UNIVERSAL AND PROFICIENT UNITED MEDICAL PROFESSIONALS (UPUMP) REVIEW

SPECIALIST

DIAGNOSTIC EXAM I
Amiel Benj Matt-jai A. Lopoz, BSN, RN
November 2023 PNLE Topnotcher

Directions: Select the best answer for each question. Top the board exam!

Situation 1. Student nurse Angela is studying The Philippine Nursing Act of 2002 for their
upcoming finals exam for Nursing Leadership and Management.

1. Angela knows how to interpret whether the scores of a nursing license applicant are a
pass, fail, or in conditional status. Interpret the following:

Nursing Practice 1: 95%

Nursing Practice 2: 89%
Nursing Practice 3: 57%
Nursing Practice 4: 60%
Nursing Practice 5: 89%
Average: 78%

a. Pass
b. Fail
c. Conditional
d. Not enough information

2. She also knows that under the law, nurses who have not actively practiced the
profession for 5 consecutive years need to undergo:
a. 1 month of didactic training and 3 months of practical training.
b. 3 months of didactic training and 3 months of practical training.
c. 2 months of didactic training and 3 months of practical training.
d. 3 months of didactic training and 1 month of practical training.

3. All the following are qualifications of faculty members of nursing schools, except:
a. Be a member of good standing of the Philippine Nurses Association.
b. Be a holder of a master’s degree in nursing, education, or other allied medical
health sciences.
c. Have at least three (3) years of clinical experience in a field specialization.
d. Be a registered nurse in the Philippines.

4. She also knows that the said act was signed into a law by which Philippine president?
a. Joseph Estrada
b. Fidel V. Ramos
c. Ferdinand Marcos Sr.
d. Gloria Macapagal-Arroyo

5. In case a license gets revoked or suspended, student nurse Angela is correct to state
that the re-issuance of revoked licenses is done after a maximum of how many years
from the date of revocation?
a. 1 year
b. 2 years
c. 3 years
d. 4 years

Situation 2. Student nurse Bryan is also reviewing for the same exam, but he is focusing on the
legal doctrines in nursing.

6. Bryan is correct to say that this legal doctrine is triggered into effect by an extraordinary
event or the occurrence of an extreme set of circumstances that is completely beyond
the control of the people involved.
a. Res ipsa loquitur
b. Captain-of-the-ship doctrine
c. Force majeure
d. Respondeat superior

7. In a case where a surgical sponge was left in the peritoneal cavity of a patient in which
the sponge caused complications and harm, which legal doctrine is in play?
a. Res ipsa loquitur

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b. Captain-of-the-ship doctrine
c. Force majeure
d. Respondeat superior

8. This legal doctrine is mainly used in the operating room, where the surgeon is liable for
any wrongful action of anyone in the room involved in the procedure.
a. Res ipsa loquitur
b. Captain-of-the-ship doctrine
c. Force majeure
d. Respondeat superior

9. Which of the following statements is correct about the legal doctrine of respondeat
superior?
a. The statement is translated as “let the subordinate answer for the actions of his
master.”
b. There is no transfer of liability, rather, there is an extension of liability.
c. This legal doctrine talks about forces that are unforeseen or inevitable.
d. The employer is free of liability from the wrongful actions of its employee.

10. This legal doctrine states that if someone willingly places themselves in a position where
harm might result, knowing that some degree of harm might result, they are not liable to
bring a claim against the other party.
a. Talem qualem
b. Ex turpi causa non oritur action
c. Last clear chance doctrine
d. Volenti non fit injuria

Situation 3. Conrad is admitted to the medical-surgical ward of a certain hospital and is being
cared for by nurse Dante. Conrad has been diagnosed with late liver cirrhosis.

11. During morning rounds, nurse Dante notices that Conrad is breathing heavily and states
that he has difficulty breathing. What would be the first action that the nurse would do?
a. Call the physician and report the findings.
b. Assess for heart sounds.
c. Elevate the head of the bed and provide oxygen on 2L/minute.
d. Call a code blue.

12. Upon assessing the patient, the nurse notices dilated veins running across the
abdominal area. The nurse knows that this is referred to as:
a. Spider angiomas
b. Varicose veins
c. Caput medusae
d. Caput succedaneum

13. Morning rounds also involve measuring the abdominal girth of the patient. Which of the
following statements indicates that the nurse understands how to correctly perform the
procedure?
a. Bring the tape measure around 2 finger widths above the umbilicus.
b. Bring the tape measure at the level of the xiphoid process.
c. Bring the tape measure at the level of the umbilicus.
d. Bring the tape measure at the level as the patient desires.

14. Nurse Dante is consciously monitoring for complications of his patient's condition. Which
of the following is a complication of liver cirrhosis that is characterized by coarse, rapid,
nonrhythmic extensions and flexions in the wrist and fingers?
a. Apraxia
b. Asterixis
c. Astereognosis
d. Alogia

15. Conrad's primary physician prescribed him with potassium-sparing diuretics to help with
fluid retention. Nurse Dante is correct to identify which of the following drugs as a
potassium-sparing diuretic?
a. Aldactone
b. Hydrochlorothiazide
c. Mannitol

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d. Furosemide

Situation 4. Ester is scheduled for a thoracentesis to remove the fluid from her right lung. She
is being prepared by nurse Fred for the procedure.

16. Ester is skeptical about the procedure and expresses her fear of being punctured. Nurse
Fred is practicing therapeutic communication when he says what statement to the
patient?
a. "The procedure is painless and will only take a couple seconds."
b. "I have no words to describe how painful the procedure is going to be."
c. "Please try to calm down as we will not proceed with the procedure when you say
things like that.
d. "I hear you and I am here to listen. Tell me more of your concerns."

17. Ester is being positioned in the procedure room, but she is unable to sit up. Nurse Fred
is correct to place her in which position as an alternative?
a. Left-side lying position
b. Right-side lying position
c. Prone
d. Lithotomy

18. The primary physician prescribed an antitussive to suppress Ester's persistent coughing.
The nurse would question which drug when ordered by the physician?
a. Benzonatate
b. Dextromethorphan
c. Codeine
d. Alvimopan

19. Before the procedure, which of the following instructions is important to enforce to Ester?
a. Instruct the client to breathe rapidly when the needle is being inserted.
b. Instruct the patient to take a deep breath and hold it when the needle is
being inserted.
c. Instruct the client to cough three times after the needle is inserted.
d. Instruct the client to place her hands on her knees when the needle is being
inserted.

20. After the procedure, which of the following actions is the most immediate priority?
a. Monitor the client's respiratory status.
b. Reassure the patient that she is being well-cared for.
c. Apply a pressure dressing on the puncture site.
d. Review the chest x-ray results to monitor for pneumothorax.

Situation 5. Nurse Gino is reviewing and interpreting the arterial blood gas results of several
patients.

21. Nurse Gino interprets the ABG of patient A as respiratory alkalosis. He expects which of
the following assessment findings in patient A?
a. Deep, rapid breathing
b. Vomiting and diarrhea
c. Joint pain
d. Fever

22. Patient A should have which of the following ABG values?

a. pH: 7.20; PaCO2: 52; HCO3: 24
b. pH: 7.48; PaCO2: 26; HCO3: 23
c. pH: 7.36; PaCO2: 38; HCO3: 23
d. pH: 7.45; PaCO2: 40; HCO3: 25

23. Patient B has chronic obstructive pulmonary disease. With this diagnosis, the expected
ABG interpretation would be?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis

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24. In maintaining the acid-base balance of the body, nurse Gino knows that the two primary
organs involved in this process are?
a. Lungs and liver
b. Brain and heart
c. Lungs and kidneys
d. Kidneys and liver

25. Metabolic acidosis was interpreted from patient B's ABG results. The nurse expects
which of the following values?
a. pH: 7.23; PaCO2: 47; HCO3: 25
b. pH: 7.36; PaCO2: 37; HCO3: 24
c. pH: 7.29; PaCO2: 40; HCO3: 19
d. pH: 7.30; PaCO2: 51; HCO3: 26

Situation 6. Helen, a 24-year-old woman, comes to the clinic reporting nausea, vomiting,
amenorrhea, and she feels as if something is moving in her belly. She thinks that she is
pregnant.

26. Based on Helen's reported symptoms, these are symptoms are classified as:
a. Probable signs
b. Positive signs
c. Presumptive signs
d. Assumptive signs

27. After a series of tests, it was confirmed that Helen was indeed pregnant. The nurse
knows that when Helen stated she felt something move in her belly, this phenomenon is
known as:
a. Braxton-Hick's
b. Quickening
c. Ballottement
d. Melasma

28. She was then asked by the nurse-on-duty when her last menstrual period was. She
stated that the first day of her last menstrual cycle was on September 14. What is her
estimated date of confinement?
a. July 21
b. June 21
c. August 21
d. May 21

29. The computation of the next preceding question is referred to as?

a. Näegel's rule
b. Bartholomew's rule
c. McDonald's rule
d. Leopold's rule

30. Helen was also subjected to fundal height measurement. What is the first thing the nurse
would do?
a. Place the client in a supine position.
b. Place the end of the tape measure at the level of the symphysis pubis.
c. Stretch the tape to the top of the uterine fundus.
d. Assist the patient to empty her bladder.

Situation 7. Ingrid, a 9-year-old child, was brought to the clinic by her mother due to excessive
scalp scratching. The nurse observes white specks which look like eggs on the child's scalp
upon inspection.

31. Given the signs presented by Ingrid, the nurse would be correct to suspect what
infestation?
a. Pediculosis corporis
b. Pediculosis capitis
c. Pediculosis pubis
d. Pediculosis humanus

32. Ingrid's head was further inspected. The nurse knows which area of the head lice are
commonly found?

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a. Parietal area
b. Temporal area
c. Occipital area
d. Frontal area

33. As a homemade alternative to permethrin shampoo to get rid of the lice, a vinegar and
water mixture was recommended. This mixture is made in what vinegar to water ratio?
a. 1:1
b. 1:2
c. 1:3
d. 1:4

34. Which of the following is the most appropriate nursing diagnosis for Ingrid?
a. Risk for Aspiration
b. Risk for Impaired Skin Integrity
c. Risk for Isolation
d. Risk for Dehydration

35. The nurse is rendering health teachings to the mother and the patient regarding
preventive measures for head lice. The nurse is correct to state the following
instructions, except:
a. Teach the child not to share hats, combs, or brushes.
b. Change bedding and clothing every day.
c. Seal toys that cannot be washed in plastic bags for two weeks.
d. Launder linen in cold water for 10 minutes and dry in a hot dryer for 20
minutes.

Situation 8. Jared, a 23-year-old man, was visited by the mental health nurse clinician as
requested by the family. The family states that Jared has an irrational fear of leaving home
alone, stating that he might die if he goes out of his house.

36. Given the situation, Jared is most likely experiencing what type of phobia?
a. Claustrophobia
b. Arachnophobia
c. Agoraphobia
d. Astraphobia

37. In taking care of Jared, the psychiatric nurse is aware that the most used defense
mechanism used by persons with phobias is:
a. Projection
b. Repression
c. Denial
d. Undoing

38. The psychiatrist ordered Jared to take benzodiazepines to ease his symptoms. Which of
the following drugs are classified under this drug class?
a. Xanax
b. Prilosec
c. Catapres
d. Celexa

39. As prescribed, the patient was also scheduled for systematic desensitization therapy for
multiple sessions. These therapy sessions are performed in adjunct with
pharmacological treatment modalities. The treatment methods are deemed successful,
after several sessions, when Jared exhibits which of the following?
a. He can talk to other people through the phone.
b. He can write about his feelings about the therapy sessions.
c. He can go out to the grocery store with his family.
d. He can drive through a large highway on his own.

40. Several other therapies are also available for specific phobias. Which of the following
therapies describes a process in which patients place themselves in fearful stimuli, in
vivo?
a. Flooding or Implosion
b. Token Economy
c. Electroconvulsive Therapy

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d. Imaginal Systematic Desensitization

Situation 9. In the medical-surgical ward of a certain hospital, Karen, a 22-year-old female,

complains of intense dull pain in the right lower quadrant. She is also presenting with low-grade
fever, an elevated WBC count, and abdominal guarding. The primary physician suspects
appendicitis.

41. To elicit more information about the physician’s suspicions, the nurse palpates the
patient’s left lower quadrant. Karen grimaces and states that she feels pain in the right
lower quadrant. This means that Karen is presenting with what sign?
a. Rovsing’s Sign
b. Obturator Sign
c. Grey-Turner’s Sign
d. Iliopsoas Sign

42. Confirmation of the diagnosis is done through CT scan or ultrasound. However, before
radiologic studies are performed, which of the following tests must be performed on
patients who are in the same demographic as Karen?
a. Urinalysis
b. Complete blood count
c. Pregnancy test
d. Stool examination

43. Appendicitis almost always results from an obstruction in the appendiceal lumen. Which
problem should the nurse identify as the cause of this obstruction?
a. Monolith
b. Fecalith
c. Ptyalith
d. Tonsillolith

44. The results of the CT scan come back and confirm that Karen’s case is indeed
appendicitis. She is now scheduled for an appendectomy. When caring for Karen
preoperatively, the nurse needs intervention from her superior when she performs which
of the following?
a. Monitor for changes in level of pain.
b. Apply heat packs to the abdomen for 15 minutes to relieve pain.
c. Position the client in the right side-lying position to promote comfort.
d. Maintaining NPO status.

45. Upon performing the preoperative care, Karen reports that her pain suddenly eased,
stating that it has gone down to a very much more tolerable level. The nurse should:
a. Assure Karen that her condition is lightening up.
b. Call the surgeon and prepare an OR.
c. Document findings in the patient’s chart.
d. Provide comfort measures to further ease Karen’s pain.

Situation 10. Leonora, a 45-year-old woman, comes to the health center on Friday morning
reporting low-grade afternoon fever, night sweats, and loss of weight over the course of three
weeks. She is subjected to several tests to confirm a tuberculosis diagnosis.

46. Leonora is subjected to a Mantoux tuberculin test to screen her for tuberculosis. Her
reading is positive when it shows:
a. 12 mm induration reading on Monday morning.
b. 5 mm induration reading on Friday afternoon.
c. 8 mm induration reading on Monday morning.
d. 10 mm induration reading on Tuesday afternoon.

47. In line with the National TB Control Program, which of the following is considered key
policies in case finding of tuberculosis cases? Select all that apply.

i. Tuberculosis cases can be made based on chest x-ray results alone.

ii. The only contraindication for sputum collection is hemoptysis.
iii. Any healthcare professional can perform Direct Sputum Smear Microscopy.
iv. Passive case finding shall be implemented in all health stations.
v. Hospitalization is recommended when complications develop.

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a. I, II, and III

b. II, III, and IV
c. II, IV, and V
d. I, II, and IV

48. Through the DSSM, it has been confirmed that Leonora has tested positive for
tuberculosis. To facilitate efficient treatment, categorization of patients is crucial. Since
this is the first time Leonora tested positive, she would be in what category of patient
classification?
a. Category I
b. Category II
c. Category III
d. Category IV

49. If Leonora were to be diagnosed with chronic tuberculosis, she would be in what
category of patient classification?
a. Category I
b. Category II
c. Category III
d. Category IV

50. Leonora’s initial patient categorization entails intensive HRZE treatment for 2 months
and continuative HR treatment for 4 months. The ‘R’ in these therapies has what known
side effect?
a. Red-orange body fluid discoloration
b. Peripheral neuropathy
c. Hyperuricemia
d. Optic neuritis

Situation 11. Leprosy is an ancient disease that causes permanent physical disability. The
condition is caused by Mycobacterium leprae, which primarily attacks the Schwann cells. The
following questions apply.

51. The disease progression of leprosy ranges from five months to five years, producing
distinct signs and symptoms throughout. All the following are considered early signs and
symptoms of leprosy, except:
a. Nasal obstruction
b. Non-blanchable reddened skin color
c. Thickened and painful nerves
d. Clawing of fingers and toes

52. To prevent leprosy, which of the following vaccines may be helpful?

a. Pentavalent
b. PCV
c. BCG
d. Rotavirus

53. Diagnosis of leprosy involves the use of the slit skin smear test. The nurse is correct to
identify the following areas where skin samples can be retrieved, except:
a. Knee
b. Elbow
c. Scalp
d. Earlobe

54. Chemotherapy for multibacillary leprosy involves three main drugs. Which of the
following is not included?
a. Clofazimine
b. Dapsone
c. Isoniazid
d. Rifampicin

55. Treatment for leprosy has also been made easily available to patients in domiciliary
settings by the government through the Liberalization of Leprosy Treatment Act. This is:
a. Republic Act 4073
b. Republic Act 7043
c. Republic Act 4037

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d. Republic Act 7304

Situation 12. Manuel, a 35-year-old carpenter, suffered a terrible fall on duty. He was taken to
the emergency room with an obvious deformity on his left thigh and left wrist.

56. After initial stabilization of the thigh, he was taken to the radiology department to assess
his deformity. Results showed that his right femoral neck was broken off and driven into
the lower part of the femur. The nurse is correct to identify this as a?
a. Oblique fracture
b. Comminuted fracture
c. Impacted fracture
d. Greenstick fracture

57. Meanwhile, he also fractured his left wrist as he used the palm of his hand to attempt to
break the fall. The hand has a deformity resembling a dinner fork. This fracture is known
as?
a. Colles’ fracture
b. Smith fracture
c. Boxer’s fracture
d. Galeazzi fracture

58. Treatment was given to the injured extremities and plaster casts were applied. The nurse
is giving cast care instructions to Manuel but identified that he needs further teaching
when he states which of the following?
a. “I should keep my cast and extremity elevated, as instructed.”
b. “I can use a hair dryer on a cool setting to dry my plaster cast.”
c. “I should inform you right away when I feel numbness or tingling on my casted
leg.”
d. “I should handle my wet plaster casts with my fingertips until dry.”

59. Buck’s traction was also applied to the thigh to alleviate muscle spasms and immobilize
the affected limb by maintaining a straight pull on the limb using weights. In caring for
Manuel, the nurse would be sure to implement the following interventions, except:
a. Ensure that the ropes are outside the grooves of the pulleys.
b. Ensure that the pulleys are not obstructed.
c. Frequently check the ropes for fraying.
d. Ensure that the weights hang freely and do not touch the floor.

60. A few hours later, Manuel complains of numbness and tingling on his right foot and toes.
When evaluated, the area is pale and edematous. The nurse quickly notifies the primary
healthcare provider because what complication may be occurring?
a. Fat embolism
b. Infection
c. Compartment syndrome
d. Avascular necrosis

Situation 13. Putting the hospital's new wing in order is head nurse Nico's job. His freedom to
act as he pleases has been conferred by the director of nursing.

61. In dealing with staff nurses, he has substantial trust and confidence in his subordinates’
capabilities. He also communicates downward and upward channels and usually uses
the ideas and opinions of his staff. Which of the following describes Nico’s style of
management?
a. Consultative
b. Participative
c. Benevolent-authoritative
d. Exploitative-authoritative

62. Nurse Nico decides to illustrate the organizational structure. He is correct when he
identifies that all the following are included in the illustration, except:
a. Level of authority
b. Lines of communication
c. Span of control
d. Unity of direction

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63. He also plans of assigning competent people to fill the roles designed in the hierarchy.
Which process refers to this process?
a. Staffing
b. Scheduling
c. Recruitment
d. Induction

64. He also checks the documentary requirements for the applicants for staff nurse position.
Which of the following documents is not necessary?
a. Certificate of previous employment
b. Record of related learning experience
c. Membership to an accredited professional organization
d. Professional identification card

65. Nurse Nico also 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

Situation 14. Oscar, a 29-year-old male, was admitted into a mental health institution for severe
depressive episodes. He has severe reduction in oral intake causing him to become
malnourished. His primary mental health physician prescribed him Electroconvulsive Therapy
(ECT).

66. Electroconvulsive therapy is considered a first-line treatment for Oscar’s condition. The
nurse is aware that other conditions that use ECT as a first-line treatment are all the
following, except:
a. Schizoaffective psychosis
b. Schizophrenia
c. Treatment-resistant Parkinson’s disease
d. Severe depression

67. The nurse is also aware that in ECT, there are several contraindications. Which of the
following is considered as an absolute contraindication for the procedure?
a. Recent myocardial infarction
b. Glaucoma
c. Both A and B
d. Neither A nor B

68. Basic medications are given to prevent aspiration, for anesthesia, and for body paralysis
to prevent seizure-related injuries. Which of the following medications is commonly used
in ECT and is administered intravenously to cause immediate anesthesia?
a. Etomidate
b. Methohexital
c. Pethidine
d. Propofol

69. Before the procedure, all the following activities is important for the nurse to do, except:
a. Obtain baseline vital signs.
b. Obtain informed consent.
c. Maintain NPO status for at least 4 hours before the treatment, as prescribed.
d. Hairpins, contact lenses, and dentures are permitted during therapy.

70. After eight sessions of treatment, the client comes out of his room all groomed and
dressed. He has a smile on his face and states he is now cured of his depression. The
nurse would institute which of the following?
a. Assure the patient that his condition will continually get better.
b. Increase frequency of checking the client in his room to every 10 minutes.
c. Ensure any harmful objects are removed from the room of the client.
d. Contact the family to come pick up Oscar from the institution.

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Situation 15. A mother brings her 6-year-old child to a certain hospital presenting with facial
edema, an enlarged abdomen, and lethargy. It is suspected that the child has nephrotic
syndrome.

71. Nephrotic syndrome is a kidney disorder characterized by increased glomerular

permeability. The manifestations of the syndrome are the following, except:
a. Hypolipidemia
b. Weight gain
c. Hypoalbuminemia
d. Edema

72. The nurse is collecting a urine sample from the child who is experiencing proteinuria due
to the disorder. The nurse knows that the urine will appear:
a. Foamy and dark
b. Pale amber
c. Tea-colored
d. Pinkish red

73. Constant monitoring of complications is being done by the nurse-on-duty. Which of the
following assessment findings would prompt the nurse to notify the physician
immediately?
a. Elevated lipid levels
b. Urine protein result of 4+
c. Shifting dullness upon palpation of the abdomen
d. Reddened, warm, swollen area on the patient’s leg

74. Corticosteroid therapy is usually prescribed as soon as the diagnosis has been made.
Which of the following nursing diagnoses is pertinent to this therapeutic modality?
a. Constipation
b. Ineffective thermoregulation
c. Risk for infection
d. Impaired sleep patterns

75. Nutrition-wise, a low-sodium diet is given to the patient to prevent fluid retention. Fluids
may also be restricted to 1L/day, as prescribed. In addition to these, which of the
following diets may also be prescribed to patients with nephrotic syndrome?
a. Low-carbohydrate diet
b. Low-fat diet
c. High-potassium diet
d. Clear liquid diet

Situation 16. Nurse Patrick is floated to the renal dialysis unit. He is mostly familiar with the
equipment, process, and principles of hemodialysis and peritoneal dialysis.

76. Hemodialysis (HD) involves the diffusion of dissolved particles through a semipermeable
membrane made of thin, porous cellophane. When asked, the nurse is correct to identify
all the following particles that can pass through the cellophane, except:
a. Proteins
b. Creatinine
c. Water
d. Uric acid

77. This process is described as the movement of fluid across a semipermeable membrane
because of an artificially created pressure gradient.
a. Osmosis
b. Ultrafiltration
c. Diffusion
d. Active transport

78. Patient A comes to the unit for his scheduled hemodialysis treatment. His HD access is
an internal arteriovenous fistula over his left arm. Which of the following nursing actions
would require intervention from his supervisor?
a. He performs blood pressure taking on the right arm of the patient.
b. He teaches patient A hand-flexing exercises, such as ball squeezing.
c. He palpates for a bruit or auscultates for a thrill over the fistula.

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d. He teaches the patient to report any feelings of tingling or discomfort in the

extremity.

79. At the other side of the unit sits patient B with an ongoing peritoneal dialysis. Nurse
Patrick comes to check out his outflow and notices that it is running slow. What would be
the best nursing action for this occurrence?
a. Ask patient B to perform the Valsalva maneuver.
b. Offer patient B a glass of cold water.
c. Instruct patient B to stand up for 5 minutes.
d. Assist the patient to turn from side to side.

80. One of the most dreaded complications of peritoneal dialysis is peritonitis. The nurse is
correct to identify which of the following signs is related to peritonitis?
a. Brown outflow
b. Bloody outflow
c. Cloudy outflow
d. Pale amber outflow

Situation 17. Quinta, a 64-year-old female, comes to the emergency room of a certain hospital
complaining of eye pain, nausea, and reports seeing halos around lights. Glaucoma is a
suspected diagnosis.

81. The term glaucoma is used to refer to a group of ocular conditions characterized by
elevated intraocular pressure IOP. If left untreated, increased IOP damages the optic
nerve and nerve fiber layer. What is the normal IOP?
a. 10 to 21 mmHg
b. 7 to 15 mmHg
c. 100 to 150 mmHg
d. 60 to 90 mmHg

82. In measuring the IOP, the nurse knows that it is appropriate to use which of the following
assessment tools:
a. Goniometer
b. Tonometer
c. Rosenbaum screener
d. Snellen’s chart

83. Quinta asks the nurse the differences between open-angle glaucoma and closed-angle
glaucoma. The nurse would be correct to state the following, except:
a. The onset of open-angle glaucoma is usually slow and progressive.
b. Open-angle glaucoma is painless and initially asymptomatic.
c. Closed-angle glaucoma develops symptoms that are noticeable.
d. Open-angle glaucoma requires immediate medical attention.

84. The nurse is rendering health teachings to Quinta regarding her condition. Which of the
following statements is most helpful?
a. Inform the patient that her medications are for life.
b. Suggest a low-sodium diet to reduce fluid build-up in the eyes.
c. Inform her of the possibility of enucleation when eye pain reoccurs.
d. Teach the patient to keep her room dimly lit to prevent halos.

85. Further teaching was also rendered regarding the use of medications. The nurse would
question the primary healthcare provider on which of the following prescribed
medications?
a. Acetazolamide
b. Timolol
c. Atropine
d. Latanoprost

Situation 18. The nurse is caring for Randy, a 45-year-old patient diagnosed with acromegaly.
He is married and states that he fears his wife might leave him because of how he looks.

86. Acromegaly is a disorder caused by an excess of growth hormone production in adults.

Randy is correct to identify the following symptoms that are present in the condition.
Select all that apply.
i. Coarse facial features

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ii. Deepening of the voice

iii. Hypotension
iv. Colon polyps
v. Visual disturbances

a. I, II, IV, V
b. II, III, IV, V
c. I, II, III, V
d. II, III, IV, V

87. The growth hormone in acromegaly is hypersecreted because of a benign growth in

which endocrinal gland?
a. Adrenal gland
b. Hypothalamus
c. Posterior pituitary gland
d. Anterior pituitary gland

88. The patient undergone a hypophysectomy via craniotomy to remove the tumor causing
elevated growth hormone levels. There is no need for the charge nurse to intervene
when the nurse placed Randy in what position after a supratentorial approach?
a. Flat on bed
b. Trendelenburg
c. Prone
d. Head of the bed elevated

89. Three days post-op, the nurse notices Randy constantly looking at his reflection in the
mirror with a worried look on his face. He constantly keeps looking at how large his jaw
is and how oily his skin is getting. The nurse would institute interventions under what
appropriate nursing diagnosis?
a. Disturbed Body Image
b. Fluid Volume Deficit
c. Ineffective Coping
d. Knowledge Deficit

90. Knowing Randy’s concerns about himself and his relationship with his wife, all the
following are appropriate nursing interventions, except:
a. Encourage the patient to verbalize his feelings about the whole situation.
b. Establish a trusting professional relationship with the patient.
c. Offer counseling options, as requested.
d. Offer advice regarding how he should deal with his issues.

Situation 19. Sarah is the nurse-in-charge of the blood transfusions of the entire floor. She is
well-versed in the whole transfusion process, from pre-procedure to post-procedure.

91. Patient C is scheduled for a blood transfusion of a unit of packed red blood cells. After
Sarah had obtained the unit of PRBC from the blood bank and had checked the blood
bag properly with another nurse, she must assess which of the following from patient C?
a. Vital signs
b. Skin color
c. Last hemoglobin level
d. Urine output

92. About 8 minutes after the nurse begins the transfusion, the patient complains of chills,
chest tightness, and dyspnea. Which of the following nursing actions is the most priority
at this point?
a. Notify physician of a possible transfusion reaction.
b. Stop the infusion and flush the line with normal saline.
c. Slow down the infusion rate of the blood.
d. Administer diuretics, as prescribed.

93. The patient asks nurse Sarah why the blood needs to be transfused within a 4-hour time
frame. The nurse is correct when she states which of the following?
a. Exceeding the prescribed time increases the risk for hypervolemia.
b. Exceeding the prescribed time increases the risk for bacterial proliferation.
c. Exceeding the prescribed time increases the risk for allergic reactions.
d. Exceeding the prescribed time increases the risk for circulatory overload.

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94. In the adjacent room, Sarah is also monitoring patient D, a child who has thalassemia, in
for long-term transfusion therapy. Patient D is more likely to experience iron overload
due to their therapeutic requirements. Sarah is correct to identify which of the following
as the antidote for this possible complication?
a. Deferoxamine
b. Dimercaprol
c. Flumazenil
d. Leucovorin

95. After initiating a blood transfusion for a 67-year-old patient with cardiovascular issues,
the nurse notes signs of possible circulatory overload, including dyspnea, sudden
anxiety, jugular distention, and crackles, around 45 minutes into the transfusion. What is
the priority nursing action for Sarah at this point?
a. Notify the physician of the condition.
b. Stop the infusion and flush with normal saline.
c. Slow the infusion.
d. Assure the patient that this is an expected occurrence.

Situation 20. Nurse Tristan is the assigned medicating nurse in the oncology floor of a certain
hospital. He is adept in administering the drug and identifying and monitoring complications.

96. Patient F, a 48-year-old female, is diagnosed with breast cancer and is for
chemotherapy. Which of the following drugs is usually used to treat this type of
malignancy?
a. Carboplatin
b. Tamoxifen
c. Vincristine
d. Temozolomide

97. The nurse is preparing to administer methotrexate to a patient with leukemia. Nurse
Tristan is aware to also prepare what medication to counter the effects of methotrexate
toxicity?
a. Deferoxamine
b. Dimercaprol
c. Flumazenil
d. Leucovorin

98. Busulfan was prescribed to patient G, a 23-year-old male, with myeloid leukemia. Which
of the following laboratory studies would nurse Tristan check for first?
a. Serum calcium level
b. Blood urea nitrogen
c. Uric acid level
d. Thyroid function tests

99. Patient H complained to nurse Tristan that they are short of breath. A dry, hacking cough
was also noted upon assessment. Nurse Tristan is correct to identify which
antineoplastic medication may be causing this complication?
a. Vincristine
b. Bleomycin
c. Cisplatin
d. Asparaginase

100. Different antimetabolite medications act on specific phases of the cell cycle to
destroy cancer cells, while others are phase nonspecific. Which of the following are
cell cycle phase-specific medications? Select all that apply.

i. Chlorambucil
ii. Busulfan
iii. Hydroxyurea
iv. Etoposide

a. I, II
b. II, III
c. III, IV
d. I, IV

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