NP2 Flashcards
SITUATION - Zion, 11-year-old, is admitted due to bronchitis. Upon production of mucus (sputum), yellowish’ in color, fatigue, shortness of breath, slight fever and chills and chest discomfort. The physician orders 41/min oxygenation.
- The first standards step in oxygen therapy that the nurse should do is
A. assess client’s condition
B. gather all the equipment and supplies
C. prepare the client for the oxygen treatment
D. check the chart for ordered flow rate and oxygen delivery method
D
- In planning for Zion’s oxygen therapy the nurse should consider which of the following EXCEPT
A. Need for a humidifier v
B. length of tubing
C. determine the age of Excel
D. manner of administering oxygen, continuous or intermittent
B
- Which of the following is the PRIORITY action for the Rurse for Zion who is on oxygen therapy?
A. Check the flow
B. Connect the flow mater to the pipe oxygen outlet
C. turn on the oxygen
D. attach the humidifier and connecting tubing to the 2 oxygen delivery
B
- What PRIORITY precautionary measure should be done by the nurse during the oxygen therapy?
A. Humidifier’s water should be checked regularly
B. No smoking sign
C. Oxygen tank should have belt
D. Limit visitors
B
5 One evening, Zion complained of dyspnea despite continuous oxygen therapy. What should be the first action of the nurse?
A. Reassess the client
B. Give PRN medication
C. Assess the patency of the tubing
D. Refer client to the physician
C
SITUATION - The senior nurse Reese; is planning to revisit and implement a change in the management system for the obstetric Unit. This would be a pilot unit as planned by the administration. Many problems have occurred one of which is the present documentation system, and the charge nurse determines that a change is required.
What should be the INITIAL STEP in the process of change for the senior nurse.
A. Set goals and priorities regarding the change process
B. Plan strategies and implement the change.
C. Identify potential solutions and strategies for the change.
D. Identify the inefficiency that needs improvement or correction.
D
Nurse Reese is preparing the patient assignment for the day and need to assign patient to midwife and nursing assistant. Which patient should the nurse assign to the midwife because of patient needs that cannot be met by the nursing assistant? A patient requiring
A. dressing change of post caesarian surgery
B, collecting of urine specimen for urinalysis testing X
C. performing range-of-motion exercise twice a day
D. taking of vital signs measurement every 4 hours
A
Because of the scarcity of nurses in the hospital settings, different service delivery models were proposed.
Which situation represents the primary nursing care delivery model?
A. The nursing aide is assigned to make beds and other errands.
B. The nurse develops a plan of care for patients and collaborates with other team members.
C. The nurse performs all task needed by the individual patient to optimize health.
D. The nurse provides care to 4 patients while the nursing aide is to care for 2 patients.
B
One of the post-caesarian patients has a private duty nurse and is responsible for providing holistic care to her patient during the shift. What modality of nursing care is implemented?
A. Primary
B. Team
C. Total care
D. Functional
C
Lillian complains of unbearable plain. Which of the following characteristics are EMPHASIZED in a culturally sensitive nursing care?
(Select all that apply)
I. The expression of pain is affected by learned behavior
II. physiologically, all individuals experience pain in a similar manner.
III. Some Asian people has high response to pain medications.
IV. Patients should be assessed for plain regardless of overt symptomatology.
A.Ill and IV
B. I and II
C. I and III
D. II and Ill
A
At which stage of Lewin’s planned change indicate the nurse identifying, planning and implementing appropriate strategies ensuring that driving forces exceed restraining forces?
A. refreezing
B. unfreezing
C. movement
D. in activism
C
SITUATION - Olivia, a 25-year-old, high school student Visited the health center for prenatal check-up. Per nurse’s initial assessment, the patient drink alcohol and smokes cigarettes about 5 sticks a day for 2 years now.
Her last menstrual period (LMP) was October 10, 2020
- Base on the nurse’s computation utilizing Naegele’s rule, the patient’s excepted date of birth (EDB) Will be on
A. September 17, 2021
B. June 17, 2021
C. July 17, 2021
D. August 17, 2021
C
- Which of the following is the MOST common emotional response among women during the first trimester of pregnancy?
A. Ambivalence
B. Depression
C. Acceptance
D. Jealousy
A
Olivia mentioned that she can experience uttering squeezing. Which of the following signs of normal pregnancy should the nurse consider?
A. Braxton-Hicks contractions
B. Hegar’s sign
C. Ballottement
D. Goodell’s sign
A
Nurse Emma advised the patient to quit smoking because nicotine will contribute to
A. low birth weight infant
B. ectopic tubal pregnancy
C. congenital anomalies
D. large for gestation age infants
A
Emotional lability is common to pregnant women.
Identify which of the following reaction is accepted as part of a normal pregnancy?
A. Feelings are easily hurt by remarks
B. Mood swing
C. Amusing or even charming situation
D. Narcissism
B
SITUATION - Nurse Lingling is in the process of evaluating the effectiveness of her teaching which is the critical part of the process.
- Which of the following would BEST help Nurse Lingling in conducting her evaluation?
A. Written examination knowledge
B. Change in behavior
C. Return demonstration
D. obtain feedback from the client
C
12 Which of the following aspects nurses continually teach patients to do? (Select all that apply)
1. Disease or disorder
2. Diet medication
3. Treatments
4. Self-care
A. 1 only
B. 1, 2, 3
C. 1, 2, 3, &4
D. 283
C
- The first step in teaching is assessing which of the following? (Select all that apply).
major - Learning needs
- knowledge deficit
- Education background
- Social status
A. 1, 2, 3
B. 38 4
C. 1 only
D, 1, 2, 3, 4
D
- Which of the following environmental factors affect _earning? (Select all that apply)
- Client comfort
- Lighting
- Noise level
- Room temperature
A. 2 & 4
B. 3 & 4
C. 1 only
D. 1,2, 3, 4
D
- Which of the following environmental factors affect learning? (Select all that apply).
- Nursing specialist
- Videotapes
- Demonstration equipment
- Books
A. 2 & 4
B. 2 & 3
C. 1, 2,3, & 4
D. 1, 2 & 3
234
SITUATION - Ramon, 6-year-old, has been recently diagnosed to have acute Lymphocytic Leukemia. The child has undergone chemotherapy. However, the father is witnessing before his very eyes his first child dying. The father is very much depressed.
- In what way will the nurse handle the situation?
A. Tell her to trust on god’s love and mercy
B. Tell her that death is a reality
C. Encourage her to keep calm because the health care team is doing their best to help Ramon recover.
D. Encourage the mother to express more about her thought and feelings
D
22 The APPROPRIATE nursing diagnosis to protect the patient from further injury is, which of the following?
A. Altered mucous membrane related to chemotherapy.
B. Interrupted family processes related to life threatening illness of a family member.
C. Fatique related to disease process.
D. Risk for injury related to thrombocytopenia.
D
- Mouth sores have developed in the child’s mouth.
The father asked the nurse the reasons for this. The MOST APPROPRIATE response of the nurse os
A. “The child’s oral hygiene needs to be improved.” V
B. “There is no need to have them/” X
C. “He is allergic to the drug so I will report this to the doctor and suggest a change of during.”
D.” Mouth sores result because the cells of the mouth are sensitive to chemotherapy
D
24-Ramon died at 10:00 PM. His father cried much and
refused to move Ramon’s body. What is the APPROPRIATE approach of the nurse?
A. Talk about the reality of death
B. Leave the mother and the child for the last time
C. Silence to allow the mother to grieve
D. Cry with the mother as you remember your own experience of death in family.
C
- The nurse’s MAIN responsibility in preparing Ramon’s discharge is, which of the following?
A. Assist the mother to pay the hospital bill.
B. Prepare Ramon’s cadaver
C. Prepare the death certificate.
D. Extend condolences to the bereaved family
C
SITUATION - Asst Chief for education & Training, Nurse Mendoza, is planning to conduct an inservice training program on intravenous therapy for the staff nurses.
- To be able to justify the conduct of any inservice training program in a hospital, which of the following should be the bases for the implementation of the program?
- Needs assessment
- Needs analysis
3 Per recommendation by the chief Nurse - Incident Reports
A. 1, 2, & 4
B. 1, 2, & 3
C. 1 only
D. 1, 2, 3, & 4
A
The BEST rationale for the conduct of the program is mich of the following?
A. Ensure safe practice in the hospital
B. Provide knowledge and skills to all nursing staff in IV therapy
C. Improve nursing practice in general
D. Deliver safe and quality nursing to all care patients on intravenous therapy
D
- One of the lecturers discussed the complications that patients may have while on IV therapy. Which of the following is the most common complication that IV patient may contract while on IV therapy?
A. Embolism.
B. Cardiac overload
C. Phlebitis
D. Aneurysm
C
- The participants may avail of continuing professional Development (CPD) units if Nurse Mendoza had filed the program to be CPD accredited to which of the following?
A. Professional Regulatory Board of Nursing
B. Professional Regulation Commission
C. Continuing Professional Development Council for
Nursing
D. Commission on Higher Education
A
- The participants should know the way by which they may obtain CPD units aside from attending inservice training programs, which are EXCEPT
A. professional seminars and conference
B. graduate studies
C. short course training for specialization
D. joining nursing service committees
D
SITUATION - The concept of reproductive health is introduced as early as primary and secondary levels with different degrees of concentration. Students, interested to continue health courses were asking questions on human sexuality.
- Nurse Hailey discusses the 2020 National Health
Goals. Which of the following statements is an EXCEPTION in planning sexual health programs.
A. Make sexual education program voluntary
B. Increase the proportion of adolescents who have never engaged in sexual intercourse.
C. Reduce deaths from cancer resulting from uterine cervix.
D. Reduce deaths from cancer of the uterine cervix.
B
- Maternal and child Nursing is a concept under the national Goals. Which objective should nurse Hailey emphasize to support the program?
A. Avoid having misdirected children and become street children.
B. Promote the well-being of the mother’s family life and family planning.
C. Consider that every child has love, security, and a better future.
D. Avoid complications of pregnancy and promote vaginal deliveries.
B
- Which of the following topics should the patient feel
MORE comfortable when reproductive anatomy and physiology is discussed with the nurse?
A. Sexual health education
B. Gender reassignment
C. Varied sexual positions
D. Gender identify
A
- When can the patient tell all information to the
nurse?
A. All diagnostic laboratory test performed had been competed
B. Once the feeling of security is established in the nurse-patient relationship
C. A change in physical appearance occurs
D. The nurse knows the genogram of the patient
B
- Which nursing diagnosis is NOT RELEVANT to sexual health?
A. Anxiety-related inability to conceive after six months.
B. Health-seeking behaviors relayed to reproductive functioning.
C. Sexual dysfunction related to high-risk sexual behaviors.
D. Risk for infection related to high-risk sexual behaviors.
A
SITUATION - Ruby, a pregnant patient 37-week gestation is admitted due to who has a diagnosis of sickle cell anemia.
- Nurse Sophia administer oxygen to patient Ruby and Implements additional measures to prevent a sickling crisis from occurring?
A. Maintain strict asepsis.
B. Maintains adequate hydration.
C. Monitors the temperature.
D. Reassures the patient.
B
- Nurse Sophie hooks a 1000 mL intravenous (IV)
solution of D5water as ordered by the physician at 9 am to infuse 80 mL/hr. via macro drop infusion at what would be the level of the remaining amount in the IV bag at 2 pm?
A. 500
B. 200
C.400
D. 300
C
- The patient began receiving an intravenous (IV) infusion of packed red blood cells 30 minutes ago. The patients complain of difficultly of breathing, itching and a tight sensation the chest. Which is the IMMEDIATE action of the nurse?
A. Recheck the unit of blood for compatibility.
B. Call the physician.
C. Check the patient’s temperature
D. Stop the infusion.
D
- Nurse Sophie checks the gauge of the patient’s intravenous catheter. Which is the smallest gauge catheter that the nurse can use to administer blood?
A. 22-gauge
B. 18-gauge
C. 20-guage
D. 12-guage
A