Recalls 4 - NP3 Flashcards
Situation 1
Mr. GI Joe is 55 year old, married, a car dealer has consulted the ER because of on and fever, indigestion,
weight loss, right abdominal pain, body malaise, and itchiness of the skin. Based on the health history the patient has
been a chain smoker and drinks alcoholic beverages almost every day especially when he has clients to entertain. His
physical examination showed he has suspected liver cirrhosis. He was advised for admission for further work-up and
treatment.
- You are the nurse on duty when Mr. GI Joe was admitted in the pay floor. In your observational data what additional EARLY SIGN of liver cirrhosis do you expect patient to manifest?
A. Gonadal atrophy
B. Hypotension
C. Splenomegaly
D. Ankle edema
A. Gonadal atrophy
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2. Which of the following statements is TRUE of liver cirrhosis?
- Nutritional deficiency with decreased protein intake attributes to liver damage.
- Cirrhosis can happen to people with alcohol intake
- Women are at greater risk for the development of alcohol-induced liver disease
- Most patients affected by liver cirrhosis are between 40 to 60 years of age.
A. 1, 2, 3, and 4
B. 1 & 2
C. 1, 2 & 3
D. 2 & 3
D. 2 & 3
- During Mr. GI Joe’s confinement he developed further itchiness of the skin and jaundice. Which of the following nursing actions is NOT recommended as this will induce skin breakdown?
A. Add baking soda when bathing the patient.
B. Massage the skin with emollients every 2 hours.
C. Use of commercial soaps and alcohol-based lotions.
D. Rub the itchy skin with knuckles instead of using the nails.
C. Use of commercial soaps and alcohol-based lotions.
- At early stage of Mr. GI Joe’s disease process, the physician ordered this SPECIFIC diet for Mr. GI Joe, You emphasized to the dietitian that he should be served foods that is _________.
A. High carbohydrate and low sodium
B. High calorie and high carbohydrate
C. Low protein and high fat
D. High protein and high fat
A. High carbohydrate and low sodium
- Mr. GI Joe started to develop ascites and complained of heaviness of the lower extremities to the physician. An order of Spironolactone (Aldactone) 25 mg. /day. What adverse effect of the drug should you monitor?
A. Hyperkalemia
B. Palpitation
C. Irregular pulse rate
D. Hypokalemia
A. Hyperkalemia
Situation 2
Juliet, a Pediatric Cardiovascular Nurse is assigned to take care of 3 children in her unit. She just admitted a
12- year- old female patient suffering from Rheumatic Fever (RF)
- When doing an assessment, which ONE of the following conditions is NOT present based on the Jones Criteria?
A. Erythema Marginatum
B. Subcutaneous nodules
C. Chorea
D. Bronchopneumonia
D. Bronchopneumonia
- In Rheumatic fever, the factor contributory to the development of this disease process is brought about by __________.
A. Auto-immune reaction to streptococcal infection
B. Auto-immune reaction to collagen disease
C. Parents had rheumatic heart disease
D. Exposure to colds and droplet infection
A. Auto-immune reaction to streptococcal infection
- Marimar, 6 years old, is receiving digitals for having Patent Ductus Arteriosus with heart failure with heart failure. Prior to the administration of the medicines, which of the following nursing actions should be done by nurse Rica?
A. Take the carotid pulse rate for one full minute.
B. Take the heart rate for one full minute
C. Take the respiratory rate
D. Take the blood pressure
B. Take the heart rate for one full minute
- While Nurse Juliet was doing her regular rounds, one of the mothers approached her saying that her child who has a Tetralogy of Fallot preferred to squat on bed rather than assuming a supine position. The BEST action of the Nurse is ___________.
A. Let the mother continue the position of her child if she feels comfortable with it.
B. Divert the child’s attention by letting her join the nurses’ rounds
C. Put her on bed and start to administer oxygen inhalation
D. Discourage the child and let her lie on bed with 2 pillows instead.
A. Let the mother continue the position of her child if she feels comfortable with it.
- Another patient in the Unit is Nikki, 8 years old, waiting to be scheduled for surgery because of a Coarctation of the Aorta. With this disorder, Nikki will manifest which one of the following symptoms?
A. Murmur and bruit of the lungs
B. Central and peripheral edema
C. Hypertension and diminished pulses in the extremities.
D. Hepatomegaly and shortness of breath
C. Hypertension and diminished pulses in the extremities.
Situation 3
Mr. Gaudencio Suarez is a surgical nurse in a medical center and he had been practicing for almost five years
in this unit. The staffs go on shift rotation. For that shift, he had two patients for operation. One is for Lobectomy and
another is for Nephrectomy
- When is the BEST time for the operative consent is be signed by his patients?
A. As soon as the surgical procedure is explained to the patient
B. On admission when the relatives are around
C. Aday before the surgery
D. Before any pre-op medications are administered
A. As soon as the surgical procedure is explained to the patient
- Which of the following nursing goals are achieved when early ambulation is done by post-surgery patients?
- Improved circulation
- Improved respiratory functions
- Prevent venous stasis
- Prevent emboli formation
A. 3 and 4
B. 1, 2, 3,4
C. 1, 3, 4
D. 1 and 2
B. 1, 2, 3,4
- Which of the following patients is MOST at risk during the induction of anesthesia?
A. 6-year-old with history of allergy
B. 65year old diabetic woman
C. 35 year old TB case
D. 25 year old Polio Case
B. 65year old diabetic woman
- As a circulating nurse, which of the following is your PRIORITY nursing action to promote safety of your patient?
A. Prevent peri-operative position injury
B. Provide adequate lighting during the procedure
C. Optimize surgeon’s access to surgical site
D. Maintain surgical aseptic technique during the procedure
D. Maintain surgical aseptic technique during the procedure
- Being the nurse in the Post-Anesthesia Care Unit, which of the following is your PRIORITY concern after surgery?
A. Monitor vital signs
B. Observe surgical site for bleeding
C. Validate doctor’s orders
D. Check level of consciousness
A. Monitor vital signs
- There are several factors contributory to the development of these conditions. Which of the following are the PRIORITY causative factors that should be emphasized by Nurse Lydia in her health teaching?
A. Cigarette smoking
B. Aging process and alcohol intake
C. Stress and overacidity
D. Sedentary life and obesity
D. Sedentary life and obesity
- Mr. Jesse is admitted due to congestive heart failure. Nurse Brilliantina would expect that if the failure is on the right side of the heart, the patient will manifest which of the following.
A. Jugular vein distention
B. Crackles on auscultation
C. Dry productive cough
D. Improved bowel elimination
A. Jugular vein distention
- The patient has been receiving, Digoxin 0.25 mg per day to regulate his heart rate. Which of the following outcomes would indicate that his medication is achieving its desired effects?
A. Improved appetite
B. Increased pedal edema
C. Increased urine elimination
D. Improved bowel elimination
C. Increased urine elimination
- The other patient of Nurse Brilliantina is suffering from Buerger’s disease. He has been complaining of intermittent claudication of the lower extremities which has been giving him so much discomfort. What is the Best nursing action she should perform to address the patient’s complaint?
A. Allow the patient to lie flat on bed
B. Teach him foot care and leg exercises.
C. Place affected extremities in a dependent position
D. Apply hot water bag to the affected extremities
B. Teach him foot care and leg exercises.
- Which of the following information is NOT True of Buerger’s disease?
A. Small and medium arteries and veins are mostly affected.
B. Smoking is a major cause of Buerger’s disease.
C. Incidence of Buerger’s disease is high in men than women.
D. Astrong relationship exists between diabetes and Buerger’s disease.
D. Astrong relationship exists between diabetes and Buerger’s disease.
Situation 5
Gloria, 58 years old, beautician has undergone bowel obstruction surgery. During his first day
post-op. she vomited clear liquids about three times during your shift. Her vital signs include: temp-37.9 degree
C. 138/84 PR-78/min and RR- 26/min. her surgical incision is intact, slight bleeding, swilling and tenderness with
slight pain.
- Which of the following manifestations would indicate the development of wound infection?
A. Presence of elevated red blood cells count.
B. Profuse and increasing perspiration.
C. Increased blood pressure, respiratory rate and pulse rate.
D. Increasing pain on the surgical incision.
D. Increasing pain on the surgical incision.
- If the wound draining is serosanguineous, it means that the secretion is colored ______.
A. Yellow-tinged
B. Pinkish-red
C. Green-tinged
D. Bright-red
B. Pinkish-red
- Later during the day, Gloria became confused, started to pull out her IV fluids as well as her wound dressings. Complained of severe pain over the wound area. The PRIORITY action of the NURSE is to ________.
A. Apply sterile dressings over the surgical wound
B. Call the surgeon at once for the health status of the patient
C. Administer the pain medication at once
D. Restrain the hands of the patient
C. Administer the pain medication at once
- The drug of choice of pain relief to patient Gloria considering score of 8 which was assessed by the nurse based on the rating scale of 0-10 (0-lowest, 10 is the highest) is ________.
A. Morphines S04
B. Ibuprofen
C. Demerol
D. Paracetamol
A. Morphines S04
- When patient is receiving opioid medication, the nurse should observe complications from the side effects by ______.
A. Checking for the presence of loose bowel movement
B. Observing signs and symptoms of addiction
C. Assessing changes of circulatory status
D. Assessing wakefulness of the patient at least every 2 hours
D. Assessing wakefulness of the patient at least every 2 hours
Situation 6
Mr Rodney, a post- operative, was given Amoxycillin at 12 midnight by the nurse on duty (NOD). The
physician asked the patient during his rounds if he has receive the drug, the patient answered “NO”. The physician
clarified the claim from the chart and from the chart and from the NOD.
- When the physician clarifies the process of Drug Administration, this Quality Improvement Process is known as
A. System analysis
B. Root cause Analysis
C. Problem identification
D. Pareto Chart
B. Root cause Analysis
- Which of the following is the primary reason why the physician wanted to clarify the process?
A. Measures the turnaround time of medication
B. Better communication with patient and result
C. Identify gap in the medication administration
D. Improve care management in drug administration
C. Identify gap in the medication administration
- While the medical director is conducting his rounds he observed the presence of scattered supplies and equipment along the corridor as well as 02 tank not properly secured. The Quality Circle (QC) team was informed about this observation. Which of the following is the BEST strategies to be adopted by the team with this concern?
A. Adopt the 5 S audit.
B. Identify and prioritize the problem
C. Select Alternative Solution.
D. Enhance Continuous quality improvement.
A. Adopt the 5 S audit.
- The approach adopted by quality circle team was presented to top management. Which of the following tools is APPROPRIATE to be utilized as a guide for their time management?
A. Pre chart
B. Radar chart
C. Process of flow chart
D. Gantt chart
D. Gantt chart
- In order to determine if the implementation of the activity is successful, the First step to be done by the team is ______________.
A. Prioritize the problem
B. Coordinate with the different units
C. Have a random report to the supervisor
D. Develop a monitoring plan
D. Develop a monitoring plan
Situation 7
Nurse Tin is assigned in the Surgical Ward of a Tertiary Medical Center with several patients who are for
diagnostic tests and for surgery.
- Mr. Anthony, 38 years old, is scheduled for Laparoscopic Cholecystectomy in the morning the next day. He verbalizes to you and says, “Dr. Unido will open me up to remove my gallstones?” which of the following is your BEST response?
A. “Let us discuss with the surgeon your operation before you go to the OR.”
B. “I know the surgeon will remove your stones with a new technique.”
C. “Let me call the OR supervisor to discuss the procedure with you.”
D. “I will call the anaesthesiologist to explain more the procedure.”
A. “Let us discuss with the surgeon your operation before you go to the OR.”
- A critical component before Mr. Anthony goes for surgery is the nurse’ preoperative teaching. Which of the following is NOT advisable prior to surgery?
A. Teach him deep breathing exercises
B. Fast at midnight, but can drink water if he becomes thirsty.
C. Instruct him to void before going to the operating room.
D. Teach him leg and coughing exercises
B. Fast at midnight, but can drink water if he becomes thirsty.
- While giving health instructions to Anthony. He looks very anxious and said to you, “I might not be able to wake from anesthesia after my operation.” Your BEST response is _________.
A. “Do not worry, everything will be alright.”
B. “Let me tell to your family your fear.”
C. “I will not let you go to the OR until I have talked to your surgeon.”
D. “Don’t Say that, I will discuss your concerns with your anaesthesiologist.”
D. “Don’t Say that, I will discuss your concerns with your anaesthesiologist.”
- Mr. Anthony returned back to the ward, after recovering from anaesthesia. He complain of pain over the scapular region. Which of the following nursing actions should you do?
A. Apply heating pad over the painful area.
B. Turn client from side to side.
C. Give demerol as ordered.
D. Apply cold pack over the affected area.
A. Apply heating pad over the painful area.
- After 5 days, Mr. Anthony is ready to go home. His discharge instructions include observations of the following complications, EXCEPT:
A. Palpitation
B. Loss of appetite
C. Increased body temperature
D. Bleeding
B. Loss of appetite
Situation 8
Meg is assigned as charge nurse at the Cardiovascular Ward in a Medical Center. There are 20 patients,
classified as follows: 2 Total Care (TC), Partial Care (PC) and 9 Ambulatory Care (AC). The ward’s morning duty are 3 staff
nurses and 2 nursing attendants (NA).
- How will your distribute the patients to the 3 Registered Nurses and 2 Nursing Assistants?
A. 2 Registered Nurse for Total Care patients, 1 Registered Nurse and 1 Nursing Assistant for Primary Care Patients, 1 Nursing Assistant for Total Care.
B. 1Registered Nurse and 1 Nursing Assistant for Total Care Patients, 1 Registered Nurse and 1 Nursing Assistant for Primary Care Patient, 1 Registered Nurse for Ambulatory Care patients.
C. 2 Registered Nurse for Total Care patients, 2 Nursing Assistant for Primary Care Patients, 1 Registered Nurse for Ambulatory Care Patients.
D. 1 Registered Nurse for Total Care patients, Registered Nurse and 1 Nursing Assistant for Primary Care patients, 1 Registered Nurse and 1 Nursing Assistant for Ambulatory Care patients
B. 1Registered Nurse and 1 Nursing Assistant for Total Care Patients, 1 Registered Nurse and 1 Nursing Assistant for Primary Care Patient, 1 Registered Nurse for Ambulatory Care patients.
- In as much as this is a cardio-ward what basic equipment/materials should be available at all times?
- o2
- Ambu Bag
- Suction Apparatus
- Endotracheal
A. 1, 2, 4
B. 1, 2, 3, 4
C. 1, 2, 3
D. 2, 3, 4
B. 1, 2, 3, 4
- Which of the following emergency medicines should be available at the emergency cart at the Cardio Ward?
- Epinephrine 3. Valium 2. Demerol 4. Coumadin
A. 1, 3
B. 1, 2
C. 2, 4
D. 3, 4
D. 3, 4
- When stocking fluids in the emergency cart. What should Nurse Meg instruct the nurses?
- Put the recently- delivered at the back of the old stock
- Put the old stock in front of the newly-delivered ones
- Check the fluids for sediments and discoloration
- Keep the fluids inside the cooler
A. 1, 2
B. 1, 4
C. 3, 4
D. 2, 3
D. 2, 3
- How will Nurse Meg arrange the patients in the ward? Put the ______________.
A. Primary Care in between the Ambulatory Care patients.
B. Primary Care and Ambulatory Care patients together and Total Care at the corner of the room.
C. Total Care patients near the nurses and the Ambulatory farthest
D. Ambulatory Care patients near the Total Care ones.
C. Total Care patients near the nurses and the Ambulatory farthest