SIMON CLARICE SAMOSIR JOURNEY : NCLEX MIX

1. Alzheimer's patient incontinent of urine during the night times. The nursing care includes
a) Offers bed pan every 2 hour b) Limit fluids during evening time c) Foley's catheter
ANSWERS

a. Offers bed pan every 2 hours-NO, would be appropriate to bring the client to the toilet or commode every 2 hours during the day, but this action means you disturb the client's sleep.

b. Limit fluids during evening times, BEST ANSWER-(Source: Black & Hawks, Medical-Surgical Nursing 7th edition) Specific interventions for the Alzheirmer's client with urinary incontinence: "Sometimes the client forgets where the bathroom is located. Having bright lights and frequently taking the client there may help control incontinence. Fluid intake after the dinner meal can be restricted to maintain continence during the night.

c. Foley's catheter-NO, would increase risk of lower urinary tract infection, inappropriate and not necessary.

2. After immediate post operative hysterectomy patient to observe (or) Nursing care includes
a) Observe vaginal bleedin b) Urine outpu c) Vital signs
ANSWERS
c) Vital signs-BEST ANSWER, as this provides the best/most information about the client's response to surgery and anesthesia.

3. Dilantin prescribed to the patient, instructions to patient include
a) Reticulocyte counts b) Platelet counts
ANSWERS

a. Reticulocyte counts-Yes, this will test for decreased reticulocyte count a sign that the patient is developing aplastic anemia, a potentially life threatening side effect of Dilantin therapy.

b. Platelet counts-No, however Dilantin can decrease the platelet count and result in thrombocytopenia. Aplastic anemia is considered to be more serious (Davis Drug Guide)

4.        On the ECG found a straight line, first Nurse
a) Assess the patien                                 b) Cardiopulmonary resuscitation                           c) IV fluids
ANSWER
a)   Assess the patient-BEST ANSWER, always assess the patient to be sure there is no equipment malfunction, and/or to confirm the information on the monitor

5. 15% superficial burns, 20% partial thickness burns. If the fluids adequate
a) Urine output 30-40ml/hr b) BP c) Vital signs d) Skin turgor

ANSWER…

a) Urine output 30-40ml/hr BEST ANSWER, the patient's fluid balance/hydration status is best evaluated by assessing urine output

6. Urine output should be between 0.5 and 1.0 mL/kg/hr, which for a 130 lb adult would be between 29.5 -59 mL/hr. Most nursing textbooks consider 30 mL/hr of urine output to indicate appropriate fluid balance/hydration.
b) BP c) Vital signs d) Skin turgor

ANSWER

For b, c, and d many other factors can affect these findings. Urine output directly correlates with the patient's hydration status/fluid balance.

7.                 6. 20 week pregnant most concerned
a) Butterfly rash on both cheeks and nose                                       b) Uterus palpate at the level of symphysis pubis
c) Sereous fluid drain in the breasts                                                d) Breast enlargement
ANSWERS
a) Butterfly rash on both cheeks and nose-NO this is Cholasma the "mask of pregancy", result of hormonal changes in pregnancy.
b) Uterus palpate at the level of symphysis pubis-BEST ANSWER this correlates with 12 weeks gestation and the patient in the question is 20 weeks. This is a significant difference.
c) Sereous fluid drain in the breasts-NO, leaking of clear fluid from the breasts during pregnancy is not unusual.
d) Breast enlargement-NO, the breast enlarge during pregnancy.

8. The sterile technique is broken when:
a) The sterile field and supplies are wet b) Clean the area peripheral to center
ANSWERS

a) The sterile field and supplies are wet-BEST ANSWER, this would allow microorganisms to enter the sterile field through the wet surface.

b) Clean the area peripheral to center-NO, this is inappropriate technique but response a, specifically describes how a sterile field can be contaminated and is an important principle in maintaining sterile fields.

9. The metal piece is embedded on the left eye
a) Pressure dressing is applied on the left eye b) Dressing is applied on both eyes c) Irrigate the eye with saline
ANSWERS

a. Pressure dressing is applied on the left eye-NO, this would "push" the object further into the eye.

b. Dressing is applied on both eyes-BEST ANSWER, you want to keep the left eye still, and because both eyes move together the uninjured eye must be covered to prevent movement in the injured eye.

c. Irrigate the eye with saline-NO, the object is embedded, meaning deep within the eye. Irrigation will not remove the object but theoretically it could cause it to move resulting in further damage.

10. After cerebral angiogram, patient is

a) Encourage fluids b) obseve contrast medium in the urine c) walking
ANSWERS

a. Encourage fluids-BEST ANSWER, when ever contrast medium/X-ray dyes are administer the client is hydrated to facilitate excretion of the dye.

b. obseve contrast medium in the urine-NO, should not be observable to patient or nurse.

c. walking-NO, bedrest would be maintained for a prescribed period of time.

COMMUNITY HEALTH NURSING

1. Which is the primary goal of community health nursing?
A. To support and supplement the efforts of the medical profession in the promotion of health and prevention of illness
B. To enhance the capacity of individuals, families and communities to cope with their health needs
C. To increase the productivity of the people by providing them with services that will increase their level of health
D. To contribute to national development through promotion of family welfare, focusing particularly on mothers and children.
Answer: (B) To enhance the capacity of individuals, families and communities to cope with their health needs
To contribute to national development through promotion of family welfare, focusing particularly on mothers and children.

2. CHN is a community-based practice. Which best explains this statement?
A. The service is provided in the natural environment of people.
B. The nurse has to conduct community diagnosis to determine nursing needs and problems.
C. The services are based on the available resources within the community.
D. Priority setting is based on the magnitude of the health problems identified.
Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs and problems. Community-based practice means providing care to people in their own natural environments: the home, school and workplace, for example.

3. Population-focused nursing practice requires which of the following processes?
A. Community organizing B. Nursing process

C. Community diagnosis D. Epidemiologic process
Answer: (C) Community diagnosis
Population-focused nursing care means providing care based on the greater need of the majority of the population. The greater need is identified through community diagnosis.

4. R.A. 1054 is also known as the Occupational Health Act. Aside from number of employees, what other factor must be considered in determining the occupational health privileges to which the workers will be entitled?
A. Type of occupation: agricultural, commercial, industrial
B. Location of the workplace in relation to health facilities
C. Classification of the business enterprise based on net profit
D. Sex and age composition of employees
Answer: (B) Location of the workplace in relation to health facilities
Based on R.A. 1054, an occupational nurse must be employed when there are 30 to 100 employees and the workplace is more than 1 km. away from the nearest health center.

5. A business firm must employ an occupational health nurse when it has at least how many employees?
A. 21 B. 101 C. 201 D. 301
Answer: (B) 101
Again, this is based on R.A. 1054.

6. When the occupational health nurse employs ergonomic principles, she is performing which of her roles?
A. Health care provider B. Health educator C. Health care coordinator D. Environmental manager
Answer: (D) Environmental manager
Ergonomics is improving efficiency of workers by improving the worker’s environment through appropriately designed furniture, for example.

7. A garment factory does not have an occupational nurse. Who shall provide the occupational health needs of the factory workers?
A. Occupational health nurse at the Provincial Health Office
B. Physician employed by the factory
C. Public health nurse of the RHU of their municipality
D. Rural sanitary inspector of the RHU of their municipality
Answer: (C) Public health nurse of the RHU of their municipality
You’re right! This question is based on R.A.1054.

8. “Public health services are given free of charge.” Is this statement true or false?
A. The statement is true; it is the responsibility of government to provide basic services.
B. The statement is false; people pay indirectly for public health services.
C. The statement may be true or false, depending on the specific service required.
D. The statement may be true or false, depending on policies of the government concerned.
Answer: (B) The statement is false; people pay indirectly for public health services.
Community health services, including public health services, are pre-paid services, though taxation, for example.

9. According to C.E.Winslow, which of the following is the goal of Public Health?
A. For people to attain their birthrights of health and longevity
B. For promotion of health and prevention of disease
C. For people to have access to basic health services
D. For people to be organized in their health efforts
Answer: (A) For people to attain their birthrights of health and longevity
According to Winslow, all public health efforts are for people to realize their birthrights of health and longevity.

10. We say that a Filipino has attained longevity when he is able to reach the average lifespan of Filipinos. What other statistic may be used to determine attainment of longevity?
A. Age-specific mortality rate B. Proportionate mortality rate C. Swaroop’s index D. Case fatality rate
Answer: (C) Swaroop’s index
Swaroop’s index is the percentage of the deaths aged 50 years or older. Its inverse represents the percentage of untimely deaths (those who died younger than 50 years).

11. Which of the following is the most prominent feature of public health nursing?
A. It involves providing home care to sick people who are not confined in the hospital.
B. Services are provided free of charge to people within the catchments area.
C. The public health nurse functions as part of a team providing a public health nursing services.
D. Public health nursing focuses on preventive, not curative, services.
Answer: (D) Public health nursing focuses on preventive, not curative, services.
The catchment area in PHN consists of a residential community, many of whom are well individuals who have greater need for preventive rather than curative services.

12. According to Margaret Shetland, the philosophy of public health nursing is based on which of the following?
A. Health and longevity as birthrights B. The mandate of the state to protect the birthrights of its citizens
C. Public health nursing as a specialized field of nursing D. The worth and dignity of man
Answer: (D) The worth and dignity of man

This is a direct quote from Dr. Margaret Shetland’s statements on Public Health Nursing.

13. Which of the following is the mission of the Department of Health?
A. Health for all Filipinos B. Ensure the accessibility and quality of health care
C. Improve the general health status of the population D. Health in the hands of the Filipino people by the year 2020
Answer: (B) Ensure the accessibility and quality of health care

14. Region IV Hospital is classified as what level of facility?
A. Primary B. Secondary C. Intermediate D. Tertiary
Answer: (D) Tertiary
Regional hospitals are tertiary facilities because they serve as training hospitals for the region

15. Which is true of primary facilities?
A. They are usually government-run.
B. Their services are provided on an out-patient basis.
C. They are training facilities for health professionals.
D. A community hospital is an example of this level of health facilities.
Answer: (B) Their services are provided on an out-patient basis.
Primary facilities government and non-government facilities that provide basic out-patient services.

16. Which is an example of the school nurse’s health care provider functions?
A. Requesting for BCG from the RHU for school entrant immunization
B. Conducting random classroom inspection during a measles epidemic
C. Taking remedial action on an accident hazard in the school playground
D. Observing places in the school where pupils spend their free time
Answer: (B) Conducting random classroom inspection during a measles epidemic
Random classroom inspection is assessment of pupils/students and teachers for signs of a health problem prevalent in the community.

17. When the nurse determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating
A. Effectiveness B. Efficiency C. Adequacy D. Appropriateness
Answer: (B) Efficiency
Efficiency is determining whether the goals were attained at the least possible cost.

18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where will you apply?
A. Department of Health B. Provincial Health Office C. Regional Health Office D. Rural Health Unit
Answer: (D) Rural Health Unit
R.A. 7160 devolved basic health services to local government units (LGU’s ). The public health nurse is an employee of the LGU.

19. R.A. 7160 mandates devolution of basic services from the national government to local government units. Which of the following is the major goal of devolution?
A. To strengthen local government units B. To allow greater autonomy to local government units
C. To empower the people and promote their self-reliance D. To make basic services more accessible to the people
Answer: (C) To empower the people and promote their self-reliance
People empowerment is the basic motivation behind devolution of basic services to LGU’s.

20. Who is the Chairman of the Municipal Health Board?
A. Mayor B. Municipal Health Officer C. Public Health Nurse D. Any qualified physician
Answer: (A) Mayor
The local executive serves as the chairman of the Municipal Health Board.

21. Which level of health facility is the usual point of entry of a client into the health care delivery system?
A. Primary B. Secondary C. Intermediate D. Tertiary
Answer: (A) Primary
The entry of a person into the health care delivery system is usually through a consultation in out-patient services.

22. The public health nurse is the supervisor of rural health midwives. Which of the following is a supervisory function of the public health nurse?
A. Referring cases or patients to the midwife B. Providing technical guidance to the midwife
C. Providing nursing care to cases referred by the midwife D. Formulating and implementing training programs for midwives
Answer: (B) Providing technical guidance to the midwife
The nurse provides technical guidance to the midwife in the care of clients, particularly in the implementation of management guidelines, as in Integrated Management of Childhood Illness.

23. One of the participants in a hilot training class asked you to whom she should refer a patient in labor who develops a complication. You will answer, to the
A. Public Health Nurse B. Rural Health Midwife
C. Municipal Health Officer D. Any of these health professionals
Answer: (C) Municipal Health Officer
A public health nurse and rural health midwife can provide care during normal childbirth. A physician should attend to a woman with a complication during labor.

24. You are the public health nurse in a municipality with a total population of about 20,000. There are 3 rural health midwives among the RHU personnel. How many more midwife items will the RHU need?
A. 1 B. 2 C. 3 D. The RHU does not need any more midwife item.
Answer: (A) 1
Each rural health midwife is given a population assignment of about 5,000.

25. If the RHU needs additional midwife items, you will submit the request for additional midwife items for approval to the
A. Rural Health Unit B. District Health Office
C. Provincial Health Office D. Municipal Health Board
Answer: (D) Municipal Health Board
As mandated by R.A. 7160, basic health services have been devolved from the national government to local government units.

26. As an epidemiologist, the nurse is responsible for reporting cases of notifiable diseases. What law mandates reporting of cases of notifiable diseases?
A. Act 3573 B. R.A. 3753 C. R.A. 1054 D. R.A. 1082
Answer: (A) Act 3573
Act 3573, the Law on Reporting of Communicable Diseases, enacted in 1929, mandated the reporting of diseases listed in the law to the nearest health station

27. According to Freeman and Heinrich, community health nursing is a developmental service. Which of the following best illustrates this statement?
A. The community health nurse continuously develops himself personally and professionally.
B. Health education and community organizing are necessary in providing community health services.
C. Community health nursing is intended primarily for health promotion and prevention and treatment of disease.
D. The goal of community health nursing is to provide nursing services to people in their own places of residence.
Answer: (B) Health education and community organizing are necessary in providing community health services.
The community health nurse develops the health capability of people through health education and community organizing activities

28. Which disease was declared through Presidential Proclamation No. 4 as a target for eradication in the Philippines?
A. Poliomyelitis B. Measles C. Rabies D. Neonatal tetanus
Answer: (B) Measles
Presidential Proclamation No. 4 is on the Ligtas Tigdas Program.

29. The public health nurse is responsible for presenting the municipal health statistics using graphs and tables. To compare the frequency of the leading causes of mortality in the municipality, which graph will you prepare?
A. Line B. Bar C. Pie D. Scatter diagram
Answer: (B) Bar
A bar graph is used to present comparison of values, a line graph for trends over time or age, a pie graph for population composition or distribution, and a scatter diagram for correlation of two variables.

30. Which step in community organizing involves training of potential leaders in the community?
A. Integration B. Community organization C. Community study D. Core group formation
Answer: (D) Core group formation
In core group formation, the nurse is able to transfer the technology of community organizing to the potential or informal community leaders through a training program.

31. In which step are plans formulated for solving community problems?
A. Mobilization B. Community organization C. Follow-up/extension D. Core group formation
Answer: (B) Community organization
Community organization is the step when community assemblies take place. During the community assembly, the people may opt to formalize the community organization and make plans for community action to resolve a community health problem.

32. The public health nurse takes an active role in community participation. What is the primary goal of community organizing?
A. To educate the people regarding community health problems
B. To mobilize the people to resolve community health problems
C. To maximize the community’s resources in dealing with health problems
D. To maximize the community’s resources in dealing with health problems
Answer: (D) To maximize the community’s resources in dealing with health problems
Community organizing is a developmental service, with the goal of developing the people’s self-reliance in dealing with community health problems. A, B and C are objectives of contributory objectives to this goal.

33. An indicator of success in community organizing is when people are able to
A. Participate in community activities for the solution of a community problem
B. Implement activities for the solution of the community problem
C. Plan activities for the solution of the community problem
D. Identify the health problem as a common concern
Answer: (A) Participate in community activities for the solution of a community problem
Participation in community activities in resolving a community problem may be in any of the processes mentioned in the other choices.

34. Tertiary prevention is needed in which stage of the natural history of disease?
A. Pre-pathogenesis B. Pathogenesis C. Prodromal D. Terminal
Answer: (D) Terminal
Tertiary prevention involves rehabilitation, prevention of permanent disability and disability limitation appropriate for convalescents, the disabled, complicated cases and the terminally ill (those in the terminal stage of a disease)

35. Isolation of a child with measles belongs to what level of prevention?
A. Primary B. Secondary C. Intermediate D. Tertiary
Answer: (A) Primary
The purpose of isolating a client with a communicable disease is to protect those who are not sick (specific disease prevention).

36. On the other hand, Operation Timbang is _____ prevention.
A. Primary B. Secondary C. Intermediate D. Tertiary
Answer: (B) Secondary
Operation Timbang is done to identify members of the susceptible population who are malnourished. Its purpose is early diagnosis and, subsequently, prompt treatment.

37. Which type of family-nurse contact will provide you with the best opportunity to observe family dynamics?
A. Clinic consultation B. Group conference C. Home visit D. Written communication
Answer: (C) Home visit
Dynamics of family relationships can best be observed in the family’s natural environment, which is the home.

38. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of families. The youngest child of the de los Reyes family has been diagnosed as mentally retarded. This is classified as a
A. Health threat B. Health deficit C. Foreseeable crisis D. Stress point
Answer: (B) Health deficit
Failure of a family member to develop according to what is expected, as in mental retardation, is a health deficit.

39. The de los Reyes couple have a 6-year old child entering school for the first time. The de los Reyes family has a
A. Health threat B. Health deficit C. Foreseeable crisis D. Stress point
Answer: (C) Foreseeable crisis
Entry of the 6-year old into school is an anticipated period of unusual demand on the family.

40. Which of the following is an advantage of a home visit?
A. It allows the nurse to provide nursing care to a greater number of people.
B. It provides an opportunity to do first hand appraisal of the home situation.
C. It allows sharing of experiences among people with similar health problems.
D. It develops the family’s initiative in providing for health needs of its members.
Answer: (B) It provides an opportunity to do first hand appraisal of the home situation.
Choice A is not correct since a home visit requires that the nurse spend so much time with the family. Choice C is an advantage of a group conference, while choice D is true of a clinic consultation.

41. Which is CONTRARY to the principles in planning a home visit?
A. A home visit should have a purpose or objective.
B. The plan should revolve around family health needs.
C. A home visit should be conducted in the manner prescribed by the RHU.
D. Planning of continuing care should involve a responsible family member.
Answer: (C) A home visit should be conducted in the manner prescribed by the RHU.
The home visit plan should be flexible and practical, depending on factors, such as the family’s needs and the resources available to the nurse and the family

42. The PHN bag is an important tool in providing nursing care during a home visit. The most important principle of bag technique states that it
A. Should save time and effort.
B. Should minimize if not totally prevent the spread of infection.
C. Should not overshadow concern for the patient and his family.
D. May be done in a variety of ways depending on the home situation, etc.
Answer: (B) Should minimize if not totally prevent the spread of infection.
Bag technique is performed before and after handling a client in the home to prevent transmission of infection to and from the client.

43. To maintain the cleanliness of the bag and its contents, which of the following must the nurse do?
A. Wash his/her hands before and after providing nursing care to the family members.
B. In the care of family members, as much as possible, use only articles taken from the bag.
C. Put on an apron to protect her uniform and fold it with the right side out before putting it back into the bag.
D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the contaminated side is on the outside.
Answer: (A) Wash his/her hands before and after providing nursing care to the family members.
Choice B goes against the idea of utilizing the family’s resources, which is encouraged in CHN. Choices C and D goes against the principle of asepsis of confining the contaminated surface of objects.

44. The public health nurse conducts a study on the factors contributing to the high mortality rate due to heart disease in the municipality where she works. Which branch of epidemiology does the nurse practice in this situation?
A. Descriptive B. Analytical C. Therapeutic D. Evaluation
Answer: (B) Analytical
Analytical epidemiology is the study of factors or determinants affecting the patterns of occurrence and distribution of disease in a community.

45. Which of the following is a function of epidemiology?
A. Identifying the disease condition based on manifestations presented by a client
B. Determining factors that contributed to the occurrence of pneumonia in a 3 year old
C. Determining the efficacy of the antibiotic used in the treatment of the 3 year old client with pneumonia
D. Evaluating the effectiveness of the implementation of the Integrated Management of Childhood Illness
Answer: (D) Evaluating the effectiveness of the implementation of the Integrated Management of Childhood Illness
Epidemiology is used in the assessment of a community or evaluation of interventions in community health practice.

46. Which of the following is an epidemiologic function of the nurse during an epidemic?
A. Conducting assessment of suspected cases to detect the communicable disease
B. Monitoring the condition of the cases affected by the communicable disease
C. Participating in the investigation to determine the source of the epidemic
D. Teaching the community on preventive measures against the disease
Answer: (C) Participating in the investigation to determine the source of the epidemic
Epidemiology is the study of patterns of occurrence and distribution of disease in the community, as well as the factors that affect disease patterns. The purpose of an epidemiologic investigation is to identify the source of an epidemic, i.e., what brought about the epidemic.

47. The primary purpose of conducting an epidemiologic investigation is to
A. Delineate the etiology of the epidemic
B. Encourage cooperation and support of the community
C. Identify groups who are at risk of contracting the disease
D. Identify geographical location of cases of the disease in the community
Answer: (A) Delineate the etiology of the epidemic
Delineating the etiology of an epidemic is identifying its source.

48. Which is a characteristic of person-to-person propagated epidemics?
A. There are more cases of the disease than expected.
B. The disease must necessarily be transmitted through a vector.
C. The spread of the disease can be attributed to a common vehicle.
D. There is a gradual build up of cases before the epidemic becomes easily noticeable.
Answer: (D) There is a gradual build up of cases before the epidemic becomes easily noticeable.
A gradual or insidious onset of the epidemic is usually observable in person-to-person propagated epidemics.

49. In the investigation of an epidemic, you compare the present frequency of the disease with the usual frequency at this time of the year in this community. This is done during which stage of the investigation?
A. Establishing the epidemic B. Testing the hypothesis
C. Formulation of the hypothesis D. Appraisal of facts
Answer: (A) Establishing the epidemic
Establishing the epidemic is determining whether there is an epidemic or not. This is done by comparing the present number of cases with the usual number of cases of the disease at the same time of the year, as well as establishing the relatedness of the cases of the disease.

50. The number of cases of Dengue fever usually increases towards the end of the rainy season. This pattern of occurrence of Dengue fever is best described as
A. Epidemic occurrence B. Cyclical variation C. Sporadic occurrence D. Secular variation
Answer: (B) Cyclical variation
A cyclical variation is a periodic fluctuation in the number of cases of a disease in the community.

51. In the year 1980, the World Health Organization declared the Philippines, together with some other countries in the Western Pacific Region, “free” of which disease?
A. Pneumonic plague B. Poliomyelitis C. Small pox D. Anthrax
Answer: (C) Small pox
The last documented case of Small pox was in 1977 at Somalia.

52. In the census of the Philippines in 1995, there were about 35,299,000 males and about 34,968,000 females. What is the sex ratio?
A. 99.06:100 B. 100.94:100 C. 50.23% D. 49.76%
Answer: (B) 100.94:100
Sex ratio is the number of males for every 100 females in the population.

53. Primary health care is a total approach to community development. Which of the following is an indicator of success in the use of the primary health care approach?
A. Health services are provided free of charge to individuals and families.
B. Local officials are empowered as the major decision makers in matters of health.
C. Health workers are able to provide care based on identified health needs of the people.
D. Health programs are sustained according to the level of development of the community.
Answer: (D) Health programs are sustained according to the level of development of the community.
Primary health care is essential health care that can be sustained in all stages of development of the community.

54. Sputum examination is the major screening tool for pulmonary tuberculosis. Clients would sometimes get false negative results in this exam. This means that the test is not perfect in terms of which characteristic of a diagnostic examination?
A. Effectiveness B. Efficacy C. Specificity D. Sensitivity
Answer: (D) Sensitivity
Sensitivity is the capacity of a diagnostic examination to detect cases of the disease. If a test is 100% sensitive, all the cases tested will have a positive result, i.e., there will be no false negative results.

55. Use of appropriate technology requires knowledge of indigenous technology. Which medicinal herb is given for fever, headache and cough?
A. Sambong B. Tsaang gubat C. Akapulko D. Lagundi
Answer: (D) Lagundi
Sambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea. Akapulko is used for its antifungal property.

56. . What law created the Philippine Institute of Traditional and Alternative Health Care?
A. R.A. 8423 B. R.A. 4823 C. R.A. 2483 D. R.A. 3482
Answer: (A) R.A. 8423
(none)

57. In traditional Chinese medicine, the yielding, negative and feminine force is termed
A. Yin B. Yang C. Qi D. Chai
Answer: (A) Yin
Yang is the male dominating, positive and masculine force.

58. What is the legal basis for Primary Health Care approach in the Philippines?
A. Alma Ata Declaration on PHC B. Letter of Instruction No. 949
C. Presidential Decree No. 147 D. Presidential Decree 996
Answer: (B) Letter of Instruction No. 949
Letter of Instruction 949 was issued by then President Ferdinand Marcos, directing the formerly called Ministry of Health, now the Department of Health, to utilize Primary Health Care approach in planning and implementing health programs.

59. Which of the following demonstrates intersectoral linkages?
A. Two-way referral system B. Team approach
C. Endorsement done by a midwife to another midwife D. Cooperation between the PHN and public school teacher
Answer: (D) Cooperation between the PHN and public school teacher
Intersectoral linkages refer to working relationships between the health sector and other sectors involved in community development.

60. The municipality assigned to you has a population of about 20,000. Estimate the number of 1-4 year old children who will be given Retinol capsule 200,000 I.U. every 6 months.
A. 1,500 B. 1,800 C. 2,000 D. 2,300
Answer: (D) 2,300
Based on the Philippine population composition, to estimate the number of 1-4 year old children, multiply total population by 11.5%.

61. Estimate the number of pregnant women who will be given tetanus toxoid during an immunization outreach activity in a barangay with a population of about 1,500.
A. 265 B. 300 C. 375 D. 400
Answer: (A) 265
To estimate the number of pregnant women, multiply the total population by 3.5%.

62. To describe the sex composition of the population, which demographic tool may be used?
A. Sex ratio B. Sex proportion C. Population pyramid D. Any of these may be used.
Answer: (D) Any of these may be used.
Sex ratio and sex proportion are used to determine the sex composition of a population. A population pyramid is used to present the composition of a population by age and sex.

63. Which of the following is a natality rate?
A. Crude birth rate B. Neonatal mortality rate C. Infant mortality rate D. General fertility rate
Answer: (A) Crude birth rate
Natality means birth. A natality rate is a birth rate.

64. You are computing the crude death rate of your municipality, with a total population of about 18,000, for last year. There were 94 deaths. Among those who died, 20 died because of diseases of the heart and 32 were aged 50 years or older. What is the crude death rate?
A. 4.2/1,000 B. 5.2/1,000 C. 6.3/1,000 D. 7.3/1,000
Answer: (B) 5.2/1,000
To compute crude death rate divide total number of deaths (94) by total population (18,000) and multiply by 1,000.

65. Knowing that malnutrition is a frequent community health problem, you decided to conduct nutritional assessment. What population is particularly susceptible to protein energy malnutrition (PEM)?
A. Pregnant women and the elderly B. Under-5 year old children
C. 1-4 year old children D. School age children
Answer: (C) 1-4 year old children
Preschoolers are the most susceptible to PEM because they have generally been weaned. Also, this is the population who, unable to feed themselves, are often the victims of poor intrafamilial food distribution.

66. Which statistic can give the most accurate reflection of the health status of a community?
A. 1-4 year old age-specific mortality rate B. Infant mortality rate
C. Swaroop’s index D. Crude death rate
Answer: (C) Swaroop’s index
Swaroop’s index is the proportion of deaths aged 50 years and above. The higher the Swaroop’s index of a population, the greater the proportion of the deaths who were able to reach the age of at least 50 years, i.e., more people grew old before they died

67. In the past year, Barangay A had an average population of 1655. 46 babies were born in that year, 2 of whom died less than 4 weeks after they were born. There were 4 recorded stillbirths. What is the neonatal mortality rate?
A. 27.8/1,000 B. 43.5/1,000 C. 86.9/1,000 D. 130.4/1,000
Answer: (B) 43.5/1,000
To compute for neonatal mortality rate, divide the number of babies who died before reaching the age of 28 days by the total number of live births, then multiply by 1,000.

68. Which statistic best reflects the nutritional status of a population?
A. 1-4 year old age-specific mortality rate B. Proportionate mortality rate
C. Infant mortality rate D. Swaroop’s index
Answer: (A) 1-4 year old age-specific mortality rate
Since preschoolers are the most susceptible to the effects of malnutrition, a population with poor nutritional status will most likely have a high 1-4 year old age-specific mortality rate, also known as child mortality rate.

69. What numerator is used in computing general fertility rate?
A. Estimated midyear population B. Number of registered live births
C. Number of pregnancies in the year D. Number of females of reproductive age
Answer: (B) Number of registered live births
To compute for general or total fertility rate, divide the number of registered live births by the number of females of reproductive age (15-45 years), then multiply by 1,000.

70. You will gather data for nutritional assessment of a purok. You will gather information only from families with members who belong to the target population for PEM. What method of data gathering is best for this purpose?
A. Census B. Survey C. Record review D. Review of civil registry
Answer: (B) Survey
A survey, also called sample survey, is data gathering about a sample of the population.

71. In the conduct of a census, the method of population assignment based on the actual physical location of the people is termed
A. De jure B. De locus C. De facto D. De novo
Answer: (C) De facto
The other method of population assignment, de jure, is based on the usual place of residence of the people.

72. The Field Health Services and Information System (FHSIS) is the recording and reporting system in public health care in the Philippines. The Monthly Field Health Service Activity Report is a form used in which of the components of the FHSIS?
A. Tally report B. Output report C. Target/client list D. Individual health record
Answer: (A) Tally report
A tally report is prepared monthly or quarterly by the RHU personnel and transmitted to the Provincial Health Office.

73. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which component will be most useful?
A. Tally report B. Output report C. Target/client list D. Individual health record
Answer: (C) Target/client list
The MDT Client List is a record of clients enrolled in MDT and other relevant data, such as dates when clients collected their monthly supply of drugs.

74. Civil registries are important sources of data. Which law requires registration of births within 30 days from the occurrence of the birth?
A. P.D. 651 B. Act 3573 C. R.A. 3753 D. R.A. 3375
Answer: (A) P.D. 651
P.D. 651 amended R.A. 3753, requiring the registry of births within 30 days from their occurrence.

75. Which of the following professionals can sign the birth certificate?
A. Public health nurse                                                 B. Rural health midwife
C. Municipal health officer                                          D. Any of these health professionals
Answer: (D) Any of these health professionals
D. R.A. 3753 states that any birth attendant may sign the certificate of live birth.

76. Which criterion in priority setting of health problems is used only in community health care?
A. Modifiability of the problem B. Nature of the problem presented
C. Magnitude of the health problem D. Preventive potential of the health problem
Answer: (C) Magnitude of the health problem
Magnitude of the problem refers to the percentage of the population affected by a health problem. The other choices are criteria considered in both family and community health care

77. The Sentrong Sigla Movement has been launched to improve health service delivery. Which of the following is/are true of this movement?
A. This is a project spearheaded by local government units.
B. It is a basis for increasing funding from local government units.
C. It encourages health centers to focus on disease prevention and control.
D. Its main strategy is certification of health centers able to comply with standards.
Answer: (D) Its main strategy is certification of health centers able to comply with standards.
Sentrong Sigla Movement is a joint project of the DOH and local government units. Its main strategy is certification of health centers that are able to comply with standards set by the DOH.

78. Which of the following women should be considered as special targets for family planning?
A. Those who have two children or more
B. Those with medical conditions such as anemia
C. Those younger than 20 years and older than 35 years
D. Those who just had a delivery within the past 15 months
Answer: (D) Those who just had a delivery within the past 15 months
The ideal birth spacing is at least two years. 15 months plus 9 months of pregnancy = 2 years

79. Freedom of choice is one of the policies of the Family Planning Program of the Philippines. Which of the following illustrates this principle?
A. Information dissemination about the need for family planning
B. Support of research and development in family planning methods
C. Adequate information for couples regarding the different methods
D. Encouragement of couples to take family planning as a joint responsibility
Answer: (C) Adequate information for couples regarding the different methods
To enable the couple to choose freely among different methods of family planning, they must be given full information regarding the different methods that are available to them, considering the availability of quality services that can support their choice.

80. A woman, 6 months pregnant, came to the center for consultation. Which of the following substances is contraindicated?
A. Tetanus toxoid B. Retinol 200,000 IU C. Ferrous sulfate 200 mg D. Potassium iodate 200 mg. capsule
Answer: (B) Retinol 200,000 IU
Retinol 200,000 IU is a form of megadose Vitamin A. This may have a teratogenic effect.

81. . During prenatal consultation, a client asked you if she can have her delivery at home. After history taking and physical examination, you advised her against a home delivery. Which of the following findings disqualifies her for a home delivery?
A. Her OB score is G5P3. B. She has some palmar pallor.
C. Her blood pressure is 130/80. D. Her baby is in cephalic presentation.
Answer: (A) Her OB score is G5P3.
Only women with less than 5 pregnancies are qualified for a home delivery. It is also advisable for a primigravida to have delivery at a childbirth facility.

82. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?
A. Niacin B. Riboflavin C. Folic acid D. Thiamine
Answer: (C) Folic acid
It is estimated that the incidence of neural tube defects can be reduced drastically if pregnant women have an adequate intake of folic acid.

83. You are in a client’s home to attend to a delivery. Which of the following will you do first?
A. Set up the sterile area. B. Put on a clean gown or apron.
C. Cleanse the client’s vulva with soap and water. D. Note the interval, duration and intensity of labor contractions.
Answer: (D) Note the interval, duration and intensity of labor contractions.
Assessment of the woman should be done first to determine whether she is having true labor and, if so, what stage of labor she is in.

84. In preparing a primigravida for breastfeeding, which of the following will you do?
A. Tell her that lactation begins within a day after delivery.
B. Teach her nipple stretching exercises if her nipples are everted.
C. Instruct her to wash her nipples before and after each breastfeeding.
D. Explain to her that putting the baby to breast will lessen blood loss after delivery.
Answer: (D) Explain to her that putting the baby to breast will lessen blood loss after delivery.
Suckling of the nipple stimulates the release of oxytocin by the posterior pituitary gland, which causes uterine contraction. Lactation begins 1 to 3 days after delivery. Nipple stretching exercises are done when the nipples are flat or inverted. Frequent washing dries up the nipples, making them prone to the formation of fissures.

85. A primigravida is instructed to offer her breast to the baby for the first time within 30 minutes after delivery. What is the purpose of offering the breast this early?
A. To initiate the occurrence of milk letdown
B. To stimulate milk production by the mammary acini
C. To make sure that the baby is able to get the colostrum
D. To allow the woman to practice breastfeeding in the presence of the health worker
Answer: (B) To stimulate milk production by the mammary acini
Suckling of the nipple stimulates prolactin reflex (the release of prolactin by the anterior pituitary gland), which initiates lactation.

86. In a mothers’ class, you discuss proper breastfeeding technique. Which is of these is a sign that the baby has “latched on” to the breast properly?
A. The baby takes shallow, rapid sucks. B. The mother does not feel nipple pain.
C. The baby’s mouth is only partly open. D. Only the mother’s nipple is inside the baby’s mouth.
Answer: (B) The mother does not feel nipple pain.
When the baby has properly latched on to the breast, he takes deep, slow sucks; his mouth is wide open; and much of the areola is inside his mouth. And, you’re right! The mother does not feel nipple pain.

87. You explain to a breastfeeding mother that breast milk is sufficient for all of the baby’s nutrient needs only up to ____.
A. 3 months B. 6 months C. 1 year D. 2 years
Answer: (B) 6 months
After 6 months, the baby’s nutrient needs, especially the baby’s iron requirement, can no longer be provided by mother’s milk alone.

88. What is given to a woman within a month after the delivery of a baby?
A. Malunggay capsule B. Ferrous sulfate 100 mg. OD
C. Retinol 200,000 I.U., 1 capsule D. Potassium iodate 200 mg, 1 capsule
Answer: (C) Retinol 200,000 I.U., 1 capsule
A capsule of Retinol 200,000 IU is given within 1 month after delivery. Potassium iodate is given during pregnancy; malunggay capsule is not routinely administered after delivery; and ferrous sulfate is taken for two months after delivery.

89. Which biological used in Expanded Program on Immunization (EPI) is stored in the freezer?
A. DPT B. Tetanus toxoid C. Measles vaccine D. Hepatitis B vaccine
Answer: (C) Measles vaccine
Among the biologicals used in the Expanded Program on Immunization, measles vaccine and OPV are highly sensitive to heat, requiring storage in the freezer.

90. Unused BCG should be discarded how many hours after reconstitution?
A. 2 B. 4 C. 6 D. At the end of the day
Answer: (B) 4
While the unused portion of other biologicals in EPI may be given until the end of the day, only BCG is discarded 4 hours after reconstitution. This is why BCG immunization is scheduled only in the morning.

91. . In immunizing school entrants with BCG, you are not obliged to secure parental consent. This is because of which legal document?
A. P.D. 996 B. R.A. 7846 C. Presidential Proclamation No. 6 D. Presidential Proclamation No. 46
Answer: (A) P.D. 996
Presidential Decree 996, enacted in 1976, made immunization in the EPI compulsory for children under 8 years of age. Hepatitis B vaccination was made compulsory for the same age group by R.A. 7846.

92. Which immunization produces a permanent scar?
A. DPT B. BCG C. Measles vaccination D. Hepatitis B vaccination
Answer: (B) BCG
BCG causes the formation of a superficial abscess, which begins 2 weeks after immunization. The abscess heals without treatment, with the formation of a permanent scar.

93. A 4-week old baby was brought to the health center for his first immunization. Which can be given to him?
A. DPT1 B. OPV1 C. Infant BCG D. Hepatitis B vaccine 1
Answer: (C) Infant BCG
Infant BCG may be given at birth. All the other immunizations mentioned can be given at 6 weeks of age.

94. You will not give DPT 2 if the mother says that the infant had
A. Seizures a day after DPT 1. B. Fever for 3 days after DPT 1.
C. Abscess formation after DPT 1. D. Local tenderness for 3 days after DPT 1.
Answer: (A) Seizures a day after DPT 1.
Seizures within 3 days after administration of DPT is an indication of hypersensitivity to pertussis vaccine, a component of DPT. This is considered a specific contraindication to subsequent doses of DPT.

95. A 2-month old infant was brought to the health center for immunization. During assessment, the infant’s temperature registered at 38.1°C. Which is the best course of action that you will take?
A. Go on with the infant’s immunizations.
B. Give Paracetamol and wait for his fever to subside.
C. Refer the infant to the physician for further assessment.
D. Advise the infant’s mother to bring him back for immunization when he is well.
Answer: (A) Go on with the infant’s immunizations.
In the EPI, fever up to 38.5°C is not a contraindication to immunization. Mild acute respiratory tract infection, simple diarrhea and malnutrition are not contraindications either.

96. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her baby will have protection against tetanus for how long?
A. 1 year B. 3 years C. 10 years D. Lifetime
Answer: (A) 1 year
The baby will have passive natural immunity by placental transfer of antibodies. The mother will have active artificial immunity lasting for about 10 years. 5 doses will give the mother lifetime protection.

97. A 4-month old infant was brought to the health center because of cough. Her respiratory rate is 42/minute. Using the Integrated Management of Child Illness (IMCI) guidelines of assessment, her breathing is considered
A. Fast B. Slow C. Normal D. Insignificant
Answer: (C) Normal
In IMCI, a respiratory rate of 50/minute or more is fast breathing for an infant aged 2 to 12 months.

98. Which of the following signs will indicate that a young child is suffering from severe pneumonia?
A. Dyspnea B. Wheezing C. Fast breathing D. Chest indrawing
Answer: (D) Chest indrawing
In IMCI, chest indrawing is used as the positive sign of dyspnea, indicating severe pneumonia.

99. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best management for the child?
A. Prescribe an antibiotic. B. Refer him urgently to the hospital.
C. Instruct the mother to increase fluid intake. D. Instruct the mother to continue breastfeeding.
Answer: (B) Refer him urgently to the hospital.
Severe pneumonia requires urgent referral to a hospital. Answers A, C and D are done for a client classified as having pneumonia.

100.        A 5-month old infant was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes back slowly after a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category?
A. No signs of dehydration                                                         B. Some dehydration
C. Severe dehydration                                                                 D. The data is insufficient.
Answer: (B) Some dehydration
Using the assessment guidelines of IMCI, a child (2 months to 5 years old) with diarrhea is classified as having SOME DEHYDRATION if he shows 2 or more of the following signs: restless or irritable, sunken eyes, the skin goes back slow after a skin pinch.

101. Based on assessment, you classified a 3-month old infant with the chief complaint of diarrhea in the category of SOME DEHYDRATION. Based on IMCI management guidelines, which of the following will you do?
A. Bring the infant to the nearest facility where IV fluids can be given.
B. Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
C. Give the infant’s mother instructions on home management.
D. Keep the infant in your health center for close observation.
Answer: (B) Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
In the IMCI management guidelines, SOME DEHYDRATION is treated with the administration of Oresol within a period of 4 hours. The amount of Oresol is best computed on the basis of the child’s weight (75 ml/kg body weight). If the weight is unknown, the amount of Oresol is based on the child’s age.

102. A mother is using Oresol in the management of diarrhea of her 3-year old child. She asked you what to do if her child vomits. You will tell her to
A. Bring the child to the nearest hospital for further assessment.
B. Bring the child to the health center for intravenous fluid therapy.
C. Bring the child to the health center for assessment by the physician.
D. Let the child rest for 10 minutes then continue giving Oresol more slowly.
Answer: (D) Let the child rest for 10 minutes then continue giving Oresol more slowly.
If the child vomits persistently, that is, he vomits everything that he takes in, he has to be referred urgently to a hospital. Otherwise, vomiting is managed by letting the child rest for 10 minutes and then continuing with Oresol administration. Teach the mother to give Oresol more slowly.

103. A 1 ½ year old child was classified as having 3rd degree protein energy malnutrition, kwashiorkor. Which of the following signs will be most apparent in this child?
A. Voracious appetite B. Wasting C. Apathy D. Edema
Answer: (D) Edema
Edema, a major sign of kwashiorkor, is caused by decreased colloidal osmotic pressure of the blood brought about by hypoalbuminemia. Decreased blood albumin level is due a protein-deficient diet.

104. Assessment of a 2-year old child revealed “baggy pants”. Using the IMCI guidelines, how will you manage this child?
A. Refer the child urgently to a hospital for confinement.
B. Coordinate with the social worker to enroll the child in a feeding program.
C. Make a teaching plan for the mother, focusing on menu planning for her child.
D. Assess and treat the child for health problems like infections and intestinal parasitism.
Answer: (A) Refer the child urgently to a hospital for confinement.
“Baggy pants” is a sign of severe marasmus. The best management is urgent referral to a hospital.

105. During the physical examination of a young child, what is the earliest sign of xerophthalmia that you may observe?
A. Keratomalacia B. Corneal opacity C. Night blindness D. Conjunctival xerosis
Answer: (D) Conjunctival xerosis
The earliest sign of Vitamin A deficiency (xerophthalmia) is night blindness. However, this is a functional change, which is not observable during physical examination.The earliest visible lesion is conjunctival xerosis or dullness of the conjunctiva due to inadequate tear production.

106. To prevent xerophthalmia, young children are given Retinol capsule every 6 months. What is the dose given to preschoolers?
A. 10,000 IU B. 20,000 IU C. 100,000 IU D. 200,000 IU
Answer: (D) 200,000 IU
Preschoolers are given Retinol 200,000 IU every 6 months. 100,000 IU is given once to infants aged 6 to 12 months. The dose for pregnant women is 10,000 IU.

107. The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
A. Palms B. Nailbeds C. Around the lips D. Lower conjunctival sac
Answer: (A) Palms
The anatomic characteristics of the palms allow a reliable and convenient basis for examination for pallor.

108. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. R.A. 8976 mandates fortification of certain food items. Which of the following is among these food items?
A. Sugar B. Bread C. Margarine D. Filled milk
Answer: (A) Sugar
R.A. 8976 mandates fortification of rice, wheat flour, sugar and cooking oil with Vitamin A, iron and/or iodine.

109. What is the best course of action when there is a measles epidemic in a nearby municipality?
A. Give measles vaccine to babies aged 6 to 8 months.
B. Give babies aged 6 to 11 months one dose of 100,000 I.U. of Retinol
C. Instruct mothers to keep their babies at home to prevent disease transmission.
D. Instruct mothers to feed their babies adequately to enhance their babies’ resistance.
Answer: (A) Give measles vaccine to babies aged 6 to 8 months.
Ordinarily, measles vaccine is given at 9 months of age. During an impending epidemic, however, one dose may be given to babies aged 6 to 8 months. The mother is instructed that the baby needs another dose when the baby is 9 months old.

110. A mother brought her daughter, 4 years old, to the RHU because of cough and colds. Following the IMCI assessment guide, which of the following is a danger sign that indicates the need for urgent referral to a hospital?
A. Inability to drink B. High grade fever C. Signs of severe dehydration D. Cough for more than 30 days
Answer: (A) Inability to drink
A sick child aged 2 months to 5 years must be referred urgently to a hospital if he/she has one or more of the following signs: not able to feed or drink, vomits everything, convulsions, abnormally sleepy or difficult to awaken.

111.        Management of a child with measles includes the administration of which of the following?
A. Gentian violet on mouth lesions                                             B. Antibiotics to prevent pneumonia
C. Tetracycline eye ointment for corneal opacity                         D. Retinol capsule regardless of when the last dose was given
Answer: (D) Retinol capsule regardless of when the last dose was given
An infant 6 to 12 months classified as a case of measles is given Retinol 100,000 IU; a child is given 200,000 IU regardless of when the last dose was given.

112.        A mother brought her 10 month old infant for consultation because of fever, which started 4 days prior to consultation. To determine malaria risk, what will you do?
A. Do a tourniquet test.                                                               B. Ask where the family resides.
C. Get a specimen for blood smear.                                            D. Ask if the fever is present everyday.
Answer: (B) Ask where the family resides.
Because malaria is endemic, the first question to determine malaria risk is where the client’s family resides. If the area of residence is not a known endemic area, ask if the child had traveled within the past 6 months, where he/she was brought and whether he/she stayed overnight in that area.

113. The following are strategies implemented by the Department of Health to prevent mosquito-borne diseases. Which of these is most effective in the control of Dengue fever?
A. Stream seeding with larva-eating fish
B. Destroying breeding places of mosquitoes
C. Chemoprophylaxis of non-immune persons going to endemic areas
D. Teaching people in endemic areas to use chemically treated mosquito nets
Answer: (B) Destroying breeding places of mosquitoes
Aedes aegypti, the vector of Dengue fever, breeds in stagnant, clear water. Its feeding time is usually during the daytime. It has a cyclical pattern of occurrence, unlike malaria which is endemic in certain parts of the country.

114.        Secondary prevention for malaria includes
A. Planting of neem or eucalyptus trees                                                      B. Residual spraying of insecticides at night
C. Determining whether a place is endemic or not                                      D. Growing larva-eating fish in mosquito breeding places
Answer: (C) Determining whether a place is endemic or not
This is diagnostic and therefore secondary level prevention. The other choices are for primary prevention.

115. Scotch tape swab is done to check for which intestinal parasite?
A. Ascaris B. Pinworm C. Hookworm D. Schistosoma
Answer: (B) Pinworm
Pinworm ova are deposited around the anal orifice.

116. Which of the following signs indicates the need for sputum examination for AFB?
A. Hematemesis B. Fever for 1 week C. Cough for 3 weeks D. Chest pain for 1 week
Answer: (C) Cough for 3 weeks
A client is considered a PTB suspect when he has cough for 2 weeks or more, plus one or more of the following signs: fever for 1 month or more; chest pain lasting for 2 weeks or more not attributed to other conditions; progressive, unexplained weight loss; night sweats; and hemoptysis.

117. Which clients are considered targets for DOTS Category I?
A. Sputum negative cavitary cases
B. Clients returning after a default
C. Relapses and failures of previous PTB treatment regimens
D. Clients diagnosed for the first time through a positive sputum exam
Answer: (D) Clients diagnosed for the first time through a positive sputum exam
Category I is for new clients diagnosed by sputum examination and clients diagnosed to have a serious form of extrapulmonary tuberculosis, such as TB osteomyelitis.

118. To improve compliance to treatment, what innovation is being implemented in DOTS?
A. Having the health worker follow up the client at home
B. Having the health worker or a responsible family member monitor drug intake
C. Having the patient come to the health center every month to get his medications
D. Having a target list to check on whether the patient has collected his monthly supply of drugs
Answer: (B) Having the health worker or a responsible family member monitor drug intake
Directly Observed Treatment Short Course is so-called because a treatment partner, preferably a health worker accessible to the client, monitors the client’s compliance to the treatment.

119. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of leprosy?
A. Macular lesions B. Inability to close eyelids C. Thickened painful nerves D. Sinking of the nosebridge
Answer: (C) Thickened painful nerves
The lesion of leprosy is not macular. It is characterized by a change in skin color (either reddish or whitish) and loss of sensation, sweating and hair growth over the lesion. Inability to close the eyelids (lagophthalmos) and sinking of the nosebridge are late symptoms.

120.        Which of the following clients should be classified as a case of multibacillary leprosy?
A. 3 skin lesions, negative slit skin smear                                   B. 3 skin lesions, positive slit skin smear
C. 5 skin lesions, negative slit skin smear                                   D. 5 skin lesions, positive slit skin smear
Answer: (D) 5 skin lesions, positive slit skin smear
A multibacillary leprosy case is one who has a positive slit skin smear and at least 5 skin lesions.

121. In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?
A. Liver cancer B. Liver cirrhosis C. Bladder cancer D. Intestinal perforation
Answer: (B) Liver cirrhosis
The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which affects the small intestine and the liver. Liver damage is a consequence of fibrotic reactions to schistosoma eggs in the liver.

122.        What is the most effective way of controlling schistosomiasis in an endemic area?
A. Use of molluscicides                                                              B. Building of foot bridges
C. Proper use of sanitary toilets                                                  D. Use of protective footwear, such as rubber boots
Answer: (C) Proper use of sanitary toilets
The ova of the parasite get out of the human body together with feces. Cutting the cycle at this stage is the most effective way of preventing the spread of the disease to susceptible hosts.

123. When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is
A. I B. II C. III D. IV
Answer: (B) II
A communal faucet or water standpost is classified as Level II.

124.        For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?
A. Use of sterile syringes and needles                                        B. Safe food preparation and food handling by vendors
C. Proper disposal of human excreta and personal hygiene        D. Immediate reporting of water pipe leaks and illegal water connections
Answer: (A) Use of sterile syringes and needles
Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.

125. Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?
A. DPT B. Oral polio vaccine C. Measles vaccine D. MMR
Answer: (A) DPT
DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only. OPV and measles vaccine are highly sensitive to heat and require freezing. MMR is not an immunization in the Expanded Program on Immunization.

126. You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
A. 45 B. 50 C. 55 D. 60
Answer: (A) 45
To estimate the number of infants, multiply total population by 3%.

127. In Integrated Management of Childhood Illness, severe conditions generally require urgent referral to a hospital. Which of the following severe conditions DOES NOT always require urgent referral to a hospital?
A. Mastoiditis B. Severe dehydration C. Severe pneumonia D. Severe febrile disease
Answer: (B) Severe dehydration
The order of priority in the management of severe dehydration is as follows: intravenous fluid therapy, referral to a facility where IV fluids can be initiated within 30 minutes, Oresol/nasogastric tube, Oresol/orem. When the foregoing measures are not possible or effective, tehn urgent referral to the hospital is done.

128. A client was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed does not return within how many seconds?
A. 3 B. 5 C. 8 D. 10
Answer: (A) 3
Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.

129.        A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test result. In the absence of other signs, which is the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?
A. Insert an NGT and give fluids per NGT.                               B. Instruct the mother to give the child Oresol.
C. Start the patient on intravenous fluids STAT.                         D. Refer the client to the physician for appropriate management.
Answer: (B) Instruct the mother to give the child Oresol.
Since the child does not manifest any other danger sign, maintenance of fluid balance and replacement of fluid loss may be done by giving the client Oresol.

130. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.
A. Nasal mucosa B. Buccal mucosa C. Skin on the abdomen D. Skin on the antecubital surface
Answer: (B) Buccal mucosa
Koplik’s spot may be seen on the mucosa of the mouth or the throat.

131. Among the following diseases, which is airborne?
A. Viral conjunctivitis B. Acute poliomyelitis C. Diphtheria D. Measles
Answer: (D) Measles
Viral conjunctivitis is transmitted by direct or indirect contact with discharges from infected eyes. Acute poliomyelitis is spread through the fecal-oral route and contact with throat secretions, whereas diphtheria is through direct and indirect contact with respiratory secretions.

132. Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
A. Hemophilus influenzae B. Morbillivirus C. Steptococcus pneumoniae D. Neisseria meningitidis
Answer: (A) Hemophilus influenzae
Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age distribution is not specific in young children.

133. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
A. Stream seeding B. Stream clearing C. Destruction of breeding places D. Zooprophylaxis
Answer: (D) Zooprophylaxis
Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just before nightfall. The Anopheles mosquito takes his blood meal from the animal and goes back to its breeding place, thereby preventing infection of humans.

134. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A. Stream seeding B. Stream clearing C. Destruction of breeding places D. Zooprophylaxis
Answer: (A) Stream seeding
Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the Anopheles mosquito

135.        Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control?
A. Use of chemically treated mosquito nets                                B. Seeding of breeding places with larva-eating fish
C. Destruction of breeding places of the mosquito vector           D. Use of mosquito-repelling soaps, such as those with basil or citronella
Answer: (C) Destruction of breeding places of the mosquito vector
Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.

136. A 4-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of “rice water” stools. The client is most probably suffering from which condition?
A. Giardiasis B. Cholera C. Amebiasis D. Dysentery
Answer: (B) Cholera
Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary dysentery are characterized by the presence of blood and/or mucus in the stools. Giardiasis is characterized by fat malabsorption and, therefore, steatorrhea.

137. In the Philippines, which specie of schistosoma is endemic in certain regions?
A. S. mansoni B. S. japonicum C. S. malayensis D. S. haematobium
Answer: (B) S. japonicum
S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the Middle East; and S. malayensis only in peninsular Malaysia.

138. A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?
A. Hepatitis A B. Hepatitis B C. Tetanus D. Leptospirosis
Answer: (D) Leptospirosis
Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats.

139. MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?
A. I B. II C. III D. IV
Answer: (C) III
Waterworks systems, such as MWSS, are classified as level III.

140. You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course of action that you may take?
A. Get a thorough history of the client, focusing on the practice of high risk behaviors.
B. Ask the client to be accompanied by a significant person before revealing the result.
C. Refer the client to the physician since he is the best person to reveal the result to the client.
D. Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.
Answer: (D) Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.
A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A negative supplementary test result means that the ELISA result was false and that, most probably, the client is not infected.

141.        Which is the BEST control measure for AIDS?
A. Being faithful to a single sexual partner                                 B. Using a condom during each sexual contact
C. Avoiding sexual contact with commercial sex workers          D. Making sure that one’s sexual partner does not have signs of AIDS
Answer: (A) Being faithful to a single sexual partner
Sexual fidelity rules out the possibility of getting the disease by sexual contact with another infected person. Transmission occurs mostly through sexual intercourse and exposure to blood or tissues

142.        . The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic infections is characterized by tonsillopharyngitis?
A. Respiratory candidiasis                                          B. Infectious mononucleosis
C. Cytomegalovirus disease                                        D. Pneumocystis carinii pneumonia
Answer: (B) Infectious mononucleosis
Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and lymphadenopathy.

143. To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?
A. Contact tracing B. Community survey C. Mass screening tests D. Interview of suspects
Answer: (A) Contact tracing
Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted infections, such as sexually transmitted diseases.

144.        Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is NOT an action expected of these drugs.
A. They prolong the life of the client with AIDS.                                       B. They reduce the risk of opportunistic infections
C. They shorten the period of communicability of the disease.                   D. They are able to bring about a cure of the disease condition.
Answer: (D) They are able to bring about a cure of the disease condition.
There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic infections and prolong life, but does not cure the underlying immunodeficiency.

145. A barangay had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to women in the first trimester of pregnancy in the barangay?
A. Advice them on the signs of German measles.
B. Avoid crowded places, such as markets and moviehouses.
C. Consult at the health center where rubella vaccine may be given.
D. Consult a physician who may give them rubella immunoglobulin.
Answer: (D) Consult a physician who may give them rubella immunoglobulin.
Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in pregnancy. Immune globulin, a specific prophylactic against German measles, may be given to pregnant women.

146. You were invited to be the resource person in a training class for food handlers. Which of the following would you emphasize regarding prevention of staphylococcal food poisoning?
A. All cooking and eating utensils must be thoroughly washed.
B. Food must be cooked properly to destroy staphylococcal microorganisms.
C. Food handlers and food servers must have a negative stool examination result.
D. Proper handwashing during food preparation is the best way of preventing the condition.
Answer: (D) Proper handwashing during food preparation is the best way of preventing the condition.
Symptoms of this food poisoning are due to staphylococcal enterotoxin, not the microorganisms themselves. Contamination is by food handling by persons with staphylococcal skin or eye infections.

147. In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?
A. The older one gets, the more susceptible he becomes to the complications of chicken pox.
B. A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
C. To prevent an outbreak in the community, quarantine may be imposed by health authorities.
D. Chicken pox vaccine is best given when there is an impending outbreak in the community.
Answer: (A) The older one gets, the more susceptible he becomes to the complications of chicken pox.
Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.

148. Complications to infectious parotitis (mumps) may be serious in which type of clients?
A. Pregnant women
B. Elderly clients
C. Young adult males
D. Young infants
Answer: (C) Young adult males
Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.

Situation 1 - Mr. Ibarra is assigned to the triage area and while on duty, he assesses the condition of Mrs. Simon who came in with asthma. She has difficulty breathing and her respiratory rate is 40 per minute. Mr. Ibarra is asked to inject the client epinephrine 0.3mg subcutaneously

1.       The indication for epinephrine injection for Mrs Simon is to:
a. Reduce anaphylaxis                                                                     b. Relieve hypersensitivity to allergen
c. Relieve respirator distress due to bronchial spasm                      d. Restore client’s cardiac rhythm

2. When preparing the epinephrine injection from an ampule, the nurse initially:
a. Taps the ampule at the top to allow fluid to flow to the base of the ampule
b. Checks expiration date of the medication ampule
c. Removes needle cap of syringe and pulls plunger to expel air
d. Breaks the neck of the ampule with a gauze wrapped around it

3. Mrs. Simon is obese. When administering a subcutaneous injection to an obese patient, it is best for the nurse to:
a Inject needle at a 15 degree angle' over the stretched skin of the client
b. Pinch skin at the Injection site and use airlock technique
c. Pull skin of patient down to administer the drug in a Z track
d. Spread skin or pinch at the injection site and inject needle at a 45-90 degree angle

4.       When preparing for a subcutaneous injection, the proper size of syringe and needle would be:
a. Syringe 3-5ml and needle gauge 21 to 23                                    b. Tuberculin syringe 1 mi with needle gauge 26 or 27
c. Syringe 2ml and needle gauge 22                                                d. Syringe 1-3ml and needle gauge 25 to 27

5.       The rationale for giving medications through the subcutaneous route is;
a. There are many alternative sites for subcutaneous injection                         b. Absorption time of the medicine is slower
c. There are less pain receptors in this area                                      d. The medication can be injected while the client is in any position

Situation 2 - The use of massage and meditation to help decrease stress and pain have been strongly recommended based on documented testimonials.

6. Martha wants to do a study on, this topic. "Effects of massage and meditation on stress and pain." The type of research that best suits this topic is:
a. applied research b. qualitative research c. basic research d. quantitative research

7.       The type of research design that does not manipulate independent variable is:
a. experimental design                                                     b. quasi-experimental design
c. non-experimental design                                              d. quantitative design

8.       This research topic has the potential to contribute to nursing because it seeks to:
a. include new modalities of care                                     b. resolve a clinical problem
c. clarify an ambiguous modality of care                         d. enhance client care

9.       Martha does review of related literature for the purpose of:
a. determine statistical treatment of data research                                             b. gathering data about what is already known or unknown
c. to identify if problem can be replicated                                                        d. answering the research question

10. Client’s rights should be protected when doing research using human subjects. Martha identifies these rights as follows EXCEPT:
a. right of self-determination b. right to compensation c. right of privacy d. right not to be harmed

Situation 3 - Richard has a nursing diagnosis of ineffective airway clearance related to excessive secretions and is at risk for infection because of retained secretions. Part of Nurse Mario's nursing care plan is to loosen and remove excessive secretions in the airway,

11. Mario listens to Richard's bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:
a. Client lying on his back then flat on his abdomen on Trendelenburg position
b. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his back and on his abdomen
c. Client lying flat on his back and then flat on his abdomen
d. Client lying on his right then left side on Trendelenburg position

12.    When documenting outcome of Richard's treatment Mario should include the following in his recording EXCEPT:
a. Color, amount and consistent of sputum                     b. Character of breath sounds and respirator/rate before and after procedure
c. Amount of fluid intake of client before and after the procedure                                   d. Significant changes in vital signs

13. When assessing Richard for chest percussion or chest vibration and postural drainage Mario would focus on the following EXCEPT:
a. Amount of food and fluid taken during the last meal before treatment
b. Respiratory rate, breath sounds and location of congestion
c. Teaching the client's relatives to perform 'the procedure
d. Doctor's order regarding position restriction and client's tolerance for lying flat

14.    Mario prepares Richard for postural drainage and percussion. Which of the flowing is a special consideration when doing the procedure?
a. Respiratory rate of 16 to 20 per minute                                                       b. Client can tolerate sitting and lying position
c. Client has no signs of infection                                                                   d. Time of fast food and fluid intake of the client

15. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedure is;
a. Percussion uses only one hand white vibration uses both hands
b. Percussion delivers cushioned blows to the chest with cupped palms while gently shakes secretion loose on the exhalation cycle
c. In both percussion and vibration the hands are on top of each other and hand action is in tune with client's breath rhythm
d. Percussion slaps the chest to loosen secretions while vibration shakes the secretions along with the inhalation of air

Situation 4 - A 61 year old man, Mr. Regalado, is admitted to the private ward for observation; after complaints of severe chest pain. You are assigned to take care of the client.

16.    When doing an initial assessment, the best way for you to identify the client’s priority problem is to:
a. Interview the client for chief complaints and other symptoms                     b. Talk to the relatives to gather data about history of illness
c. Do auscultation to check for chest congestion                             d. Do a physical examination white asking the client relevant questions

17. Upon establishing Mr. Regalado's nursing needs, the next nursing approach would be to:
a. introduce the client to the ward staff to put the client and family at ease
b. Give client and relatives a brief tour of the physical set up the unit
c. Take his vital signs for a baseline assessment
d. Establish priority needs and implement appropriate interventions

18.    Mr. Regalado says he has "trouble going to sleep". In order to plan your nursing intervention you will.
a. Observe his sleeping patterns in the next few day                                       b. Ask him what he means by this statement
c. Check his physical environment to decrease noise level                              d. Take his blood pressure before sleeping and upon waking up

19.    Mr. Regalado's lower extremities are swollen and shiny. He has pitting pedal edema. When taking care of Mr. Regalado, which of the following intervention would be the most appropriate immediate nursing approach.
a. Moisturize lower extremities to prevent skin irritation                 b. Measure fluid intake and output to decrease edema
c. Elevate lower extremities for postural drainage                                           d. Provide the client a list of food low in sodium

20.    Mr. Regalado will be discharged from your unit within the hour. Nursing actions when preparing a client for discharge include all EXCEPT:
a. Making a final physical assessment before client leaves the hospital                           b. Giving instructions about his medication regimen
c. Walking the client to the hospital exit to ensure his safety                                           d. Proper recording of pertinent data

Situation 5 - Nancy, mother of 2 young kids. 36 years old, had a mammogram and was told that she has breast cysts and that she may need surgery. This causes her anxiety as shown by increase in her pulse and respiratory rate, sweating and feelings of tension.

21.    Considering her level of anxiety, the nurse can best assist Nancy by:
a. Giving her activities to divert her attention                                  b. Giving detailed explanations about the treatments she will undergo
c. Preparing her and her family in case surgery is not successful    d. Giving her clear but brief information at the level of her understanding

22. Nancy blames God for her situation. She is easily provoked to tears and wants to be left alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or go to church stating that God has abandoned her. The nurse understands that Nancy is grieving for her self and is in the stage of:
a. bargaining b. denial c. anger d. acceptance

23. The nurse visits Nancy and prods her to eat her food. Nancy replies "what's the use? My time is running out. The nurse's best response would be:
a. "The doctor ordered full diet for you so that you will be strong for surgery."
b. "I understand how you fee! but you have 1o try for your children's sake."
c. "Have you told your, doctor how you feel? Are you changing your mind) about surgery?"
d. "You sound like you are giving up."

24. The nurse feels sad about Nancy's illness and tells her head nurse during the end of shift endorsement that "it's unfair for Nancy to have cancer when she is still so young and with two kinds. The best response of the head nurse would be:
a. Advise the nurse to "be strong and learn to control her feelings"
b. Assign the nurse to another client to avoid sympathy for the client
c. Reassure the nurse that the client has hope if she goes through all statements prescribed for her
c. Ask the other nurses what they feel about the patient to find out if they share the same feelings

25. Realizing that she feels angry about Nancy's condition, the nurse Seams that being self-aware is a conscious process that she should do in any situation like this because:
a. This is a necessary part of the nurse -client relationship process
b. The nurse is a role model for the client and should be strong
C. How the nurse thinks and feels affect her actions towards her client and her work
d. The nurse has to be therapeutic at all times and should not be affected

Situation 6 – Mrs. Seva, 32 years old, asks you about possible problems regarding her elimination now that she is in the menopausal stage.

26. Instruction on health promotion regarding urinary elimination is important. Which would you include?
a. Hold urine, as long as she can before emptying the bladder to strengthen her sphincters muscles
b. If burning sensation is experienced while voiding, drink pineapple-juice
c. After urination, wipe from anal area up towards the pubis
d. Jell client to empty the bladder at each voiding

27.    Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?
a. inhibition of the parasympathetic reflex                                       b. weakness of sphincter muscles of the anus
c. loss of tone of the smooth muscles of the color                           d. decreased ability to absorb fluids in the lower intestines

28. The nurse understands that one of these factors contributes to constipation:
a. excessive exercise b. high fiber diet c. no regular tine for defecation daily d. prolonged use of laxative

29.    Mrs. Seva talks about rear of being incontinent due to a prior experience of dribbling urine when laughing or sneezing and when she has a full bladder. Your most appropriate .instruction would be to:
a. tell client to drink less fluids to avoid accidents                                           b. instruct client to start wearing thin adult diapers
c. ask the client to bring change of underwear "just in case"                           d. teach client pelvic exercise to strengthen perineal muscles

30. Mrs. Seva asked for instructions for skin care for her mother who has urinary incontinence and is almost always in bed. Your instruction would focus on prevention of skin irritation and breakdown by
a. Using thick diapers to absorb urine well
b. Drying the skin with baby powder to prevent or mask the smell of ammonia
c. Thorough washing, rising and during of skin area that get wet with urine
d. Making sure that linen are smooth and dry at all times

Situation 7 - Using Maslow's need theory, Airway, Breathing and Circulation are the physiological needs vital to life. The nurse's knowledge and ability to identify and immediately intervene to meet these needs is important to save lives.

31.    Which of these clients has a problem with the transport of oxygen from the lungs to the tissues:
a. Carol with a tumor in the brain                                                    b. Theresa with anemia
c. Sonny Boy with a fracture in the femur                                       d. Brigette with diarrhea

32. You noted from the lab exams in the chart of Mr. Santos that he has reduced oxygen in the blood.
This condition is called:
a. Cyanosis b. Hypoxia c. Hypoxemia d. Anemia

33.    You will nasopharyngeal suctioning Mr. Abad. Your guide for the length of insertion of the tubing for an adult would be:
a. tip of the nose to the base of the .neck                                         b.   the distance from the tip of the nose to the middle of the cheek
c. the distance from the tip of the nose to the tip of the ear lobe                      d. eight to ten inches

34. While doing nasopharyngeal suctioning on .Mr. Abad, the nurse can avoid trauma to the area by:
a. Apply suction for at least 20-30 seconds each time to ensure that all secretions are removed
b. Using gloves to prevent introduction of pathogens to the respiratory system
c. Applying no suction while inserting the catheter
d. Rotating catheter as it is inserted with gentle suction

35. Myrna has difficulty breathing when on her back and must sit upright in bed to breath, effectively and comfortably. The nurse documents this condition as:
a. Apnea b. Orthopnea c. Dyspnea d. Tachypnea

Situation 8 - You are assigned to screen for hypertension: Your task is to take blood pressure readings and you are informed about avoiding the common mistakes in BP taking that lead to 'false or inaccurate blood pressure readings.

36. When taking blood pressure reading the cuff should be:
a. deflated fully then immediately start second reading for same client
b deflated quickly after inflating up to 180 mmHg
c. large enough to wrap around upper arm of the adult client 1 cm above brachial artery
d. inflated to 30 mmHg above the estimated systolic BP based on palpation of radial or bronchial artery

37. Chronic Obstructive Pulmonary Disease (COPD) in one of the leading causes of death worldwide and is a preventable disease. The primary cause of COPD is:
a. tobacco hack b. bronchitis c. asthma d. cigarette smoking

38. In your health education class for clients with diabetes you teach, them the areas, for control . Diabetes which include all EXCEPT:
a. regular physical activity b. thorough knowledge of foot care c. prevention nutrition d. proper nutrition

39. You teach your clients the difference between, Type I (IDDM) and Type II (NDDM) Diabetes. Which of the following is true?
a. both types diabetes mellitus clients are all prone to developing ketosis
b. Type II (NIDDM) is more common and is also preventable compared to Type I (IDDM) diabetes which is genetic in etiology
c. Type I (IDDM) is characterized by fasting hyperglycemia
d. Type II (IDDM) is characterized by abnormal immune response

40. Lifestyle-related diseases in general share areas common risk factors. These are the following except
a. physical activity b. smoking c. genetics d. nutrition

Situation 9 - Nurse Rivera witnesses a vehicular accident near the hospital where she works. She decides to get involved and help the victims of the accident.

41. Her priority nursing action would be to:
a. Assess damage to property
b. Assist in the police investigation since she is a witness
c. Report the incident immediately to the local police authorities
d. Assess the extent of injuries incurred by the victims, of the accident

42. Priority attention should be given to which of these clients?
a. Linda who shows severe anxiety due to trauma of the accident
b. Ryan who has chest injury, is pate and with difficulty of breathing
c. Noel who has lacerations on the arms with mild-bleeding
c. Andy whose left ankle swelled and has some abrasions

43.    In the emergency room, Nurse Rivera is assigned to attend to the client with .lacerations on the arms, while assessing the extent of the wound the nurse observes that the wound is now starting to bleed profusely. The most immediate nursing action would be to:
a. Apply antiseptic to prevent infection                                           b. Clean the wound vigorously of contaminants
c. Control and. reduce bleeding of the wound                 d. Bandage the wound and elevate the arm

44.    The nurse applies pressure dressing on the bleeding site. This intervention is done to:
a. Reduce the need to change dressing frequently                           b. Allow the pus to surface faster
c. Protect the wound from micro organisms in the air                     d. Promote hemostasis

45. After the treatment, the client is sent home and asked to come back for follow-up care. Your responsibilities when the client is to be discharged include the following EXCEPT:
a. Encouraging the client to go to the, outpatient clinic for follow up care
b. Accurate recording, of treatment done and instructions given to client
c. Instructing the client to see you after discharge for further assistance
d. Providing instructions regarding wound care

Situation 10 - While working in the clinic, a new client, Geline, 35 years old, arrives for her doctor's appointment. As the clinic nurse, you are to assist the client fiil up forms, gather data and make an assessment.

46. The nurse purpose of your initial nursing interview is to:
a. Record pertinent information in the client chart for health team to read
b Assist the client find solutions to her health concerns
c. Understand her lifestyle, health needs and possible problems to develop a plan of care
d. Make nursing diagnoses for identified health problems

47. While interviewing Geline, she starts to moan and doubles up in pain, She tells you that this pain occurs about an hour after taking black coffee without breakfast for a few weeks now. You will record this as follows:
a. Claims to have abdominal pains after intake of coffee unrelieved by analgesics
b. After drinking coffee, the client experienced severe abdominal pain
c. Client complained of intermittent abdominal pain an hour after drinking coffee
d. Client reported abdominal pain an hour after drinking black coffee for three weeks now

48. Geline tells you that she drinks black coffee frequently within the day to "have energy and be wide awake" and she eats nothing for breakfast and eats strictly vegetable salads for lunch and dinner to lose weight. She has lost weight during the past two weeks, in planning a healthy balanced diet with Geline, you will:
a. Start her off with a cleansing diet to free her body of toxins then change to a vegetarian, diet and drink plenty of fluids
b. Plan a high protein, diet; low carbohydrate diet for her considering her favorite food
c. Instruct her to attend classes in nutrition to find food rich in complex carbohydrates to maintain daily high energy level
d. Discuss with her the importance of eating a variety of food from the major food groups with plenty of fluids

49. Geline tells you that she drinks 4-5 cups of black coffee and diet cola drinks. She also smokes up to a pack of cigarettes daily. She confesses that she is in her 2nd month of pregnancy but she does not want to become fat that is why she limits her food intake. You warn or caution her about which of the following?
a. Caffeine products affect the central nervous system and may cause the mother to have a "nervous breakdown"
b. Malnutrition and its possible effects on growth and development problems in the unborn fetus
c. Caffeine causes a stimulant effect on both the mother and the baby
d. Studies show conclusively that caffeine causes mental retardation

50. Your health education plan for Geline stresses proper diet for a pregnant woman and the prevention of non-communicable diseases that are influenced by her lifestyle these include of the following EXCEPT:
a. Cardiovascular diseases b. Cancer c. Diabetes Mellitus d. Osteoporosis

Situation 11 - Management of nurse practitioners is done by qualified nursing leaders who have had clinical experience and management experience.

51.    An example of a management function of a nurse is:
a. Teaching patient do breathing and coughing exercises                                b. Preparing for a surprise party for a client
c. Performing nursing procedures for clients                                                  d. Directing and evaluating the staff nurses

52. Your head nurse in the unit believes that the staff nurses are not capable of decision making so she makes the decisions for everyone without consulting anybody. This type of leadership is:
a. Laissez faire leadership b. Democratic leadership c. Autocratic leadership d. Managerial leadership

53. When the head nurse in your ward plots and approves your work schedules and directs your work, she is demonstrating:
a. Responsibility b. Delegation c. Accountability d. Authority

54.    The following tasks can be safely delegated' by a nurse to a non-nurse health worker EXCEPT:
a. Transfer a client from bed to chair                                                               b. Change IV infusions
c. Irrigation of a nasogastric tube                                                                    d. Take vital signs

55. You made a mistake in giving the medicine to the wrong client You notify the client’s doctor and write an incident report. You are demonstrating:
a. Responsibility b. Accountability c. Authority d. Autocracy

Situation 12 – Mr. Dizon, 84 years old, is brought to the .Emergency Room for complaint of hypertension flushed face, severe headache, and nausea. You are doing the initial assessment of vital signs.

56. You are to measure the client’s initial blood pressure reading by doing all of the following EXCEPT:
a. Take the blood pressure reading on both arms for comparison
b. Listen to and identify the phases of Korotkoff’s sounds
c. Pump the cuff up to around 50 mmHg above the point where the pulse is obliterated
d. Observe procedures for infection control

57. A pulse oximeter is attached to Mr. Dizon’s finger to:
a. Determine if the client’s hemoglobin level is low and if he needs blood transfusion
b. Check level of client’s tissue perfusion
c. Measure the efficacy of the client’s anti hypertensive medications
d. Detect oxygen saturation of arterial blood before symptoms of hypoxemia develops

58.    After a few hours in the Emergency Room, Mr. Dizon is admitted to the ward with an order of hourly monitoring of blood pressure. The nurse finds that the cuff is too narrow and this will cause the blood pressure reading to be:
a. Inconsistent                                                                 b. low systolic and high diastolic pressure
c. higher than what the reading should be                       d. lower than what the reading should be

59. Through the client’s health history, you gather that Mr. Dizon smokes and drinks coffee. When taking the blood pressure of a client who recently smoked or drank coffee, how long should be the nurse wait before taking the client’s blood pressure for accurate reading?
a. 15 minutes b. 30 minutes c. 1 hour d. 5 minutes

60.    While the client has the pulse oximeter on his fingertip, you notice that the sunlight is shining on .the area where the oximeter is. Your action will be to:
a. Set and turn on the alarm of the oximeter                                                    b. Do nothing since there is no identified problem
c. Cover the fingertip sensor with a towel or bedsheet                                    d. Change the location of the sensor every four hours

Situation 13 - The nurse's understanding of ethico-legal responsibilities will guide his/her nursing practice.

61. The principles that .govern right and proper conducts of a person regarding life, biology and the health professions is referred to as:
a. Morality b. Religion c. Values d. Bioethics

62. The purpose of having nurses’ code of ethics is:
a. Delineate the scope and areas of nursing practice
b. Identify nursing action recommended for specific healthcare situations
c. To help the public understand professional conduct, expected of nurses
d. To define the roles and functions of the health care giver, nurses, clients

63.    The most important nursing responsibility where ethical situations emerge in patient care is to:
a. Act only when advised that the action is ethically sound                                                             b. Not take sides remain neutral and fair
c. Assume that ethical questions are the responsibility: of the health team                                      d. Be accountable for his or her own action

64.    You inform the patient about his rights which include the following EXCEPT:
a. Right to expect reasonable continuity of care                   b. Right to consent to or decline to participate in research studies or experiments
c. Right to obtain information about another patient            d. Right to expect that the records about his care will be treated as confidential

65. The principle states that a person has unconditional worth and has the capacity to determine his own destiny.
a. Bioethics b. Justice c. Fidelity d. Autonomy

Situation 14 – Your director of nursing wants to improve the quality of health care offered in the hospital. As a staff nurse in that hospital you know that this entails quality assurance programs.

66.    The following mechanisms can be utilized as part of the quality assessment program of your hospital EXCEPT:
a. Patient satisfaction surveys provided                                           b. Peer review clinical records of care of client
c. RO of the Nursing Intervention Classification                            d.

67. The nurse of the Standards of Nursing Practice is important in the hospital. Which of the following statements best describes what it is?
a. These are statements that describe the maximum or highest level of acceptable performance in nursing practice.
b. It refers to the scope of nursing as defined in Republic Act 9173
c. It is a license issued by the Professional Regulation Commission to protect the public from substandard nursing practice.
d. The Standards of care includes the various steps of the nursing process and the standards of professional performance.

68. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?
a. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
b. Have two nurses validate the phone order, both nurses sign the order and the doctor should sign his order within 24 hours.
c. Have the registered nurse, family and doctor sign the order
d. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

69. To ensure the client safety before starting blood transfusion the following are needed before the procedure can be done EXCEPT:
a. take baseline vital signs
b. blood should be warmed to room temperature for 30 minutes before blood transfusion is administered
c. have two nurses verify client identification, blood type, unit number and expiration date of blood
d. get a consent signed for blood transfusion

70. Part of standards of care has to do with the use of restraints. Which of the following statements is NOT true?
a. Doctor’s order for restraints should be signed within 24 hours
b. Remove and reapply restraints every two hours
c. Check client’s pulse, blood pressure and circulation every four hours
d. Offer food and toileting every two hours

Situation 15 – During the NUTRITION EDUCATION class discussion a 58 year old man, Mr. Bruno shows increased interest.

71.    Mr. Bruno asks what the "normal" allowable salt intake is. Your best response to Mr. Bruno is:
a. 1 tsp of salt/day with iodine and sprinkle of MSG                                      b. 5 gms per day or 1 tsp of table salt/day
c. 1 tbsp of salt/day with some patis and toyo                                 d. 1 tsp of salt/day but not patis or toyo

72.    Your instructions to reduce or limit salt intake include all the following EXCEPT:
a. eat natural food with little or no salt added                                                  b. limit use of table salt and use condiments instead
c. use herbs and spices                                                                                    d. limit intake of preserved or processed food

73.    Teaching strategies and approaches when giving nutrition education is influenced by age, sex and immediate concerns of the group. Your presentation for a group of young mothers would be best if you focus on:
a. diets limited in salt and fat                                                                           b. harmful effect on drugs and alcohol intake
c. commercial preparation of dishes                                                                d. cooking demonstration and meal planning

74.    Cancer cure is dependent on
a. use of alternative methods of healing                                                           b. watching out for warning signs of cancer
c. proficiency in doing breast self-examination                                               d. early detection and prompt treatment

75. The role of the health worker in health education is to:
a. report incidence of non-communicable disease to community health center
b. educate as many people about warning signs of non-communicable diseases
c. focus on smoking cessation projects
d. monitor clients with hypertension

Situation 16 – You are assigned to take care of 10 patients during the morning shift. The endorsement includes the IV infusion and medications for these clients.

76. Mr. Felipe, 36 years old is to be given 2700ml of D5RL to infuse for 18 hours starting at 8am. At what rate should the IV fluid be flowing hourly?
a. 100 ml/hour b. 210 ml/hour c. 150 ml/hour d. 90 ml/hour

77. Mr. Atienza is to receive 150mg/hour of D5W IV infusion for 12 hours for a total of 1800ml. He is also losing gastric fluid which must be replaced every two hours. Between 8am to 10am. Mr. Atienza has lost 250ml of gastric fluid. How much fluid should he receive at 11am?
a. 350 ml/hour b. 275 ml/hour c. 400 ml/hour d. 200 ml/hour

78. You are to apply a transdermal patch of nitroglycerin to your client. The following important guidelines to observe EXCEPT:
a. Apply to hairlines clean are of the skin not subject to much wrinkling
b. Patches may be applied to distal part of the extremities like forearm
c. Change application and site regularly to prevent irritation of the skin
d. Wear gloves to avoid any medication of your hand

79.    You will be applying eye drops to Miss Romualdez. After checking all the necessary information and cleaning the affected eyelid and eyelashes you administer the ophthalmic drops by instilling the eye drops.
a. directly onto the cornea                                                                b. pressing on the lacrimal duct
c. into the outer third of the lower conjunctival sac                         d. from the inner canthus going towards the side of the eye

80. When applying eye ointment, the following guidelines apply EXCEPT:
a. squeeze about 2 cm of ointment and gently close but not squeeze eye
b. apply ointment from the inner canthus going outward of the affected eye
c. discard the first bead of the eye ointment before application because the tube likely to expel more than desired amount of ointment
d. hold the tube above the conjunctival sac do not let tip touch the conjuctiva

Situation 17 – The staff nurse supervisor request all the staff nurses to “brainstorm” and learn ways to instruct diabetic clients on self-administration of insulin. She wants to ensure that there are nurses available daily to do health education classess.

81.    The plan of the nurse supervisor is an example of
a. in service education process                                        b. efficient management of human resources
c. increasing human resources                                         d. primary prevention

82.    When Mrs. Guevarra, a nurse, delegates aspects of the clients care to the nurse-aide who is an unlicensed staff, Mrs. Guevarra.
a. makes the assignment to teach the staff member          b. is assigning the responsibility to the aide but not the accountability for those tasks
c. does not have to supervise or evaluate the aide            d. most know how to perform task delegated

83.    Connie, the-new nurse, appears tired and sluggish and lacks the enthusiasms she give six weeks ago when she started the job. The nurse supervisor should:
a. empathize with the nurse and listen to her                                   b. tell her to take the day off
c. discuss how she is adjusting to her new job                                d. ask about her family life

84. Process of formal negotiations of working conditions between a group of registered nurses and employer is:
a. grievance b. arbitration c. collective bargaining d. strike

85. You are attending a certification program on cardiopulmonary resuscitation (CPR) offered and required by the hospital employing you. This is;
a. professional course towards credits b. in-service education c. advance training d. continuing education

Situation 18 - There are various developments in health education that the nurse should know about.

86. The provision of health information in the rural areas nationwide through television and radio programs and video conferencing is referred to as:
a. Community health program b. Telehealth program c. Wellness program d. Red cross program

87. A nearby community provides blood pressure screening, height and weight measurement smoking cessation classes and aerobics class services. This type of program is referred to as:
a. outreach program b. hospital extension program c. barangay health center d. wellness center

88. Part of teaching client in health promotion is responsibility for one’s health. When Danica states she need to improve her nutritional status this means:
a. Goals and interventions to be followed by client are based on nurse's priorities
b. Goals and intervention developed by nurse and client should be approved by the doctor
c. Nurse will decide goals and, interventions needed to meet client goals
d. Client will decide the goals and interventions required to meet her goals

89.    Nurse Beatrice is providing tertiary prevention to Mrs. De Villa. An example of tertiary provestion is:
a. Marriage counseling                                                    b. Self-examination for breast cancer
c. Identifying complication of diabetes                            d. Poison, control

90. Mrs. Ostrea has a schedule for Pap Smear. She has a strong family history of cervical cancer. This is an example of:
a. tertiary prevention b. secondary prevention c. health screening d. primary prevention

Situation: 19 - Ronnie has a vehicular accident where he sustained injury to his left ankle. In the Emergency Room, you notice how anxious he looks.

91. You establish rapport with him and to reduce his anxiety you initially
a. Take him to the radiology, section for X-ray of affected extremity
b. Identify yourself and state your purpose in being with the client
c. Talk to the physician for an order of Valium
d. Do inspection and palpation to check extent of his injuries

92. While doing your assessment, Ronnie asks you "Do I have a fracture? I don't want to have a cast.” The most appropriate nursing response would be:
a. "You have to have an X-ray first to know if you have a fracture."
b. "Why do you; sound so scared? It is just a cast and it's not painful"
c. "You seem to be concerned about being in a cast."
d. "Based on my assessment, there doesn’t seem to be a fracture."

ANSWER KEY
1. C 2. B 3. D 4. D 5. B 6. B 7. C 8. D 9. B 10. B 11. B 12. C 13. C 14. D 15. A 16. A 17. C 18. B 19. A 20. C 21. D 22. C 23. D 24. D 25. C 26. D 27. C 28. D 29. D 30. C 31. B 32. C 33. C 34. C 35. B 36. D 37. D 38. B 39. B 40. C 41. D 42. B 43. D 44. D 45. C 46. C 47. D 48. D 49. B 50. D 51. D 52. C 53. D 54. B 55. B 56. C 57. D 58. C 59. B 60. C 61. D 62. C 63. D 64. C 65. D 66. D 67. A 68. D 69. D 70. C 71. B 72. B 73. D 74. D 75. B 76. C 77. - 78. B 79. B 80. C 81. C 82. B 83. C 84. C 85 B 86. B 87. A 88. D 89. C 90. B 91. B 92. C

1.        Ms. Castro is newly-promoted to a patient care manager position. She updates her knowledge on the theories in management and leadership in order to become effective in her new role. She learns that some managers have low concern for services and high concern for staff. Which style of management refers to this?
A. Organization Man                                                      B. Impoverished Management
C. Country Club Management                                        D. Team Management
Answer: (C) Country Club Management
Country club management style puts concern for the staff as number one priority at the expense of the delivery of services. He/she runs the department just like a country club where every one is happy including the manager.

2. Her former manager demonstrated passion for serving her staff rather than being served. She takes time to listen, prefers to be a teacher first before being a leader, which is characteristic of
A. Transformational leader B. Transactional leader C. Servant leader D. Charismatic leader
Answer: (C) Servant leader
Servant leaders are open-minded, listen deeply, try to fully understand others and not being judgmental

3. On the other hand, Ms. Castro notices that the Chief Nurse Executive has charismatic leadership style. Which of the following behaviors best describes this style?
A. Possesses inspirational quality that makes followers gets attracted of him and regards him with reverence
B. Acts as he does because he expects that his behavior will yield positive results
C. Uses visioning as the core of his leadership
D. Matches his leadership style to the situation at hand.
Answer: (A) Possesses inspirational quality that makes followers gets attracted of him and regards him with reverence
Charismatic leaders make the followers feel at ease in their presence. They feel that they are in good hands whenever the leader is around.

4. Which of the following conclusions of Ms. Castro about leadership characteristics is TRUE?
A. There is a high correlation between the communication skills of a leader and the ability to get the job done.
B. A manager is effective when he has the ability to plan well.
C. Assessment of personal traits is a reliable tool for predicting a manager’s potential.
D. There is good evidence that certain personal qualities favor success in managerial role.
Answer: (C) Assessment of personal traits is a reliable tool for predicting a manager’s potential.
It is not conclusive that certain qualities of a person would make him become a good manager. It can only predict a manager’s potential of becoming a good one.

5. She reads about Path Goal theory. Which of the following behaviors is manifested by the leader who uses this theory?
A. Recognizes staff for going beyond expectations by giving them citations
B. Challenges the staff to take individual accountability for their own practice
C. Admonishes staff for being laggards.
D. Reminds staff about the sanctions for non performance.
Answer: (A) Recognizes staff for going beyond expectations by giving them citations
Path Goal theory according to House and associates rewards good performance so that others would do the same

6. One leadership theory states that “leaders are born and not made,” which refers to which of the following theories?
A. Trait B. Charismatic C. Great Man D. Situational
Answer: (C) Great Man
Leaders become leaders because of their birth right. This is also called Genetic theory or the Aristotelian theory

7. She came across a theory which states that the leadership style is effective dependent on the situation. Which of the following styles best fits a situation when the followers are self-directed, experts and are matured individuals?
A. Democratic B. Authoritarian C. Laissez faire D. Bureaucratic
Answer: (C) Laissez faire
Laissez faire leadership is preferred when the followers know what to do and are experts in the field. This leadership style is relationship-oriented rather than task-centered

8. She surfs the internet for more information about leadership styles. She reads about shared leadership as a practice in some magnet hospitals. Which of the following describes this style of leadership?
A. Leadership behavior is generally determined by the relationship between the leader’s personality and the specific situation
B. Leaders believe that people are basically good and need not be closely controlled
C. Leaders rely heavily on visioning and inspire members to achieve results
D. Leadership is shared at the point of care.
Answer: (D) Leadership is shared at the point of care.
Shared governance allows the staff nurses to have the authority, responsibility and accountability for their own practice.

9.        Ms. Castro learns that some leaders are transactional leaders. Which of the following does NOT characterize a transactional leader?
A. Focuses on management tasks                                                   B. Is a caretaker
C. Uses trade-offs to meet goals                                                     D. Inspires others with vision
Answer: (D) Inspires others with vision
Inspires others with a vision is characteristic of a transformational leader. He is focused more on the day-to-day operations of the department/unit.

10.     She finds out that some managers have benevolent-authoritative style of management. Which of the following behaviors will she exhibit most likely?
A. Have condescending trust and confidence in their subordinates                                 B. Gives economic or ego awards
C. Communicates downward to the staff                                                                        D. Allows decision making among subordinates
Answer: (A) Have condescending trust and confidence in their subordinates
Benevolent-authoritative managers pretentiously show their trust and confidence to their followers

11. Harry is a Unit Manager I the Medical Unit. He is not satisfied with the way things are going in his unit. Patient satisfaction rate is 60% for two consecutive months and staff morale is at its lowest. He decides to plan and initiate changes that will push for a turnaround in the condition of the unit. Which of the following actions is a priority for Harry?
A. Call for a staff meeting and take this up in the agenda. B. Seek help from her manager.
C. Develop a strategic action on how to deal with these concerns. D. Ignore the issues since these will be resolved naturally.
Answer: (A) Call for a staff meeting and take this up in the agenda.
This will allow for the participation of every staff in the unit. If they contribute to the solutions of the problem, they will own the solutions; hence the chance for compliance would be greater.

12.     She knows that there are external forces that influence changes in his unit. Which of the following is NOT an external force?
A. Memo from the CEO to cut down on electrical consumption                     B. Demands of the labor sector to increase wages
C. Low morale of staff in her unit                                                                   D. Exacting regulatory and accreditation standards
Answer: (C) Low morale of staff in her unit
Low morale of staff is an internal factor that affects only the unit. All the rest of the options emanate from the top executive or from outside the institution.

13. After discussing the possible effects of the low patient satisfaction rate, the staff started to list down possible strategies to solve the problems head-on. Should they decide to vote on the best change strategy, which of the following strategies is referred to this?
A. Collaboration B. Majority rule C. Dominance D. Compromise
Answer: (B) Majority rule
Majority rule involves dividing the house and the highest vote wins.1/2 + 1 is a majority.

14. One staff suggests that they review the pattern of nursing care that they are using, which is described as a
A. job description B. system used to deliver care C. manual of procedure D. rules to be followed
Answer: (B) system used to deliver care
A system used to deliver care. In the 70’s it was termed as methods of patient assignment; in the early 80’s it was called modalities of patient care then patterns of nursing care in the 90’s until recently authors called it nursing care systems.

15.     Which of the following is TRUE about functional nursing?
A. Concentrates on tasks and activities                           B. Emphasizes use of group collaboration
C. One-to-one nurse-patient ratio                                    D. Provides continuous, coordinated and comprehensive nursing services
Answer: (A) Concentrates on tasks and activities
Functional nursing is focused on tasks and activities and not on the holistic care of the patients

16.     Functional nursing has some advantages, which one is an EXCEPTION?
A. Psychological and sociological needs are emphasized.                               B. Great control of work activities.
C. Most economical way of delivering nursing services.                                D. Workers feel secure in dependent role
Answer: (A) Psychological and sociological needs are emphasized.
When the functional method is used, the psychological and sociological needs of the patients are neglected; the patients are regarded as ‘tasks to be done ‘

17.     He raised the issue on giving priority to patient needs. Which of the following offers the best way for setting priority?
A. Assessing nursing needs and problems                                     B. Giving instructions on how nursing care needs are to be met
C. Controlling and evaluating the delivery of nursing care              D. Assigning safe nurse: patient ratio
Answer: (A) Assessing nursing needs and problems
This option follows the framework of the nursing process at the same time applies the management process of planning, organizing, directing and controlling

18.     Which of the following is the best guarantee that the patient’s priority needs are met?
A. Checking with the relative of the patient                                     B. Preparing a nursing care plan in collaboration with the patient
C. Consulting with the physician                                                    D. Coordinating with other members of the team
Answer: (B) Preparing a nursing care plan in collaboration with the patient
The best source of information about the priority needs of the patient is the patient himself. Hence using a nursing care plan based on his expressed priority needs would ensure meeting his needs effectively.

19.     When Harry uses team nursing as a care delivery system, he and his team need to assess the priority of care for a group of patients, which of the following should be a priority?
A. Each patient as listed on the worksheet                                      B. Patients who needs least care
C. Medications and treatments required for all patients   D. Patients who need the most care
Answer: (D) Patients who need the most care
In setting priorities for a group of patients, those who need the most care should be number-one priority to ensure that their critical needs are met adequately. The needs of other patients who need less care ca be attended to later or even delegated to assistive personnel according to rules on delegation.

20.     She is hopeful that her unit will make a big turnaround in the succeeding months. Which of the following actions of Harry demonstrates that he has reached the third stage of change?
A. Wonders why things are not what it used to be                                          B. Finds solutions to the problems
C. Integrate the solutions to his day-to-day activities                                      D. Selects the best change strategy
Answer: (C) Integrate the solutions to his day-to-day activities
Integrate the solutions to his day-to-day activities is expected to happen during the third stage of change when the change agent incorporate the selected solutions to his system and begins to create a change

21.     Julius is a newly-appointed nurse manager of The Good Shepherd Medical Center, a tertiary hospital located within the heart of the metropolis. He thinks of scheduling planning workshop with his staff in order to ensure an effective and efficient management of the department. Should he decide to conduct a strategic planning workshop, which of the following is NOT a characteristic of this activity?
A. Long-term goal-setting                                                                               B. Extends to 3-5 years in the future
C. Focuses on routine tasks                                                                            D. Determines directions of the organization
Answer: (C) Focuses on routine tasks
Strategic planning involves options A, B and D except C which is attributed to operational planning

22. Which of the following statements refer to the vision of the hospital?
A. The Good Shepherd Medical Center is a trendsetter in tertiary health care in the Philippines in the next five years
B. The officers and staff of The Good Shepherd Medical Center believe in the unique nature of the human person
C. All the nurses shall undergo continuing competency training program.
D. The Good Shepherd Medical Center aims to provide a patient-centered care in a total healing environment.
Answer: (A) The Good Shepherd Medical Center is a trendsetter in tertiary health care in the Philippines in the next five years
A vision refers to what the institution wants to become within a particular period of time.

23. The statement, “The Good Shepherd Medical Center aims to provide patient-centered care in a total healing environment” refers to which of the following?
A. Vision B. Goal C. Philosophy D. Mission
Answer: (B) Goal
B

24. Julius plans to revisit the organizational chart of the department. He plans to create a new position of a Patient Educator who has a coordinating relationship with the head nurse in the unit. Which of the following will likely depict this organizational relationship?
A. Box B. Solid line C. Broken line D. Dotted line
Answer: (C) Broken line
This is a staff relationship hence it is depicted by a broken line in the organizational structure

25. He likewise stresses the need for all the employees to follow orders and instructions from him and not from anyone else. Which of the following principles does he refer to?
A. Scalar chain B. Discipline C. Unity of command D. Order
Answer: (C) Unity of command
The principle of unity of command means that employees should receive orders coming from only one manager and not from two managers. This averts the possibility of sowing confusion among the members of the organization

26. Julius orients his staff on the patterns of reporting relationship throughout the organization. Which of the following principles refer to this?
A. Span of control B. Hierarchy C. Esprit d’ corps D. Unity of direction
Answer: (B) Hierarchy
Hierarchy refers to the pattern of reporting or the formal line of authority in an organizational structure.

27. He emphasizes to the team that they need to put their efforts together towards the attainment of the goals of the program. Which of the following principles refers to this?
A. Span of control B. Unity of direction C. Unity of command D. Command responsibility
Answer: (B) Unity of direction
Unity of direction means having one goal or one objective for the team to pursue; hence all members of the organization should put their efforts together towards the attainment of their common goal or objective.

28. Julius stresses the importance of promoting ‘esprit d corps’ among the members of the unit. Which of the following remarks of the staff indicates that they understand what he pointed out?
A. “Let’s work together in harmony; we need to be supportive of one another”
B. “In order that we achieve the same results; we must all follow the directives of Julius and not from other managers.”
C. “We will ensure that all the resources we need are available when needed.”
D. “We need to put our efforts together in order to raise the bar of excellence in the care we provide to all our patients.”
Answer: (A) “Let’s work together in harmony; we need to be supportive of one another”
The principle of ‘esprit d’ corps’ refers to promoting harmony in the workplace, which is essential in maintaining a climate conducive to work.

29.     He discusses the goal of the department. Which of the following statements is a goal?
A. Increase the patient satisfaction rate                                            B. Eliminate the incidence of delayed administration of medications
C. Establish rapport with patients.                                                   D. Reduce response time to two minutes.
Answer: (A) Increase the patient satisfaction rate
Goal is a desired result towards which efforts are directed. Options AB, C and D are all objectives which are aimed at specific end.

30. He wants to influence the customary way of thinking and behaving that is shared by the members of the department. Which of the following terms refer to this?
A. Organizational chart B. Cultural network C. Organizational structure D. Organizational culture
Answer: (D) Organizational culture
An organizational culture refers to the way the members of the organization think together and do things around them together. It’s their way of life in that organization

31.     He asserts the importance of promoting a positive organizational culture in their unit. Which of the following behaviors indicate that this is attained by the group?
A. Proactive and caring with one another                                        B. Competitive and perfectionist
C. Powerful and oppositional                                                          D. Obedient and uncomplaining
Answer: (A) Proactive and caring with one another
Positive culture is based on humanism and affiliative norms

32. Stephanie is a new Staff Educator of a private tertiary hospital. She conducts orientation among new staff nurses in her department. Joseph, one of the new staff nurses, wants to understand the channel of communication, span of control and lines of communication. Which of the following will provide this information?
A. Organizational structure B. Policy C. Job description D. Manual of procedures
Answer: (A) Organizational structure
Organizational structure provides information on the channel of authority, i.e., who reports to whom and with what authority; the number of people who directly reports to the various levels of hierarchy and the lines of communication whether line or staff.

33. Stephanie is often seen interacting with the medical intern during coffee breaks and after duty hours. What type of organizational structure is this?
A. Formal B. Informal C. Staff D. Line
Answer: (B) Informal
This is usually not published and oftentimes concealed.

34. She takes pride in saying that the hospital has a decentralized structure. Which of the following is NOT compatible with this type of model?
A. Flat organization B. Participatory approach C. Shared governance D. Tall organization
Answer: (D) Tall organization
Tall organizations are highly centralized organizations where decision making is centered on one authority level.

35.     Centralized organizations have some advantages. Which of the following statements are TRUE?
1. Highly cost-effective                                                   2. Makes management easier
3. Reflects the interest of the worker                               4. Allows quick decisions or actions.
A. 1 & 2                         B. 2 & 4                                  C. 2, 3& 4                               D. 1, 2, & 4
Answer: (A) 1 & 2
Centralized organizations are needs only a few managers hence they are less expensive and easier to manage

36.     Stephanie delegates effectively if she has authority to act, which is BEST defined as:
A. having responsibility to direct others                          B. being accountable to the organization
C. having legitimate right to act                                       D. telling others what to do
Answer: (C) having legitimate right to act
Authority is a legitimate or official right to give command. This is an officially sanctioned responsibility

37.     Regardless of the size of a work group, enough staff must be available at all times to accomplish certain purposes. Which of these purposes is NOT included?
A. Meet the needs of patients                                          B. Provide a pair of hands to other units as needed
C. Cover all time periods adequately.                              D. Allow for growth and development of nursing staff.
Answer: (B) Provide a pair of hands to other units as needed
Providing a pair of hands for other units is not a purpose in doing an effective staffing process. This is a function of a staffing coordinator at a centralized model.

38. Which of the following guidelines should be least considered in formulating objectives for nursing care?
A. Written nursing care plan B. Holistic approach C. Prescribed standards D. Staff preferences
Answer: (D) Staff preferences
Staff preferences should be the least priority in formulating objectives of nursing care. Individual preferences should be subordinate to the interest of the patients.

39.     Stephanie considers shifting to transformational leadership. Which of the following statements best describes this type of leadership?
A. Uses visioning as the essence of leadership.                              B. Serves the followers rather than being served.
C. Maintains full trust and confidence in the subordinates              D. Possesses innate charisma that makes others feel good in his presence.
Answer: (A) Uses visioning as the essence of leadership.
Transformational leadership relies heavily on visioning as the core of leadership.

40.     As a manager, she focuses her energy on both the quality of services rendered to the patients as well as the welfare of the staff of her unit. Which of the following management styles does she adopt?
A. Country club management                                          B. Organization man management
C. Team management                                                      D. Authority-obedience management
Answer: (C) Team management
Team management has a high concern for services and high concern for staff.

41.     Katherine is a young Unit Manager of the Pediatric Ward. Most of her staff nurses are senior to her, very articulate, confident and sometimes aggressive. Katherine feels uncomfortable believing that she is the scapegoat of everything that goes wrong in her department. Which of the following is the best action that she must take?
A. Identify the source of the conflict and understand the points of friction     B. Disregard what she feels and continue to work independently
C. Seek help from the Director of Nursing                                                     D. Quit her job and look for another employment.
Answer: (A) Identify the source of the conflict and understand the points of friction
This involves a problem solving approach, which addresses the root cause of the problem.

42.     As a young manager, she knows that conflict occurs in any organization. Which of the following statements regarding conflict is NOT true?
A. Can be destructive if the level is too high                                   B. Is not beneficial; hence it should be prevented at all times
C. May result in poor performance                                                 D. May create leaders
Answer: (B) Is not beneficial; hence it should be prevented at all times
Conflicts are beneficial because it surfaces out issues in the open and can be solved right away. Likewise, members of the team become more conscientious with their work when they are aware that other members of the team are watching them.

43. Katherine tells one of the staff, “I don’t have time to discuss the matter with you now. See me in my office later” when the latter asks if they can talk about an issue. Which of the following conflict resolution strategies did she use?
A. Smoothing B. Compromise C. Avoidance D. Restriction
Answer: (C) Avoidance
This strategy shuns discussing the issue head-on and prefers to postpone it to a later time. In effect the problem remains unsolved and both parties are in a lose-lose situation.

44.     Kathleen knows that one of her staff is experiencing burnout. Which of the following is the best thing for her to do?
A. Advise her staff to go on vacation.                             B. Ignore her observations; it will be resolved even without intervention
C. Remind her to show loyalty to the institution.            D. Let the staff ventilate her feelings and ask how she can be of help.
Answer: (D) Let the staff ventilate her feelings and ask how she can be of help.
Reaching out and helping the staff is the most effective strategy in dealing with burn out. Knowing that someone is ready to help makes the staff feel important; hence her self-worth is enhanced.

45.     She knows that performance appraisal consists of all the following activities EXCEPT:
A. Setting specific standards and activities for individual performance.                          B. Using agency standards as a guide.
C. Determine areas of strength and weaknesses                                              D. Focusing activity on the correction of identified behavior.
Answer: (D) Focusing activity on the correction of identified behavior.
Performance appraisal deal with both positive and negative performance; is not meant to be a fault-finding activit

46. Which of the following statements is NOT true about performance appraisal?
A. Informing the staff about the specific impressions of their work help improve their performance.
B. A verbal appraisal is an acceptable substitute for a written report
C. Patients are the best source of information regarding personnel appraisal.
D. The outcome of performance appraisal rests primarily with the staff.
Answer: (C) Patients are the best source of information regarding personnel appraisal.
The patient can be a source of information about the performance of the staff but it is never the best source. Directly observing the staff is the best source of information for personnel appraisal.

47. There are times when Katherine evaluates her staff as she makes her daily rounds. Which of the following is NOT a benefit of conducting an informal appraisal?
A. The staff member is observed in natural setting.
B. Incidental confrontation and collaboration is allowed.
C. The evaluation is focused on objective data systematically.
D. The evaluation may provide valid information for compilation of a formal report.
Answer: (C) The evaluation is focused on objective data systematically.
Collecting objective data systematically can not be achieved in an informal appraisal. It is focused on what actually happens in the natural work setting.

48. She conducts a 6-month performance review session with a staff member. Which of the following actions is appropriate?
A. She asks another nurse to attest the session as a witness.
B. She informs the staff that she may ask another nurse to read the appraisal before the session is over.
C. She tells the staff that the session is manager-centered.
D. The session is private between the two members.
Answer: (D) The session is private between the two members.
The session is private between the manager and the staff and remains to be so when the two parties do not divulge the information to others

49. Alexandra is tasked to organize the new wing of the hospital. She was given the authority to do as she deems fit. 51. She is aware that the director of nursing has substantial trust and confidence in her capabilities, communicates through downward and upward channels and usually uses the ideas and opinions of her staff. Which of the following is her style of management?
A. Benevolent –authoritative B. Consultative C. Exploitive-authoritative D. Participative
Answer: (B) Consultative
A consultative manager is almost like a participative manager. The participative manager has complete trust and confidence in the subordinate, always uses the opinions and ideas of subordinates and communicates in all directions.

50. She decides to illustrate the organizational structure. Which of the following elements is NOT included?
A. Level of authority B. Lines of communication C. Span of control D. Unity of direction
Answer: (D) Unity of direction
Unity of direction is a management principle, not an element of an organizational structure.

51. She plans of assigning competent people to fill the roles designed in the hierarchy. Which process refers to this?
A. Staffing B. Scheduling C. Recruitment D. Induction
Answer: (A) Staffing
Staffing is a management function involving putting the best people to accomplish tasks and activities to attain the goals of the organization.

52.     She checks the documentary requirements for the applicants for staff nurse position. Which one is NOT necessary?
A. Certificate of previous employment                                                            B. Record of related learning experience (RLE)
C. Membership to accredited professional organization                  D. Professional identification card
Answer: (B) Record of related learning experience (RLE)
Record of RLE is not required for employment purposes but it is required for the nurse’s licensure examination.

53. Which phase of the employment process includes getting on the payroll and completing documentary requirements?
A. Orientation B. Induction C. Selection D. Recruitment
Answer: (B) Induction
This step in the recruitment process gives time for the staff to submit all the documentary requirements for employment.

54. She tries to design an organizational structure that allows communication to flow in all directions and involve workers in decision making. Which form of organizational structure is this?
A. Centralized B. Decentralized C. Matrix D. Informal
Answer: (B) Decentralized
Decentralized structures allow the staff to make decisions on matters pertaining to their practice and communicate in downward, upward, lateral and diagonal flow.

55. In a horizontal chart, the lowest level worker is located at the
A. Left most box B. Middle C. Right most box D. Bottom
Answer: (C) Rightmost box
The leftmost box is occupied by the highest authority while the lowest level worker occupies the rightmost box.

56.     She decides to have a decentralized staffing system. Which of the following is an advantage of this system of staffing?
A. greater control of activities                                                         B. Conserves time
C. Compatible with computerization                                               D. Promotes better interpersonal relationship
Answer: (D) Promotes better interpersonal relationship
Decentralized structures allow the staff to solve decisions by themselves, involve them in decision making; hence they are always given opportunities to interact with one another.

57.     Aubrey thinks about primary nursing as a system to deliver care. Which of the following activities is NOT done by a primary nurse?
A. Collaborates with the physician                                  B. Provides care to a group of patients together with a group of nurses
C. Provides care for 5-6 patients during their hospital stay.            D. Performs comprehensive initial assessment
Answer: (B) Provides care to a group of patients together with a group of nurses
This function is done in team nursing where the nurse is a member of a team that provides care for a group of patients.

58. Which pattern of nursing care involves the care given by a group of paraprofessional workers led by a professional nurse who take care of patients with the same disease conditions and are located geographically near each other?
A. Case method B. Modular nursing C. Nursing case management D. Team nursing
Answer: (B) Modular nursing
Modular nursing is a variant of team nursing. The difference lies in the fact that the members in modular nursing are paraprofessional workers.

59.     St. Raphael Medical Center just opened its new Performance Improvement Department. Ms. Valencia is appointed as the Quality Control Officer. She commits herself to her new role and plans her strategies to realize the goals and objectives of the department. Which of the following is a primary task that they should perform to have an effective control system?
A. Make an interpretation about strengths and weaknesses                            B. Identify the values of the department
C. Identify structure, process, outcome standards & criteria                           D. Measure actual performances
Answer: (B) Identify the values of the department
Identify the values of the department will set the guiding principles within which the department will operate its activities

60. Ms. Valencia develops the standards to be followed. Among the following standards, which is considered as a structure standard?
A. The patients verbalized satisfaction of the nursing care received
B. Rotation of duty will be done every four weeks for all patient care personnel.
C. All patients shall have their weights taken recorded
D. Patients shall answer the evaluation form before discharge
Answer: (B) Rotation of duty will be done every four weeks for all patient care personnel.
Structure standards include management system, facilities, equipment, materials needed to deliver care to patients. Rotation of duty is a management system.

61. When she presents the nursing procedures to be followed, she refers to what type of standards?
A. Process B. Outcome C. Structure D. Criteria
Answer: (A) Process
Process standards include care plans, nursing procedure to be done to address the needs of the patients.

62.     The following are basic steps in the controlling process of the department. Which of the following is NOT included?
A. Measure actual performance                                                                       B. Set nursing standards and criteria
C. Compare results of performance to standards and objectives                     D. Identify possible courses of action
Answer: (D) Identify possible courses of action
This is a step in a quality control process and not a basic step in the control process.

63.     Which of the following statements refers to criteria?
A. Agreed on level of nursing care                                 B. Characteristics used to measure the level of nursing care
C. Step-by-step guidelines                                              D. Statement which guide the group in decision making and problem solving
Answer: (B) Characteristics used to measure the level of nursing care
Criteria are specific characteristics used to measure the standard of care.

64.     She wants to ensure that every task is carried out as planned. Which of the following tasks is NOT included in the controlling process?
A. Instructing the members of the standards committee to prepare policies                    B. Reviewing the existing policies of the hospital
C. Evaluating the credentials of all nursing staff                                                             D. Checking if activities conform to schedule
Answer: (A) Instructing the members of the standards committee to prepare policies
Instructing the members involves a directing function.

65. Ms. Valencia prepares the process standards. Which of the following is NOT a process standard?
A. Initial assessment shall be done to all patients within twenty four hours upon admission.
B. Informed consent shall be secured prior to any invasive procedure
C. Patients’ reports 95% satisfaction rate prior to discharge from the hospital.
D. Patient education about their illness and treatment shall be provided for all patients and their families.
Answer: (C) Patients’ reports 95% satisfaction rate prior to discharge from the hospital.
This refers to an outcome standard, which is a result of the care that is rendered to the patient.

66.     Which of the following is evidence that the controlling process is effective?
A. The things that were planned are done                                       B. Physicians do not complain.
C. Employees are contended                                                           D. There is an increase in customer satisfaction rate.
Answer: (A) The things that were planned are done
Controlling is defined as seeing to it that what is planned is done.

67. Ms. Valencia is responsible to the number of personnel reporting to her. This principle refers to:
A. Span of control B. Unity of command C. Carrot and stick principle D. Esprit d’ corps
Answer: (A) Span of control
Span of control refers to the number of workers who report directly to a manager.

68.     She notes that there is an increasing unrest of the staff due to fatigue brought about by shortage of staff. Which action is a priority?
A. Evaluate the overall result of the unrest                                      B. Initiate a group interaction
C. Develop a plan and implement it                                                 D. Identify external and internal forces.
Answer: (B) Initiate a group interaction
Initiate a group interaction will be an opportunity to discuss the problem in the open.

69. Kevin is a member of the Nursing Research Council of the hospital. His first assignment is to determine the level of patient satisfaction on the care they received from the hospital. He plans to include all adult patients admitted from April to May, with average length of stay of 3-4 days, first admission, and with no complications. Which of the following is an extraneous variable of the study?
A. Date of admission B. Length of stay C. Age of patients D. Absence of complications
Answer: (C) Age of patients
An extraneous variable is not the primary concern of the researcher but has an effect on the results of the study. Adult patients may be young, middle or late adult.

70. He thinks of an appropriate theoretical framework. Whose theory addresses the four modes of adaptation?
A. Martha Rogers B. Sr. Callista Roy C. Florence Nightingale D. Jean Watson
Answer: (B) Sr. Callista Roy
Sr. Callista Roy developed the Adaptation Model which involves the physiologic mode, self-concept mode, role function mode and dependence mode

71.     He opts to use a self-report method. Which of the following is NOT TRUE about this method?
A. Most direct means of gathering information                               B. Versatile in terms of content coverage
C. Most accurate and valid method of data gathering                      D. Yields information that would be difficult to gather by another method
Answer: (C) Most accurate and valid method of data gathering
The most serious disadvantage of this method is accuracy and validity of information gathered

72.     Which of the following articles would Kevin least consider for his review of literature?
A. “Story-Telling and Anxiety Reduction Among Pediatric Patients”            B. “Turnaround Time in Emergency Rooms”
C. “Outcome Standards in Tertiary Health Care Institutions”                         D. “Environmental Manipulation and Client Outcomes”
Answer: (B) “Turnaround Time in Emergency Rooms”
The article is for pediatric patients and may not be relevant for adult patients.

73. Which of the following variables will he likely EXCLUDE in his study?
A. Competence of nurses B. Caring attitude of nurses C. Salary of nurses D. Responsiveness of staff
Answer: (C) Salary of nurses
Salary of staff nurses is not an indicator of patient satisfaction, hence need not be included as a variable in the study.

74. He plans to use a Likert Scale to determine
A. degree of agreement and disagreement B. compliance to expected standards

C. level of satisfaction D. degree of acceptance
Answer: (A) degree of agreement and disagreement
Likert scale is a 5-point summated scale used to determine the degree of agreement or disagreement of the respondents to a statement in a study.

75. He checks if his instruments meet the criteria for evaluation. Which of the following criteria refers to the consistency or the ability to yield the same response upon its repeated administration?
A. Validity B. Reliability C. Sensitivity D. Objectivity
Answer: (B) Reliability
Reliability is repeatability of the instrument; it can elicit the same responses even with varied administration of the instrument

76. Which criteria refer to the ability of the instrument to detect fine differences among the subjects being studied?
A. Sensitivity B. Reliability C. Validity D. Objectivity
Answer: (A) Sensitivity
Sensitivity is an attribute of the instrument that allow the respondents to distinguish differences of the options where to choose from

77. Which of the following terms refer to the degree to which an instrument measures what it is supposed to be measure?
A. Validity B. Reliability C. Meaningfulness D. Sensitivity
Answer: (A) Validity
Validity is ensuring that the instrument contains appropriate questions about the research topic

78. He plans for his sampling method. Which sampling method gives equal chance to all units in the population to get picked?
A. Random B. Accidental C. Quota D. Judgment
Answer: (A) Random
Random sampling gives equal chance for all the elements in the population to be picked as part of the sample.

79. Raphael is interested to learn more about transcultural nursing because he is assigned at the family suites where most patients come from different cultures and countries. Which of the following designs is appropriate for this study?
A. Grounded theory B. Ethnography C. Case study D. Phenomenology
Answer: (B) Ethnography
Ethnography is focused on patterns of behavior of selected people within a culture

80. The nursing theorist who developed transcultural nursing theory is
A. Dorothea Orem B. Madeleine Leininger C. Betty Newman D. Sr. Callista Roy
Answer: (B) Madeleine Leininger
Madeleine Leininger developed the theory on transcultural theory based on her observations on the behavior of selected people within a culture

81. Which of the following statements best describes a phenomenological study?
A. Involves the description and interpretation of cultural behavior
B. Focuses on the meaning of experiences as those who experience it
C. Involves an in-depth study of an individual or group
D. Involves collecting and analyzing data that aims to develop theories grounded in real-world observations
Answer: (B) Focuses on the meaning of experiences as those who experience it
Phenomenological study involves understanding the meaning of experiences as those who experienced the phenomenon.

82. He systematically plans his sampling plan. Should he decides to include whoever patients are admitted during the study he uses what sampling method?
A. Judgment B. Accidental C. Random D. Quota
Answer: (B) Accidental
Accidental sampling is a non-probability sampling method which includes those who are at the site during data collection.

83. He finally decides to use judgment sampling. Which of the following actions of Raphael is correct?
A. Plans to include whoever is there during his study.
B. Determines the different nationality of patients frequently admitted and decides to get representations samples from each.
C. Assigns numbers for each of the patients, place these in a fishbowl and draw 10 from it.
D. Decides to get 20 samples from the admitted patients
Answer: (B) Determines the different nationality of patients frequently admitted and decides to get representations samples from each.
Judgment sampling involves including samples according to the knowledge of the investigator about the participants in the study.

84. He knows that certain patients who are in a specialized research setting tend to respond psychologically to the conditions of the study. This is referred to as
A. Bias B. Hawthorne effect C. Halo effect D. Horns effect
Answer: (B) Hawthorne effect
Hawthorne effect is based on the study of Elton Mayo and company about the effect of an intervention done to improve the working conditions of the workers on their productivity. It resulted to an increased productivity but not due to the intervention but due to the psychological effects of being observed. They performed differently because they were under observation.

85. Which of the following items refer to the sense of closure that Raphael experiences when data collection ceases to yield any new information?
A. Saturation B. Precision C. Limitation D. Relevance
Answer: (A) Saturation
Saturation is achieved when the investigator can not extract new responses from the informants, but instead, gets the same responses repeatedly.

86.     In qualitative research the actual analysis of data begins with:
A. search for themes                                                                       B. validation of thematic analysis
C. weave the thematic strands together                                            D. quasi statistics
Answer: (A) search for themes
The investigator starts data analysis by looking for themes from the verbatim responses of the informants

87. Raphael is also interested to know the coping abilities of patients who are newly diagnosed to have terminal cancer. Which of the following types of research is appropriate?
A. Phenomenological B. Ethnographic C. Grounded Theory D. Case Study
Answer: (C) Grounded Theory
Grounded theory inductively develops a theory based on the observed processes involving selected people

88. Which of the following titles of the study is appropriate for this study?
A. Lived Experiences of Terminally-Ill Cancer Patients B. Coping Skills of Terminally-Ill Cancer Patients in a Selected Hospital
C. Two Case Studies of Terminally-Ill Patients in Manila D. Beliefs & Practices of Patients with Terminal Cancer
Answer: (B) Coping Skills of Terminally-Ill Cancer Patients in a Selected Hospital
The title has a specific phenomenon, sample and research locale.

89.     Ms. Montana plans to conduct a research on the use of a new method of pain assessment scale. Which of the following is the second step in the conceptualizing phase of the research process?
A. Formulating the research hypothesis                                                          B. Review related literature
C. Formulating and delimiting the research problem                                       D. Design the theoretical and conceptual framework
Answer: (B) Review related literature
After formulating and delimiting the research problem, the researcher conducts a review of related literature to determine the extent of what has been done on the study by previous researchers.

90. Which of the following codes of research ethics requires informed consent in all cases governing human subjects?
A. Helsinki Declaration B. Nuremberg Code C. Belmont Report D. ICN Code of Ethics
Answer: (A) Helsinki Declaration
Helsinki Declaration is the first international attempt to set up ethical standards in research involving human research subjects.

91. Which of the following ethical principles was NOT articulated in the Belmont Report?
A. Beneficence B. Respect for human dignity C. Justice D. Non-maleficence
Answer: (D) Non-maleficence
Non-maleficence is not articulated in the Belmont Report. It only includes beneficence, respect for human dignity and justice.

92.     After the review session has been completed, Karen and the staff signed the document. Which of the following is the purpose of this?
A. Agree about the content of the evaluation.                                  B. Signify disagreement of the content of the evaluation.
C. Document that Karen and the staff reviewed the evaluation.                       D. Serve as basis for future evaluation.
Answer: (C) Document that Karen and the staff reviewed the evaluation.
Signing the document is done to serve as a proof that performance review was conducted during that date and time.

93. A nurse who would like to practice nursing in the Philippines can obtain a license to practice by:
A. Paying the professional tax after taking the board exams
B. Passing the board exams and taking the oath of professionals
C. Paying the examination fee before taking the board exams
D. Undergoing the interview conducted by the Board of Nursing and taking the board exams
Answer: (B) Passing the board exams and taking the oath of professionals
For a nurse to obtain a license to practice nursing in the Philippines, s/he must pass the board examinations and then take the oath of professionals before the Board of Nursing.

94. Reciprocity of license to practice requires that the country of origin of the interested foreign nurse complies with the following conditions:
A. The country of origin has similar preparation for a nurse and has laws allowing Filipino nurses to practice in their country.
B. The Philippines is recognized by the country of origin as one that has high quality of nursing education
C. The country of origin requires Filipinos to take their own board examination
D. The country of origin exempts Filipinos from passing their licensure examination
Answer: (A) The country of origin has similar preparation for a nurse and has laws allowing Filipino nurses to practice in their country.
According to the Philippine Nurses Act of 2002, foreign nurses wanting to practice in the Philippines must show proof that his/her country of origin meets the two essential conditions: a) the requirements for registration between the two countries are substantially the same; and b) the country of origin of the foreign nurse has laws allowing the Filipino nurse to practice in his/her country just like its own citizens

95. Nurses practicing the profession in the Philippines and are employed in government hospitals are required to pay taxes such as:
A. Both income tax and professional tax
B. Income tax only since they are exempt from paying professional tax
C. Professional tax which is paid by all nurses employed in both government and private hospitals
D. Income tax which paid every March 15 and professional tax which is paid every January 31.
Answer: (B) Income tax only since they are exempt from paying professional tax
According to the Magna Carta for Public Health Workers, government nurses are exempted from paying professional tax. Hence, as an employee in the government, s/he will pay only the income tax.

96. According to RA 9173 Philippine Nursing Act of 2002, a graduate nurse who wants to take must licensure examination must comply with the following qualifications:
A. At least 21 years old, graduate of BSN from a recognized school, and of good moral character
B. At least 18 years old, graduate of BSN from a recognized school and of good moral character
C. At least 18 years old, provided that when s/he passes the board exams, s/he must be at least 21 years old; BSN graduate of a recognized school, and of good moral character
D. Filipino citizen or a citizen of a country where we have reciprocity; graduate of BSN from a recognized school and of good moral character
Answer: (D) Filipino citizen or a citizen of a country where we have reciprocity; graduate of BSN from a recognized school and of good moral character
RA 9173 section 13 states that the qualifications to take the board exams are: Filipino citizen or citizen of a country where the Philippines has reciprocity; of good moral character and graduate of BSN from a recognized school of nursing. There is no explicit provision about the age requirement in RA 9173 unlike in RA7164 (old law).

97. Which of the following is TRUE about membership to the Philippine Nurses Association (PNA)?
A. Membership to PNA is mandatory and is stipulated in the Philippine Nursing Act of 2002
B. Membership to PNA is compulsory for newly registered nurses wanting to enter the practice of nursing in the country
C. Membership to PNA is voluntary and is encouraged by the PRC Code of Ethics for Nurses
D. Membership to PNA is required by government hospitals prior to employment
Answer: (C) Membership to PNA is voluntary and is encouraged by the PRC Code of Ethics for Nurses
Membership to any organization, including the PNA, is only voluntary and this right to join any organization is guaranteed in the 1987 constitution of the Philippines. However, the PRC Code of Ethics states that one of the ethical obligations of the professional nurse towards the profession is to be an active member of the accredited professional organization.

98. When the license of the nurse is revoked, it means that the nurse:
A. Is no longer allowed to practice the profession for the rest of her life
B. Will never have her/his license re-issued since it has been revoked
C. May apply for re-issuance of his/her license based on certain conditions stipulated in RA 9173
D. Will remain unable to practice professional nursing
Answer: (C) May apply for re-issuance of his/her license based on certain conditions stipulated in RA 9173
RA 9173 sec. 24 states that for equity and justice, a revoked license maybe re-issued provided that the following conditions are met: a) the cause for revocation of license has already been corrected or removed; and, b) at least four years has elapsed since the license has been revoked.

99.     According to the current nursing law, the minimum educational qualification for a faculty member of a college of nursing is:
A. Only a Master of Arts in Nursing is acceptable                         B. Masters degree in Nursing or in the related fields
C. At least a doctorate in nursing                                                    D. At least 18 units in the Master of Arts in Nursing Program
Answer: (B) Masters degree in Nursing or in the related fields
According to RA 9173 sec. 27, the educational qualification of a faculty member teaching in a college of nursing must be masters degree which maybe in nursing or related fields like education, allied health professions, psychology.

100. The educational qualification of a nurse to become a supervisor in a hospital is:
A. BSN with at least 9 units of post graduate studies in nursing administration
B. Master of Arts in Nursing major in administration
C. At least 2 years experience as a head nurse
D. At least 18 units of post graduate studies in nursing administration
Answer: (A) BSN with at least 9 units of post graduate studies in nursing administration
According to RA 9173 sec. 29, the educational qualification to be a supervisor in a hospital is at least 9 units of postgraduate studies in nursing administration. A masters degree in nursing is required for the chief nurse of a secondary or tertiary hospital.

101. The Board of Nursing has quasi-judicial power. An example of this power is:
A. The Board can issue rules and regulations that will govern the practice of nursing
B. The Board can investigate violations of the nursing law and code of ethics
C. The Board can visit a school applying for a permit in collaboration with CHED
D. The Board prepares the board examinations
Answer: (B) The Board can investigate violations of the nursing law and code of ethics
Quasi-judicial power means that the Board of Nursing has the authority to investigate violations of the nursing law and can issue summons, subpoena or subpoena duces tecum as needed.

102. When a nurse causes an injury to the patient and the injury caused becomes the proof of the negligent act, the presence of the injury is said to exemplify the principle of:
A. Force majeure B. Respondeat superior C. Res ipsa loquitur D. Holdover doctrine
Answer: (C) Res ipsa loquitur
Res ipsa loquitur literally means the thing speaks for itself. This means in operational terms that the injury caused is the proof that there was a negligent act.

103. Ensuring that there is an informed consent on the part of the patient before a surgery is done, illustrates the bioethical principle of:
A. Beneficence B. Autonomy C. Truth telling/veracity D. Non-maleficence
Answer: (B) Autonomy
Informed consent means that the patient fully understands what will be the surgery to be done, the risks involved and the alternative solutions so that when s/he give consent it is done with full knowledge and is given freely. The action of allowing the patient to decide whether a surgery is to be done or not exemplifies the bioethical principle of autonomy.

104. When a nurse is providing care to her/his patient, s/he must remember that she is duty bound not to do doing any action that will cause the patient harm. This is the meaning of the bioethical principle:
A. Non-maleficence B. Beneficence C. Justice D. Solidarity
Answer: (A) Non-maleficence
Non-maleficence means do not cause harm or do any action that will cause any harm to the patient/client. To do good is referred as beneficence.

105. When the patient is asked to testify in court, s/he must abide by the ethical principle of:
A. Privileged communication B. Informed consent C. Solidarity D. Autonomy
Answer: (A) Privileged communication
All confidential information that comes to the knowledge of the nurse in the care of her/his patients is considered privileged communications. Hence, s/he is not allowed to just reveal the confidential information arbitrarily. S/he may only be allowed to break the seal of secrecy in certain conditions. One such condition is when the court orders the nurse to testify in a criminal or medico-legal case.

106. When the doctor orders “do not resuscitate”, this means that
A. The nurse need not give due care to the patient since s/he is terminally ill
B. The patient need not be given food and water after all s/he is dying
C. The nurses and the attending physician should not do any heroic or extraordinary measures for the patient
D. The patient need not be given ordinary care so that her/his dying process is hastened
Answer: (C) The nurses and the attending physician should not do any heroic or extraordinary measures for the patient
Do not resuscitate” is a medical order which is written on the chart after the doctor has consulted the family and this means that the members of the health team are not required to give extraordinary measures but cannot withhold the basic needs like food, water, and air. It also means that the nurse is still duty bound to give the basic nursing care to the terminally ill patient and ensure that the spiritual needs of the patient is taken cared of.

107. Which of the following statements is TRUE of abortion in the Philippines?
A. Induced abortion is allowed in cases of rape and incest
B. Induced abortion is both a criminal act and an unethical act for the nurse
C. Abortion maybe considered acceptable if the mother is unprepared for the pregnancy
D. A nurse who performs induced abortion will have no legal accountability if the mother requested that the abortion done on her.
Answer: (B) Induced abortion is both a criminal act and an unethical act for the nurse
Induced abortion is considered a criminal act which is punishable by imprisonment which maybe up to a maximum of 12 years if the nurse gets paid for it. Also, the PRC Code of Ethics states that the nurse must respect life and must not do any action that will destroy life. Abortion is an act that destroys life albeit at the beginning of life.

108. Which of the following is NOT true about a hypothesis? Hypothesis is:
A. testable B. proven
C. stated in a form that it can be accepted or rejected D. states a relationship between variables
Answer: (B) proven
Hypothesis is not proven; it is either accepted or rejected. Hypothesis is testable and is defined as a statement that predicts the relationship between variables

109. Which of the following measures will best prevent manipulation of vulnerable groups?
A. Secure informed consent B. Payment of stipends for subjects
C. Protect privacy of patient D. Ensure confidentiality of data
Answer: (A) Secure informed consent
Securing informed consent will free the researcher from being accused of manipulating the subjects because by so doing he/she gives ample opportunity for the subjects to weigh the advantages/disadvantages of being included in the study prior to giving his consent. This is done without any element of force, coercion, threat or even inducement.

110. Which of the following procedures ensures that Ms. Montana has fully described to prospective subjects the nature of the study and the subject’s rights?
A. Debriefing B. Full disclosure C. Informed consent D. Covert data collection
Answer: (B) Full disclosure
Full disclosure is giving the subjects of the research information that they deserve to know prior to the conduct of the study

111. This technique refers to the use of multiple referents to draw conclusions about what constitutes the truth
A. Triangulation B. Experiment C. Meta-analysis D. Delphi technique
Answer: (A) Triangulation
Triangulation makes use of different sources of information such as triangulation in design, researcher and instrument.

112. The statement, “Ninety percent (90%) of the respondents are female staff nurses validates previous research findings (Santos, 2001; Reyes, 2005) that the nursing profession is largely a female dominated profession is an example of
A. implication B. interpretation C. analysis D. conclusion
Answer: (B) interpretation
Interpretation includes the inferences of the researcher about the findings of the study.

113. The study is said to be completed when Ms. Montana achieved which of the following activities?
A. Published the results in a nursing journal. B. Presented the study in a research forum.
C. The results of the study is used by the nurses in the hospital D. Submitted the research report to the CEO.
Answer: (C) The results of the study is used by the nurses in the hospital
The last step in the research process is the utilization of the research findings.

114. Situation : Stephanie is a nurse researcher of the Patient Care Services Division. She plans to conduct a literature search for her study.
Which of the following is the first step in selecting appropriate materials for her review?
A. Track down most of the relevant resources B. Copy relevant materials
C. Organize materials according to function D. Synthesize literature gathered.
Answer: (A) Track down most of the relevant resources
The first step in the review of related literature is to track down relevant sources before copying these. The last step is to synthesize the literature gathered.

115. She knows that the most important categories of information in literature review is the:
A. research findings B. theoretical framework C. methodology D. opinions

Answer: (A) research findings
The research findings is the most important category of information that the researcher should copy because this will give her valuable information as to what has been discovered in past studies about the same topic.

116. She also considers accessing electronic data bases for her literature review. Which of the following is the most useful electronic database for nurses?
A. CINAHL B. MEDLINE C. HealthSTAR D. EMBASE
Answer: (A) CINAHL
This refers to Cumulative Index to Nursing and Allied Health Literature which is a rich source for literature review for nurses. The rest of the sites are for medicine, pharmacy and other health-related sites.

117. While reviewing journal articles, Stephanie got interested in reading the brief summary of the article placed at the beginning of the journal report. Which of the following refers to this?
A. Introduction B. Preface C. Abstract D. Background
Answer: (C) Abstract
Abstract contains concise description of the background of the study, research questions, research objectives, methods, findings, implications to nursing practice as well as keywords used in the study.

118. She notes down ideas that were derived from the description of an investigation written by the person who conducted it. Which type of reference source refers to this?
A. Footnote B. Bibliography C. Primary source D. Endnotes
Answer: (C) Primary source
. This refers to a primary source which is a direct account of the investigation done by the investigator. In contrast to this is a secondary source, which is written by someone other than the original researcher.

119. She came across a study which is referred to as meta-analysis. Which of the following statements best defines this type of study?
A. Treats the findings from one study as a single piece of data
B. Findings from multiple studies are combined to yield a data set which is analyzed as individual data
C. Represents an application of statistical procedures to findings from each report
D. Technique for quantitatively combining and thus integrating the results of multiple studies on a given topic.
Answer: (D) Technique for quantitatively combining and thus integrating the results of multiple studies on a given topic.
Though all the options are correct, the best definition is option D because it combines quantitatively the results and at the same time it integrates the results of the different studies as one finding.

120. This kind of research gathers data in detail about an individual or groups and presented in narrative form, which is
A. Case study B. Historical C. Analytical D. Experimental
Answer: (A) Case study
Case study focuses on in-depth investigations of single entity or small number of entities. It attempts to analyze and understand issues of importance to history, development or circumstances of the person or entity under study.

121. Stephanie is finished with the steps in the conceptual phase when she has conducted the LAST step, which is
A. formulating and delimiting the problem. B. review of related literature
C. develop a theoretical framework D. formulate a hypothesis
Answer: (D) formulate a hypothesis
The last step in the conceptualizing phase of the research process is formulating a hypothesis. The rest are the first three steps in this phase.

122. She states the hypothesis of the study. Which of the following is a null hypothesis?
A. Infants who are breastfed have the same weight as those who are bottle fed.
B. Bottle-fed infants have lower weight than breast-fed infants
C. Cuddled infants sleep longer than those who are left by themselves to sleep.
D. Children of absentee parents are more prone to experience depression than those who live with both parents.
Answer: (A) Infants who are breastfed have the same weight as those who are bottle fed.
Null hypothesis predicts that there is no change, no difference or no relationship between the variables in the study

123. She notes that the dependent variable in the hypothesis “Duration of sleep of cuddled infants is longer than those infants who are not cuddled by mothers” is
A. Cuddled infants B. Duration of sleep C. Infants D. Absence of cuddling
Answer: (B) Duration of sleep
Duration of sleep is the ‘effect’ (dependent variable) of cuddling ‘cause’ (independent variable)

124. Situation: Aretha is a nurse researcher in a tertiary hospital. She is tasked to conduct a research on the effects of structured discharge plan for post-open heart surgery patients.
She states the significance of the research problem. Which of the following statements is the MOST significant for this study?
A. Improvement in patient care B. Development of a theoretical basis for nursing
C. Increase the accountability of nurses. D. Improves the image of nursing
Answer: (A) Improvement in patient care
The ultimate goal of conducting research is to improve patient care which is achieved by enhancing the practice of nurses when they utilize research results in their practice.

125. Regardless of the significance of the study, the feasibility of the study needs to be considered. Which of the following is considered a priority?
A. Availability of research subjects B. Budgetary allocation
C. Time frame D. Experience of the researcher
Answer: (A) Availability of research subjects
Availability is the most important criteria to be considered by the researcher in determining whether the study is feasible or not. No matter how significant the study may be if there are no available subjects/respondents, the study can not push through.

126. Aretha knows that a good research problem exhibits the following characteristics; which one is NOT included?
A. Clearly identified the variables/phenomenon under consideration. B. Specifies the population being studied.
C. Implies the feasibility of empirical testing D. Indicates the hypothesis to be tested.
Answer: (D) Indicates the hypothesis to be tested.
Not all studies require a hypothesis such as qualitative studies, which does not deal with variables but with phenomenon or concepts.

127. She states the purposes of the study. Which of the following describe the purpose of a study?
1. Establishes the general direction of a study
2. Captures the essence of the study
3. Formally articulates the goals of the study
4. Sometimes worded as an intent
A. 1, 2, 3 B. 2, 3, 4 C. 1, 3, 4 D. 1, 2, 3, 4
Answer: (D) 1, 2, 3, 4
The purposes of a research study covers all the options indicated.

128. She opts to use interviews in data collection. In addition to validity, what is the other MOST serious weakness of this method?
A. Accuracy B. Sensitivity C. Objectivity D. Reliability
Answer: (A) Accuracy
Accuracy and validity are the most serious weaknesses of the self-report data. This is due to the fact that the respondents sometimes do not want to tell the truth for fear of being rejected or in order to please the interviewer.

129. She plans to subject her instrument to pretesting. Which of the following is NOT achieved in doing pretesting?
A. Determines how much time it takes to administer the instrument package
B. Identify parts that are difficult to read or understand
C. Determine the budgetary allocation for the study
D. Determine if the measures yield data with sufficient variability
Answer: (C) Determine the budgetary allocation for the study
Determining budgetary allocation for the study is not a purpose of doing a pretesting of the instruments. This is done at an earlier stage of the design and planning phase.

130. She tests the instrument whether it looks as though it is measuring appropriate constructs. Which of the following refers to this?
A. Face validity B. Content validity C. Construct Validity D. Criterion-related validity
Answer: (A) Face validity
Face validity measures whether the instrument appears to be measuring the appropriate construct. It is the easiest type of validity testing.

131. Which of the following questions would determine the construct validity of the instrument?
A. “What is this instrument really measuring?”
B. “How representative are the questions on this test of the universe of questions on this topic?”
C. “Does the question asked looks as though it is measuring the appropriate construct?”
D. “Does the instrument correlate highly with an external criterion?
Answer: (A) “What is this instrument really measuring?”
Construct validity aims to validate what the instrument is really measuring. The more abstract the concept, the more difficult to measure the construct

132. Which of the following experimental research designs would be appropriate for this study if she wants to find out a cause and effect relationship between the structured discharge plan and compliance to home care regimen among the subjects?
A. True experiment B. Quasi experiment C. Post-test only design D. Solomon four-group
Answer: (C) Post-test only design
Post- Test only design is appropriate because it is impossible to measure the compliance to home care regimen variable prior to the discharge of the patient from the hospital.

133. One hypothesis that she formulated is “Compliance to home care regimen is greater among patients who received the structured discharge plan than those who received verbal discharge instructions.’ Which is the independent variable in this study?
A. Structured discharge plan B. Compliance to home care regimen
C. Post-open heart surgery patients D. Greater compliance
Answer: (A) Structured discharge plan
Structured discharge plan is the intervention or the ‘cause’ in the study that results to an ‘effect’, which is compliance to home care regimen or the dependent variable.

134. Situation : Alyssa plans to conduct a study about nursing practice in the country. She decides to refresh her knowledge about the different types of research in order to choose the most appropriate design for her study.
She came across surveys, like the Social Weather Station and Pulse Asia Survey. Which of the following is the purpose of this kind of research?
A. Obtains information regarding the prevalence, distribution and interrelationships of variables within a population at a particular time
B. Get an accurate and complete data about a phenomenon.
C. Develop a tool for data gathering.
D. Formulate a framework for the study
Answer: (A) Obtains information regarding the prevalence, distribution and interrelationships of variables within a population at a particular time
Surveys are done to gather information on people’s actions, knowledge, intentions, opinions and attitudes.

135. She will likely use self-report method. Which of the following self-report methods is the most respected method used in surveys?
A. Personal interviews B. Questionnaires C. Telephone interviews D. Rating Scale
Answer: (A) Personal interviews
Personal interviews is the best method of collecting survey data because the quality of information they yield is higher than other methods and because relatively few people refuse to be interviewed in person.

136. Alyssa reads about exploratory research. Which of the following is the purpose of doing this type of research?
A. Inductively develops a theory based on observations about processes involving selected people
B. Makes new knowledge useful and practical.
C. Identifies the variables in the study
D. Finds out the cause and effect relationship between variables
Answer: (C) Identifies the variables in the study
Exploratory research is the first level of investigation and it deals with identifying the variables in the study.

137. She reviews qualitative design of research. Which of the following is true about ethnographic study?
A. Develops theories that increase the knowledge about a certain phenomenon.
B. Focuses on the meanings of life experiences of people
C. Deals with patterns and experiences of a defined cultural group in a holistic fashion
D. In-depth investigation of a single entity
Answer: (C) Deals with patterns and experiences of a defined cultural group in a holistic fashion
Ethnographic research deals with the cultural patterns and beliefs of certain culture groups.

138. She knows that the purpose of doing ethnographic study is to:
A. Understand the worldview of a cultural group B. Study the life experiences of people
C. Determine the relationship between variables D. Investigate intensively a single entity
Answer: (A) Understand the worldview of a cultural group
The aim of ethnographers is to learn from the members of a cultural group by understanding their way of life as they perceive and live it.

139. Alyssa wants to learn more about experimental design. Which is the purpose of this research?
A. Test the cause and effect relationship among the variable under a controlled situation
B. Identify the variables in the study
C. Predicts the future based on current intervention
D. Describe the characteristics, opinions, attitudes or behaviors of certain population about a current issue or event
Answer: (A) Test the cause and effect relationship among the variable under a controlled situation
Experimental research is a Level III investigation which determines the cause and effect relationship between variables.

140. She knows that there are three elements of experimental research. Which is NOT included?
A. Manipulation B. Randomization C. Control D. Trial
Answer: (D) Trial
Trial is not an element of experimental research. Manipulation of variables, randomization and control are the three elements of this type of research

141. Alyssa knows that there are times when only manipulation of study variables is possible and the elements of control or randomization are not attendant. Which type of research is referred to this?
A. Field study B. Quasi-experiment C. Solomon-Four group design D. Post-test only design
Answer: (B) Quasi-experiment
Quasi-experiment is done when randomization and control of the variables are not possible.

142. One of the related studies that she reads is a phenomenological research. Which of the following questions is answered by this type of qualitative research?
A.” What is the way of life of this cultural group?”
B. “What is the effect of the intervention to the dependent variable?”
C. “What the essence of the phenomenon is as experienced by these people?”
D. “What is the core category that is central in explaining what is going on in that social scene?”
Answer: (C) “What the essence of the phenomenon is as experienced by these people?”
Phenomenological research deals with the meaning of experiences as those who experienced the phenomenon understand it.

143. Other studies are categorized according to the time frame. Which of the following refers to a study of variables in the present which is linked to a variable that occurred in the past?
A. Prospective design B. Retrospective design C. Cross sectional study D. Longitudinal study
Answer: (B) Retrospective design
Retrospective studies are done in order to establish a correlation between present variables and the antecedent factors that have caused it.

144. Situation : Harry a new research staff of the Research and Development Department of a tertiary hospital is tasked to conduct a research study about the increased incidence of nosocomial infection in the hospital.
Which of the following ethical issues should he consider in the conduct of his study?
1. Confidentiality of information given to him by the subjects
2. Self-determination which includes the right to withdraw from the study group
3. Privacy or the right not to be exposed publicly
4. Full disclosure about the study to be conducted
A. 1, 2, 3 B. 1, 3, 4 C. 2, 3, 4 D. 1, 2, 3, 4
Answer: (D) 1, 2, 3, 4
This includes all the options as these are the four basic rights of subjects for research.

145. Which of the following is the best tool for data gathering?
A. Interview schedule B. Questionnaire C. Use of laboratory data. D. Observation
Answer: (C) Use of laboratory data.
Incidence of nosocomial infection is best collected through the use of biophysiologic measures, particularly in vitro measurements, hence laboratory data is essential.

146. During data collection, Harry encounters a patient who refuses to talk to him. Which of the following is a limitation of the study?
A. Patient’s refusal to fully divulge information.
B. Patients with history of fever and cough
C. Patients admitted or who seeks consultation at the ER and doctors offices
D. Contacts of patients with history of fever and cough
Answer: (A) Patient’s refusal to fully divulge information.
Patient’s refusal to divulge information is a limitation because it is beyond the control of Harry.

147. What type of research is appropriate for this study?
A. Descriptive- correlational B. Experiment C. Quasi-experiment D. Historical
Answer: (A) Descriptive- correlational
Descriptive- correlational study is the most appropriate for this study because it studies the variables that could be the antecedents of the increased incidence of nosocomial infection.

148. In the statement, “Frequent hand washing of health workers decreases the incidence of nosocomial infections among post-surgery patients”, the dependent variable is
A. incidence of nosocomial infections B. decreases
C. frequent hand washing D. post-surgery patients
Answer: (A) incidence of nosocomial infections
The dependent variable is the incidence of nosocomial infection, which is the outcome or effect of the independent variable, frequent hand washing.

149. Harry knows that he has to protect the rights of human research subjects. Which of the following actions of Harry ensures anonymity?
A. Keep the identities of the subject secret B. Obtain informed consent
C. Provide equal treatment to all the subjects of the study. D. Release findings only to the participants of the study
Answer: (A) Keep the identities of the subject secret
Keeping the identities of the research subject secret will ensure anonymity because this will hinder providing link between the information given to whoever is its source.

150. He is oriented to the use of electronic databases for nursing research. Which of the following will she likely access?
A. MEDLINE B. National Institute of Nursing Research

C. American Journal of Nursing D. International Council of Nurses
Answer: (B) National Institute of Nursing Research
National Institute for Nursing Research is a useful source of information for nursing research. The rest of the options may be helpful but NINR is the most useful site for nurses.

He develops methods for data gathering. Which of the following criteria of a good instrument refers to the ability of the instrument to yield the same results upon its repeated administration?
A. Validity B. Specificity C. Sensitivity D. Reliability
Answer: (D) Reliability
Reliability is consistency of the research instrument. It refers to the repeatability of the instrument in extracting the same responses upon its repeated administration.

Harry is aware of the importance of controlling threats to internal validity for experimental research, which include the following examples EXCEPT:

A. History B. Maturation C. Attrition D. Design
Answer: (D) Design
Design is not a threat to internal validity of the instrument just like the other options.

His colleague asks about the external validity of the research findings. Which of the responses of Harry is appropriate? The research findings can be
A. generalized to other settings or samples B. shown to result only from the effect of the independent variable
C. reflected as results of extraneous variables D. free of selection biases
Answer: (A) generalized to other settings or samples
External validity refers to the generalizability of research findings to other settings or samples. This is an issue of importance to evidence-based nursing practice.

SIMON CLARICE SAMOSIR JOURNEY

Saturday 25 April 2015

NCLEX MIX

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