Professional Documents
Culture Documents
(Part A)
SITUATIONAL
Situation 1 – Concerted work efforts among members of the surgical team is essential
to the success of the surgical procedure.
1. The sterile nurse or sterile personnel touch only sterile supplies and instruments.
When there is a need for sterile supply which is not in the sterile field, who hands out
these items by opening its outer cover?
A. Circulating Nurse
B. Anaesthesiologist
C. Surgeon
D. Nursing Aide
2. The OR team performs distinct roles for one surgical procedure to be accomplished
within a prescribed time frame and deliver a standard patient outcome. While the
surgeon performs the surgical procedure, who monitors the status of the client like
urine output, blood loss?
A. Scrub Nurse
B. Surgeon
C. Anaesthesiologist
D. Circulating Nurse
A. Rehabilitation department
B. Laboratory department
C. Maintenance department
D. Radiology department
4. Minimally invasive surgery is very much into technology. Aside from the usual
surgical team, who else has to be present when a client undergoes laparoscopic
surgery?
A. Information technician
B. Biomedical technician
C. Electrician
D. Laboratory technician
A. Security Division
B. Chaiplaincy
C. Social Service Section
D. Pathology department
Situation 2 – You are assigned in the Orthopedic Ward where clients are complaining
of pain in varying degrees upon movement of body parts.
6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and
is in pain. Which of the following observation would prompt you to call the doctor?
7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected
Demerol at 5 pm. The next dose of Demerol 50 mg I.M. is given:
8. You continuously evaluate the client’s adaptation to pain. Which of the following
behaviors indicate appropriate adaptation?
9. Pain in ortho cases may not be mainly due to the surgery. There might be other
factors such as cultural or psychological that influence pain. How can you alter these
factors as the nurse?
A. Explain all the possible interventions that may cause the client to worry
B. Establish trusting relationship by giving his medication on time
C. Stay with the client during pain episodes
D. Promote client’s sense of control and participation in control by listening to
his concerns
10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is
given. What is your nursing priority care in such a case?
Situation 3 – Records are vital tools in any institution and should be properly
maintained for specific use and time.
11. The patient’s medical record can work as a double edged sword. When can the
medical record become the doctor’s/nurse’s worst enemy?
13. In the hospital, when you need the medical record of a discharged patient for
research you will request permission through:
A. Doctor in charge
B. The hospital director
C. The nursing service
D. Medical records section
14. You readmitted a client who was in another department a month ago. Since you
will need the previous chart, from whom do you request the old chart?
15. Records Management and Archives Office of the DOH is responsible for
implementing its policies on record disposal. You know that your institution is covered
by this policy if:
Situation 4 – In the OR, there are safety protocols that should be followed. The OR
nurse should be well versed with all these to safeguard the safety and quality of
patient delivery outcome.
16. Which of the following should be given highest priority when receiving patient in
the OR?
17. Surgeries like I and D (incision and drainage) and debridement are relatively short
procedures but considered ‘dirty cases’. When are these procedures best scheduled?
A. Last case
B. In between cases
C. According to availability of anaesthesiologist
D. According to the surgeon’s preference
18. OR nurses should be aware that maintaining the client’s safety is the overall goal
of nursing care during the intraoperative phase. As the circulating nurse, you make
certain that throughout the procedure…
19. Another nursing check that should not be missed before the induction of general
anesthesia is:
20. Some lifetime habits and hobbies affect postoperative respiratory function. If your
client smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate
increased risk for:
21. Which of the following role would be the responsibility of the scrub nurse?
22. As a perioperative nurse, how can you best meet the safety need of the client
after administering preoperative narcotic?
A. Put side rails up and ask the client not to get out of bed
B. Send the client to OR with the family
C. Allow client to get up to go to the comfort room
D. Obtain consent form
23. It is the responsibility of the pre-op nurse to do skin prep for patients undergoing
surgery. If hair at the operative site is not shaved, what should be done to make
suturing easy and lessen chance of incision infection?
A. Draped
B. Pulled
C. Clipped
D. Shampooed
24. It is also the nurse’s function to determine when infection is developing in the
surgical incision. The perioperative nurse should observe for what signs of impending
infection?
25. Which of the following nursing interventions is done when examining the incision
wound and changing the dressing?
Situation 6 – Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is
46/min and he appears to be in acute respiratory distress.
27. Aminophylline was ordered for acute asthmatic attack. The mother asked the
nurse, what is its indication, the nurse will say:
28. You will give health instructions to Carlo, a case of bronchial asthma. The health
instruction will include the following, EXCEPT:
29. The asthmatic client asked you what breathing techniques he can best practice
when asthmatic attack starts. What will be the best position?
30. As a nurse, you are always alerted to monitor status asthmaticus who will likely
and initially manifest symptoms of:
A. metabolic alkalosis
B. respiratory acidosis
C. respiratory alkalosis
D. metabolic acidosis
31. As the head nurse in the OR, how can you improve the effectiveness of clinical
alarm systems?
32. Overdosage of medication or anesthetic can happen even with the aid of
technology like infusion pumps, sphygmomanometer and similar devices/machines.
As a staff, how can you improve the safety of using infusion pumps?
33. JCAHOs universal protocol for surgical and invasive procedures to prevent wrong
site, wrong person, and wrong procedure/surgery includes the following, EXCEPT:
34. You identified a potential risk of pre-and postoperative clients. To reduce the risk
of patient harm resulting from fall, you can implement the following, EXCEPT:
35. As a nurse, you know you can improve on accuracy of patient’s identification by 2
patient identifiers, EXCEPT:
A. identify the client by his/her wrist tag and verify with family members
B. identify client by his/her wrist tag and call his/her by name
C. call the client by his/her case and bed number
D. call the patient by his/her name and bed number
37. In the OR, the nursing tandem for every surgery is:
38. While team effort is needed in the OR for efficient and quality patient care
delivery, we should limit the number of people in the room for infection control. Who
comprise this team?
39. When surgery is on-going, who coordinates the activities outside, including the
family?
A. Orderly/clerk
B. Nurse Supervisor
C. Circulating Nurse
D. Anesthesiologist
A. Electricity
B. Inadequate supply
C. Leg work
D. Communication
41. Skin care around the stoma is critical. Which of the following is not indicated as a
skin care barriers?
A. Increased weight
B. Irritation of skin around the stoma
C. Liquid stool
D. Establishment of regular bowel movement
44. The following are appropriate nursing interventions during colostomy irrigation,
EXCEPT:
A. Increase the irrigating solution flow rate when abdominal cramps is felt
B. Insert 2-4 inches of an adequately lubricated catheter to the stoma
C. Position client in semi-Fowler
D. Hang the solution 18 inches above the stoma
45. What sensation is used as a gauge so that patients with ileostomy can determine
how often their pouch should be drained?
A. Sensation of taste
B. Sensation of pressure
C. Sensation of smell
D. Urge to defecate
A. Control group
B. Study subjects
C. General population
D. Universe
A. Randomization
B. Appropriate location
C. Appropriate number
D. Representativeness
49. Which of the following methods allows the use of any group of research subject?
A. Purposive
B. Convenience
C. Snow-ball
D. Quota
50. You decided to include 5 barangays in your municipality and chose a sampling
method that would get representative samples from each barangay. What should be
the appropriate method ofor you to use in this care?
A. Cluster sampling
B. Random sampling
C. Startified ampling
D. Systematic sampling
Situation 11 – After an abdominal surgery, the circulating and scrub nurses have
critical responsibility about sponge and instrument count.
52. What major supportive layer of the abdominal wall must be sutured with long
tensile strength such as cotton or nylon or silk suture?
A. Fascia
B. Muscle
C. Peritoneum
D. Skin
53. Like sutures, needles also vary in shape and uses. If you are the scrub nurse for a
patient who is prone to keloid formation and has low threshold of pain, what needle
would you prepare?
A. Round needle
B. Atraumatic needle
C. Reverse cutting needle
D. Tapered needle
54. Another alternative “suture” for skin closure is the use of ____________
A. Staple
B. Therapeutic glue
C. Absorbent dressing
D. Invisible suture
55. Like any nursing interventions, counts should be documented. To whom does the
scrub nurse report any discrepancy of counts so that immediate and appropriate
action is instituted?
A. Anesthesiologist
B. Surgeon
C. OR nurse supervisor
D. Circulating nurse
Situation 12 – As a nurse, you should be aware and prepared of the different roles
you play.
56. What role do you play when you hold all client’s information entrusted to you in
the strictest confidence?
A. Patient’s advocate
B. Educator
C. Patient’s Liaison
D. Patient’s arbiter
57. As a nurse, you can help improve the effectiveness of communication among
healthcare givers by:
58. As a nurse, your primary focus in the workplace is the client’s safety. However,
personal safety is also a concern. You can communicate hazards to your co-workers
through the use of the following EXCEPT:
A. Formal training
B. Posters
C. Posting IR in the bulletin board
D. Use of labels and signs
59. As a nurse, what is one of the best way to reconcile medications across the
continuum of care?
60. As a nurse, you protect yourself and co-workers from misinformation and
misrepresentations through the following EXCEPT:
Situation 13 – You are assigned at the surgical ward and clients have been
complaining of post pain at varying degrees. Pain as you know, is very subjective.
62. Pentoxidone 5 mg IV every 8 hours was prescribed for post abdominal pain.
Which will be your priority nursing action?
63. The client complained of abdominal distention and pain. Your nursing intervention
that can alleviate pain is:
64. Surgical pain might be minimized by which nursing action in the O.R.
Situation 14 – You were on duty at the medical ward when Zeny came in for
admission for tiredness, cold intolerance, constipation, and weight gain. Upon
examination, the doctor’s diagnosis was hypothyroidism.
67. As the nurse, you should anticipate to administer which of the following
medications to Zeny who is diagnosed to be suffering from hypothyroidism?
A. Levothyroxine
B. Lidocaine
C. Lipitor
D. Levophed
68. Your appropriate nursing diagnosis for Zeny who is suffering from hypothyroidism
would probably include which of the following?
69. Myxedema coma is a life threatening complication of long standing and untreated
hypothyroidism with one of the following characteristics.
A. Hyperglycemia
B. Hypothermia
C. Hyperthermia
D. Hypoglycemia
70. As a nurse, you know that the most common type of goiter is related to a
deficiency of:
A. thyroxine
B. thyrotropin
C. iron
D. iodine
Situation 15 – Mrs. Pichay is admitted to your ward. The MD ordered “Prepare for
thoracentesis this pm to remove excess air from the pleural cavity.”
71. Which of the following nursing responsibilities is essential in Mrs. Pichay who will
undergo thoracentesis?
72. Mrs. Pichay who is for thoracentesis is assigned by the nurse to any of the
following positions, EXCEPT:
A. straddling a chair with arms and head resting on the back of the chair
B. lying on the unaffected side with the bed elevated 30-40 degrees
C. lying prone with the head of the bed lowered 15-30 degrees
D. sitting on the edge of the bed with her feet supported and arms and head
on a padded overhead table
73. During thoracentesis, which of the following nursing intervention will be most
crucial?
75. Chest x-ray was ordered after thoracentesis. When your client asks what is the
reason for another chest x-ray, you will explain:
Situation 16 – In the hospital, you are aware that we are helped by the use of a
variety of equipment / devices to enhance quality patient care delivery.
76. You are to initiate an IV line to your patient, Kyle, 5, who is febrile. What IV
administration set will you prepare?
77. Kyle is diagnosed to have measles. What will your protective personal attire
include?
A. Gown
B. Eyewear
C. Face mask
D. Gloves
78. What will you do to ensure that Kyle, who is febrile, will have a liberal oral fluid
intake?
79. Before bedtime, you went to ensure Kyle’s safety in bed. You will do which of the
following:
80. Kyle’s room is fully mechanized. What do you teach the watcher and Kyle to alert
the nurses for help?
A. How to lock side rails
B. Number of the telephone operator
C. Call system
D. Remote control
Situation 17 – Tony, 11 years old, has ‘kissing tonsils’ and is scheduled for
tonsillectomy and adenoidectomy or T and A.
81. You are the nurse of Tony who will undergo T and A in the morning. His mother
asked you if Tony will be put to sleep. Your teaching will focus on:
A. spinal anesthesia
B. anesthesiologist’s preference
C. local anesthesia
D. general anesthesia
83. The RR nurse should monitor for the most common postoperative complication of:
A. hemorrhage
B. endotracheal tube perforation
C. osopharyngeal edema
D. epiglottis
84. The PACU nurse will maintain postoperative T and A client in what position?
85. Tony is to be discharged in the afternoon of the same day after tonsillectomy and
adenoidectomy. You as the RN will make sure that the family knows to:
86. Which of the following action would be of highest priority with regards to the
external shunt?
A. Avoid taking BP or blood sample from the arm with the shunt
B. Instruct the client not to exercise the arm with the shunt
C. Heparinize the shunt daily
D. Change dressing of the shunt daily
87. Diet therapy for Rudy, who has acute renal failure is low-protein, low potassium
and low sodium. The nutrition instructions should include:
A. Recommend protein of high biologic value like eggs, poultry and lean
meats
B. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
C. Allowing the client cheese, canned foods and other processed food
D. Bananas, cantaloupe, orange and other fresh fruits can be included in the
diet
88. Rudy undergoes hemodialysis for the first time and was scared of disequilibrium
syndrome. He asked you how this can be prevented. Your response is:
89. You are assisted by a nursing aide with the care of the client with renal failure.
Which delegated function to the aide would you particularly check?
90. A renal failure patient was ordered for creatinine clearance. As the nurse you will
collect…
Situation 19 – Fe is experiencing left sharp pain and occasional hematuria. She was
advised to undergo IVP by her physician.
91. Fe was so anxious about the procedure and particularly expressed her low pain
threshold. Nursing health instruction will include:
A. assure the client that the pain is associated with the warm sensation
during the administration of the Hypaque by IV
B. assure the client that the procedure painless
C. assure the client that contrast medium will be given orally
D. assure the client that x-ray procedure like IVP is only done by experts
92. What will the nurse monitor and instruct the client and significant others post
IVP?
93. Post IVP, Fe should excrete the contrast medium. You instructed the family to
include more vegetables in the diet and:
94. The IVP reveals that Fe has small renal calculus that can be passed out
spontaneously. To increase the chance of passing the stones, you instructed her to
force fluids and do which of the following?
A. Balanced diet
B. Ambulate more
C. Strain all urine
D. Bed rest
A. Colelithiasis
B. Nephrolithiasis
C. Ureterolithiasis
D. Urolithiasis
Situation 20 – At the medical-surgical ward, the nurse must also be concerned about
drug interactions.
96. You have a client with TPN. You know that in TPN like blood transfusion, these
should be no drug incorporation. However the MD’s order read; incorporate insulin to
present TPN. Will you follow the order?
97. The RN should also know that some drugs have increased adsorption when
infused in the PVC container. How will you administer drugs such as insulin,
nitroglycerine hydralazine to promote better therapeutic drug effects?
98. One patient had a ‘runaway’ IV of 50% dextrose. To prevent temporary excess of
insulin or transient hyperinsulin reaction what solution you prepare in anticipation of
the doctor’s order?
A. After excitement
B. After a good night’s rest
C. After an exercise
D. After ingestion of food