Jeffrey Ong – Sumergido, B.S.N., R.N.

1. A 69 y.o. patient with Addison’s was placed under the care of the nurse. The patient asked what could have caused the development of this disease. In response to this, the nurse will tell the patient that the most common cause is:

A.IdiopathicB.Sudden cessation of Steroids useC.AutoimmuneD.Chronic Steroids use

2. The nurse reviews the laboratories of the patient with Addison’s. Which of the following findings is the priority of the nurse?

A.Glucose 70 mg/dLB.K 5.6 mEq/LC.Sodium 148 mEq/LD.Calcium 9 mg/dL

3. The nurse reviews the chart of the patient with Addison’s admitted for 4 days. Which of the following assessment would the nurse expect to find?

A.HypocalcemiaB.HypophosphatemiaC.HyperkalemiaD.Hypertension

4. Which among the statements made by the patient indicates the need for further teaching regarding corticosteroid therapy?A. “I will eat foods high in calcium & vitamin D.”B. “I will need to avoid crossing-legs.”C. “I need to take low calories, low protein, low

sodium foods.”D. “I need to have regular eye-check ups.”

5. A nurse was given order to administer Solu-Cortef to a Mexican patient with Addison’s. The nurse knows that the best time to give the medicine is when?A. Early morning, at about 7:00a.m.B. After dinner, at 7:00p.m.C. Before going to bed, at 10:00p.m.D. After lunch, 12:30p.m.

6. The nurse was assigned to Mr. Smith, a 56 y.o. Mexican with acute Pancreatitis. The nurse knows that the major cause of this disease is:

A.Alcohol abuse and IdiopathicB.Cholelithiasis and AutoimmuneC.Alcohol abuse and cholelithiasisD.Tumors of the pancreas and Idiopathic

7. The nurse closely monitors Mr. Smith to avoid the development of complications. She would be alerted when the patient reported to experience which of the following complication for pancreatitis?  

A.Nausea & VomitingB.Cullen’s signC.Abdominal distentionD.Severe abdominal pain

8. Mr. Smith’s condition worsened and progressed to severe pancreatitis. Which among the following assessments for Mr. Smith the nurse should prioritize? 

A.Cullen’s signB.HypotensionC.CyanosisD.Renal failure

9. The nurse was assigned to 4 patients for the day. Which of the following patients has a high risk for developing pancreatitis?

A.A 49 y.o. patient with a father who died from pancreatitis

B.A 40 y.o. man with a history of cholecystectomy

C.A 35 y.o. Class II obese womanD.A 52 y.o. menopausal woman taking

estrogen.

10. Mr. Smith complains of severe abdominal pain in the morning during the nurse’s rounds. The nurse knows that the drug of choice for this is:

A.MorphineB.MeperidineC.BuprenorphineD.Nalbuphine

11. A 68-year-old with hyperthyroidism is admitted presenting thyroid storm with a pulse of 135/min. The nurse should prepare as ordered what drug to control the symptom?

A.PTUB.PropranololC.TapazoleD.Lugol’s solution

12. Mrs. Montecarlo, 56 y.o. with hyperthyroidism received Radioactive Iodine Therapy. After 4 weeks, the patient went in for follow-up and complains that the symptoms are still present. What is the nurse best response?

A.“The first dose seems ineffective. You may need another dose of the therapy.”

B.“That is the normal and expected side effect of the radioactive therapy.”

C.“There’s nothing to be bothered about. Symptoms will subside in 3 to 4 weeks.”

D.“You did not respond to the therapy. I will refer you to your physician.”

13. Mrs. Montecarlo was prescribed with Propranolol. Which of the following side effect of the drug would alert the nurse most?

A.ConfusionB.WheezingC.WeaknessD.Arrhythmias

14. The nurse is giving a discharge teaching to a patient receiving Potassium Iodide to be cautious in drinking OTC medications. The nurse instructs that she must avoid the following drugs that may contain iodine except:

A.BronchodilatorB.ExpectorantsC.Anti-tussiveD.Steroids

15. A client with Hyperthyroidism. After receiving Tapazole for 3 days, she suddenly manifests fever, sore throat & URTI. The nurse would suspect that the patient is developing which side effect of the drug?

A.LeukopeniaB.Allergy to the drugC.ThrombocytopeniaD.Aplastic anemia

16. The nurse closely monitors the patient with hyperthyroidism to prevent Thyroid Storm. She knows that which of the following is not a manifestation of a developing thyroid storm?

A.DeliriumB.Fever of 38 degree Celsius

C.Tachycardia - 135/min.D.Chest pain

17. The doctor orders medicines for the management of Thyroid Storm for a 45 y.o. Chinese patient with Hyperthyroidism who was just admitted at the Medical Unit. Which of the following should the nurse question?

A.Iodine compoundB.PTUC.Aspirin for hyperthermiaD.Hydrocortisone for adrenal insufficiency

18. Mrs. Young went in to the Surgery unit 4 hours post-thyroidectomy from the recovery room. The nurse should prepare the following at bedside except:

A.Calcium GluconateB.Tracheostomy setC.LidocaineD.Oxygen

19. The nurse monitors Mrs. Young for tetany, which is a complication of thyroidectomy. The following are the signs of tetany except:

A.HypercalcemiaB.Carpopedal spasmC.SeizureD.Photophobia

20. A 25-year-old with Multiple Sclerosis was assigned to the nurse. The nurse expects to see all of the following except one for her assessment of the primary symptoms of this disease.

A.Fatigue, weakness, numbnessB.Difficulty in coordination, loss of balanceC.DepressionD.Spasticity & drooping of the eyelids

21. The nurse knows that the etiology of Multiple Sclerosis is:

A.Auto-immuneB.GeneticC.IdiopathicD.Triggered by infection

22. The nurse visited her patients after the endorsement. The patient with Multiple sclerosis developed spasms during the rounds. What is the medication of choice the nurse anticipates to be ordered for treating spasms for this disease?

A.ValiumB.Baclofen (Lioresal)C.Tizanidine (Zanaflex)D.Dantrolene (Dantrium)

23. The nurse’s goal for the day is to promote motor function of a 25 y.o. male patient with Multiple sclerosis. She instructed the CNA what activities they will do. The nurse would question which of the following interventions she saw written by the CNA in a scratch?

A.Applying warm packs before stretching to reduce spasticity.

B.Providing ROM exercises.C.Helping the client to walk with a wide-based

gait.D.Turning the patient from time to time.

24. Beta-interferon (Betaseron) was prescribed for a patient with MS. The nurse knows that the primary purpose in giving this drug is to:

A.Decrease fatigueB.Reduce exacerbationsC.Induce remissionD.Immunosuppression

25. The patient with MS is receiving Beta-Interferon (Betaseron) SQ. He developed fever, chills, myalgia & sweating. What should the nurse do?

A.Refer to the doctor immediately.B.Withhold the next medication.C.Administer NSAID as ordered.D.Prepare antihistamine immediately.

26. The nurse is caring for a client with Parkinson’s. She knows that the cardinal features of this disease are the following except:

A. Masklike facesB. Loss of postural reflexesC. Freezing movementD. Flexed posture of neck, trunk and limbs

27. The nurse is providing health teaching regarding diet to the client with Parkinson’s. Which of the ff. favorite foods of the client she must avoid?

A.vegetable saladB.low-fat yogurtC.corn soupD.mashed potatoes

28. The night duty nurse went in to client’s room who is just about to sleep. The nurse would recommend which position in sleeping for Parkinon’s? 

A.Low-fowler’sB.Prone PositionC.Side-lying position with pillows on the headD.Any position preferred by the patient.

29. The nurse is teaching a Parkinson’s patients some exercises to avoid rigidity and development of contractures. She instructs the patient that the best time to exercise is when?

A.Early in the morningB.After taking breakfastC.2-hours after eating lunchD.An hour before dinner

30. Mr. Clark, a 64 y.o patient with Parkinson’s manifests tremors during the morning rounds. The nurse advises to the patient to do the ff. to manage tremors except:

A.Hold a rubber ballB.Use both hands to accomplish taskC.Lie face down on the floor and relax bodyD.Sleep on the unaffected side

31. A client with CVA was rushed in to the ER. Upon assessment, the nurse would expect what type of abnormal respiration?

A.KussmaulB.Cheyne-StokesC.Biot’sD.Rhonchi

32. Which among the causes of CVA the nurse should prioritize regarding the onset of the manifestations?

A.ThrombosisB.EmbolismC.HemorrhageD.TIA

33. Which among the causes of CVA should be prioritized regarding the severity of its outcome?

A.ThrombosisB.EmbolismC.HemorrhageD.TIA

34. The patient is experiencing ischemic attack. The nurse knows that irreversible damages and cerebral infarction will occur when cerebral anoxia lasts for how many minutes?

A.4 minutesB.6 minutesC.8 minutesD.10 minutes

35. To prevent cerebral anoxia, the priority intervention for the client at this time is:

A.Clear respiratory tractB.Thrombolytic therapy stat as orderedC.Initiate a codeD.Provide Oxygen at 4L/min

36. The nurse knows that in ischemic stroke, the Thrombolytic therapy must be started:

A.Immediately.B.Within an hour of the onset of manifestations.C.Within 3 hours of the onset of manifestations.D.Within 6 hours of the onset of manifestations.

37. The nurse is preparing her care plan for a patient who had a stroke. What would be the best nursing Diagnosis for the client who had hemiplegia secondary to stroke and is unaware of his paralyzed side?

A.Risk for injuryB.Unilateral NeglectC.Impaired Physical MobilityD.Knowledge deficit

38. Heparin is ordered for a patient with Ischemic stroke. The following are true about heparin except:

A.Protamine at bedsideB.PT is monitoredC.Give thru IVD.Non- teratogenic

39. A client was admitted complaining of heart burn. She was diagnosed with GERD. Which of the following drugs the nurse would anticipate the doctor will order first?

A.Ranitidine & MetoclopramideB. Antacids & RanitidineC.Metoclopramide & AntacidsD.Omeprazole & Metoclopramide

40. The nurse went in to client’s room during lunchtime. Which of the following meals on the table of the patient indicates the need for further teaching to the client?

A.Fresh Garden SaladB.A slice of strawberry cakeC.Mashed potatoesD.Spaghetti & garlic toast

41. The patient with GERD was prescribed with Reglan. The nurse knows that the primary purpose for this is?

A.Promote gastric emptyingB.Block gastric secretionC.Reduce gastric acidityD.Decrease gastric acid secretion

42. Which of the statements made by the patient indicates the need for further teaching?

A.“I should avoid eating and drinking 3 hours before sleeping.”

B.“I should decrease fluid intake at meals to prevent reflux.”

C.“I should elevate the head of the bed 6-8inches.”

D.“I should eat 6 small meals per day.”

43. The nurse caring for a client with GERD must because cautious in giving medications because some drugs may decrease LES pressure. The following drugs should be avoided by the patient except:

A.TheophyllineB.Ca channel blockersC.BethanecholD.Atropine SO4

44. A patient with Chron’s was assigned to the nurse. Upon assessment, the nurse would note that the stool consistency from the patient is:

A.Liquid StoolsB.Bloody stoolsC.Black Tarry stoolsD.Semi-liquid stools

45. The nurse prepares the client with Regional Enteritis for Barium Swallow. The patient is complaining of crampy abdominal pain and is asking for his Demerol. What should the nurse do?

A.Give Demerol as ordered.B.Report to the physician immediately.C.Withhold the pain medication.D. Postpone the procedure for the next day.

46. The patient with Ulcerative Colitis suddenly develops fever, leukocytosis, tachycardia & abdominal distention. The nurse would suspect that the patient has developed?

A.Toxic MegacolonB.Ruptured ColonC.PerforationD.Hemorrhage

47. The characteristic pattern of progression of Ulcerative Colitis is:

A.Involves entire thickness of the bowel wall.B.Starting from the distal colon, spreading

upward.C.Develops anywhere in the GI tractD.Characterized by periods of remissions and

exacerbations.

48. What is the priority nursing diagnosis for a patient with an ileostomy exhibiting an irritated & reddened skin around the stoma?

A.Disturbed Body ImageB.Risk for Impaired Skin IntegrityC.Imbalanced Nutrition, Less Than Body

RequirementsD.Fluid Volume Deficit

49. During the morning care, the patient verbalized her concern regarding odor-formation of her ileostomy. The correct nursing response would be:

A.Frequent cleaning will remove all odors.B.You can put some aspirin in the pouch.C.Bismuth is helpful and effective in reducing

odor.D.You just need to avoid eating gas formers but

fishes & meats are allowed.

50. A patient with colostomy experienced depression 2 days post-op because of the disturbance in her body image. Which of the following indicates that the patient has accepted what happened?

A.The patient reads Ostomy literatures.B.The patient looks at her abdomen in the mirror.C.The patient asks question to the nurse

regarding ostomy care.D.The patient participates in ostomy care.

51. The nurse is providing a discharge teaching for a client with ileostomy. Which among the following is a common complication of ileostomy?

A.Peristomal skin irritationB.Stomal ProlapseC.Stomal StenosisD.Stomal Stricture

52. The nurse was assigned to a pt. with Miller-Abott tube. Upon aspirating, the nurse found out that the pH of the secretion is 6.2. The nurse knows that this means?

A.the tube entered the respiratory tractB.the tube is in the gastric areaC.the tube is in the intestinal areaD.needs further assessment

53. The nurse is about to feed a client with NGT. She aspirated gastric residual amounting to 130cc. What should the nurse do?

A.Continue feeding the client.B.Withhold feeding for 30 minutes then check

again.C.Administer half of the feeding. After an hour,

administer the other half.D.Do not administer feeding.

54. A client rushed-in to ER with hematemesis. The endoscopy revealed esophageal varices. The nurse will immediately prepare what tube?

A.Miller- Abott tubeB.Salem-Sump tubeC.Sengstaken-Blakemore tubeD.Levine tube

55. The nurse is administering NGT feeding for a client. During NGT feeding, the client vomits. The nurse would do the ff. except:

A.Stop the feeding.B.Measure abdominal girth.C.Place in side-lying position.D.Administer anti-emetics as ordered.

56. The nurse was assigned to the following clients on the Medical-Surgical floor. Who among the following is not at risk to develop secondary hypertension?

A.A 29 y.o. patient with HyperthyroidismB.A 36 y.o. patient with PheochromocytomaC.A 65 y.o. patient with ArteriosclerosisD.A 49 y.o. patient with Addison’s disease

57. A patient with hypertension was assigned to the nurse. The nurse knows that the complications of HPN are the following except:

A.Angina/MIB.RVHC.RetinopathyD.Accelerated HPN

58. The relative of a patient asks the nurse about the importance of lifestyle modification to prevent HPN. Which among the following lifestyle modifications to manage HPN is the most important?

A.Maintaining normal body weight / BMIB.DASH eating planC.Reducing sodium intake to 2.4g/dayD.Regular Aerobic physical activity

59. The patient with Hypertension is to be given Lopressor. What should the nurse check before giving?

A.HRB.RRC.BPD.Temparature

60. The nurse knows that Lopressor should not be given to a patient who has a history of?

A.HPNB.AnginaC.MID.RVF

61. A patient was determined to have a chronic kidney disease that led to the development of HPN. In the management of HPN, the goal blood pressure for this patient is?

A.140/90B.130/80C.130/70D.120/80

62. The patient had an anginal attack 8 hours ago. She asks the nurse if she can have sexual intercourse with her husband. What is the nurse’s best response?

A.You are limited to complete bed rest.B.You need to take Nitroglycerin SL first.C.Sexual activity can aggravate your condition.D.You should ask your physician or sex

counselor first.

66. The patient called for the nurse and complains of unrelieved chest pain. She verbalized, “I followed your instructions carefully. I already took 3 NTG SL tablets at 5-minute intervals from my plastic pillbox. But the pain is still there.” The nurse’s best action would be:

A.Oxygenate the patient immediately.B.Administer morphine stat as ordered.C.Get NGT SL tab from the E-Cart and give to

patient.D.Call the doctor and report infarction.

64. The patient with angina develops chest pain radiating to the shoulders and neck while he was ambulating at his room. The immediate nursing action would be:

A.Give morphine as ordered.B.Start oxygen at 3L/min.C.Administer NTG as orderedD.Provide rest.

65. A patient with suspected MI is to undergo Cardiac Catheterization. What is the nursing management after the procedure?

A.Position the client to Semi-fowler’sB.Strict bed rest for 6-12 hours.C.Keep extremities extended for 4-6 hours.D.Turn client form side to side.

66. The nurse is assessing a 59 y.o. male patient with CHF who was just admitted on the Medical-Surgical Unit. Which of the following is not a manifestation of LVF:

A.Difficulty breathingB.Sharp pain on the Upper Abdomen C.Patient experiences sensation of suffocationD.Patient assumes tripod position

67. A 35 y.o. patient with RVF was assigned to the nurse. Which would be the priority assessment of the nurse?

A.Abdominal painB.AnorexiaC.Weight gainD.Fatigue

68. The nurse is caring for a 75 y.o. client with LVF. The nurse should be alerted when the patient experiences:

A.cracklesB.confusionC.pallorD.tachycardia

69. The patient is receiving Digoxin to treat CHF. The nurse should monitor for the ff. laboratories. Which is a priority?

A.BUN levelsB.Magnesium levelsC.Creatinine levelsD.Potassium levels

70. The nurse is caring for a client on oxygen therapy. Which among the Oxygen administration devices deliver the most highest Oxygen concentration?

A.Partial-Rebreather maskB.Non-rebreather maskC.Venturi maskD.Face Mask

71. A patient with Emphysema rushed in to ER complaining of difficulty breathing and shortness of breath. The nurse will immediately give oxygen via?

A.Simple Mask at 6L/minB.Nasal Cannula at 4L/min C.Venturi mask at 4L/minD.Nasal Cannula at 2L/min

72. A patient with Flail chest was assigned to the nurse. Upon assessment of the respiratory patterns of the client, the nurse would expect:

A.Mediastinal shift to the unaffected side during inspiration.

B.No mediastinal shift.C.Mediastinal shift to unaffected side on both

inspiration and expiration.D.Mediastinal shift to affected side during

inspiration.

73. The nurse is to provide a discharge health teaching to a 7 y.o. patient with Asthma regarding the use of a Metered dose Inhaler. Which of the following is not true?

A.Place the mouthpiece 1 to 2 inches away from mouth.

B.Puff during inspiration.C.Hold breath for 5-10 seconds.D.Wait for 30 seconds before administering the

next dose.

74. What is the priority nursing diagnosis for a 50 y.o. COPD client with dyspnea, wheezing, crackles, and a productive cough?

A.Ineffective Airway ClearanceB.Impaired Gas ExchangeC.Altered Tissue PerfusionD.Ineffective Breathing Pattern

75. Mr. Wayne, a 59 y.o. patient rushed in to ER and was diagnosed with ARF. He registered tall peaked T-wave in the ECG. The nurse immediately considered hyperkalemia and would prepare what drug?

A.BumetanideB.AldactoneC.KayexalateD.Lasix

76. Mr. Wayne’s condition worsened and developed to Chronic Renal Failure. The nurse knows that the leading cause of CRF is:

A.SLEB.ARFC.HPND.DM

77. The patient with renal insufficiency was admitted to the renal unit 6 hours ago. The nurse reviews the chart and questions what drug?

A.AminoglycosidesB.KayexelateC.PropranololD.Aluminum OH

78. A patient with Sickle cell disease is assigned to the nurse. The nurse is to give analgesic to the patient and she knows that she must avoid giving Demerol because this may induce:

A.Respiratory depressionB.SeizuresC.Sickle cell crisisD.Hypotension

79. Which is the most common type of crisis in Sickle cell disease?

A.Vasoocclusive crisisB.Splenic sequestrationC.Aplastic CrisisD.Hematologic crisis

80. A 6-day old neonate is diagnosed with Hip dysplasia. To correct this, the nurse will anticipate to use:

A.BSTB.Hip spica castC.Buck’s tractionD.Pavlik’s harness

81. After endorsement, the nurse visited her patients. Which of the following patients is not at risk to develop Osteoporosis?

A.a 40 y.o. Obese female ChineseB.a 48 y.o. European on early menopausal

periodC.a 56 y.o. Filipino who is a Chronic smokerD.a 65 y.o. Spanish Librarian

82. A 2y.o. child with Cystic fibrosis was admitted to the pediatric floor 2 days ago. The child frequently cries and the parents cannot stop her. For this day, the goal of the nurse is to promote the psychosocial development of the child. What should the nurse do?

A. Allow the child to explore the surroundings.B. Have the child join other children in the playpen.C. Place the child in the playpen with favorite toys.D. Bring the child to another room to play with

another child.

83 The nurse is preparing her care plan for a child with cystic fibrosis. Which of the following interventions is correct?

A.Give antitussives as ordered for cough.B.Maintain negative pressure in the room.C.Encourage a high calorie, high protein

diet.D.Discourage breast feeding.

84. A client with a history of diverticulitis complains of abdominal pain, fever, and diarrhea. Which food is responsible for the client’s symptoms?

A.Mashed potatoesB.Steamed carrotsC.Baked fishD.Whole-grain cereal

85. A client with tuberculosis has a prescription for Myambutol (ethambutol HCL). The nurse should tell the client to notify the doctor immediately if he notices:

A.Gastric distressB.Changes in hearingC.Red discoloration of body fluidsD.Changes in color vision

86. The primary cause of anemia in a client with chronic renal failure is:

A.Poor iron absorptionB.Destruction of red blood cellsC.Lack of intrinsic factorD.Insufficient erythropoietin

87. Which of the following nursing interventions has the highest priority for the client scheduled for an intravenous pyelogram?

A. Providing the client with a favorite meal for dinner

B. Asking if the client has allergies to shellfishC. Encouraging fluids the evening before the testD. Telling the client what to expect during the

test

88. A client with tuberculosis who has been on combined therapy with rifampicin and isoniazid asks the nurse how long he will have to take medication. The nurse should tell the client that:

A.Medication is rarely needed after 2 weeksB.He will need to take medication the rest of his

life.C.The course of therapy is usually 6 months.D.He will be re-evaluated in 1 month to see if

further medication is needed.

89. The nurse is caring for a client with irritable bowel syndrome. Irritable bowel syndrome is characterized by:

A.Development of pouches in the wall of the intestine

B.Alternating bouts of constipation and diarrhea

C.Swelling, thickening and abscess formationD.Hypocalcemia and iron-deficiency anemia

90. The nurse is caring for a client with stage III Alzheimer’s disease. A characteristic of this stage is:

A.Memory lossB.Failing to recognize familiar objectsC.Wandering at nightD.Failing to communicate