiratory system is the most common cause of death in children

32. In children 1 to 4 years old, which is the most common cause of death?

A. Diarrhea
B. Accidents
C. Pneumonia
D. Diseases of the heart

33. Working in the community as a PHN for almost 10 years, Aida knew the fluctuation in vital statistics. She knew that the most common cause of morbidity among the Filipinos is

A. Diseases of the heart
B. Diarrhea
C. Pneumonia
D. Vascular system diseases

34. Nurse Aida also knew that most maternal deaths are caused by

A. Hemorrhage
B. Other Complications related to pregnancy occurring in the course of labor, delivery and puerperium
C. Hypertension complicating pregnancy, childbirth and puerperium
D. Abortion

SITUATION : Barangay PinoyBSN has the following data in year 2006

1. July 1 population : 254,316
2. Livebirths : 2,289
3. Deaths from maternal cause : 15
4. Death from CVD : 3,029
5. Deaths under 1 year of age : 23
6. Fetal deaths : 8
7. Deaths under 28 days : 8
8. Death due to rabies : 45
9. Registered cases of rabies : 45
10. People with pneumonia : 79
11. People exposed with pneumonia : 2,593
12. Total number of deaths from all causes : 10,998

The following questions refer to these data

35. What is the crude birth rate of Barangay PinoyBSN?

A. 90/100,000
B. 9/100
C. 90/1000
D. 9/1000

36. What is the cause specific death rate from cardiovascular diseases?

A. 27/100
B. 1191/100,000
C. 27/100,000
D. 1.1/1000

37. What is the Maternal Mortality rate of this barangay?

A. 6.55/1000
B. 5.89/1000
C. 1.36/1000
D. 3.67/1000

38. What is the fetal death rate?

A. 3.49/1000
B. 10.04/1000
C. 3.14/1000
D. 3.14/100,000

39. What is the attack rate of pneumonia?

A. 3.04/1000
B. 7.18/1000
C. 32.82/100
D. 3.04/100

40. Determine the Case fatality ratio of rabies in this Barangay

A. 1/100
B. 100%
C. 1%
D. 100/1000

41. The following are all functions of the nurse in vital statistics, which of the following is not?

A. Consolidate Data
B. Collects Data
C. Analyze Data
D. Tabulate Data

42. The following are Notifiable diseases that needs to have a tally sheet in data reporting, Which one is not?

A. Hypertension
B. Bronchiolitis
C. Chemical Poisoning
D. Accidents

43. Which of the following requires reporting within 24 hours?

A. Neonatal tetanus
B. Measles
C. Hypertension
D. Tetanus

44. Which Act declared that all communicable disease be reported to the nearest health station?

A. 1082
B. 1891
C. 3573
D. 6675

45. In the RHU Team, Which professional is directly responsible in caring a sick person who is homebound?

A. Midwife
B. Nurse
C. BHW
D. Physician

46. During epidemics, which of the following epidemiological function will you have to perform first?

A. Teaching the community on disease prevention
B. Assessment on suspected cases
C. Monitor the condition of people affected
D. Determining the source and nature of the epidemic

47. Which of the following is a POINT SOURCE epidemic?


A. Dengue H.F
B. Malaria
C. Contaminated Water Source
D. Tuberculosis

48. All but one is a characteristic of a point source epidemic, which one is not?

A. The spread of the disease is caused by a common vehicle
B. The disease is usually caused by contaminated food
C. There is a gradual increase of cases
D. Epidemic is usually sudden

49. The only Microorganism monitored in cases of contaminated water is

A. Vibrio Cholera
B. Escherichia Coli
C. Entamoeba Histolytica
D. Coliform Test

50. Dengue increase in number during June, July and August. This pattern is called

A. Epidemic
B. Endemic
C. Cyclical
D. Secular

SITUATION : Field health services and information system provides summary data on health service delivery and selected program from the barangay level up to the national level. As a nurse, you should know the process on how these information became processed and consolidated.

51. All of the following are objectives of FHSIS Except

A. To complete the clinical picture of chronic disease and describe their natural history
B. To provide standardized, facility level data base which can be accessed for more in depth studies
C. To minimize recording and reporting burden allowing more time for patient care and promotive activities
D. To ensure that data reported are useful and accurate and are disseminated in a timely and easy to use fashion

52. What is the fundamental block or foundation of the field health service information system?

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

53. What is the primary advantage of having a target client list?

A. Nurses need not to go back to FTR to monitor treatment and services to beneficiaries thus saving time and effort
B. Help monitor service rendered to clients in general
C. Facilitate monitoring and supervision of services
D. Facilitates easier reporting

54. Which of the following is used to monitor particular groups that are qualified as eligible to a certain program of the DOH?

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

55. In using the tally sheet, what is the recommended frequency in tallying activities and services?

A. Daily
B. Weekly
C. Monthly
D. Quarterly

56. When is the counting of the tally sheet done?

A. At the end of the day
B. At the end of the week
C. At the end of the month
D. At the end of the year

57. Target client list will be transmitted to the next facility in the form of

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

58. All but one of the following are eligible target client list

A. Leprosy cases
B. TB cases
C. Prenatal care
D. Diarrhea cases

59. This is the only mechanism through which data are routinely transmitted from once facility to another

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

60. FHSIS/Q-3 Or the report for environmental health activities is prepared how frequently?

A. Daily
B. Weekly
C. Quarterly
D. Yearly

61. Nurse Budek is preparing the reporting form for weekly notifiable diseases. He knew that he will code the report form as

A. FHSIS/E-1
B. FHSIS/E-2
C. FHSIS/E-3
D. FHSIS/M-1

62. In preparing the maternal death report, which of the following correctly codes this occurrence?

A. FHSIS/E-1
B. FHSIS/E-2
C. FHSIS/E-3
D. FHSIS/M-1


63. Where should Nurse Budek bring the reporting forms if he is in the BHU Facility?

A. Rural health office
B. FHSIS Main office
C. Provincial health office
D. Regional health office

64. After bringing the reporting forms in the right facility for processing, Nurse Budek knew that the output reports are solely produced by what office?

A. Rural health office
B. FHSIS Main office
C. Provincial health office
D. Regional health office

65. Mang Raul entered the health center complaining of fatigue and frequent syncope. You assessed Mang Raul and found out that he is severely malnourished and anemic. What record should you get first to document these findings?

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

66. The information about Mang Raul’s address, full name, age, symptoms and diagnosis is recorded in

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

67. Another entry is to be made for Mang Raul because he is in the target client’s list, In what TCL should Mang Raul’s entry be documented?

A. TCL Eligible Population
B. TCL Family Planning
C. TCL Nutrition
D. TCL Pre Natal

68. The nurse uses the FHSIS Record system incorrectly when she found out that

A. She go to the individual or FTR for entry confirmation in the Tally/Report Summary
B. She refer to other sources for completing monthly and quarterly reports
C. She records diarrhea in the Tally sheet/Report form with a code FHSIS/M-1
D. She records a Child who have frequent diarrhea in TCL : Under Five

69. The BHS Is the lowest level of reporting unit in FHSIS. A BHS can be considered a reporting unit if all of the following are met except

A. It renders service to 3 barangays
B. There is a midwife the regularly renders service to the area
C. The BHS Have no mother BHS
D. It should be a satellite BHS

70. Data submitted to the PHO is processed using what type of technology?

A. Internet
B. Microcomputer
C. Supercomputer
D. Server Interlink Connections

SITUATION : Community organizing is a process by which people, health services and agencies of the community are brought together to act and solve their own problems.

71. Mang ambo approaches you for counseling. You are an effective counselor if you

A. Give good advice to Mang Ambo
B. Identify Mang Ambo’s problems
C. Convince Mang Ambo to follow your advice
D. Help Mang Ambo identify his problems

72. As a newly appointed PHN instructed to organize Barangay Baritan, Which of the following is your initial step in organizing the community for initial action?

A. Study the Barangay Health statistics and records
B. Make a courtesy call to the Barangay Captain
C. Meet with the Barangay Captain to make plans
D. Make a courtesy call to the Municipal Mayor

73. Preparatory phase is the first phase in organizing the community. Which of the following is the initial step in the preparatory phase?

A. Area selection
B. Community profiling
C. Entry in the community
D. Integration with the people

74. the most important factor in determining the proper area for community organizing is that this area should

A. Be already adopted by another organization
B. Be able to finance the projects
C. Have problems and needs assistance
D. Have people with expertise to be developed as leaders

75. Which of the following dwelling place should the Nurse choose when integrating with the people?

A. A simple house in the border of Barangay Baritan and San Pablo
B. A simple house with fencing and gate located in the center of Barangay Baritan
C. A modest dwelling place where people will not hesitate to enter
D. A modest dwelling place where people will not hesitate to enter located in the center of the community

76. In choosing a leader in the community during the Organizational phase, Which among these people will you choose?

A. Miguel Zobel, 50 years old, Rich and Famous
B. Rustom, 27 years old, Actor
C. Mang Ambo, 70, Willing to work for the desired change
D. Ricky, 30 years old, Influential and Willing to work for the desired change

77. Which type of leadership style should the leaders of the community practice?

A. Autocratic
B. Democratic
C. Laissez Faire
D. Consultative

78. Setting up Committee on Education and Training is in what phase of COPAR?

A. Preparatory
B. Organizational
C. Education and Training
D. Intersectoral Collaboration
E. Phase out

79. Community diagnosis is done to come up with a profile of local health situation that will serve as basis of health programs and services. This is done in what phase of COPAR?

A. Preparatory
B. Organizational
C. Education and Training
D. Intersectoral Collaboration
E. Phase out

80. The people named the community health workers based on the collective decision in accordance with the set criteria. Before they can be trained by the Nurse, The Nurse must first

A. Make a lesson plan
B. Set learning goals and objective
C. Assess their learning needs
D. Review materials needed for training

81. Nurse Budek wrote a letter to PCSO asking them for assistance in their feeding programs for the community’s nutrition and health projects. PCSO then approved the request and gave Budek 50,000 Pesos and a truckload of rice, fruits and vegetables. Which phase of COPAR did Budek utilized?

A. Preparatory
B. Organizational
C. Education and Training
D. Intersectoral Collaboration
E. Phase out

82. Ideally, How many years should the Nurse stay in the community before he can phase out and be assured of a Self Reliant community?

A. 5 years
B. 10 years
C. 1 year
D. 6 months

83. Major discussion in community organization are made by

A. The nurse
B. The leaders of each committee
C. The entire group
D. Collaborating Agencies

84. The nurse should know that Organizational plan best succeeds when

1. People sees its values
2. People think its antagonistic professionally
3. It is incompatible with their personal beliefs
4. It is compatible with their personal beliefs

A. 1 and 3
B. 2 and 4
C. 1 and 2
D. 1 and 4

85. Nurse Budek made a proposal that people should turn their backyard into small farming lots to plant vegetables and fruits. He specified that the objective is to save money in buying vegetables and fruits that tend to have a fluctuating and cyclical price. Which step in Community organizing process did he utilized?

A. Fact finding
B. Determination of needs
C. Program formation
D. Education and Interpretation

86. One of the critical steps in COPAR is becoming one with the people and understanding their culture and lifestyle. Which critical step in COPAR will the Nurse try to immerse himself in the community?

A. Integration
B. Social Mobilization
C. Ground Work
D. Mobilization

87. The Actual exercise of people power occurs during when?

A. Integration
B. Social Mobilization
C. Ground Work
D. Mobilization

88. Which steps in COPAR trains indigenous and informal leaders?

A. Ground Work
B. Mobilization
C. Core Group formation
D. Integration

89. As a PHN, One of your role is to organize the community. Nurse Budek knows that the purposes of community organizing are

1. Move the community to act on their own problems
2. Make people aware of their own problems
3. Enable the nurse to solve the community problems
4. Offer people means of solving their own problems

A. 1,2,3
B. 1,2,3,4
C. 1,2
D. 1,2,4

90. This is considered the first act of integrating with the people. This gives an in depth participation in community health problems and needs.

A. Residing in the area of assignment
B. Listing down the name of person to contact for courtesy call
C. Gathering initial information about the community
D. Preparing Agenda for the first meeting

SITUATION : Health education is the process whereby knowledge, attitude and practice of people are changed to improve individual, family and community health.

91. Which of the following is the correct sequence in health education?

1. Information
2. Communication
3. Education

A. 1,2,3
B. 3,2,1
C. 1,3,2
D. 3,1,2

92. The health status of the people is greatly affected and determined by which of the following?

A. Behavioral factors
B. Socioeconomic factors
C. Political factors
D. Psychological factors

93. Nurse Budek is conducting a health teaching to Agnesia, 50 year old breast cancer survivor needing rehabilitative measures. He knows that health education is effective when

A. Agnesia recites the procedure and instructions perfectly
B. Agnesia’s behavior and outlook in life was changed positively
C. Agnesia gave feedback to Budek saying that she understood the instruction
D. Agnesia requested a written instruction from Budek

94. Which of the following is true about health education?

A. It helps people attain their health through the nurse’s sole efforts
B. It should not be flexible
C. It is a fast and mushroom like process
D. It is a slow and continuous process

95. Which of the following factors least influence the learning readiness of an adult learner?

A. The individuals stage of development
B. Ability to concentrate on information to be learned
C. The individual’s psychosocial adaptation to his illness
D. The internal impulses that drive the person to take action

96. Which of the following is the most important condition for diabetic patients to learn how to control their diet?

A. Use of pamphlets and other materials during instructions
B. Motivation to be symptom free
C. Ability of the patient to understand teaching instruction
D. Language used by the nurse

97. An important skill that a primigravida has to acquire is the ability to bathe her newborn baby and clean her breast if she decides to breastfeed her baby, Which of the following learning domain will you classify the above goals?

A. Psychomotor
B. Cognitive
C. Affective
D. Attitudinal

98. When you prepare your teaching plan for a group of hypertensive patients, you first formulate your learning objectives. Which of the following steps in the nursing process corresponds to the writing of the learning objectives?

A. Planning
B. Implementing
C. Evaluation
C. Assessment

99. Rose, 50 years old and newly diagnosed diabetic patient must learn how to inject insulin. Which of the following physical attribute is not in anyway related to her ability to administer insulin?

A. Strength
B. Coordination
C. Dexterity
D. Muscle Built

100. Appearance and disposition of clients are best observed initially during which of the following situation?

A. Taking V/S
B. Interview
C. Implementation of the initial care
D. Actual Physical examination

95-100 are taken from actual board questions, However the answer key given in the compilation are incorrect. Comments, Question, Suggestion or Reactions? YM or MAIL me @ pinoybsn@yahoo.com

60 Zamboanga Peninsula nursing exam passers issued retake order

60 Zamboanga Peninsula nursing exam passers issued retake order
By Bong Garcia

AT LEAST 60 of the 2006 Nursing Licensure Examination (NLEX) passers who were ordered to retake the NLEX are from the Zamboanga Peninsula.

This was revealed by regional Professional Regulation Commission (PRC) officer-in-charge Irene Avila.

"Majority of them are from Zamboanga City," Avila said, whose office covers the entire Zamboanga Peninsula and the provinces of Basilan, Sulu and Tawi-Tawi, which are part of the autonomous region.

With this development, Avila said the total number of nurses who passed the 2006 NLEX was trimmed down to 458 from the total of 518.

Continue reading on :
SUNSTAR

ADB warns RP on ill-effects of 'brain drain'

ADB warns RP on ill-effects of 'brain drain'

Swelling ranks of OFWs draining local talent pool

By Daxim Lucas
Inquirer
Last updated 03:07am (Mla time) 11/06/2006

Published on page B1 of the November 6, 2006 issue of the Philippine Daily Inquirer

AN INFLUENTIAL multilateral funding agency has urged both the public and private sectors to implement more initiatives to reverse the effects of a "brain drain" caused by the swelling ranks of overseas Filipino workers (OFWs).

The Manila-based Asian Development Bank has warned that the sustained export of skilled Filipino labor could eventually end up discouraging foreign investments if the local talent pool continued to decline.

"Brain drain has an impact on foreign direct investment as capital will flow only into economies with perceived adequate supplies of skilled labor in key sectors," the bank said in a book released last week titled "Converting Migration Drains into Gains."

"One of the greatest concerns about brain drain is that the continued migration of skilled workers reduces overall productivity," it added.

The 66-nation member organization defines brain drain as a situation when a country's diaspora is disproportionately made up of skilled workers, causing the source country to experience a decline in average-per-worker income. Eventually, educational investments in the source country--such as tuition paid for nursing or computer skills courses in the Philippines--become subsidies for the destination country.

The ADB pointed out that the country's migrant labor force "encompasses a disproportionate share of the most productive age group (those between 25 to 44 years old)," which suggests a loss, even for temporary and limited periods, of "those with the most experience, on-the-job training, and likely supervisory skills."

The group also represents "a disproportionate share of individuals with greater number of years of education, especially those who have completed bachelor's or higher degrees."

Continue reading on :
http://globalnation.inq7.net/news/news/view_article.php?article_id=30728

Nursing Practice (Basic Health Care Procedures)

Nursing Practice (Basic Health Care Procedures)

The following are review questions of our basic health care procedures particularly the following concepts:
a. Moving, Transferring and Positioning Clients
b. ROM Exercises
c. Assessing Vital Signs
d. Hygienic Care

Answers will be posted soon..

Enjoy and have fun..

Brewed

Situation 1: Moving a client in good body alignment and positioning body parts properly and systematically are essential aspects of nursing practice.

1. To elicit patient’s cooperation and promote sense of well-being, Nurse Kelly must do which of the following?
a. Proper handwashing
b. Explain the procedure
c. Greet the client and introduce oneself
d. Wear a smile
2. Frequent change of position helps prevent which of the following?
a. muscle tone
b. stimulation of postural reflexes
c. good body alignment
d. formation of pressure ulcer
3. Before moving or transferring a client, what assessment should Nurse Justin anticipates?
a. client’s ability to assist
b. good body mechanics
c. client’s comfort
d. client’s well being
4. In order to protect the client and the nurse from injury, Nurse Rihanna should observe which of the following?
a. manner of walking
b. maintaining good posture
c. maintaining good poise
d. good body mechanics
5. Body mechanics can be best described as:
a. correct positioning, moving and transferring of clients
b. efficient use of body weight, coordination and strength
c. efficient, coordinated and unsafe use of the body
d. maintaining good body alignment

Situation 2: A nurse can do a number of things to ensure proper alignment and promote client’s comfort and safety.

6. Nurse Beyonce ensures that the mattress is firm. A sagging mattress used over a prolonged period can contribute to the development of which of the following?
a. Neck flexion
b. Foot drop
c. Low back pain
d. Pressure ulcer
7. The use of supportive devices can prevent stress on client’s muscles and joints. What supportive device is recommended to be placed beneath a too soft mattress for client’s who have back problems?
a. Pillows
b. Chair beds
c. Mattress
d. Bed boards
8. To avoid excessive pressure and predisposition of thrombus formation to the clients, Nurse Michelle must:
a. avoid placing one body part directly on top on another body part
b. make use of supportive devices
c. ensure that the bed is kept clean and dry
d. elicit information from the clients’ desired position
9. In order to prevent pressure ulcers in immobilized clients; Nurse Erik must plan to do which of the following?
a. Plan a systematic 24-hour schedule for position changes
b. Reposition clients every 4 hours throughout the day
c. Use only supportive devices available
d. Assume clients’ responsibility
10. Common alignment problems that can be corrected with supportive devices include all of the following EXCEPT:
a. Flexion of the neck
b. Extension of the wrist
c. Adduction of shoulder
d. External rotation of the hips

Situation 3: Ill people may have difficulty in moving even in bed. The amount of assistance the clients require depends on their own ability to move and their health status. In general, nurses should be sensitive to both the need of clients to function independently and their need for assistance to move.

11. Nurse Carrie is changing an occupied bed and is about to turn Mr. Foxx to the side. Which of the following is NOT an appropriate nursing action?
a. Move the client to one side of the bed before turning
b. Turn the client towards you with your hips, knees and ankles flexed, feet apart
c. Untuck the topsheet at the foot part of the bed to facilitate change of position
d. Turn the client away from you, with your back bent
12. In moving a client up in bed, Nurse Anika can elicit the client’s help in lessening workload by instructing him to initially do which of the following?
a. Ask client to flex the hips and knees and position the feet; be ready for pushing
b. Grasp the overhead trapeze with both hands and lift and pull during the move
c. Grasp the head of the bed with both hands and pull during the move
d. Lock the wheels on the bed and raise the side rails opposite to you
13. A client with spinal injury must in all times be kept in straight alignment when turning, so logrolling is the technique being used. The following are appropriate nursing actions EXCEPT:
a. Position yourselves and the client appropriately before the move
b. Move to the other side of the bed, and place supportive device
c. Ask client to place arms at the sides with the palms against the surface of bed
d. Roll and position the client in proper alignment in the count of three
14. Mr. Chiu is for X-ray at the Radiologic Department. To transfer him from the bed to the wheelchair, Nurse Paris should position the wheelchair:
a. parallel to the bed
b. right angle at the foot part
c. any desired position
d. at the foot part of the bed
15. In pushing the stretcher, which of the following guidelines should be observed to protect the client’s head in the event of collision?
a. lock wheels of the bed
b. push from the end where head is positioned
c. fasten safety straps across the client
d. raise the side rails on both sides

Situation 4: The nurse assists clients with appropriate exercise programs to maintain physical fitness and prepares them for ambulation.

16. Mr. Linux has undergone an abdominal surgery. To prevent thrombophlebitis, the following are appropriate nursing actions EXCEPT:
a. perform passive leg exercises
b. turn the client every one to two hours
c. massage the legs when painful
d. elevate legs to promote venous return
17. The type of exercise that Nurse Julian can perform to Mr. Lim with joint contractures is:
a. active exercise
b. passive exercise
c. active – assistive exercise
d. active – resistive exercise
18. To prevent plantar flexion in paralyzed patient which of the following protective devices may be used?
a. footboard only
b. footboard and trochanter roll
c. footboard and hand roll
d. footboard and boot splint
19. Nurse Nico is aware that ROM exercise is contraindicated to patients who have/are:
a. joint swelling and inflammation
b. intermittent fever
c. cough and colds
d. post – operative
20. In isometric exercises, Nurse Marie knows that this involves:
a. change in muscle tension and length
b. change in muscle tension
c. flexion and extension of a weak arm with sandbag tied on the forearm
d. use of weights and pulleys

Situation 5: Activities of daily living and protective positions are ways to promote activity and exercise. Correct positioning is essential to maintain an optimum level of functioning.

21. Nurse Sarah is caring to clients who have difficulty of breathing and some having heart problems. The position of choice for these clients is:
a. Supine position
b. Trendelenburg position
c. Fowler’s position
d. Orthopneic position
22. Mr. Cruize who had undergone spinal surgery should assume which position?
a. Horizontal recumbent position
b. Prone position
c. Reverse trendelenburg position
d. Dorsal recumbent position
23. The only bed position that allows full extension of the hip and knee joint is:
a. Orthopneic position
b. Prone position
c. Sim’s position
d. Lateral position
24. Mrs. Smith is for an examination of her genitalia. Nurse Cassie should assist her to assume which position?
a. Dorsal recumbent position
b. Sim’s position
c. Knee-chest position
d. Genupectoral position
25. The client assumes a posture halfway between the lateral and the prone position. Nurse Craig knows that this type of position is:
a. Lateral position
b. Prone position
d. Sim’s position
d. Supine position

Situation 6: Nursing procedures are directed toward restoring optimal mobility and preventing some of the effects of immobility. When performing these procedures, a nurse must be efficient and competent in rendering nursing care.

26. In assisting client to an erect or standing position, Nurse Rufuz must observe all of the following EXCEPT:
a. Assist patient to stand
b. Place a chair near one side where he can rest hand for support
c.
Drape with a double folded sheet around the body from the breast to legs
d. Elevate one foot on a foot stool if needed
27. Ms. Demeanor complains of difficulty of breathing while lying on bed. Nurse Missy can assist her in an orthopneic position by:
a. Elevating head of bed to 45 degrees
b. Assisting patient to sit up on bed with overbed table across the lap
c. Assisting patient to lie on his back
d. Raising knees and separate legs, with soles of feet resting on bed
28. Dr. Lopez ordered a cleansing enema for Mr. Rusty. Nurse David knows that his client assumes Sim’s position when:
a. the lower arm is positioned behind the client and upper arm is flexed
b. the client lies on his back, with the knees raised
c. one side of the body is flexing the top hip and knee and placing his leg in front
d. the client sits on bed with an overbed table across the lap
29. How will you position Mr. Seoul to a Semi-Fowler’s position?
a. Elevate head of bed to an angle of 35 degrees
b. Place arms at the sides, pronated and elevate with pillow
c. Place patient in supine position
d. Elevate head of bed to an angle of 50 degrees
30. In genupectoral position, the client kneels on bed with hips in air and chest on table. In order to provide privacy, Nurse Jasmine must do which of the following?
a. Provide hand rolls if needed
b. Cover with top sheet and pick lower end of the sheet to expose the area
c. Drape with a double folded sheet around the body from the waist to legs
d. Cover with top sheet and fold back in area to be examined

Situation 7: Vital signs are determined to monitor the functions of the body. Nurse Jasmine should measure VS more often if the client’s health status requires it.
31. Monitoring of client’s VS should not be a routine procedure. The following are times to assess VS except:
a. On admission to a health care agency
b. Before and after surgery or invasive procedure
c. According to a nursing or medical order
d. Only after administration of medications
32. Nurse Jasmine knows that the primary purpose of taking VS initially is:
a. To establish data base
b. To monitor for disease progression
c. To identify proper treatment
d. To prepare for surgery
33. Which of the following is not a cardinal sign?
a. Temperature
b. Blood pressure
c. Heart rate
d. Pain
34. In order to elicit the patient’s cooperation, Nurse Jasmine must do which of the following?
a. Explain the procedure
b. Wash hands
c. Greet the client and introduce one self
d. Take a look and smile
35. Nurse Jasmine knows that the best way to prevent transfer of microorganisms is:
a. Use of hand sanitizer
b. Disinfection of used materials
c. Handwashing
d. Health assessment

Situation 8: Nurse Julian is the staff nurse assigned at the Medical Ward of Aquinas University Hospital. In order to render nursing care, he must be knowledgeable of the anatomy and physiology.

36. Mr. Yang is suffering from hyperthermia. Nurse Julian knows that the center for thermoregulation is:
a. Pituitary gland
b. Hypothalamus
c. Medulla oblongata
d. Pons
37. The primary center for respiration is:
a. Pituitary gland
b. Hypothalamus
c. Medulla oblongata
d. Pons
38. Respiration is the act of breathing. The primary chemical stimulation for breathing is:
a. Low CO2 level in the blood
b. High O2 level in the blood
c. Stress
d. High CO2 level in the blood
39. Ms. Cha asks Nurse Julian where she can find the apical pulse. Nurse Julian is correct when he says:
a. “On the right mid – clavicular line, in the 5th or 6th intercostal spaces”
b. “On the left mid – clavicular line, in the 2nd or 3rd intercostal spaces”
c. “On right mid – clavicular, in the apex of your heart”
d. “On the left mid – clavicular line, in the 5th or 6th intercostal spaces”
40. Mr. Clean has myocardial infarction. Nurse Julian knows that rectal temperature taking is contraindicated. What cranial nerve will stimulate the sympathetic nervous system to cause bradycardia?
a. Vagus
b. Facial
c. Olfactory
d. Optic

Situation 9: In assessing vital signs, there are many factors to be considered that affects the accuracy and reliability of data.

41. Sympathetic nervous system stimulation increases the production of epinephrine and norepinephrine thereby increasing metabolic rate and heat production. This factor affecting the temperature is:
a. Stress
b. Exercise
c. Diurnal variation
d. Hormones
42. Nurse Joe knows that if hemorrhage happens, the body’s compensatory mechanism is:
a. Increase heart rate
b. Decrease blood pressure
c. Increase pulse rate
d. All of the above
43. All but one are factors affecting the respiratory rate:
a. Exercise
b. Stress
c. Diurnal variations
d. Environment
44. Hypertension is one of the 10 leading cause of death among Filipinos. This factor can be classified into:
a. Age
b. Race
c. Genetics
d. Gender
45. Which of the following is a non – modifiable factor affecting the blood pressure?
a. Stress
b. Race
c. Exercise
d. Diet

Situation 10: Nurse Pido is going to take the VS of his patient. As a competent nurse, he must be knowledgeable of the variations in taking the body temperature, pulse, respiration and blood pressure.

46. The most accessible and convenient method of taking temperature is:
a. Oral
b. Axillary
c. Rectal
d. Tympanic
47. After taking the temperature per orem, Nurse Pido must clean the thermometer in what manner?
a. From bulb to stem in a back and forth motion
b. From stem to bulb in a rotating motion
c. From stem to bulb in a rotating motion
d. From center down and upward
48. Nurse Pido is aware that his patient is febrile when the mercury reading in the thermometer is:
a. 36.5 degrees Celsius
b. 37.8 degrees Celsius
c. 97.6 degrees Fahrenheit
d. 99.6 degrees Fahrenheit
49. Mr. Dido is in traction, in order to assess good circulation in the foot, Nurse Pido must palpate for:
a. Apical pulse
b. Radial pulse
c. Posterior tibial
d. Femoral pulse
50. Nurse Pido observed the movement of Mr. Dido’s chest upward and inward. This type of breathing is:
a. Costal breathing
b. Diaphragmatic breathing
c. Abdominal breathing
d. Kussmaul’s breathing

Situation 11: The accuracy of VS taking is an important indicator of the client’s condition and is used extensively as a basis for nursing interventions.

51. The use of appropriate size of the BP cuff is an important factor to get an accurate reading. Nurse Lindsay knows that a cuff that is too narrow or tight can cause which findings?
a. Hypertension
b. False low reading .
c. False high reading
d. Ecchymosis
52. Mrs. Lee is taking a beta blocker medication. Nurse Wolverine knows that this drug causes which of the following?
a. Decrease RR
b. Decrease PR
c. Decrease Temperature
d. Decrease BP
53. Nurse Ray is going to take the RR of Mr. Black. Upon entrance in the room, he noticed that Mr. Black has deep and rapid respiration. Based from your assessment, what acid – base imbalance will occur?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
54. Nico is the student nurse assigned at the neonatal intensive care unit. Dr. Lopez requested him to take the heart rate of Baby See. After doing so, Nico knows that the normal heart rate of a newborn is:
a. 80 – 180 beats/min
b. 75 – 120 beats/min
c. 80 – 140 breaths/min
d. 60 – 100 breaths/min
55. Rectal temperature taking is the most accurate method of measurement. To reduce friction and prevent trauma to the mucous membranes, Nurse Cindy must do which of the following?
a. Lubricate thermometer with soap
b. Insert thermometer 4 inches above the sphincter
c. Lubricate thermometer with water soluble jelly
d. Instruct the client to breathe out then insert thermometer

Questions 56 – 85 are all about promoting hygiene

56. The following are functions of the skin, EXCEPT:
a. First line of defense
b. Maintains body temperature
c. Is a secretory organ
d. produces and absorbs Vitamin E
57. The gland that is primarily located in the axilla and anogenital areas is:
a. Apocrine gland
b. Eccrine gland
c. Sweat gland
d. Sebaceous gland
58. What is the science of health and its maintenance?
a. Nursing
b. Health Education
c. Hygiene
d. Personal Hygiene
59. If hygiene is promoted and maintained, the individual has a feeling of all of the following EXCEPT:
a. Comfort .
b. Shame and doubt
c. Well-being
d. Self-confidence
60. Which of the following is a personal hygiene?
a. Bathing
b. Hair care
c. Perineal care
d. Eye care
61. When superficial layers of the skin are scraped or rubbed away, the term is:
a. Erythema
b. Abrasion
c. Acne
d. Vitiligo
62. What is the most effective measure to relief dryness of the skin?
a. Increase fluid intake
b. Apply cream/lotion
c. Avoid use of alcohol
d. Bathe less frequently
63. A common skin problem that is characterized by papules, pustules and comedones is:
a. Wheal
b. Patch
c. Acne
d. Erythema
64. It is a large fluid-filled sac:
a. Tumor
b. Papule
c. Cyst
d. Bulla
65. Athlete’s foot is what type of secondary skin lesion?
a. Excoriation
b. Fissure
c. Erosion
d. Lichenification
66. The initial nursing action when providing bed bath is:
a. Close the door and windows of the patient’s room
b. Inform the client and explain the purpose of procedure
c. Remove the client’s gown under the top sheet
d. Place the bed in flat position
67. Nurse Kenzo is giving bed bath to Mr. Hall who is on strict bed rest. To increase venous return, the nurse bathes the clients extremities by using:
a. Using firm strokes from distal to proximal
b. Firm circular strokes from proximal to distal
c. Short, patting strokes from distal to proximal
d. Smooth, light strokes back and forth
68. Which of the following is inappropriate when performing genital care to male clients?
a. Wear gloves
b. Use circular motion from the penile shaft towards the glans
c. Retract prepuce if uncircumcised
d. Use moist washcloth with soap
69. Which of the following is the most important nursing consideration when performing perineal care to female clients?
a. Use up-downward stroke
b. Use posterior-anterior stroke
c. Wash from back to front
d. Use rubbing stroke
70. To ensure asepsis when bathing a client in bed, the nurse should do which of the following?
a. Wash from distal to proximal areas
b. Pat dry skin surface
c. Wash from clean areas to dirty areas
d. Assess bath water temperature
71. When removing the client’s gown with IVF on his left arm, the nurse should:
a. Remove the side of the gown without the contraption first
b. Remove the side of the gown with contraption first
c. Remove either sides of the gown
d. Remove the IVF then just reinsert it
72. Moving the client to one side of the bed before bathing prevents which of the following?
a. Promotes relaxation and client’s comfort
b. Prevents injury to the nurse and client
c. Maintains asepsis
d. Prevents overreaching and undue muscle strain
73. To retain heat and water better during bed bath, the nurse should:
a. Check water temperature frequently
b. Make bath mitt out of the wash cloth
c. Turn – off electric fans
d. Use warm water only
74. In peri care, in order to maintain client’s dignity, the nurse should:
a. Provide privacy
b. Explain the purpose of the procedure
c. Position and drape the client
d. Wear clean gloves
75. A type of massage that involves a smooth, long stroke and moving the hands up and down the back is:
a. Petrissage
b. Tapotement
c. Back Rub
d. Effleurage
76. Which of the following can be an afternoon care to your client?
a. Bed bath
b. Back Massage
c. Perineal care
d. Stretching of bed linens
77. In combing or brushing a long hair, the nurse should:
a. Start from the tip of the hair to remove tangles
b. Start from the mid part then down to the tip
c. Begin from the scalp then down to the tip
d. Distribute and part the hair into three sections
78. To stimulate the circulation of the blood in the scalp through massage, the nurse should perform which of the following?
a. Bed bath
b. Back rub
c. Hair shampoo
d. Hair care
79. In hair shampoo, to prevent from irritating the client’s eyes, the nurse should:
a. Wipe from inner to outer canthus
b. Cover the eyes with wash cloth
c. Plug ears with cotton balls
d. Advise clients to gently close the eyes
80. Infestation of the scalp with lice is:
a. Pediculosis humanis
b. Pediculosis pubis
c. Pediculosis capitis
d. Pediculosis corporis
81. Which of the following should not be included when providing patient’s teaching on hygienic measures?
a. Do not rub the eyes
b. Remove cerumen from the ear with cotton tipped applicator
c. Blow the nose with one nares closed
d. Use eye drops at regular basis
82. The best position for female client during perineal care is:
a. Supine
b. b. Dorsal recumbent
c. Lateral
d. Semi – fowlers
83. The body’s first line of defense is which of the following?
a. Skin
b. b. An intact and healthy skin
c. Tissues
d. Hair
84. All of the following are primary purposes of bed bath EXCEPT:
a. Assessment
b. Nurse-patient interaction
c. Circulation
d. Documentation
85. Mr. Liu is a diabetic client, he asked the nurse on how to cut his toenails particularly the corns, the nurse’s best response would be:
a. Cut nail straight across
b. Trim toenails from the edge
c. Consult a podiatrist
d. Soak foot to a basin with warm water

End of Nursing Practice (Basic Health Care Procedures)

This material may not be published, broadcast, rewritten or redistributed.
Thank you.
BREWED

Sunday, November 05, 2006

50 item Pharmacology Exam

50 item Pharmacology Exam

1. A client with myasthenia gravis reports the occurrence of difficulty chewing. The physician prescribes pyridostigmine bromide (Mestinon) to increase muscle strength for this activity. The nurse instructs the client to take the medication at what time, in relation to meals?

a. after dinner daily when most fatigued
b. before breakfast daily
c. as soon as arising in the morning
d. thirty minutes before each meal

2. A client is advised to take senna (Senokot) for the treatment of constipation asks the nurse how this medication works. The nurse responds knowing that it:

a. accumulates water in the stool and increases peristalsis
b. stimulates the vagus nerve
c. coats the bowel wall
d. adds fiber and bulk to the stool

3. A client is receiving heparin sodium by continuous intravenous infusion. The nurse monitors the client for which adverse effect of this therapy?

a. decreased blood pressure
b. increased pulse rate
c. ecchymoses
d. tinnitus

4. A client is being treated for acute congestive heart failure (CHF) and the client’s vital signs are as follows: BP 85/50 mm Hg; pulse, 96 bpm; respirations, 26 cpm. The physician prescribes digoxin (Lanoxin). To evaluate a therapeutic effectiveness of this medication, the nurse would expect which of the following changes in the client’s vital signs?

a. BP 85/50 mm Hg, pulse 60 bpm, respirations 26 cpm
b. BP 98/60 mm Hg, pulse 80 bpm, respirations 24 cpm
c. BP 130/70 mm Hg, pulse 104 bpm, respirations 20 cpm
d. BP 110/40 mm Hg, 110 bpm, respirations 20 cpm

5. Diazepam (Valium) is prescribed for a client with anxiety. The nurse instructs the client to expect which side effect?

a. incoordination
b. cough
c. tinnitus
d. hypertension

6. A client receives oxytocin (Pitocin) to induce labor. During the administration of the oxytocin, it is most important for the nurse to monitor:

a. urinary output
b. fetal heart rate
c. central venous pressure
d. maternal blood glucose

7. A clinic nurse is performing assessment on a client who is being seen in the clinic for the first time. When asking about the client’s medication history, the client tells the nurse that he takes nateglinide (Starlix). The nurse then questions the client about the presence of which disorder that is treated with this medication?

a. hypothyroidism
b. insomnia
c. type 2 diabetes mellitus
d. renal failure

8. A client who is taking rifampin (Rifadin) as part of the medication regimen for the treatment of tuberculosis calls the clinic nurse and reports that her urine is a red-orange color. The nurse tells the client to:

a. come to the clinic to provide a urine sample
b. stop the medication until further instructions are given by the physician
c. take the medication dose with an antacid to prevent this adverse effect
d. expect a red-orange color in urine, feces, sweat, sputum, and tears as a harmless side effect

9. A nurse is caring for a client with a tracheostomy that has been diagnosed with a respiratory infection. The client is receiving vancomycin hydrochloride (Vancocin) 500 mg intravenously every 12 hours. Which of the following would indicate to the nurse that the client is experiencing an adverse effect of the medication?

a. decreased hearing acuity
b. photophobia
c. hypotension
d. bradycardia

10. A nurse is caring for a client with a diagnosis of metastatic breast carcinoma who is receiving tamoxifen citrate (Nolvadex) 10 mg orally twice daily. Which of the following would indicate to the nurse that the client is experiencing a side effect related to the medication?

a. hypetension
b. diarrhea
c. nose bleeds
d. vaginal bleeding

11. A client has just been given a prescription for diphenoxylate with atropine (Lomotil). The nurse teaches the client which of the following about the use of this medication?

a. drooling may occur while taking this medication
b. irritability may occur while taking this medication
c. this medication contains a habit-forming ingredient
d. take the medication with a laxative of choice

12. A nurse is gathering data from client about the client’s medication history and notes that the client is taking tolterodine tartrate (Detrol LA). The nurse determines that the client is taking the medication to treat which disorder?

a. glaucoma
b. renal insufficiency
c. pyloric stenosis
d. urinary frequency and urgency

13. A client has an order to receive psyllium (Metamucil) daily. The nurse administers this medication with:

a. a multivitamin and mineral supplement
b. a dose of an antacid
c. applesauce
d. eight ounces of liquid

14. A nurse is teaching a client taking cyclosporine (Sandimmune) after renal transplant about medication information. The nurse tells the client to be especially alert for:

a. signs of infection
b. hypotension
c. weight loss
d. hair loss

15. A nurse reinforces dietary instruction for the client receiving spironolactone (Aldactone). Which food would the nurse instruct the client to avoid while taking this medication?

a. crackers
b. shrimp
c. apricots
d. popcorn

16. Oral lactulose (Chronulac) is prescribed for the client with a hepatic disorder and the nurse provides instructions to the client regarding this medication. Which statement by the client indicates a need for further instructions?

a. “I need to take the medication with water’”
b. “ I need to increase fluid intake while taking the medication”
c. “ I need to increase fiber in the diet”
d. “I need to notify the physician of nausea occurs”

17. A home care nurse provides instructions to a client taking digoxin (Lanoxin) 0.25 mg daily. Which statement by the client indcates a need for further instructions?

a. “I will take my prescribed antacid if I become nauseated”
b. “It is important to have my blood drawn when prescribed”
c. “I will check my pulse before I take my medication”
d. “I will carry a medication identification card with me”

18. A client with anxiety disorder is taking buspirone (BuSpar) and tells the nurse that it is difficult to swallow the tablets. The nurse tells the client to:

a. dissolve the tablet in a cup of coffee
b. crush the tablet before taking it
c. call the physician for a change in medication
d. mix the tablet uncrushed in custard

19. A nurse is caring for a child with CHF provides instructions to the parents regarding the administration of digoxin (Lanoxin). Which statement by the mother indicates a need for further instructions?

a. “If my child vomits after I give the medication, I will not repeat the dose”
b. “I will check my child’s pulse before giving the medication”
c. “I will check the dose of the medication with my husband before I give the medication”
d. “I will mix the medication with food”

20. A nurse provides instructions to a client who will begin an oral contraceptives. Which statement by the client indicates the need for further instructions?

a. “I will take one pill daily at the same time every day”
b. “I will not need to use an additional birth control method once I start these pills”
c. “If I miss a pill I need to take it as soon as I remember”
d. “If I miss two pills I will take them both as soon as I remember and I will take two pills the next day also”

21. A nurse provides instructions to a client taking clorazepate (Tranxene) for management of an anxiety disorder. The nurse tells the client that:

a. drowsiness is a side effect that usually disappears with continued therapy
b. if dizziness occurs, call the physician
c. smoking increases the effectiveness of the medication
d. if gastrointestinal disturbances occur, discontinue the medication

22. A client with Parkinson’s disease has begun therapy with levodopa (L-dopa). The nurse determines that the client understands the action of the medication if the client verbalizes that results may not be apparent for:

a. 24 hours
b. Two to three days
c. One week
d. Two to three weeks

23. A nurse in a physician’s office is reviewing the results of a client’s phenytoin (Dilantin) level drawn that morning. The nurse determines that the client has a therapeutic drug level if the client’s result was:

a. 3 mcg/ml
b. 8 mcg/ml
c. 15 mcg/ml
d. 24mcg/ml

24. A nurse is caring for a client with a genitourinary tract infection receiving amoxicillin (Augmentin) 500 mg every 8 hours. Which of the following would indicate to the nurse that the client is experiencing an adverse effect related to the medication?

a. hypertension
b. nausea
c. headache
d. watery diarrhea

25. A nurse is caring for a client with glaucoma who receives a daily dose of acetazolamide (Diamox). Which of the following would indicate to the nurse that the client is experiencing an adverse effect of the medication?

a. constipation
b. difficulty swallowing
c. dark-colored urine and stools
d. irritability

26. A nurse is caring for a client with a diagnosis of meningitis who is receiving amphotericin B (Fungizone) intravenously. Which of the following would indicate to the nurse that the client is experiencing an adverse effect related to the medication?

a. nausea
b. decreased urinary output
c. muscle weakness
d. confusion

27. A nurse has formulated a nursing diagnosis of Disturbed Body Image for a client who is taking spironolactone (Aldactone). The nurse based this diagnosis on assessment of which side effect of the medication?

a. edema
b. weight gain
c. excitability
d. decreased libido

28. A nurse is caring for the client with a history of mild heart failure who is receiving diltiazem hydrochloride (Cardizem) for hypertension. The nurse would assess the client for:

a. bradycardia
b. wheezing
c. peripheral edema and weight gain
d. apical pulse rate lower than baseline

29. The wound of a client with an extensive burn injury is being treated with the application of silver sulfadiazine (Silvadene). Which symptom would indicate to the nurse that the client is experiencing a side effect related to systemic absorption?

a. pain at the wound site
b. burning and itching at the wound site
c. a localized rash
d. photosensitivity

30. A nurse is caring for a client with a diagnosis of rheumatoid arthritis who is receiving sulindac (Clinoril) 150 mg po twice daily. Which finding would indicate to the nurse that the client is experiencing a side effect related to the medication?

a. diarrhea
b. photophobia
c. fever
d. tingling in the extremities

31. The nurse notes that the client is receiving filgrastim (Neupogen). The nurse checks which of the following to determine medication effectiveness?

a. neutrophil count
b. platelet count
c. blood urea nitrogen
d. creatinine level

32. A nurse is monitoring a client who is taking fluphenazine decanoate (Prolixin) for signs of leucopenia. Which finding indicates a sign of this blood dyscrasia?

a. blurred vision
b. constipation
c. sore throat
d. dry mouth

33. A nurse is administering amphotericin B (Fungizone) to a client intravenously to treat a fungal infection. The nurse monitors the result of which electrolyte study during therapy with this medication?

a. sodium
b. potassium
c. calcium
d. chloride

34. A clinic nurse asks a client with diabetes mellitus being seen in the clinic for the first time to list the medications that she is taking. Which combination of medications taken by the client should the nurse report to the physician?

a. Acetohexamide (Dymelor) and trimethoprim-sulfamethoxazole (Bactrim)
b. Chlorpropamide (Diabenase) and amitriptyline (Elavil)
c. Glyburide (DiaBeta) and Lanoxin (Digoxin)
d. Tolbutamide (Orinase) and amoxicillin (Amoxil)

35. A nurse is caring for a client receiving streptogramin (Synercid) by intravenous intermittent infusion for the treatment of a bone infection develops diarrhea. Which nursing action would the nurse implement?

a. administer an antidiarrheal agent
b. notify the physician
c. discontinue the medication
d. monitor the client’s temperature

36. A client has been taking fosinopril (Monopril) for 2 months. The nurse determines that the client is having the intended effects of therapy if the nurse notes which of the following?

a. lowered BP
b. lowered pulse rate
c. increased WBC
d. increased monocyte count

37. A client is taking labetalol (Normodyne). The nurse monitors the client for which frequent side effect of the medication?

a. tachycardia
b. impotence
c. increased energy level
d. night blindness

38. An older client has been using cascara sagrada on a long-term basis. The nurse determines that which laboratory result is a result of the side effects of this medication?

a. sodium 135 mEq/L
b. sodium 145 mEq/L
c. potassium 3.1 mEq/L
d. potassium 5.0 mEq/L

39. A client has an order to begin short-term therapy with enoxaparin (Lovenox). The nurse explains to the client that this medication is being ordered to:

a. dissolve urinary calculi
b. reduce the risk of deep vein thrombosis
c. relieve migraine headaches
d. stop progression of multiple sclerosis

40. Quinidine gluconate (Dura Quin) is prescribed for a client. The nurse reviews the client’s medical record, knowing that which of the following is a contraindication in the use of this medication?

a. complete atrioventricular (AV) block
b. muscle weakness
c. asthma
d. infection

41. A client has been taking benzonatate (Tessalon) as ordered. The nurse tells the client that this medication should do which of the following?

a. take away nausea and vomiting
b. calm the persistent cough
c. decrease anxiety level
d. increase comfort level

42. Auranofin (Ridaura) is prescribed for a client with rheumatoid arthritis, and the nurse monitors the client for signs of an adverse effect related to the medication. Which of the following indicates an adverse effect?

a. nausea
b. diarrhea
c. anorexia
d. proteinuria

43. A nurse is providing instructions to a client regarding quinapril hydrochloride (Accupril). The nurse tells the client:

a. to take the medication with food only
b. to rise slowly from a lying to a sitting position
c. to discontinue the medication if nausea occurs
d. that a therapeutic effect will be noted immediatedly

44. A female client tells the clinic nurse that her skin is very dry and irritated. Which product would the nurse suggest that the client apply to the dry skin?

a. glycerin emollient
b. aspercreame
c. myoflex
d. acetic acid solution

45. A client with advanced cirrhosis of the liver is not tolerating protein well, as eveidenced by abnormal laboratory values. The nurse anticipates that which of the following medications will be prescribed for the client?

a. lactulose (Chronulac)
b. ethacrynic acid (Edecrin)
c. folic acid (Folvite)
d. thiamine (Vitamin B1)

46. A nurse is planning dietary counseling for the client taking triamterene (Dyrenium). The nurse plans to include which of the following in a list of foods that are acceptable?

a. baked potato
b. bananas
c. oranges
d. pears canned in water

47. A client is taking famotidine (Pepcid) asks the home care nurse what would be the best medication to take for a headache. The nurse tells the client that it would be best to take:

a. aspirin (acetylsalicylic acid, ASA)
b. ibuprofen (Motrin)
c. acetaminophen (Tylenol)
d. naproxen (Naprosyn)

48. A nurse has taught a client taking a xanthine bronchodilator about beverages to avoid. The nurse determines that the client understands the information if the client chooses which of the following beverages from the dietary menu?

a. chocolate milk
b. cranberry juice
c. coffee
d. cola

49. A client with histoplasmosis has an order for ketoconazole (Nizoral). The nurse teaches the client to do which of the following while taking this medication?

a. take the medication on an empty stomach
b. take the medication with an antacid
c. avoid exposure to sunlight
d. limit alcohol to 2 ounces per day

50. A nurse is preparing the client’s morning NPH insulin dose and notices a clumpy precipitate inside the insulin vial. The nurse should:

a. draw up and administer the dose
b. shake the vial in an attempt to disperse the clumps
c. draw the dose from a new vial
d. warm the bottle under running water to dissolve the clump

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50 item Integumentary Exam

50 item Integumentary Exam

1. A nurse is caring for a burn client who has sustained thoracic burns and smoke inhalation and is risk for impaired gas exchange. The nurse avoids which action in caring for this client?

a. repositioning the client from side to side every 2 hours
b. maintaining the client in a supine position with the head of the bed elevated
c. suctioning the airway as needed
d. providing humidified oxygen as prescribed


2. A client sustains a burn injury to the entire right arm, entire right leg, and anterior thorax. According to the rule of nine’s the nurse determines that what body percent was injured?

Answer: ______________________________________

3. A nurse assesses a burn injury and determines that the client sustained a full-thickness fourth-degree burn if which of the following is noted at the site of injury?

a. a wet shiny weeping wound surface
b. a dry wound surface
c. charring at the wound site
d. blisters


4. A client is brought to the emergency room following a burn injury. In assessment the nurse notes that the client’s eyebrow and nasal hairs are singed. The nurse would identify this type of burn as:

a. thermal
b. electrical
c. radiation
d. chemical

5. A nurse assesses the carbon monoxide level of a client following a burn injury and notes that the level is 8%. Based on this level, which finding would the nurse expect to note during the assessment of the client?

a. tachycardia
b. tachypnea
c. coma
d. impaired visual acuity

6. A nurse assesses the client’s burn injury and determines that the client sustained a partial-thickness superficial burn. Based on this determination, which finding did the nurse note?

a. a wet, shiny, weeping wound
b. a dry wound surface
c. charring at the wound site
d. absence of wound sensation

7. A nurse assesses the client’s burn injury and determines that the client sustained a partial-thickness deep burn. Based on this determination, which finding did the nurse note?

a. a wet, shiny, weeping wound surface
b. a dry wound surface
c. charring at the wound site
d. total absence of wound sensation

8. On assessment of a child, the nurse notes the presence of white patches on the child’s tongue and determines that they may be indicative of candidiasis (thrush). The nurse understands that the white patches of candidiasis (thrush):

a. adhere to the tongue even when scraped with tongue blade
b. cause the tongue to bleed continuously around the patch
c. produce a red circle in the center of the white lesion
d. will occur only in the tongue

9. On assessment, a nurse notes a flat brown circular nevi on the skin of a client that measures less than one centimeter. The client asks, “Is this cancer?” The nurse makes which response to the client?

a. “These are likely to be benign moles.”
b. “These require immediate attention because they are probably cancer.”
c. “These indicate malignancy.”
d. “These are probably verrucae.”

10. A nurse is performing a skin assessment on a client. The nurse understands that moles with variegated color, irregular borders, and/or an irregular surface should be considered:

a. suspicious
b. normal
c. common
d. benign

11. A client is diagnosed with herpes zoster (shingles). Which pharmacological therapy would the nurse expect to be prescribed to treat this disorder?

a. tetracycline hydrochloride (achromycin)
b. erythromycin base (e-mycin)
c. acyclovir (zovirax)
d. indomethacin (indocin)

12. A nurse reviews the record of a client diagnosed with pemphigus and notes that the physician has documented the presence of Nikolsky’s sign. Based on this documentation, which of the following would the nurse expect to note?

a. client complains of discomfort behind the knee on forced dorsiflexion of the foot
b. a spasm of the facial muscles elicited by tapping the facial nerve in the region of the parotid gland
c. carpal spasm elicited by compressing the upper arm
d. the epidermis of the client’s skin can be rubbed off by slight friction or injury


13. A hospitalized client is diagnosed with scabies. Which of the following would a nurse expect to note on inspection of the client’s skin?

a. the appearance of vesicles or pustules
b. the presence of white patches scattered about the trunk
c. multiple straight or wavy threadlike lines beneath the skin
d. patchy hair loss and round, red macules with scales

14. A client is seen in the health care clinic and the physician suspects herpes zoster. The nurse prepares the items needed to perform the diagnostic test to confirm this diagnosis. Which item will the nurse obtain?

a. a biopsy kit
b. a wood’s light
c. a culture swab and tube
d. a patch test kit

15. A nurse reviews the health care record of a client diagnosed with herpes zoster. Which finding would the nurse expect to note as characteristic of this disorder?

a. a generalized red body rash that causes pruritus
b. small blue-white spots with a red base noted on the extremities
c. a fiery red edematous rash on the cheeks and neck
d. clustered and grouped skin vesicles

16. A client returns to the clinic for a follow-up treatment following a skin biopsy of a suspicious lesion performed 1 week ago. The biopsy report indicated that the lesion is a squamous cell carcinoma. The nurse plans care knowing that which of the following describes the characteristic of this type of a lesion?

a. it is highly metastatic
b. it does not metastasize
c. it is characterized by local invasion
d. it is encapsulated

17. A nurse reviews the record of a client scheduled for removal of a skin lesion. The record indicates that the lesion is an irregularly shaped, pigmented papule with a blue-toned color. The nurse determines that this description of the lesion is characteristic of:

a. melanoma
b. basal cell carcinoma
c. squamous cell carcinoma
d. actinic keratosis

18. A nurse is reviewing the nursing care plan for a client for whom a stage 4 decubiti ulcer has been documented. Which of the following would the nurse expect to note on assessment of the client?

a. a reddened area that returns to a normal skin color after 15 to 20 minutes of pressure relief
b. intact skin
c. an area in which the top layer of skin is missing
d. a deep ulcer that extends into muscle and bone.

19. A nurse notes documentation of a stage 3 pressure ulcer in a client’s record. Which of the following would the nurse expect to note on assessment of the client?

a. a deep ulcer that extends into muscle and bone
b. a deep ulcer that extends into the dermis and the subcutaneous tissue
c. an area in which the top layer of skin is missing
d. a reddened area that returns to normal skin color after 15 to 20 minutes of pressure relief

20. A client is in the health care clinic for complaints of pruritus. Following diagnostic studies, it has been determined that there is not a pathophysiological process causing the pruritus. The nurse prepares instructions for the client to assist in reducing the problem and tells the client to:

a. use a dehumidifier in the home
b. ensure that the temperature in the home is high, especially during the winter months
c. use a cool-mist vaporizer, especially during the winter months
d. avoid use of skin moisturizers following a bath

21. A client is seen in the health care clinic because of complaints of lesions on the elbows and the knees. The lesions are red raised papules, and large plaques covered by silvery scales are also noticed on the elbows and the knees. Psoriasis is diagnosed and the nurse provides information about treatment to the client. The nurse determines that the client needs additional information if the client states that which of the following is a component of the treatment plan?

a. tar baths
b. ultraviolet light treatments
c. topical lubricants
d. systemic corticosteroids

22. A client is seen in the health care clinic and a biopsy is performed on a skin lesion that the physician suspects malignant melanoma. The nurse prepares a plan of care for the client based on which characteristics of this type of skin cancer?

a. it is an aggressive cancer that requires aggressive therapy to control its rapid spread
b. it is a slow-growing cancer and seldom metastasizes
c. it can grow so large that an entire area, such as the nose, the lip, or the ear must be removed and reconstructed if it occurs on the face
d. it is the most common form of skin cancer

23. A nurse is caring for a client brought to the emergency room following a burn injury that occurred in the basement of the home. Which initial finding would indicate the presence of inhalation injury?

a. expectoration of sputum tinged with blood
b. the presence of singed nasal hair
c. absent breath sounds in the lower lobes bilaterally
d. tachycardia

24. A nurse is caring for a client who arrives at the emergency room with the emergency medical services team following a severe burn injury from an explosion. Once the initial assessment has been performed by the physician and life-threatening dysfunctions have been addressed, the nurse reviews the physician’s orders anticipating that which pain medication will be prescribed?

a. intravenous (IV) morphine sulfate
b. aspirin with oxycodone (percodan) via nasogastric tube
c. acetaminophen (tylenol) with codeine sulfate
d. morphine sulfate by the subcutaneous route

25. A nurse is assessing the operative site in a client who underwent a breast reconstruction. The nurse is inspecting the flap and the areola of the nipple and notes that the areola is a deep red color around the edge. The nurse takes which action first?

a. document the findings
b. elevate the breast
c. encourage nipple massage
d. notify the physician

26. A nurse performs a skin assessment on an assigned client and notes the presence of lesions that are red-tan scaly plaques. The nurse documents this findings as:

a. seborrhea
b. xerosis
c. pruritus
d. actinic keratoses

27. A community health nurse has provided fire safety instructions to a group of individuals who are part of a disaster response team. Which statement by a group member indicates a need for further instructions?

a. “the victim may be rolled on the ground to extinguish the flames”
b. “a blanket or another cover can be used to smother the flames”
c. “flames should be doused with water”
d. “keep the victim in standing position so flames won’t spread to other parts of the body”

28. A community health nurse is providing a teaching session to firefighters in a small community regarding care to a victim at the scene of a burn injury. The community health nurse instructs the firefighters that in the event of a tar burn the immediate action would be to:

a. cool the injury with water
b. remove all clothing immediately
c. remove the tar from the burn injury
d. leave any clothing that is saturated with tar in place


29. The client who sustained an inhalation injury arrives in the emergency department. On assessment of the client, the nurse notes that the client is very confused and combative. The nurse determines that the client is experiencing:

a. anxiety
b. fear
c. hypoxia
d. pain

30. The client is diagnosed with stage 1 of Lyme disease. The nurse assesses the client for the hallmark characteristic of this stage. Which assessment finding would the nurse expect to note?

a. dizziness and headaches
b. enlarged and inflamed joints
c. arthralgias
d. skin rash

31. The emergency department nurse is performing an assessment on a client who has sustained circumferential burns of both legs. Which assessment would be the priority in caring for this client?

a. assessing peripheral pulses
b. assessing neurological status
c. assessing urine output
d. assessing blood pressure

32. The nurse is reviewing the discharge instructions for a client who had skin biopsy. Which statement by the client indicates a need for further instructions?

a. “I will watch for any drainage from the wound”
b. “I will return tomorrow to have the sutures removed”
c. “I will use antibiotic ointment as prescribed”
d. “I will keep the dressing dry”

33. The nurse preparing to assist the physician to examine the client’s skin with a Wood’s light would do which of the following?

a. obtain an informed consent
b. tell the client that the procedure is painless
c. shave the skin site
d. prepare a local anesthetic

34. The nurse provides discharge instructions to a client following patch testing. Which instruction would the nurse provide to the client?

a. return to the clinic in 2 weeks for the initial reading
b. reapply the patch if it comes off
c. continue all current activities
d. keep the test sites dry

35. A nurse is preparing a client for skin grafting and notes that the physician has documented that the client is scheduled for heterograft. The nurse understands that the heterograft used for the burn client is skin from:

a. another species
b. a cadaver
c. the burned client
d. a skin bank

36. Following assessment and diagnostic evaluation, it has been determined that the client has Stage II of Lyme disease. The nurse expects to note which assessment finding that is most indicative of this stage?

a. erythematous rash
b. cardiac conduction defects
c. arthralgias
d. enlargement of joints

37. The clinic nurse reads the chart of a client that was seen by the physician and notes that the physician has documented that the client has Stage III of Lyme disease. Which clinical manifestation would the nurse expect to note in the client?

a. a generalized skin rash
b. a cardiac dysrhythmia
c. complaints of joint pain
d. paralysis in the extremity where the tick bite occurred

38. A female client arrives at the health care clinic and tells the nurse that she was bitten by a tick and would like to be tested for Lyme disease. The client tells the nurse that she removed the tick and flushed it down the toilet. Which nursing action is appropriate?

a. refer the client for a blood test immediately
b. inform the client that the tick is needed to perform the test
c. inform the client that she will need to return in 6 weeks to be tested because testing before this time is not reliable
d. ask the client about the size and color of the tick

39. The client suspected of having Stage I of Lyme disease is seen in the health care clinic and is told that the Lyme disease test is positive. The client asks the nurse about the treatment for the disease. The nurse responds to the client, anticipating which of the following to be part of the treatment plan?

a. no treatment unless symptoms develop
b. a 3-week course of oral antibiotic therapy
c. treatment with intravenous penicillin G
d. ultraviolet light therapy

40. The client with acquired immunodeficiency syndrome (AIDS) is suspected of having cutaneous Kaposi’s sarcoma. The nurse prepares the client for which test that will confirm the presence of this type of sarcoma?

a. sputum culture
b. liver biopsy
c. punch biopsy of the lesion
d. white blood cell count

41. The client who is newly admitted to the hospital for treatment of acute cellulitis of the lower left leg asks the nurse about the nature of the disorder. The nurse would respond that cellulitis is actually:

a. a skin infection into the deep dermis and subcutaneous fat
b. an acute superficial infection
c. an inflammation of the epidermis
d. an epidermal infection caused by Staphylococcus

42. A nurse is preparing a plan of care for a client with a diagnosis of acute cellulitis of the lower leg. The nurse anticipates which measure will be prescribed to treat this condition?

a. warm moist compresses to the affected area
b. cold compresses to the affected area
c. heat lamp treatments 4 times daily
d. alternating hot to cold compresses every 2 hours

43. A clinic nurse provides instructions to a client who will be taking isotretinoin (Accutane) for severe cystic acne. Which statement by the client indicates the need for further instructions?

a. “I need to return to the clinic for a blood test to check my triglyceride level”
b. “The medication may cause my lips to burn”
c. “The medication may cause dryness and burning in my eyes”
d. “I need to take vitamin A supplements to improve the effectiveness of this treatment”

44. A client sustained full-thickness burns to both hands from scalding water. A sheet graft was surgically applied to the wounds. The nurse tells the client that this type of graft is indicated for which of the following primary purposes?

a. better adherence to the wound bed
b. better cosmetic result
c. better donor site availability
d. easier to care for initially

45. A client sustained a major burn is beginning to take an oral diet again. The nurse plans to encourage the client to eat variety of which of the following types of foods to best help in continued wound healing and tissue repair?

a. high carbohydrate and low protein
b. high fat and low carbohydrate
c. high protein and high fat
d. high protein and high carbohydrate

46. A client with a major burn is admitted to the emergency department. The nurse anticipates that which of the following routes will be ordered for analgesics for this client?

a. intramuscular
b. intravenous
c. oral
d. subcutaneous

47. A nurse is performing a skin assessment of a client who is immobile and notes the presence of partial thickness skin loss of the upper layer of the skin in the sacral area. The nurse documents these findings as a:

a. stage 1 pressure ulcer
b. stage 2 pressure ulcer
c. stage 3 pressure ulcer
d. stage 4 pressure ulcer

48. A student nurse is instructed by the registered nurse to monitor a client who has dark skin for cyanosis. The registered nurse determines that the student needs instructions regarding physical assessment techniques for the dark-skinned client if the student states that the best area to assess for cyanosis was in the:

a. nail beds
b. lips
c. sclera of the eye
d. tongue

49. A client with severe psoriasis has a nursing diagnosis of Chronic Low Self-Esteem. The nurse uses which therapeutic strategy when working with this client?

a. listening attentively
b. pretending not to notice affected skin areas
c. keeping communications brief
d. approaching the client in a formal manner

50. A nurse caring for a client who sustained a high-voltage electrical injury analyzes the client’s test results. Which finding would the nurse interpret as increasing the client’s risk of developing acute tubular necrosis?

a. myoglobin in the urine
b. carbonaceous sputum
c. hyperkalemia
d. cloudy cerebrospinal fluid

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