NURSING. MIDWIFERY. PHARMACY. MEDTECH.

CRIMINOLOGY
108 Lumabang Street, Brgy. Quezon, Solano, Nueva Vizcaya
TEL. (078) 326- 6922/09066885809
COMPETENCY EVALUATION
MEDICAL-SURGICAL NURSING

Instructions:
1. Choose the best answer and shade the corresponding letter on the answer sheet.
2. Avoid erasures or any form of alteration.
3. Use pencil in shading your answers.
___________________________________________________________________________________________________
SITUATION: Mr. Ramos was barbecuing outdoors when the gas tank exploded. He sustained second degree and third degree burns of the anterior portion of BOTH
upper extremities, the upper half of his anterior trunk and the anterior and posterior portions of his left lower extremity.
1. The BEST initial management of burns that can be employed at the scene is generally which of the following:
a. Pour cold water over the burned areas
b. Apply clean dressing to the affected area
c. Rinse the area with mild soap and water
d. Apply betadine over the area
2. At the emergency room, the nurse assessed the extent of the burn on the patient’s body. Based on the rules of nine, which of the following is the BEST estimate of
the burn?
a. 36 % c. 27%
b. 45 % d. 54 %
3. Which one of the following blood value determinations is most likely be useful to evaluate the adequacy of the fluid replacement in burns?
a. Creatinine levels c. Hematocrit level
b. Blood urea nitrogen d. Carbon dioxide tension
4. The nurse is administering the prescribed IVF. When she evaluated the patient, she suspected fluid overload because of which finding?
a. Dark and scant urine output c. Bradycardia and hypotension
b. Moist rales d. Facial flushing and twitching
5. The doctor orders Silver Sulfadiazine (Flammazine) for application over the burn area. The nurse understands that one disadvantage of this drug is that:
a. It causes lactic acidosis c. It has minimal eschar penetration
b. It must be constantly applied d. It is bacteriostatic

Situation: Mr. Merlin is admitted because of acute renal failure.

6. Which action should the nurse take when caring for Mr. Merlin in the oliguric phase of acute renal failure?
a. Encourage to eat low carbohydrate diet
b. Observe for signs and symptoms of tetany
c. Ensure fluid restriction
d. Encourage increased range of motion exercise
7. The nurse reads the chart and determines that there is an order to give aluminum hydroxide. The reason for this order is it :
a. Removes the protein wastes of metabolism
b. Binds phosphates in the gastrointestinal tract
c. Exchanges sodium for potassium in the colon
d. Inhibits the development of infection
8. The patient’s electrolyte imbalance remained unresolved and the physician ordered for a peritoneal dialysis. The nurse carried out the procedure and determined
that the patient complains of shortness of breath. The nurse should first:
a. Stop the infusion of the dialysate c. Check the patient’s weight
b. Elevate the head of the bed d. Drain the fluid that was infused

Situation: Mr. Aquino is admitted to the hospital with the diagnosis of chronic glaucoma
9. Which of the following statement of the patient may be indicative of glaucoma?
a. Sandy feeling and itching of the eyes c. Clouding of vision and diplopia
b. Frontal headaches while reading d. Complains of tunnel vision
10. The nurse assists the physician in doing a tonometry. The physician determines that there is an increased intra-ocular pressure. The nurse knows that it should
normally be:
a. 10-21 mmHg c. 20-30 mmHg
b. 12-14 mmHg d. 1-10 mmHg
11. The nurse asked the patient about her current home medications: Aluminum hydroxide. Metoprolol, Atropine and Ferrous sulfate. She must relay which
information to the physician?
a. The patient is hypertensive and taking Metoprolol
b. The patient is taking atropine
c. The patient has infection
d. The patient is not a good candidate for operation

Situation: Proper function of the renal system is essential to life. Dysfunction of the kidneys and lower urinary tract is common and necessitates the nurse understanding
of the conditions. The following questions will pertain to this concept:
12. The physician orders the nurse to obtain specimen for urine culture and sensitivity. The nurse will collect the specimen by:
a. Collecting a clean catch, mid-stream urine
b. Obtaining the clean catch initial voided urine
c. Collect the residual urine
d. Obtain the urine from the urinal/bed pan
13. The patient complains of symptoms- Flank pain, fever and hypogastric pain and dysuria. The nurse suspects:
a. Urinary tract infection c. Acute renal failure
b. Renal stones d. Urinary incontinence
14. There are numerous causes of acute renal failure. A pre-renal cause of acute renal failure may be:
a. Gentamycin nephrotoxicity c. Hypovolemic shock
b. Acute tubular necrosis d. Urinary tract obstruction
15. The nurse taking care of a patient with acute renal failure knows that the client will undergo the three phases of ARF. The findings of hyponatremia, hypokalemia
and hypovolemia will likely be in what stage?
a. Oliguric stage c. Recovery stage
b. Diuretic stage d. Convalescent stage
16. Anemia may be a manifestation of chronic renal failure. The nurse knows that the pathophysiology of anemia is:
a. Decreased bone marrow blood forming cells
b. Decreased secretion of erythropoietin
c. Toxic substances in the body will destroy the red blood cells
d. The blood cells are destroyed by the kidney
17. The nurse differentiates NEPHROTIC syndromes from nephritic syndromes. Which finding below is characteristic of NEPHROTIC SYNDROME?
a. Oliguria c. Gross hematuria
b. Pronounced proteinuria d. Hypertension

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18. The nurse is teaching a client with advanced chronic renal failure about foods to avoid. It would be most accurate for the nurse to teach the client to avoid foods
high in:
a. Carbohydrates c. Fats
b. Iron d. Proteins
19. A client with acute renal failure is being assessed to determine if the cause is post-renal. Which condition will most likely lead to the post-renal ARF?
a. Heart failure c. Ureterolithiasis
b. Nephritic syndromes d. Diabetic nephropathy

Situation: Allan, a social worker in Caritas de Maria, sustained burns during the fire incident and he was rushed to the hospital
20. Ms. Janice is the ER nurse attending to the patient. Her very first nursing management is to:
a. Check vital signs c. Apply burn ointment to the injury
b. Asses the patency of the airway d. Administer oxygen inhalation therapy
21. Applying the rule of Nines, Ms. Janice notes that the body part which has the largest percentage of skin?
a. Face and neck c. Anterior trunk
b. Perineum d. Left upper arm
22. After assessing the patient, Ms. Janice made a diagnosis of Fluid Volume Deficit. The assessment findings that will support her analysis are the following, except:
a. Tachycardia c. Dysuria
b. Restlessness d. Oliguria
23. The nursing care for Mr. Aquino during the initial phase of treatment should include plans to:
a. Encourage ambulation to prevent pneumonia
b. Restore fluid volume via IVF therapy
c. Provide referral to the psychiatrist
d. Prevent respiratory complication by giving bronchodilator
24. The nurse was instructed to apply MAFENIDE over the burn area. She is knowledgeable about the advantage of this drug over silver sulfadiazine is that mafenide:
a. Has better eschar penetration c. Has minimal lactic acidosis complication
b. Does not stain the skin d. Improves wound healing faster
25. The physician instructs the nurse to insert Foley catheter and the purpose of this is:
a. To obtain urine specimen
b. To assure accurate urinary output measurements
c. To determine the workload of the kidney
d. TO prevent bladder distention

Situation: You are a nurse at VRH and in charge of patients with EENT problems.
26. A nurse is caring for a client with diagnosis of detached retina, which assessment finding would validate the diagnosis?
a. Complaints of floating spots and curtain being drawn in the visual field
b. Complaints of loss of peripheral vision
c. Complaints of painless blurry vision and hazy visual field
d. Complaints of reddened conjunctiva
27. During early post-operative period, a client who had cataract surgery of the right eye should be positioned on his:
a. Left side c. Prone
b. Right side d. Trendelenburg
28. Which of the following statements if made by the patient who had cataract surgery ready for discharge will need further intervention?
a. I must not cough vigorously c. I must not bend or stoop down
b. I should wipe my eyes from outer to inner side d. I will try to sleep on my unaffected side
29. A client has Meniere’s disease, is now experiencing vertigo. Which instruction would the nurse give to control the symptom?
a. Increase the fluid intake c. Avoid sudden head movement
b. Sit still while watching TV d. Limit the intake of potassium
30. A nurse is reviewing the meals of the patient with Meneire’s disease. Which items below, if chosen by the patient for dinner needs further intervention from the
nurse?
a. Canned tomato juice and hamburger c. Rice cake and fresh orange juice
b. Vegetable salad with vinegar d. Gelatin and lemon tea

Situation: Patient Tolits Cruz, a 32 year-old commercial model, is admitted to the hospital because of “palpitation”. The blood chemistry yields a potassium level of 5.9
mEq/L.
31. Hyperkalemia is established in the patient. The nurse knows that one of the following can be a possible cause of potassium excess, and it may be:
a. Untreated renal failure c. Use of furosemide diuretic
b. Metabolic alkalosis d. Hyperaldosteronism
32. The nurse is careful to interpret the laboratory result of hyperkalemia. A condition of pseudohyperkalemia exists and it can be caused by:
a. Use of tight tourniquet in obtaining blood sample
b. Injection of hypertonic solution of saline
c. Decreased WBC count
d. Thrombocytopenia
33. The nurse hooks the patient in the cardiac monitor. The ECG finding most likely reflecting hyperkalemia is:
a. Shortened QRS complex c. Peaked T waves
b. ST segment elevation d. Shortened PR interval
34. Emergency drugs were ordered by the doctor to immediately reverse the hyperkalemic state. The nurse anticipates that the following drugs to be ordered. Identify
which is questionable:
a. IV regular insulin followed by dextrose infusion c. Sodium bicarbonate IV
b. Beta-agonists like salbutamol d. Spironolactone (Aldactone)
35. The nurse instructs the patient to avoid high potassium diet. She eliminates all of the following foods on the hospital tray, except:
a. Banana split c. Apple and orange slices
b. Fresh carrot sticks d. Mashed potatoes

Situation: A client is brought to the hospital after vomiting bright red blood and is admitted to the emergency department with a bleeding duodenal ulcer.
36. While the client is bleeding, it will be essential for the nurse to assess frequently for sign of early shock. Which one of the following is an important indicator of
early shock.
a. tachycardia c. increased urinary output
b. dry flushed skin d. loss of consciousness
37. If the client develops a sudden sharp pain in the mid epigastric region along with a rigid, board-like abdomen the nurse should understand that these clinical
manifestations most likely indicate that:
a. an intestinal obstruction has developed c. the esophagus has become inflamed
b. additional ulcers have developed d. the ulcer has perforated
38. The client tells the nurse that he had black stools before admission to the hospital but had not reported this to his physician. Based on the information, which
nursing diagnosis would be appropriate for the client?
a. ineffective individual coping related to fear of diagnosis of chronic illness
b. knowledge deficit related to unfamiliarity with significant signs & symptoms
c. constipation related to decreased gastric motility
d. altered nutrition: less than body requirements
39. The client asks the nurse what causes an ulcer to develop. The nurse responds that recent research indicates many peptic ulcers are result of:
a. work related stress c. diets high in fat and spicy foods
b. Helicobacter pylori infection d. a genetic defect in gastric mucosa
40. The client has been taking Propantheline Bromide (Pro-Banthine) at home the nurse should prepare a teaching plan for the client that indicated medication acts
primarily to:

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 a. suppress gastric secretion
b. neutralize acid in the stomach
c. shorten the time required for digestion in the stomach
d. improve the mixing of foods and gastric secretions
41. The client reports frequent episodes of epigastric pain that awaken him during the night, a feeling of fullness in the abdomen, and anxiety about his health. Based
on the data, which nursing diagnosis would be appropriate?
a. altered nutrition: less than body requirements related to anorexia
b. sleep pattern disturbance related to epigastric pain
c. ineffective individual coping related to exacerbation of duodenal ulcer
d. activity intolerance related to abdominal pain
42. Which of the following expected outcomes would be most appropriate for this client? The client will:
a. verbalize absence of epigastric pain
b. accept the need to inject himself with vitamin B12 for the rest of his life
c. understand the need to increase his exercise activity
d. eliminate all stress from his life
43. The nurse preparing to teach the client about the diet he should follow at home after discharge. The nurse should explain that this diet will most likely consist of:
a. full liquid and pureed foods c. any foods that he can tolerate
b. high fat high protein diet d. six meals a day
44. Which one of the following statements indicates that the client understands the dietary modifications he will need to follow at home?
a. “I should eat a bland, soft diet” c. “I should drink several glasses of milk a day”
b. “It is important to eat six meals a day” d. “ I should avoid alcohol and caffeine”
45. The client undergoes an upper gastrointestinal endoscopy to help the physician visualize the ulcers location and severity. Immediately after the endoscopy, what
should the nurse evaluate besides his vital signs?
a. return of gag reflex c. breath sounds
b. bowel sounds d. intake and output

Situation: Jaime a 24 year old patient comes to the ER hyperventilating and complaining of numbness and tingling in his hands. He states he had an argument with his
girlfriend about 30 minutes ago.
46. The doctor prescribes an ABG analysis, which reveals a pH of 7.64; PCO2 of 26 mmHg, PO2 of 100 mmHg, HCO3 of 22 mEq/L. After analyzing the results, the
nurse determines that the patient is experiencing:
a. Respiratory acidosis c. Respiratory alkalosis
b. Metabolic acidosis d. Metabolic alkalosis
47. The nurse should tell Jaime to do which of the following to correct the hyperventilation?
a. Take frequent shallow breaths c. Take frequent deep breaths
b. Breathe into a paper bag d. Sit quietly and forget about the argument

Situation: Juana is a 23 year old patient with a history of type 1 DM. She presents to the ER with nausea, which she has had for 2 days. Her serum glucose level is 565
mg/dl and her urine is positive of ketones.
48. Juana has abnormally deep, gasping respirations. This breathing pattern is known as:
a. Bradypnea c. Cheyne-stokes respirations
b. Biot’s respirations d. Kussmaul’s respirations
49. Juana’s ABG analysis reveals a pH of 7.25, pCO2 of 33 mmHg; pO2 of 102 mmHg and HCO3 of 19 mEq/L. After analyzing these values, the nurse determines
that the patient is experiencing?
a. Respiratory acidosis c. Respiratory alkalosis
b. Metabolic acidosis d. Metabolic alkalosis
50. Jose was noted to have dyspnea, shallow breathing and disorientation. ABG was taken which revealed the following results: pH - 7.28, PCO2 – 54, HCO3 – 30,
pO2 - 65%. ABG results can be interpreted as:
a. Respiratory alkalosis c. Metabolic alkalosis
b. Respiratory acidosis d. Metabolic acidosis
51. Luis was noted to hyperventilate, is drowsy. ABG was taken which revealed the following results: pH - 7.18 PCO2 – 35, HCO3 – 15, pO2 - 77%. ABG results
can be interpreted as:
a. Respiratory alkalosis c. Metabolic alkalosis
b. Respiratory acidosis d. Metabolic acidosis
52. Pedro’s ABG analysis reveals a pH of 7.55, pCO2 of 28 mmHg; pO2 of 85 mmHg and HCO3 of 24 mEq/L. After analyzing these values, the nurse determines
that the patient is experiencing?
a. Respiratory acidosis c. Respiratory alkalosis
b. Metabolic acidosis d. Metabolic alkalosis
53. Which of the following ABG results indicates metabolic acidosis?
a. pH of 7.25, pCO2 of 42 mmHg, HCO3 of 18 mEq/L. PO2 of 70 mmHg
b. pH of 7.46, pCO2 of 30 mmHg, HCO3 of 26 mEq/L. PO2 of 80 mmHg
c. pH of 7.38, pCO2 of 45 mmHg, HCO3 of 22 mEq/L. PO2 of 50 mmHg
d. pH of 7.31, pCO2 of 40 mmHg, HCO3 of 26 mEq/L. PO2 of 78 mmHg
54. A child 5 years of age was having loose watery stool of 5 episodes/day for the past 3 days. On the third day, he was brought to the nearest district hospital for
consult. Most likely acid base imbalance the patient may experience is:
a. Respiratory acidosis c. Respiratory alkalosis
b. Metabolic acidosis d. Metabolic alkalosis

Situation: Thyroid gland is located anterior to the upper part of the trachea and just inferior to the larynx. It is a butterfly shaped gland which has 2 lobes connected by
a structure called the isthmus. It secretes thyroid hormone: THYROXINE (T4), TRIIODOTHYRONINE (T3) and calcitonin. It primarily controls the rate of body
metabolism and growth. Questions 1-5 refer to this situation.
55. A female client with thyrotoxicosis would probably report which changes related to her weight during initial assessment?
a. Weight gain b. Weight loss

c. Both A & B
d. None of the above
56. A client with a large goiter is scheduled for a sub total thyroidectomy to treat thyrotoxicosis. Drug of choice is:
a. Lugol’s solution c. Both A & B
b. Levothyroxine d. None of the above
57. Which of the following measures is most often recommended when preparing Iodide solution for administration?
a. Pour the solution over ice chips
b. Mix solution with an antacid
c. Dilute the solution with water, milk, or fruit juice and have the client drink it with a straw
d. Disguise the solution in a pureed fruit or vegetable.
58. Levothyroxine is best administered at?
a. Morning c. Anytime of the day
b. Afternoon d. At bedtime
59. Which of the following medications should be available to provide emergency treatment if a client develops tetany after a subtotal thyroidectomy?
a. Sodium phosphate c. Calcium gluconate
b. Potassium iodide d. Sodium bicarbonate

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Situation: Luisa, 45 years of age complains of body weakness and drooping of eyelids. She went to the Out patient department of a hospital and was tentatively
diagnosed as a case of myasthenia gravis.
60. Luisa not only complains of ptosis. She also complains of diplopia, dysphonia, dysphagia and dyspnea. This is characteristic of:
a. Ascending paralysis c. Descending paralysis
b. duchenne paralysis d. Risus sardonicus
61. Myasthenia gravis is characterized by periods of remission and exacerbations. Major precipitating factor that Luisa should avoid that may lead to exacerbation is:
a. Poor nutrition b. Infection
c. Change in weather
d. Exposure to allergens
62. A priority nursing care for Luisa’s case includes:
a. Encourage active ROM exercises c. Recommended enemas for constipation
b. Give medications exactly as ordered d. Exercises regime to build muscle strength
63. The nurse is aware that the ultimate danger in Luisa’s case is progressive weakness and, eventually, the onset of myasthenic crisis. This complication is:
a. Neurological Emergency c. Cardiac Emergency
b. Respiratory emergency d. Orthopedic emergency

64. Nurse Joy should give Luisa this medication:

a. Morphine sulfate c. Muscle relaxants
b. Neomycin d. Pyridostigmine
65. Luisa complains of diplopia. Nursing measures include:
a. Frequent rest periods c. Avoid alcohol, tonic water and cigarette smoke
b. Take medications on time d. Eye patch applied on affected eye

Situation: Luis a 32-year-old man fell on top a coconut tree. He is alert and conscious but cannot move his arms or legs on command
66. The primary concern when moving an individual with possible spinal cord injury is to:
a. Wrap and support the extremities which can easily injured
b. Move the individual gently to reduce pain
c. Immobilize the head and neck to prevent further injury
d. Cushion the back with pillows to ensure comfort
67. Luis suffers cervical spinal cord injury. Which of the following would be the least important intervention during acute stage:
a. Turning and positioning every 2 hours c. Maintaining patients airway
b. Maintaining proper alignment d. None of the above
68. Which of the following would not be expected during spinal shock:
a. Tachycardia c. Hypotension
b. Rapid respiration d. Dry warm skin
69. Most common stimulus for autonomic dysreflexia is:
a. Bowel distention c. Anxiety
b. Bladder distention d. Increased intracranial pressure
70. A client with C6 spinal injury would most likely have which of the following symptoms?
a. Aphasia c. Paraplegia
b. Hemiparesis d. Tetraplegia

Situation: The OR is divided into three zones to control traffic flow and contamination
71. What OR attires are worn in the restricted area?
a. Scrub suit, OR shoes, head cap c. Mask, OR shoes, scrub suit
b. Head cap, scrub suit, mask, OR shoes d. Cap, mask, gloves, shoes
72. Which of the following nursing interventions should be given the highest priority when receiving a client in the OR?
a. check for the presence of dentures, jewelry, nail polish and other accessories
b. receive the client at the semi-restricted area and change his gown
c. assess level of consciousness
d. verify the identification and informed consent
73. Conversation while in the operation is ongoing is minimized because:
a. full concentration is demanded during the entire procedure
b. it annoys the surgeon
c. it is unethical to talk about the client
d. it enhances spread of microorganism to the incision area
74. In the OR, “Surgical Conscience” means
a. Observance of Operating Room Protocol at all times
b. Use of prescribed OR attire in all areas of the OR
c. Honest adherence to surgical aseptic techniques all the time
d. Strict implementation of “Standard Precaution”

Situation: You are assigned at the PACU. At 9:30 AM, post-op clients started to be wheeled in from the OR.
75. Which nursing diagnosis has priority among client in the PACU?
a. Acute body pain related to discomfort of wound and immobility
b. Body image disturbances because of wound dressing and drains
c. Ineffective airway clearance related to general anesthesia
d. Knowledge deficit related to lack of information because patients are all sedated
76. Which of the following clients at the PACU will demonstrate the effectiveness of preoperative teaching?
a. The client demonstrate deep breathing, coughing, splintering and leg exercises
b. The client manifests normal temperature
c. The clients sleeps well
d. The client has good balance I and O
77. Which of the following remark indicates that he client’s relative understood the discharge instruction for wound care?
a. “If the wound is painful, I will say it is normal”
b. “It is alright to use adhesive tape over the wound to keep it intact”
c. “It is ok for his pet to remain at his bedside to keep him company”
d. “I will report any redness or swelling of the wound”
78. You just transferred out a post-out client to her room. What would your instruction to the family include to prevent accidents?
a. Report when the IV infusion is almost finished
b. Test the call system if functioning
c. Keep the room lights on for 24 hours
d. Make sure the side rails are up
79. One of your post-op patients has a temperature of 37.9 C and was shivering. You covered him with a blanket and later took his temperature again and it is now
38.9 C. The nursing student asked you to explain the absence of shivering even if the temperature was higher.
a. The patient is no longer febrile thus he is no longer chilling.
b. Shivering normally disappears as temperature become higher.
c. The body has reached its new set point thus the absence of shivering.
d. The patient is feeling better.

Situation: The following questions deal with vascular diseases.

80. In caring for a client with peripheral arterial occlusive disease of the lower extremities, to promote perfusion to the affected limbs, the nurse should:
a. Elevate both lower extremities to promote venous drainage

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 b. Massage the legs to promote comfort
c. Apply warm compress on the abdomen to promote vasodilation of distal arteries of the extremities
d. Use an elastic compression stocking to prevent stasis of blood
81. Buerger’s disease is a condition that commonly affects males more than females. The most common predisposing factor for this is:
a. Chronic alcoholism c. Cigarette smoking
b. High fat intake d. Diabetes mellitus
82. In clients with Buerger’s disease who had an amputation, which of the following equipments is the most important at bedside?
a. Scissors c. Tourniquet
b. Tracheostomy set d. Clamp
83. Foot care instructions for clients with Buerger’s disease include all of the following, EXCEPT:
a. Stop cigarette smoking c. Wear open-toe shoes at home
b. Avoid cross-leg sitting d. Wash the feet daily with soap and water
84. A client with Raynaud’s disease complains of cold and numbness on her fingers. The nurse assesses the client for early sign of vasoconstriction and lack of blood
supply, which is:
a. Cyanosis c. Pallor
b. Calor d. Rubor
85. A client asks the nurse why a person develops varicosities. The nurse responds by saying that varicose veins are permanently distended veins. The predisposing
factor/s for this condition is/ are:
a. Prolonged standing/ sitting c. Hereditary weakness of the venous valves
b. Pregnancy d. All of these

Situation: While on duty, Ara encountered patients with hematologic problems.

86. Ara is caring for Mrs. Torres, a client with iron deficiency anemia who was prescribed with Ferrous sulfate tablets. Which of the following health teachings to this
client is inappropriate?
a. Take the drug on an empty stomach for better absorption of the drug
b. Eat foods rich in fibers, like vegetables to prevent constipation
c. Use a straw to prevent staining of the teeth
d. A dark-colored stool is a harmless side effect of the drug
87. Parenteral iron replacement is usually administered using the Z-track technique, with the main purpose of:
a. Enhancing absorption of iron into the muscles
b. Preventing leakage of iron and prevent staining of the skin
c. Minimizing muscle trauma
d. Facilitating absorption of iron into subcutaneous tissues
88. Which of the following would be the priority nursing diagnosis for a client with iron deficiency anemia?
a. Excess fluid volume related to anemia c. Activity intolerance related to fatigue
b. Imbalanced nutrition related to nausea d. Impaired tissue perfusion
89. The classic diagnostic test to determine the cause of vitamin B12 deficiency is Schilling’s test. The specimen used for this test is:
a. Blood c. Urine
b. Stool d. Semen
90. A patient with sickle cell disease is admitted to the hospital with sickle cell crisis. Which of the following treatments would the nurse most likely expect to
include in the patient’s plan of care?
a. Parenteral iron therapy c. Exchange transfusion
b. Intravenous fluid therapy d. Heparin therapy

Situation: Mr. Tan, 45 y/o, is brought to the ER due to precordial pain

91. If Mr. Tan is experiencing MI, the following enzymes will be increased except:
a. ALT c. CK
b. AST d. LDH
92. The nurse will administer a sublingual nitroglycerin to the above patient. Which is not a correct health teaching?
a. The patient should discontinue taking the drug if he experiences burning sensation under the tongue.
b. The onset of action is within 1-2 minutes and its effect will last up to 30 minutes.
c. When seated at the edge of the bed, the patient should dangle legs before standing or ambulating.
d. The patient can take 3 doses at 5 minutes interval.
93. An I.V. morphine sulfate is prescribed. Morphine sulfate is given because it:
a. eliminates pain, reduces preload, and increases myocardial contractility.
b. lowers peripheral resistance, reduces cardiac workload, and decreases myocardial oxygen demand.
c. raises the blood pressure, lowers myocardial oxygen demand, and eliminates pain.
d. increases venous return, lowers peripheral resistance, and reduces cardiac workload.
94. When assessing a client w/ chest pain,the nurse obtains a thorough history.Which statement is suggestive of angina pectoris?
a. “the pain lasted for 35 minutes”.
b. “the pain resolved after I ate sandwich”.
c. “the pain worsened when I took a deep breath”.
d. “the pain occurred while I was climbing the stairs up to the 4th floor”.
95. The nurse strongly suspects pericarditis as a complication from MI if she observes:
a. pleuritic chest pain c. pleural friction rub
b. dyspnea on exertion d. leaning forward position
96. Laxatives will be given to this patient in order to:
a. promote soft stools
b. prevent decreased heart rate
c. prevent accumulation of ammonia
d. stimulate bowel peristalsis

Situation: Ash, a non-smoker, is admitted to your unit with a tentative diagnosis of lung cancer.
97. Ash’s initial reaction was “This is impossible, me of all people when I never smoked in all my life.” Ash is the stage of:
a. Denial c. Bargaining
b. Anger d. Acceptance
98. Most common initial manifestation that Ash would like to complain is:
a. Hemoptysis c. Hoarseness
b. Chronic cough d. Chest pain
99. Ash is for bronchoscopy. Which of the following information provided by the nurse to the patient is wrong?
a. A fiberoptic tube will be inserted through the mouth but it will not be painful
b. You are allowed to drink and drink right after the procedure
c. If you become hoarse, I will give you throat lozenges
d. It is alright for your sputum to be blood tinged after the examination
100. The patient is receiving cyclophosphamide. It is important for the nurse before administering the drug to:
a. See that blood studies are normal
b. Make sure that renal function tests are normal
c. Check the liver function test
d. Make sure that radiation precaution are in place

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