Identification and understanding the nuances in the levels of prevention.

The following set of

questions is a mix of situational and objective statements that describe this niche.

1. During a teaching session, the nurse is education a client about the symptoms associated
with COVID-19. This falls under which level of prevention?
A. Primary
B. Secondary
C. Tertiary

2. Three days after admission for a brain attack (CVA), a client has a nasogastric tube
inserted. Streptokinase was also given to address emboli build-up that was leading to the
injury. This intervention falls under which level of prevention?
A. Primary
B. Secondary
C. Tertiary

3. The Primary level of prevention aims to improve the level of health and well-being of
the individual. The following is a list of interventions, all but one of the following is
classified under this level of prevention, select all that apply(SATA):

1. Conducting an aerobic exercise program to clients with a family history of hypertension.

2. Teaching the mother of a newborn about the signs of good attachment.
3. Isolating a COVID-19 positive client.
4. EBRT
5. Mastectomy in a patient with Breast Cancer
6. Oophorectomy in a patient with Breast Cancer

A. 1236
B. 1356
C. 456
D. 3456
E. 13456

4. During times of emergency, proper prioritization will help mitigate or prevent casualties.
Application of a tourniquet to stem the bleeding falls under which level of prevention?
A. Primary
B. Secondary
C. Tertiary
5. Under the new classification of health care facilities, a Category B Facility utilizes
which level of prevention?
A. Primary
B. Secondary
C. Tertiary

6. Which of the following statements is accurate in describing the concept behind the
Tertiary level of prevention?

A. It addresses or alters the behavior of the client that leads to development of long-term
illnesses.
B. It aims to mitigate the immediate effects of the illness on the system.
C. It aims to preserve the remaining functions of the system, following a chronic or
debilitating illness.
D. A and C
E. B and C

7. The levels of prevention are classified according to:

A. Purpose
B. Procedure
C. Priority

8. MUGA falls under which level of prevention?

A. Primary C. Tertiary
B. Secondary D. None

9. Vaccination against COVID-19 is paramount in protecting the public. Who among these
individuals will have the most significant benefits to mass vaccination?
A. Espinas, who works in the post-office.
B. Steve, a school-age child returning to a face-to-face class setup.
C. Daora, under HAART.

10. When the interventions are done to alter the individual's behavior prior to onset of a
problem, this pertains to:
A. Primary Level of Prevention
 B. Secondary Level of Prevention
C. Tertiary Level of Prevention

SITUATION: Oxygen is an odorless, colorless, tasteless gas that consists the 21% of air in the
atmosphere is the most important physiologic need.
11. During the first 36 hours after the insertion of chest tubes, when assessing the function
of a three chamber, closed-chest drainage system, the nurse notes that the there is
continuous bubbling in the chamber with a floating ball. What action should the nurse
take?
A. Simply document the observation
B. Clamp the tube segments
C. Perform press-release method in the dirtiest part of the tube
D. Apply a vasoocclusive dressing at the tube insertion site
E. Prepare another chest tube for possible reinsertion

12. The nurse monitors and look out for complications associated with a Chest-tube
drainage system, which assessment is considered correct?
A. The rise and fall of water in the drainage chamber indicates optimum function.
B. Continuous bubbling in the water-seal chamber means proper function.
C. Sudden cessation of bubbling in the suction chamber means an air leak may be
present in the system.
D. None

13. Which of the following oxygen delivery system can deliver 24-45% of oxygen at a flow
rate of 2-6Lpm?
A. Nasal cannula D. Non-rebreathing face mask
B. Simple face mask E. Venturi mask
C. Partial rebreathing face mask

14. The doctor ordered a pulmonary toilette procedure to a client. X-ray and physical
assessment reveals that the pooling of secretions is located at the apical segment of the
anterior right lung? Which of the following position must not be utilized to drain the
secretions?
A. Sitting D. Prone
B. Supine E. Upright
C. Left side lying

15. A nurse is performing oropharyngeal suctioning on an unconscious client. Which of the

following action is safe?
A. Insert the catheter approximately 15cms while applying suction
B. Allow 20-30second intervals between each suction and limit suction at a total of
15minutes
C. Gently rotate the catheter while applying suction
D. Apply suction for 5 seconds while inserting the catheter and continue for another 5
seconds before withdrawing
SITUATION: Vital signs
16. According to the National Institutes of Health stepped-care approach to treating primary
hypertension, which of the following is a correct statement?
A. The 1st resort in the management of primary hypertension is to treat the cause of
hypertension
B. The rearmost step in the management of primary hypertension is the use of drug
combination therapy
C. The cause of rebound hypertension is the overuse of antihypertensive drugs
D. The last step in the management of secondary hypertension is drug combination
therapy

17. All of the following will create a false-high reading during blood pressure monitoring
except all but one:
(here are the scenarios)
1. Unsupported arm
2. A very wide cuff size
3. A tight cuff
4. Very fast deflation of the cuff
5.The eye lever is lower than the gauge during reading

Choices are as follows:

A. 234
B. 125
C. 145
D. 135
E. None.

18. Which of the following statements about hypertension is false?

A. There is no treatment for hypertension.
B. Primary hypertension cannot be predicted accurately.
C. Secondary hypertension is always associated as a complication to a pre-existing
condition
D. None of the above. All are true

SITUATIONS: The following questions pertain to Intravenous Fluid Therapy.

19. If the client develops leakage of fluid around the underlying tissues of the skin. The first
thing to do is.
A. Assess for pallor and tenderness.
B. Discontinue the infusion.
C. Check the client’s vital signs.
 D. Apply cold compress to the site

20. Based on the correct response in the preceding number, which will be the next course of
action for the nurse?
A. Apply warm compress to the site
B. Notify the physician
C. Check the solution
D. Start a new line at a site, distal to the area affected.

21. A physician has written an order to discontinue an intravenous line. A nurse obtains
which of the following supplies from the unit supply area for use in applying pressure to
the site after removing the IV catheter?
A. Band-aid D. Betadine swab
B. Sterile 2x2 gauze E. Hydrogen peroxide swab
C. Alcohol swab

22. A client has just undergone insertion of central venous catheter at the bedside. A nurse
would be sure to check the results of which of the following before increasing the flow
rate of the IV solution attached to the line from KVO (keep vein open) to 100ml/hour?
A. Serum electrolytes D. Intake and output record
B. Serum osmolality E. Portable MRI
C. Portable chest x-ray

23. A nurse hears an attending physician asking an intern to prescribe a hypotonic IV

solution for a client. Which of the following IV solutions would the nurse expect the
intern to prescribe?
A. 0.45% NSS (1/2 NSS) C. 10% dextrose in water (10% D/W)
B. 5% Dextrose in water (5% D/W) D. 5% Dextrose in 0.9% saline
(NSS)

SITUATION: Parenteral nutrition is feeding a person intravenously, bypassing the usual

process of eating and digestion.
24. A client has been discharged to home on total parenteral nutriton. With each visit, home
care nurses assess which of the following parameters most closely in monitoring this
therapy?
A. Temperature and weight C. Pulse and weight
 B. Temperature and blood pressure D. Pulse and blood pressure

25. A nurse is caring for a group of adult clients on an acute care medical-surgical nursing
unit. The nurse plans to obtain which of the following most essential pieces of
equipment before hanging the solution?
A. Electronic infusion pump C. Urine test strips
B. Blood glucose meter D. Noninvasive blood pressure
monitor

26. A client is receiving nutrition by means of total parenteral nutrition (TPN). A nurse
monitors the client for complications of therapy. Which one is not a possible
complication of TPN therapy?
A. Hyperglycemia D. Severe pain
B. Infection E. Embolism
C. Hypoglycemia

27. A nurse is changing the central line dressing of a client receiving total parenteral
nutrition (TPN). The nurse notes that the catheter insertion site appears reddened. The
nurse next assesses which of the following items?
A. Tightness of tubing connections C. Expiration date of the bag
B. Client’s temperature D. Time of last dressing change

28. A nurse is making initial rounds at the beginning of the shift. The total parenteral
nutrition (TPN) bag of an assigned client is empty. Which of the following solutions
readily available on the nursing unit should the nurse hung until another TPN solution is
mixed and delivered to the nursing unit?
A. 10% Dextrose in water C. 5% Dextrose in Ringer’s
Lactate
B. 5% Dextrose in 0.9% Sodium Chloride D. 20% Dextrose in water

SITUATION: Electrolytes are minerals in the body that have an electric charge. Electrolytes are
necessary for the proper functioning of the body systems and for the maintenance of fluid
balance.
29. A nurse is reading the physician’s progress notes in the client’s record and reads that the
physician has documented “insensible fluid loss of approximately 800ml daily.” The
nurse understands that this type of fluid loss can occur through:
A. The gastrointestinal tract C. Wound drainage
B. Urinary output D. The skin

30. The nurse is assigned to care for a group of clients. On review of the client’s medical
records, the nurse determines that which client is at risk for fluid volume deficit?
 A. A client taking fluticasone for 7 months C. A client with cirrhosis
B. A client with SIADH D. None

31. A nurse is caring for a client who has been taking diuretics on a long term basis. A fluid
volume deficit is suspected. Which assessment finding would be noted in a client with
this condition?
A. Crackles C. Decreased hematocrit
B. Increased blood pressure D. Increased hematocrit

32. A nurse is assigned to care for a group of clients. On review on client’s medical records,
the nurse determines that which client is at risk for fluid volume excess?
A. The client following Thoracentesis C. The client with uncontrolled
DM type II
B. The client with under NGT feeding D. The client on gastrointestinal
suctioning

33. The nurse has been teaching a client how to use an incentive spirometer that must
be used at home for several days after discharge. Which client action indicates an
accurate understanding of the technique?
a. The client takes slow, deep breaths to expel and elevate the spirometer ball
while in an upright position
b. The client takes slow, shallow breaths to elevate the ball,
c. The client should blow the spirometer device in a comfortable position
d. A and B
E. None

34 . Nurse Mina prepares Hilde, a client who had convalesced from pneumonia, for
postural drainage and percussion. Which of the following is a special consideration
when doing the procedure?
a. Respiratory rate of 16 to 20 per minute
b. Client can tolerate sitting and lying positions
c. Client has no signs of infection
d. Time of last food and fluid intake of the client

35. What is the difference between percussion and vibration?

a. Percussion is responsible for loosening secretions. While vibration helps with
expectorations.
b. Percussion delivers cushioned blow to the chest with cupped palms only during
inhalation while vibration 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. None of the above
 36. How long should you insert the catheter used in nasotracheal suctioning?
a. From the mouth to the midsternum
b. From the tip of the nose, to the earlobe and to the xyphoid process
c. From the tip of the nose to the earlobe
d. From the tip of the nose, to the earlobe and to the side of the neck

37 . After Thoracentesis, the patient is put on what position?

a. Prone c. Side lying, ipsilateral to affected area
b. Side lying, contralateral to affected aread. None of the above

38. In preparing the client for assessment immediately after thoracentesis, which of
the following will help the nurse verify if there is a marked improvement or
exacerbation in the client’s status?
a. Checking the respiratory rate
b. Auscultation
c. Checking for signs of infection at the site
d. A and B
e. All of the above

39. A pulse oximeter is attached to Ms. Dizon to:

a. Determine if the client’s hemoglobin level is low and if she needs blood
transfusion
b. Check the level of tissue perfusion
c. check the client’s Arterial blood gas
d. Detect oxygen saturation of the arterial blood before symptoms of hypoxemia
develops

40. A client’s ABG results area as follows:

pH: 7.48
PaCO2: 33 mm/Hg
HCO3: 25 mEq/L

Which acid-base imbalance can be inferred from the findings above?

A. Resipiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
E. None.

41. What about the degree of compensation? (refer to the preceding number)

A. Partially Compensated
B. Fully Compensated
C. Uncompensated
D. None

42. A client’s ABG results area as follows:

pH: 7.38
PaCO2: 47 mm/Hg
HCO3: 27 mEq/L

Which acid-base imbalance can be inferred from the findings above?

A. Resipiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
E. None.

43. What about the degree of compensation? (refer to the preceding number)

A. Partially Compensated
B. Fully Compensated
C. Uncompensated
D. None

44. A client’s ABG results area as follows:

pH: 7.32
PaCO2: 48 mm/Hg
HCO3: 20 mEq/L

Which acid-base imbalance can be inferred from the findings above?

A. Resipiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
E. None
45. What about the degree of compensation? (refer to the preceding number)

A. Partially Compensated
B. Fully Compensated
C. Uncompensated
D. None

46. Tests are routinely used in patients with chronic respiratory disorders. They are performed
to assess respiratory function and to determine the extent of dysfunction. Which of the
following helps assess the degree of function of the lungs?
A. Spirometer. C. Mechanical ventilator.
B. Pulse oximetry. D. Iron lung machine.

47. Air trapping of carbon dioxide happens in emphysema due to loss of alveolar elasticity.
Elevated carbon dioxide in the blood is called:
A. Hypercarbia. C. Hypoxemia.
B. Hypocapnia. D. Hypercarbonemia.

48. Which of the following is the acid-base imbalance resulting from a prolonged attack of
asthma indicating an impending respiratory failure?
A. Metabolic acidosis. C. Respiratory acidosis.
B. Metabolic alkalosis. D. Respiratory alkalosis.

49. After submitting herself for an x-ray, the client is waiting for the results. During this time,
experiencing difficulty of breathing, diaphoresis and dizziness. What acid-base imbalance can
be expected?
A. Metabolic acidosis.
B. Metabolic alkalosis.
C. Respiratory acidosis.
D. Respiratory alkalosis.

50. Which of the following statements is true about acid-base disturbances?

A. The greater the H+ concentration, the more acidic the solution and the lower the pH.
B. The lower the H+ concentration, the more alkaline the solution and the lower the pH.
C. The greater the H+ concentration, the more acidic the solution and the higher the pH.
D. The lower the H+ concentration, the more acidic the solution and the higher the pH.