differences and similarities between aggressive and non-aggressive cognitively impaired, elderly, institutionalized people?”
31. Investigation of cognitively impaired individual presented some ethical dilemmas. Which of the following protocol would be considered unethical?
A. Recording interaction with the elderly with their permission B. Verbal permission from the subject is unnecessary C. Data coded and recorded solely by the investigation
D. A written consent from the institution and a significant other 32. A semi-structured interview was conducted. This means that:
A. Interview is conducted precisely in the same manner B. Interviewer is not held to any specific question
C. Subject is allowed to express without any suggestion from interviewer
D. Interviewer is free to probe beyond a number of specific major questions 33. The type of study conducted is:
A. Descriptive C. experimental
B. Quasi-experimental D. case study
34. The review of literature included reference to retrospective studies. Such studies have the advantages EXCEPT:
A. Data are inexpensive to obtain
B. Possibility of memory bias and distortion of fact C. There is much material available
D. It is easy to get data
35. The average age of the respondents was 86. this represents:
A. the sum ages divided by total number of participants B. the youngest participant is 86 years old
C. the oldest participant is 86 years old
D. most of the number participant is 86 years old
Situation 8 – Mr. David is brought to the hospital due to pain radiating to the hip and leg. He is diagnosed with a herniated lumbar disk. H is scheduled for myelogram.
36. After the procedure, the nurse must include which of th following nursing action in his care?
A. Assess for movement and sensation of the lower extremity B. Place the client in most comfortable position
C. Lying supine with heels flexed
D. Bed rest with bed elevated at 45 degrees
37. Mr. David is scheduled for lumbar laminectomy. Post operatively the nurse should:
A. Logroll the client with the help of another nurse B. Inform the client that he should be in supine position C. Assess the sensory loss in his legs
D. Instruct the patient to move from side to side
38. Trimethobenzamine Hydrochloride (Tigan) was administered postoperatively. The action of this drug is effective when it:
A. Controls nausea C. controls muscle spasm
B. Controls pain D. controls edema
39. Mr. David is to ambulate for the first time following surgery. What nursing action should be BEST when the client begins to faint?
A. Get another nurse for help
B. Maneuver the client to a sitting position
C. Get back to his bed and place in side lying position
D. Assist the client to form a wide base of support and lean against the nurse
40. Mr. David has to wear back brace. Which position is recommended when the brace is applied?
A. Sitting position C. lying on his side in bed B. Standing position D. supine position in bed
Situation 9 – Through the nurse-patient relationship, the nurse intervenes utilizing effective communication techniques. The following are varied situations in a psychiatry ward.
41. The patient verbalizes, “Masama and pakiramdam ko. Hindi ako nakatulog kagabi.“A therapeutic response of the nurse would be:
A. “Baka ini-istorbo ka na naman ng mga boses.”
B. „Sinabi mo sana sa nars nabigyan ka ng sedative mo.“
C. Relax lang! Huwag ka masyadong mag-iisip ng mga problema mo.“
D. “Maari mo bang sabihin sa akin and mga naiisip at nararamdaman mo?“
42. Soledad is terminally ill of cancer. Looking sad, she expresses, “Wala na yata akong pag-asang mabuhay pa,” A response which fosters hope is:
A. “Mukhang napakabigat ang dinaramdam ninyo. Andito po ako at puwede tayong mag-usap.“
B. “Huwag po ninyong isipin ang sakit ninyo. Bale wala yon. Andito naman ako para makausap ninyo.”
C. “Lakasan ang loob ninyo. Lahat naman po tayo ay doon ang patutunguhan.”
D. “Gagaling din po kayo. Huwag po kayong mag-aalala.”
43. Camilia verbalizes, “Pinag-uusapan nila ako. Ayaw nila ako.“ A therapeutic response is:
A. “Nalulungkot ba ang pakiramdam mo?”
B. “Hayaan mo sila. Ang mahalaga ay ang palagay mo sa sarili mo.”
C. “Sino ang ‘nila’ na tinutukoy mo?”
D. “Huwag mong isipin yan. Hindi tama yan.”
44. During socialization, Nicanor was provoked, became furious and started shouting “Walang hiya kayo! Ako ang bida dito!” The nurse’s action is:
A. Take him away form the group until he manages to have control of himself.
B. Immediately restrain him and put him on isolation to protect other patients.
C. Prevent him from becoming more furious by giving an extra PRN dose of sedative.
D. Respond with, “Nicanor, pare-pareho lang kayo ng mga ibang pasyente dito.”
45. Nicanor becomes verbally assaultive to the nurse. He says, “Ikaw, nurse, wala kanga lam!
Marunong pa ako sa iyo e. Ano ba ang ipinagmamalaki mo!” The nurse responds therapeutically by:
A. admonishing him with, “Ako ang nurse dito. Dapat sumunod ka sa akin.”
B. Acknowledging his behavior, however, put him in his right senses ; respond with,
“Oo nga, galit ka sa nurse pero hindi tama na naninigaw ka.”
C. Acknowledging his behavior and respond, “Nagagalit ka sa nurse at nawawala ka ng control sa sarili mo.”
D. Ignoring the behavior of the patient
Situation 10 – Nicanor was discharged form the hospital and recovered from a manic episode of Bipolar Disorder. NIcanor was readmitted with an entirely different behavior.
he was very depressed.
46. The defense mechanism utilized by manic patients to cover up depression is:
A. reaction formation C. displacement
B. compensation D. denial
47. The psychodymanics of depression is:
A. lax super-ego B. weak super-ego
C. internalized hostility feelings D. narcissistic personality
48. Which of these drugs is likely to indicated to Nicanor?
A. Serenace (Haloperidol) B. Valium (Diazepam)
C. Tofranil (Imipramine HCl) D. Trilaton (Pherpenazine)
49. Therapeutic use of self is essential in relating with psychiatric patients. This is BEST demonstrated in:
A. sympathizing with the miserable feelings of Nicanor B. engaging Nicanor in productive activity
C. engaging NIcanor in introspective thinking
D. suppressing her own feelings toward NIcanor
50. After three days of antidepressant medication, Nicanor still manifests depression. The nurse evaluates this as:
A. unusual because action of antidepressant drug is immediate
B. expected because it takes about two weeks for the medication to be effective C. unexpected because it takes within one week for the medication to be effective D. ineffective because perhaps the drug’s dose is inadequate
Situation 11 - Ninety year old Purita is confined at the medical unit for respiratory ailment for which a breathing apparatus is prescribed for her to use while she sleeps. She refuses to wear it continuously though she fully understands the medical indication for it.
51. Which of these etical principles can guide the nurse in her action?
A. Beneficence C. Autonomy
B. Fidelity D. Nonmaleficence
52. Purita has six children who are already adults. They differ in their opinion whether or not to allow their mother to decide for herself. The nurse would encourage family conference for:
A. the eldest child’s opinion to be given priority B. majority of the children to decide
C. allowing the medical staff to decide in their behalf D. consensus building
53. Breathing treatments are to be given to Purita. In anticipation that Purita might refuse, Dinio, one of the children requests that he be the one to sign the consent in behalf of their mother. The nurse explains that Purita is rational in her thinking and which of these client’s right must be regarded?
A. Right to refuse treatment B. Right to privacy
C. Right to informed consent D. Right of habeas consent
54. Which of these would be the nurse’s priority following the treatment principle of least restrictive alternative?
A. One of one staffing C. Physical restraint B. Use of on site guard/watcher D. Seclusion
55. Purita talks about her joy in having responsible and accomplished children and recalls challenging career as a lawyer. She is demonstrating a sense of:
A. ego integrity C. generativity
B. industry D. autonomy
Situation 12 – Marina, 26 years old, is aloof in relating with other patients and members of the staff. She claims that the medications being given her are meant to poison her.
She is also suspicious about the food being served for her.
56. Basically, Marina is suspicious because of her inability to develop a sense of:
A. Intimacy C. Trust
B. Generativity D. Intiative
57. Marina utilizes projection by being suspicious. This means that she:
A. unconsciously refuses to accept a feeling, thought or impulse and attributes it to someone else
B. justifies behavior, attitudes and feelings with excuses C. involuntarily refuses to acknowledge reality
D. involuntarily excludes wishes, impulses, memories and feelings from awareness
58. Which of these nursing approaches is MOST appropriate for the nurse to begin with?
A. Engage Marina for at least one hour in a one-to-one interaction daily B. Invite her to socialize with other patients
C. Make self available while maintaining distance until patient shows readiness to interact
D. Refer her for activity therapy
59. When she resists to take her medication, it is best to:
A. let her read the drug literature to convince her that it is therapeutic
B. force her to take the drug to maintain therapeutic effectiveness of the drug C. have the same nurse, who she interacts with regularly, administer the drug D. request the doctor to give her medication
60. Another reason why she refuses to take Thorazine is because she complains of robot like movement and slurred speech. The nurse’s action is:
A. decrease the dosage of thorazine
B. explain the extrapyramidal side effects and administer Benadryl C. avoid giving foods that are rich in tyramine
D. withhold medication until referral is made to the doctor
Situation 13 – The supervising nurse received report that a staff nurse is displaying frequent irritation, anger, and even indifference toward clients and co-workers.
61. The initial action of the supervisor would be to:
A. post guidelines on proper decorum of nurses in the bulletin board B. write a memo of warning to the nurse
C. request anecdotal report form nurse’s co-workers D. call the nurse for a one on one conference
62. The nurse expressed increasing feelings of dissatisfaction. The supervising nurse intervenes therapeutically by taking the role of:
A. administrator by relieving her of responsibilities B. therapist by delving into the nurse’s internal conflicts C. counselor by actively listening
D. educator by reorienting her of her role as a nurse
63. Coupled with poor work performance, mental and physical fatigue and actual withdrawal from client contact and nursing duties, the nurse can be said to be suffering from:
A. psychotic anxiety B. staff burnout
C. personality maladjustment D. neurotic depression
64. A priority in the nurse’s personal development would be to:
A. address her physical well-being B. boost her self-confidence C. provide social support
D. help her find value and meaning in her work
65. The most relevant professional program for her would be:
A. assertiveness training B. stress management
C. group dynamics and team building D. behavior modification
Situation 14 – The purpose of the nursing care plan is to identify the care for an individual patient based on his problems. The nurse writes a nursing care plan for a patient based on nursing care standards.
66. Given this example of a problem, “Anxiety due to a job interview”. The “due to” or the reason for the problem should be included if it is known. The initial step in identifying problems is:
A. gather data about the patient
B. determine if the problems are usual or unusual C. analyze the data
D. analyze the problems as concisely as possible
67. Given this example of an expected outcome: “Openly verbalize anxiety about job interview. Identify how he can prepare for the job interview.” Which of these is not a criterion of expected outcomes?
A. An expected outcome is stated in terms of what the patient will do B. An expected outcome is stated in terms of what the nurse will do C. Every outcome must be measurable
D. Every outcome answers the question “How will you know when the problem is resolved?”
68. The following are reasons for setting deadlines within which to achieve outcomes of care EXCEPT:
A. Indicate specific times to review progress or lack of progress B. Does not allow plans to be changed
C. Allow plans the need to be changed
D. Set the time by which the expected outcome should be reached 69. Which of these is not a relevant nursing order?
A. Ask the patient any untoward side effects of medications he is taking B. Have patient role play interview situation
C. Discuss with a patient with specific means he might prepare for the job interview D. Ask the patient what he is feeling about the job interview
70. Which of these practices on evaluation support nursing care? Review of care plan is:
A. a nursing team responsibility
B. the sole responsibility of the primary nurse C. the responsibility of peers
D. the sole responsibility of the supervisor
Situation 15 – A nurse assigned in the neurologic unit is taking care of clients with varying