Nle Reviewers_ Care of Clients With Physiologic and Psychosocial Alterations

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NLE reviewers: CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS

NLE reviewers Tuesday, April 3, 2012

CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS Situation 1 - Because of the serious consequences of severe burns management requires a multi disciplinary approach. You have important responsibilities as a nurse. 1. While Sergio was lighting a barbecue grill with a lighter fluid, his shirt burst into flames. The most effective way to extinguish the flames with as little further damage as possible is to: a. log roll on the grass/ground b. slap the flames with his hands c. remove the burning clothes d. pour cold liquid over the flames 2. Once the flames are extinguished, it is most important to: a. cover Sergio with a warm blanket b. give him sips of water c. calculate the extent of his burns d. assess the Sergio's breathing 3. Sergio is brought to the Emergency Room after the barbecue grill accident. Based on the assessment of the physician, Sergio sustained superficial partial thickness bums on his trunk, right upper extremities ad right lower extremities. His wife asks what that means. Your most accurate response would be: a. Structures beneath the skin are damaged b. Dermis is partially damaged c. Epidermis and dermis are both damaged d. Epidermis is damaged 4. During the first 24 hours after thermal injury, you should assess Sergio for a. hypokalemia and hypernatremia b. hypokalemia and hyponatremia c. hyperkalemia and hyponatremia d. hyperkalemia and hypernatremia 5. Teddy, who sustained deep partial thickness and full thickness burns of the face, whole anterior chest and both upper extremities two days ago, begins to exhibit extreme restlessness. You recognize that this most likely indicates that Teddy is developing: a. Cerebral hypoxia b. Hypervolemia c. Metabolic acidosis d. Renal failure . Situation 2 - You are now working as a staff nurse in a general hospital. You have to be prepared to handle situations with ethico-legal and moral implications. 6. You are on night duty in the surgical ward. One of our patients Martin is prisoner who sustained an abdominal

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gunshot wound. He is being guarded by policemen from the local police unit. During your rounds you heard a commotion. You saw the policeman trying to hit Martin. You asked why he was trying to hurt Martin. He denied the matter. Which among the following activities will you do first? a. Write an incident report b. Call security officer and report the incident c. Call your nurse supervisor and report the incident : d. Call the physician on duty 7. You are on morning duty in the medical ward. You have 10 patients assigned to you. During your endorsement rounds, you found out that one of your patients was not in bed. The patient next to him informed you that he went home without notifying the nurses. Which among the following will you do first? a. Make and incident report b. Call security to report the incident c. Wait for 2 hours before reporting d. Report the incident to your supervisor 8. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. Which among the following will you do first? a. Write an incident report and refer the matter to the nursing director b. Keep your findings to yourself c. Report the matter to your supervisor d. Find out from the endorsement any patient who might have been given narcotics 9. You are on duty in the medical ward. The mother of your patient who is also a nurse came running to the nurse station and informed you that Fiolo went into cardiopulmonary arrest. Which among the following will you do first? a. Start basic life support measures b. Call for the Code c. Bring the crush cart to the room d. Go to see Fiolo and assess for airway patency and breathing problems 10. You are admitting Jorge to the ward and you found out that he is positive for HIV. Which among the following will you do first? a. Take note of it and plan to endorse this to next shift b. Keep this matter to your self c. Write an incident report d. Report the matter to your head nurse Situation 3 - Colorectal cancer can affect old and younger people. Surgical procedures and other modes of treatment are done to ensure quality of life. You are assigned in the Cancer institute to care of patients with this type of cancer. 11. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the CI. After taking the history and vital signs the physician does which test as a screening test for colorectal cancer. a. Barium enema b. Carcinoembryonig antigen c. Annual digital rectal examination d. Proctosigmoidoscopy 12. To confirm his impression of colorectal cancer, Larry will require which diagnostic study? a. carcinoembryonic antigen b. proctosigmoidbscopy c. stool hematologic test d. abdominal computed tomography (CT) test 13. The following are risk factors for colorectal cancer, EXCEPT: a. inflammatory bowels b. high fat, high fiver diet c. smoking d. genetic factors-familial adenomatous polyposis

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NLE reviewers: CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS

14. Symptoms associated with cancer of the colon include: a. constipation, ascites and mucus in the stool b. diarrhea, heartburn and eructation c. blood in the stools, anemia, and pencil-shaped, stools d. anorexia, hematemesis, and increased peristalsis 15. Several days prior to bowel surgery, Larry may be given sulfasuxidine and neomycin primarily to: a. promote rest of the bowel by minimizing peristalsis b. reduce the bacterial content of the colon c. empty the bowel of solid waste d. soften the stool by retaining water in the colon Situation 4 - ENTEROSTOMAL THERAPY is now considered especially in nursing. You are participating in the OSTOMY CARE CLASS. 16. You plan to teach Fermin how to irrigate the colostomy when: a. The perineal wound heals and Fermin can sit comfortably on the commode b. Fermin can lie on the side comfortably, about the 3rd postoperative day c. The abdominal incision is close and contamination is no longer a danger d. The stool starts to become formed, around the 7th postoperative day 17. When preparing to teach Fermin how to irrigate his colostomy, you should plan to do the procedure: a. When Fermin would have normal bowel movement b. At least 2 hours before visiting hours c. Prior to breakfast and morning care d. After Fermin accepts alteration in body image 18. When observing a rectum demonstration of colostomy irrigation, you know that more teaching is required if Fermin: a. Lubricates the tip of the catheter prior to inserting into the stoma b. Hands the irrigating bag on the bathroom door doth hook during fluid insertion c. Discontinues the insertion of fluid after only 500 ml of fluid had been insertion d. Clamps off the flow of fluid when feeling uncomfortable 19. You are aware that teaching about colostomy care is understood when Fermin states, "I will contact my physician and report: a. If I have any difficulty inserting the irrigating tub into the stoma.” b. If I notice a loss of sensation to touch in the stoma tissue." c. The expulsion of flatus while the irrigating fluid is running out." d. When mucus is passed from the stoma between irrigation." 20. You would know after teaching. Fermin that dietary instruction for him is effective when he states, "It is important that I eat: a. Soft foods that are easily digested and absorbed by my large intestine." b. Bland food so that my intestines do not become irritate." c. Food low in fiber so that there is less stool." d. Everything that I ate before the operation, while avoiding foods that cause gas." Situation 5 - Ensuring safety is one of your most important responsibilities. You will need to provide instructions and information to your clients to prevent complications. 21. Randy has chest tubes attached to a pleural drainage system. When caring for him you should: a. empty the drainage system at the end of the shift b. clamp the chest tube when auctioning c. palpate the surrounding areas for crepitus d. change the dressing daily using aseptic techniques 22. Fanny came in from PACU after pelvic surgery. As Fanny's nurse you know that the sign that would be indicative of a developing thrombophlebitis would be:

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a. a tender, painful area on the leg b. a pitting edema of the ankle c. a reddened area at the ankle d. pruritus on the calf and ankle 23. To prevent recurrent attacks on Terry who has acute glumerulonephritis, you should instruct her to: a. seek early treatment for respiratory infections b. take showers instead of tub bath c. continue to take the same restrictions on fluid intake d. avoid situations that involve physical activity 24. Herbert has a laryngectomy and he is now for discharge. Re verbalized his concern regarding his laryngectomy tube being dislodged. What should you teach him first? a. Recognize that prompt closure of the tracheal opening may occur b. Keep calm because there is no immediate emergency c. Reinsert another tubing immediately d. Notify the physician at once 25. When caring for Larry after an exploratory chest surgery and pneumonectomy, your priority would be to maintain: a. supplementary oxygen b. ventilation exchange c. chest tube drainage d. blood replacement Situation 6 - Infection can cause debilitating consequences when host resistance is compromised and virulence of microorganisms and environmental factors are favorable. Infection control is one important responsibility of the nurse to ensure quality of care. 26. Honrad, who has been complaining of anorexia and feeling tired, develops jaundice. After a workup he is diagnosed of having Hepatitis A. His wife asks you about gamma globulin for herself and her household help. Your most appropriate response would be: a. "Don't worry your husband's type of hepatitis is no longer communicable" b. "Gamma globulin provides passive immunity for Hepatitis B" c. "You should contact your physician immediately about getting gamma globulin." d. "A vaccine has been developed for this type of hepatitis" 27. Voltaire develops a nosocomial respiratory tract infection. He asks you what that means. a. "You acquired the infection after you have been admitted to the hospital." b. "This is a highly contagious infection requiring complete isolation." c. "The infection you had prior to hospitalization flared up." d. "As a result of medical treatment, you have acquired a secondary infection.'' 28. As a nurse you know that one of the complications that you have to watch out for when caring for Omar who is receiving total parenteral nutrition is: a. stomatitis b. hepatitis c. dysrhythmia d. infection 29. A solution used to treat Pseudomonas would infection is: a. Dakin's solution b. Half-strength hydrogen peroxide b. Acetic acid d. Betadine 30. Which of the following is most reliable in diagnosing a wound infection? a. Culture and sensitivity b. Purulent drainage from a wound

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NLE reviewers: CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS

c. WBC count of 20,000/pL d. Gram stain testing Situation 7 - As a nurse you need to anticipate the occurrence of complications of stroke so that life threatening situations can be prevented. 31. Wendy is admitted to the hospital with signs and symptoms of stroke. Her Glasgow Coma Scale is 6 on admission. A central venous catheter was inserted and an I.V. infusion was started. As a nurse assigned to Wendy what will he your priority goal? a. Prevent skin breakdown b. Preserve muscle function c. Promote urinary elimination d. Maintain a patent airway 32. Knowing that for a comatose patient hearing is the best last sense to be lost, as Judy's nurse, what should you do? a. Tell her family that probably she can't hear them b. Talk loudly so that Wendy can hear you c. Tell her family who are in the room not to talk d. Speak softly then hold her hands gently 33. Which among the following interventions should you consider as the highest priority when caring for June who has hemiparersis secondary to stroke? a. Place June on an upright lateral position b. Perform range of motion exercises c. Apply antiembolic stocking d. Use hand rolls or pillows for support 34. Ivy, age 40, was admitted to the hospital with a severe headache, stiff neck and photophobia. She was diagnosed with a subarachnoid hemorrhage secondary to ruptured aneurysm. While waiting for surgery, you can provide a therapeutic by doing which of the following? a. honoring her request for a television b. placing her bed near the window c. dimming the light in her room d. allowing the family unrestricted visiting privileges 35. When performing a neurological assessment on Walter, you find that his pupils are fixed and dilated. This indicated that he: a. probably has meningitis b. is going to be blind because of trauma c. is permanently paralyzed d. has received a significant brain injury Situation 8 - With the improvement in life expectancies and the emphasis in the quality of life it is important to provide quality care to our older patients. There are frequently encountered situations and issues relevant to the older, patients. 36. Hypoxia may occur in the older patients because of which of the following physiologic changer associated with aging. a Ineffective airway clearance b. Decreased alveolar surface area c. Decreased anterior-posterior chest diameter d. Hyperventilation 37. The older patient is at higher risk for in inconvenience because of: a. dilated urethra b. increased glomerular filtration rate c. diuretic use d. decreased bladder capacity 38. Merle, age 86, is complaining of dizziness when she stands up. This may indicate:

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a. dementia b. a visual problem c. functional decline d. drug toxicity 39. Cardiac ischemia in an older patient usually produces: a. ST-T wave changes b. Very high creatinine kinase level c. chest pain radiating to the left arm d. acute confusion 40. The most dependable sign of infection in the older patient is: a. change in mental status pain b. fever c. pain d. decreased breath sound with crackles Situation 9 - A "disaster" is a large-scale emergency—even a small emergency left unmanaged may turn into a disaster. Disaster preparedness is crucial and is everybody's business. There are agencies that are in charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated approach to the management of emergency program and activities for all four emergency phases (mitigation, preparedness, response, and recovery), for all type of emergencies and disasters (natural, man-made, and attack) and for all levels of government and the private sector. 41. Which of the four phases of emergency management is defined as "sustained action that reduces or eliminates long-term risk to people and properly from natural hazards and the effect"? a. Recovery b. Mitigation c. Response d. Preparedness 42. You are a community health nurse collaborating with the Red Cross and working with disaster relief following a typhoon which flooded and devastated the whole province. Finding safe housing for survivors, organizing support for the family, organizing counseling debriefing sessions and securing physical care are the services you are involved with. To which type of prevention are these activities included. a. Tertiary prevention b. Primary prevention c. Aggregate care prevention d. Secondary prevention 43. During the disaster you see a victim with a green tag, you know that the person: a. has injuries that are significant and require medical care but can wait hours will threat to life or limb b. has injuries that are life threatening but survival is good with minimal intervention c. indicates injuries that are extensive and chances of survival are unlikely even with definitive care d. has injuries that are minor and treatment can be delayed from hours to days 44. The term given to a category of triage that refers to life threatening or potentially life threatening injury or illness requiring immediate treatment: a. Immediate b. Emergent c. Non-acute d. Urgent 45. Which of the following terms refer to a process by which the individual receives education about recognition of stress reactions and management strategies for handling stress which may be instituted after a disaster? a. Critical incident stress management b. Follow-up c. Defriefing d. Defusion Situation 10 - As a member of the health and nursing team you have a crucial role to play in ensuring that all the members participate actively is the various tasks agreed upon,

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46. While eating his meal, Matthew accidentally dislodges his IV line and bleeds. Blood oozes on the surface of the over-bed table. It is most appropriate that you instruct the housekeeper to clean the table with: a. Acetone b. Alcohol c. Ammonia d. Bleach 47. You are a member of the infection control team, of the hospital. Based on a feedback during the meeting of the committee there is an increased incidence of pseudomonas infection in the Burn Unit (3 out of 10 patients had positive blood and wound culture). What is your priority activity? a. Establish policies for surveillance and monitoring b. Do data gathering about the possible sources of infection (observation, chart review, interview) c. Assign point persons who can implement policies d. Meet with the nursing group working in the burn unit and discuss problem with them feel 48. Part of your responsibility as a member of the diabetes core group is to get referrals from the various wards regarding diabetic patients needing diabetes education. Prior to discharge today 4 patients are referred to you. How would you start prioritizing your activities? a. Bring your diabetes teaching kit and start your session taking into consideration their distance from your office b. Contact the nurse-in-charge and find out from her the reason for the referral c. Determine their learning needs then prioritize d. involve the whole family in the teaching class 49. You have been designated as a member of the task force to plan activities for the Cancer Consciousness Week. Your committee has 4 months to plan and implement the plan. You are assigned to contact the various cancer support groups in your hospital. What will be your priority activity? a. Find out if there is a budget for this activity b. Clarify objectives of the activity with the task force before contacting the support groups c. Determine the VIPs and Celebrities who will be invited d. Find out how many support groups there are in the hospital and get the contact number of their president 50. You are invited to participate in the medical mission activity of your alumni association. In the planning stage everybody is expected to identify what they can do during the medical mission and what resources are needed. You though it is also your chance to share what you can do for others. What will be your most important role where you can demonstrate the impact of nursing health? a. Conduct health education on healthy lifestyle b. Be a triage nurse c. Take the initial history and document findings d. Act as a coordinator Situation 11 - One of the realities that we are confronted with is'6w mortality. It is important for us nurses to be aware of how we view suffering, pain, illness, and even our death as well as its meaning. That way we can help our patients cope with death and dying. 51. Irma is terminally ill she speaks to you in confidence. You now feel that Irma's family could be helpful if they knew what Irma has told you. What should you do first? a. Tell the physician who in turn could tell the family b. Obtain Irma's permission to share the information with the family c. Tell Irma that she has to tell her family what she told you d. Make an appointment to discuss the situation with the family 52. Ruby who has been told she has terminal cancer turns away aha refuses to respond to you. You can best help her by: a. Coming back periodically and indicating your availability if she would like you to sit with her b. Insisting that Ruby should talk with you because it is not good to Keep everything inside c. Leaving her atone because she is uncooperative and unpleasant to be with d. Encouraging her to be physically active as possible 53. Leo who is terminally ill and recognizes that he is in the process of losing, everything and everybody he loves, is depressed. Which of the following would best help him during depression?

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a. Arrange for visitors who might cheer him b. Sit down and talk with him for a while c. Encourage him to look at the brighter side of things d. Sit silently with him 54. Which of the following statements would best indicate that Ruffy; who is dying has accepted this impending death? a. "I'm ready to do." b. "I have resigned myself to dying" c. "What's the use"? d: "I'm giving up" 55. Maria, 90 years old has planned ahead for her-death-philosophically, socially, financially and emotionally. This is recognized as: a. Acceptance that death is inevitable b Avoidance of the true sedation c. Denial with planning for continued life d. Awareness that death will soon occur Situation 12 - Brain tumor, whether malignant or benign, has serious management implications nurse, you should be able to understand the consequences of the disease and the treatment. 56. You are caring for Conrad who has a brain tumor and increased intracranial Pressure (ICP). Which intervention should you include in your plan to reduce ICP? a. Administer bowel! Softener b. Position Conrad with his head turned toward the side of the tumor c. Provide sensory stimulation d. Encourage coughing and deep breathing 57. Keeping Conrad's head and neck in alignment results in: a. increased intrathoracic pressure b. increased venous outflow c. decreased venous outflow d. increased intra abdominal pressure 58. Which of the following activities may increase intracranial pressure (ICP)? a. Raising the head of the bed b. Manual hyperventilation c. Use of osmotic Diuretics d. Valsava's maneuver 59. After you assessed Conrad, you suspected increased ICP! Your most appropriate respiratory goal is to: a. maintain partial pressure of arterial 02 (PaO2) above 80 mmHg b. lower arterial pH c. prevent respiratory alkalosis d. promote CO2 elimination 60. Conrad underwent craniotomy. As his nurse; you know that drainage on a craniotomy dressing must be measured and marked. Which findings should you report immediately to the surgeon? a. Foul-smelling drainage b. yellowish drainage c. Greenish drainage d. Bloody drainage Situation 13 -As a Nurse, you have specific responsibilities as professional. You have to demonstrate specific competencies. 61. The essential components of professional nursing practice are all the following EXCEPT:

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a. Culture b. Care c. Cure d. Coordination 62. You are assigned to care for four (4) patients. Which of the following patients should you give first priority? a. Grace, who is terminally ill with breast cancer b. Emy, who was previously lucid but is now unarousable c. Aris, who is newly admitted and is scheduled for an executive check-up d. Claire, who has cholelithiasis and is for operation on call 63. Brenda, the Nursing Supervisor of the intensive care unit (ICU) is not on duty when a staff nurse committed a serious medication error. Which statement accurately reflects the accountability of the nursing supervisor? a. Brenda should be informed when she goes back on duty b. Although Brenda is not on duty, the nursing supervisor on duty decides to call her if time permits c. The nursing supervisor on duty will notify Brenda at home d. Brenda is not duty therefore it is not necessary to inform her 64. Which barrier should you avoid, to manage your time wisely? a. Practical planning b. Procrastination c. Setting limits d. Realistic personal expectation 65. You are caring for Vincent who has just been transferred to the private room. He is anxious because he fears he won't be monitored as closely as he was in the Coronary Care Unit. How can you allay his fear? a. Move his bed to a room far from nurse's station to reduce b. Assign the same nurse to him when possible c. Allow Vincent uninterrupted period of time d. Limit Vincent's visitors to coincide with CCU policies Situation 14 - As a nurse in the Oncology Unit, you have to be prepared to provide efficient and effective care to your patients. 66. Which one of the following nursing interventions would be most helpful in preparing the patient for radiation therapy? a. Offer tranquilizers and antiemetics b. Instruct the patient of the possibility of radiation burn c. Emphasis on the therapeutic value of the treatment d. Map out the precise course of treatment 67. What side effects are most apt to occur to patient during radiation therapy to the pelvis? a. Urinary retention b. Abnormal vaginal or perineal discharge c. Paresthesia of the lower extremities d. Nausea and vomiting and diarrhea 68. Which of the following can be used on the irradiated skin during a course of radiation therapy? a. Adhesive tape b. Mineral oil c. Talcum powder d. Zinc oxide ointment 69. Earliest sign of skin reaction to radiation therapy is: a. desquamation b. erythema c. atrophy d. pigmentation 70. What is the purpose of wearing a film badge while caring for the patient who is radioactive?

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a. Identify the nurse who is assigned to care for such a patient b. Prevent radiation-induced sterility c. Protect the nurse from radiation effects d. Measure the amount of exposure to radiation Situation 15 - In a disaster there must be a chain of command in place that defines the roles of each member of the response team. Within the health care group there are pre-assigned roles based on education, experience and training on disaster. 71. As a nurse to which of the following groups are you best prepared to join? a. Treatment group b. Triage group c. Morgue management d. Transport group 72. There are important principles that should guide the triage team in disaster management that you have to know if you were to volunteer as part of the triage team. The following principles should be observed in disaster triage, EXCEPT: a. any disaster plan should have resource available to triage at each facility and at the disaster site if possible b. make the most efficient use of available resources c. training on disaster is not important to the response in the event of a real disaster because each disaster is unique in itself d. do the greatest good for the greatest number of casualties 73. Which of the following categories of conditions should be considered first priority in a disaster? a. Intracranial pressure and mental status b. Lower gastrointestinal problems c. Respiratory infection d. Trauma 74. A guideline that is utilized in determining priorities is to assess the status of the following, EXCEPT? a. perfusion b. locomotion c. respiration d. mentation 75. The most important component of neurologic assessment is: a. pupil reactivity b. vital sign assessment c. cranial nerve assessment d. level of consciousness/responsiveness Situation 16 - You are going to participate in a Cancer Consciousness Week. You are assigned to take charge of the women to make them aware of cervical cancer. You reviewed its manifestations and management. 76. The following are risk factors for cervical Cancer EXCEPT: a. immunisuppressive therapy b. sex at an early age, multiple partners, exposure to socially transmitted diseases, male partner's sexual habits c. viral agents like the Human Papilloma Virus d. smoking 77. Late signs and symptoms of cervical cancer include the following EXCEPT: a. urinary/bowel changes b. pain in pelvis, leg of flank c. uterine bleeding d. lymph edema of lower extremities 78. When a panhysterectomy is performed due to cancer of the cervix, which of the following organs are moved?

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a. the uterus, cervix, and one ovary b. the uterus, cervix, and two-thirds of the vagina c. the uterus, cervix, tubes and ovaries d. the uterus and cervix 79. The primary modalities of treatment for Stage 1 and IIA cervical cancer include the following: a. surgery, radiation therapy and hormone therapy b. surgery c. radiation therapy d. surgery and radiation therapy 80. A common complication of hysterectomy is: a. thrombophlebitis of the pelvic and thigh vessels b. diarrhea due to over stimulating c. atelectasis d. wound dehiscence Situation 17 - The body has regulatory mechanism to maintain the needed electrolytes. However there are conditions/surgical interventions that could compromise life. You have to understand how management of these conditions are done. 81. You are caring for Leda who is scheduled to undergo total thyroidectomy because of a diagnosis of thyroid cancer. Prior to total thyroidectomy, you should instruct Leda to: a. Perform range and motion exercises on the head and neck b. Apply gentle pressure against the incision when swallowing c. Cough and deep breath every 2 hours d. Support head with the hands when changing position 82. As Leda's nurse, you plan to set up an emergency equipment at her beside following thyroidectomy. You should include: a An airway and rebreathing tube b. A tracheostomy set and oxygen c. A crush cart .with bed board d. Two ampules of sodium bicarbonate 83. Which of the following nursing interventions is appropriate after a total thyroidectomy? a. Place pillows under your patient's shoulders b. Raise the knee-gatch to 30 degrees c. Keep your patient in a high-fowler's position d. Support the patient's head and neck with pillows and sandbags 84. If there is an accidental injury to the parathyroid gland during a thyroidectomy which of the following might Leda develops postoperative? a. Cardiac arrest b. Dyspnea c. Respiratory failure d. Tetany 85. After surgery Leda develops peripheral numbness, tingling and muscle twitching and spasm. What would you anticipate to administer? a. Magnesium sulfate b. Calcium gluconate c. Potassium iodine d. Potassium chloride Situation 18 - NURSES are involved in maintaining a safe and health environment. This is part of quality care management. 86. The first step in decontamination is:

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a. to immediately apply a chemical decontamination foam to the area of contamination b. a thorough soap and water was and rinse of the patient c. to immediately apply personal protective equipment d. removal of the patients clothing and jewelry and then rinsing the patient with water 87. For a patient experiencing pruritus, you recommend which type of bath: a. Water b. colloidal (oatmeal) c. saline d. sodium bicarbonate 88. Induction of vomiting is indicated for the accidental poisoning patient who has ingested. a. rust remover b. gasoline c. toilet bowl cleaner d. aspirin 89. Which of the following term most precisely refer to an infection acquired in the hospital that was not present or incubating at the time of hospital admission? a. Secondary bloodstream infection b. Nosocomial infection c. Emerging infectious disease d. Primary bloodstream infection 90. Which of the following guidelines is not appropriate to helping family members cope with sudden death? a. Obtain orders for sedation of family members b. Provide details of the factors attendant to the sudden death c. Show acceptance of the body by touching it and giving the family permission to touch d. Inform the family that the patient has passed on Situation 19 - As a nurse you are expected to participate in initiating or participating in the conduct of research studies to improve nursing practice. You have to be updated on the latest trends and issues affecting profession and the best practices arrived at by the profession 91. You are interested to study the effects of meditation and relaxation on the pain experienced by cancer patients. What type of variable is pain? a. Dependant b. Correlational c. Independent d. Demographic 92. You would like to compare the support system of patients with chronic illness to those with acute illness. How will you best state your problem? a. A descriptive study to compare the support system of patients with chronic illness and those with acute illness in terms of demographic data and knowledge about interventions b. The effect of the Type of Support system of patients with chronic illness and those with acute illness c. A comparative analysis of the support: system of patients with chronic illness and those with acute illness d. A study to compare the support system of patients with chronic illness and those with acute illness 93. You would like to compare the support, system of patients with chronic illness to those with acute illness. What type of research it this? a. Correlational b. Descriptive c. Experimental d. Quasi-experimental 94. You are shown a Likert Scale that will be used in evaluating your performance in the clinical area. Which of the following questions will you not use in critiquing the Likert Scale? a. Are the techniques to complete and score the scale provided?

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b. Are the reliability and validity information on the scale described? c. If the Likert Scale is to be used for a study, was the development process described? d. Is the instrument clearly described? 95. In any research study where individual persons are involves, it is important that an informed consent for the Study is obtained. The following are essential information about the consent that you should disclose to the prospective subjects EXCEPT: a. Consent to incomplete disclosure b. Description of benefits, risks and discomforts c. Explanation of procedure d. Assurance of anonymity and confidentiality, Situation 20 - Because severe burn can affect the person's totality it is important that you apply interventions focusing on the various dimensions of man. You also have to understand the rationale of the treatment. 96. What type of debribement involves proteolytic enzymes? a. Interventional b. Mechanical c. Surgical d Chemical 97. Which topical antimicrobial is most frequently used in burn wound care? a. Neosporin b. Silver nitrate c. Silver sulfadiazine d. Sulfamylon 98. Hypertrophic burns scars are caused by: a. exaggerated contraction b. random layering of collagen c. wound ischemia d. delayed epithelialization 99. The major disadvantage of whirlpool cleansing of burn wounds is: a. patient hypothermia b. cross contamination of wound c. patient discomfort d. excessive manpower requirement 100. Oral analgecis are most frequently used to control burn injury pain: a. upon patient request b. during the emergent phase c. after hospital discharge d. during the cute phase ANSWER KEY: 1. A 2. D 3. D 4. B 5. D 6. A 7. B 8. A 9. D 10. A 11. B 12. B 13. B 14. C 15. B 16. C 17. C 18. C

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NLE reviewers: CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS

19. A 20. C 21. C 22. A 23. A 24. D 25. A 26. D 27. A 28 D 29. C 30. D 31. D 32. D 33. B 34. C 35. D 36. B 37. D 38. B 39. C 40. C 41. B 42. C 43. D 44. D 45. A 46. D 47. A 48. C 49. B 50. A 51. C 52. A 53. D 54. A 55. D 56. A 57. B 58. B 59. D 60. A 61. A 62. B 63. A 64. B 65. B 66. C 67. A 68. D 69. B 70. C 71. B 72. C 73. D 74. B 75. D 76. A 77. B 78. C 79. D 80. A 81. C 82. B 83. C 84. D 85. B 86. C 87. B 88. D 89. B 90. A 91. A 92. C 93. A 94. A 95. A 96. D 97. B 98. A

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99. A 100. C

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