DIAGNOSTIC EXAM ENHANCEMENT PART 1.pdf

NURSING.CRIMINOLOGY.LET.CSE.NAPOLCOM.FOE REVIEW 4th Floor Insular Life Bldg, Rizal St., Camia Corner, Legazpi City, Albay 4500 Tel. No: 09175002996 / 09171141434...

NURSING.CRIMINOLOGY.LET.CSE.NAPOLCOM.FOE REVIEW 4th Floor Insular Life Bldg, Rizal St., Camia Corner, Legazpi City, Albay 4500 Tel. No: 09175002996 / 09171141434 NOVEMBER 2025 NLE SEASON ENHANCEMENT REVIEW: COMPETENCY EVALUATION EXAMINATION PART 1: FOUNDATIONS OF PROFESSIONAL NURSING PRACTICE (Fundamentals and PALMR) Prepared by: Jake Roger B. Coprade, RN, MANc Instructions: 1. Choose the best answer and shade the corresponding letter on the answer sheet. 2. Avoid erasures or any form of alteration. 3. Use a pencil to shade your answers. 4. You may write, encircle, or underline words on your questionnaire. FUNDAMENTALS OF NURSING a. Nursing Diagnosis 1. A nurse is providing health teaching to her client on lifestyle b. Outcome Identification factors affecting oxygenation. Which of the following descriptions c. Evaluation is most accurate? d. Assessment a. Long-term use of alcohol stabilizes blood pressure and 11. In assessment of the abdomen of a patient with abdominal pain, improves cardiac function the nurse must first assess which quadrant or side? b. Catecholamines; epinephrine and norepinephrine released a. the symptomatic side under stress, decrease renal perfusion and blood pressure b. the asymptomatic side c. Exercise decreases heart rate and respirations lowering c. any area of the abdomen tissue perfusion d. abdominal assessment in contraindicated with patients in d. Nicotine causes vasoconstriction leading to increased heart pain rate and vascular resistance decreasing oxygen perfusion 12. Mr. Trinidad is put on a clear liquid diet. Which of the following 2. A nurse is evaluating the laboratory results of Mrs. Garcia. Which of food items is accepted for this client? the following values indicates abnormality related to nutritional a. Milk, apple juice, and coffee status? b. Milk, cola, and broth a. Serum calcium: 1.8 mEq/L c. Ice cream, coffee and tea b. BUN: 22 mg/dl d. Tea, broth, and gelatin c. Albumin: 5.0 g/ dL 13. At 9am, Jermaine has 200 cc remaining in his IV bag of PNSS. At d. Urinary Creatinine 360 mg/24h 9:30, the nurse hangs a new 1L bag of PNSS, when she retuned at 3. The client asks the nurse about Stage I- Hypertension. What is the 3pm only 600 cc was left. He was also given a 250cc glass of milk, nurse's best response? and two 250 cc cups of water via his feeding tube. He voided a total a. 110-119 mmHg systolic and 60-79 mmHg diastolic of 4 times; 210 cc, 160 cc, 140 cc and 220 cc. His liquid stool also b. 120-129 mmHg systolic and 60-79 mmHg diastolic measured 290 cc. How should the nurse record the patients I and c. 130-139 mmHg systolic and 80-89 mmHg diastolic O? d. 100-119 mmHg systolic and 50-60 mmHg diastolic a. Input: 1350 cc and output: 1020 cc 4. Mr. Cruz is a client fed through NGT to sustain his nutritional b. Input: 1550 cc and output: 730 cc needs. To prevent obstruction, the physician ordered to flush the c. Input: 1110 cc and output: 1020 cc NGT with 2 oz of NSS. Following the doctor’s order, how much d. Input: 960 cc and output: 440 cc water will the nurse instill? 14. Royette cut his finger with a knife while cooking, causing a small a. 60 mL b. 30 mL laceration and moderate bleeding. He applied direct pressure with c. 15 mL d. 90 mL a kitchen towel and after a few minutes, the wound stopped 5. Ms. De Los Santos is prescribed endotracheal suctioning as needed bleeding. Which of the following stages of adaptation by Hans Selye by his physician. Her medical history includes dysrhythmias and best describes the physiological changes experienced by Royette. previous nosocomial pneumonia. What is the nurse’s priority a. Alarm stage action to prevent complications? b. Exhaustion stage a. Suction only upon waking up c. Healing stage b. Administer antibiotics before procedure d. Resistance stage c. Hyper oxygenate the client prior to suctioning 15. In which component of the problem oriented medical record will d. Use clean technique the nurse find the doctors orders? 6. Nurse Alyson notes at 9 pm that a patient’s infusion of NSS has 250 a. Plan of care ml left to infuse. At what time will the infusion end if the IVF has a b. Database flow rate of 25 gtts/min with a drop factor of 10? c. Problem list a. 11:00 pm d. Progress notes b. 9:15 pm 16. A client receiving heparin therapy should be routinely assessed for c. 10:15 pm signs of? d. 10: 40 pm a. Hypertension 7. Bedrest is prescribed to achieve what therapeutic effect? b. Elevated hemoglobin count a. Maximize lung expansion c. Elevated WBC count b. Stimulate peristalsis d. Hypotension c. Maintain skin integrity 17. During which point of the client’s hospital stay does rehabilitation d. Reduces oxygen demand of tissues begin? 8. In assessing the patient’s abdomen. Which of the following a. A day prior to discharge sequence of physical examination is used? b. Upon follow up check up a. Percussion, inspection, palpation, auscultation c. 24 hours after discharge b. Auscultation, inspection, palpation, percussion d. Upon admission c. Inspection, palpation, percussion, auscultation 18. A client is to be prepared for thoracentesis. What position should d. Inspection, auscultation, percussion, palpation the client assume? 9. Which of the following vital sign assessments indicates cardiogenic a. Supine with head of bed elevated 30 degrees shock? b. Sitting with arms resting on over-bed table a. BP: 180/100, HR: 92 (irregular) c. Prone with head turned to side b. BP: 70/50, HR: 132 (irregular) d. Flat on bed with pillow support c. BP: 130/90, HR: 120 (regular) 19. What position is best used when performing oral care to an d. BP: 90/50, HR: 61 (regular) unconscious client? 10. A client is to be discharged after treatment of pneumonia. The a. Semi fowlers position with head turned to side nurse notes that the client is no longer experiencing; difficulty of b. Flat on bed breathing, cough and is afebrile. The nurse’s actions reflect which c. Side-lying position with head of bed lowered step of the nursing process? d. Low fowlers with head tilted downward COMMITMENT.EXCELLENCE.QUALITY 1 20. Nurse Fred is reviewing a client’s laboratory tests, the client is a c. Oral 31-year old female admitted for severe dehydration. Nurse Fred d. SubQ would expect the hematocrit to be which of the following levels? 34. When caring for clients with burns, what is the PRIORIY a. 60% intervention during the emergent phase? b. 40% a. Fluid resuscitation c. 36% b. Skin grafting d. 48% c. Maintain patent airway 21. Christian is a client admitted in the medical-surgical ward with an d. Counseling for altered body image order of hourly monitoring of blood pressure. The nurse finds that 35. A client to undergo abdominal assessment is to assume what the client is large and the available cuff is too narrow for the client. position? What abnormality in the reading will the nurse encounter? a. Supine with knees slightly flexed a. Fluctuating b. Prone b. False low c. Side-lying c. Low systolic and high diastolic d. Orthopneic position d. False high 36. The PCS gave new guidelines including leaflets to educate cancer 22. Which of the following menus is appropriate for a client on a low patients. As a nurse, when using materials like this, what is your sodium diet? responsibility? a. Misua noodles a. Read the leaflet to the patient b. Hotdog b. Read it yourself, then have the client read the material c. Pickled vegetables c. Give it for the patient to read himself d. Ham sandwich d. Let the family member read the material for the patient 23. Emman is a client to undergo Arterial blood gas monitoring. Prior 37. The hair that lines the vestibule which works as a means of to the procedure the nurse performs an Allen’s test. The client asks filtration for foreign matter; the nurse for the purpose of doing the said test. The best response a. Nares of the nurse would be? b. Cilia a. To check the patency of the ulnar artery c. Vibrissae b. To check the patency of the radial artery d. Carina c. To check the patency of the brachial artery 38. Refers to the extra air that can be inhaled well above the normal d. To check patency of the carotid artery tidal volume 24. A client with Diabetes Mellitus is at most risk of which acid-base a. Residual volume imbalance? b. Functional residual capacity a. Respiratory acidosis c. Inspiratory reserve volume b. Respiratory alkalosis d. Expiratory reserve volume c. Metabolic acidosis 39. Which of the following is the initial sign of hypoxemia in an adult d. Metabolic alkalosis client? 25. When preparing for post mortem care. What should be the nurses’ i. Tachypnea initial action? ii. Tachycardia a. Placing a pillow under the head and shoulders iii. Cyanosis b. Remove all contraptions and lines iv. Pallor c. Remove all clothing and immediately clean the body v. Irritability thoroughly vi. Flaring of Nares d. Cover the body with a shroud a. II, VI 26. Joseph is a client admitted after 2 days of severe vomiting. He b. I, II develops hypokalemia. Which of the following symptom is c. II, V significant to this condition? d. III, IV a. Muscle irritability 40. Which of the following oxygen delivery devices can deliver high b. Increased pulse rate and blood pressure flow 100% oxygen at 15 lpm? c. Lethargy a. Simple face mask d. Muscle weakness b. Non rebreather mask 27. Chronic alcoholism commonly leads to a deficiency of which c. Partial rebreather mask vitamin? d. Nasal cannula a. Riboflavin 41. Upon observation your client with a chest tube, you note oscillation b. Pantothenic acid and intermittent bubbling in the water seal bottle. What action c. Pyridoxine should the nurse take? d. Thiamine a. Check for leak 28. What is the proper anatomical location of the apical pulse? b. Prepare vaselinized/petroleum gauze a. 5th right intercostal space, midclavicular line c. Notify physician b. 2nd left intercostal space, midaxillary line d. Document as normal findings c. 3rd intercostal space left to the sternum 42. Which of the following is the first sign of dehydration? d. 4th or 5th intercostal space mid to anterior axillary line a. Restlessness 29. A client admitted for a heart condition. Which of the following is b. Tachycardia contraindicated? c. Poor skin turgor a. Oral temperature taking d. Thirst b. Blood pressure monitoring 43. Which of the following if done by the nurse contraindicates the c. Digital rectal exam standard of NGT feeding? d. Echocardiogram a. Height of the feeding should be 12 inches above the point 30. Nurse Jane observes Mr. Garcia having difficulty of breathing, in of insertion for slow induction of feeding response she elevates the head of the bed to High fowlers, then b. Clamp the NGT before all of the water is instilled to decreasing the client’s respiratory distress. Nurse Jane documents prevent air entry leading to distension this observation as what type of breathing? c. Ask the client to lie immediately in supine position to a. Hyperventilation prevent dumping syndrome b. Eupnea d. Do not give feeding and notify doctor if gastric residual is c. Tachypnea greater than or equal to 50 mL d. Orthopnea 44. What is the most life-threatening complication of clients with 31. What is the BEST intervention to prevent post-op complication? stroke? a. Encourage early ambulation a. Dehydration b. Deep breathing and coughing exercises b. Malnutrition c. Increase pain medication for comfort c. Fluid and electrolyte imbalance d. Music and dance therapy d. Aspiration 32. Upon percussion of the lung fields, which of the following sounds 45. In giving gastrostomy feeding. The initial nursing action should be will the nurse expect? to; a. Dullness a. Check for tube placement b. Resonance b. Measure the residual feeding c. Flat sound c. Check vital signs d. Tympany d. Assess for patency of the tube 33. Pain medication for burn clients are best administered through 46. Ms. Abi is a client on TPN, her 1L bag of TPN was started at 12 nn. what route? At 6am the following day, pm the nurse observed that there is a. IM feeding was 300cc remaining. At what time will the nurse replace b. IV the clients TPN? COMMITMENT.EXCELLENCE.QUALITY 2  a. 9 am 59. This term pertains to the degree of which an instrument measures b. 12 nn what is supposed to be measured + c. 3 pm a. Validity d. 6 am b. Reliability 47. What is the best NURSING ACTION to verify tube placement? c. Sensitivity a. Instill air and auscultate for gurgling sounds at the clients’ d. Accuracy epigastric region 60. Which of the following is used to communicate the results of a b. Aspirate gastric contents and test for acidity with litmus study and facilitate the description of data? paper c. Prepare client for x-ray a. Hypothesis d. Submerge tube into water and observe for bubbling b. Statistics 48. Which of the following food items contain the most amount of iron c. Tables and graphs per area of meat? d. Research statement a. Lean meat 61. Which of the following board exam ratings may grant a nurse a b. Green mongo license to practice nursing? c. Lean red meat a. GWA of 70 and a rating of 70 in NP II d. Pork liver b. GWA of 75 and a rating of 59 in NP V 49. Which of the following nursing procedures do NOT require sterile c. GWA of 84 and a rating of 59 in NP III technique/asepsis; d. GWA of 75 and a rating of 65 in NP II a. Tracheostomy suctioning 62. Upon renewal of licenses, nurses are required to present CPD units b. Urinary catheterization under RA 10912. Which of the following is NOT a means of earning c. IV insertion d. NGT Feeding CPD units? 50. Which of the following will alert the nurse as an early sign of a. Formal leaning activities hypoxia? b. Non-formal learning activities a. Client is tired and dyspneic c. Self-directed leaning activities b. Client is frequently turning from side to side d. None of the above c. The client is coughing out blood 63. Under the CPD law of RA 10912, how many units per hour can be d. The client’s heart rate is 50 BPM earned by a nurse for being a resource person of keynote speaker? PROFESSIONAL ADJUSTMENT, LEADERSHIP & MANAGEMENT, AND a. 1 credit units per hour RESEARCH b. 15 credit units per hour 51. Nurse Edra while caring for a geriatric client accidentally tears the c. 3 credit units per hour skin of her client while removing a piece of tape. The skin is d. 5 credit units per hour attached both to the tape and the patients upper arm. Nurse Edra 64. Which of the following interventions will be withdrawn once a proceeds to cut the skin to remove the tape. If harm comes to the client is on a DNR or Do Not Resuscitate order? client due to the act of cutting her skin with scissors, which of the a. Pain medication following legal torts could the nurse be charged with? b. IV Fluids a. Assault c. NGT feeding b. Negligence d. Mechanical ventilation c. Malpractice 65. The attending physician ordered 1 tablet of medication and the d. None of the above for the act is acceptable nurse accidentally administered two. The nurse reported the 52. What is the order from the Board of Nursing which requires Nurse incident to the physician and was tasked to monitor the client, no Edra to appear to PRC? untoward effects happened? Can the nurse be charged for a. Petition malpractice? b. Subpoena ad testificandum a. Yes, breach of duty exists c. Summon b. No, the nurse notified the physician d. Subpoena duces tecum c. Yes, the act was foreseeable 53. Nurse Edra knows that the suspension of the Certificate of d. No, the client was not harmed Registration should not exceed how many years? 66. A client with uterine cancer is scheduled for hysterectomy and can a. 3 no longer bear a child. If the surgery is not done, the client may die. b. 2 This is an example of what principle? c. 5 a. Epikia d. 4 b. Two-fold effect 54. If a nurse were to resign from his/her current employment, the c. Totality professional expectation for the nurse to do is? d. The Golden rule a. Inform the chief nurse properly of your resignation 67. For a study to be classified as a true experiment, it must meet these b. Submit a letter of resignation of at least 30 calendar days 3 conditions. Which of the following is NOT included? before resignation a. Manipulation c. Inform your fellow staff nurses during your break b. Control d. Submit a letter of resignation immediately upon transfer c. Induction to a new job d. Randomization 55. It is the power of the Board of Nursing to conduct trials or exercise 68. Which of the following is a management function of a nurse? due process in the suspension and/or revocation of licenses. a. Teaching patient the proper use of a MDI a. Quasi-legislative b. Evaluating and directing the staff nurses b. Executive c. Preparing for an exercise activity for clients c. Quasi-judicial d. Carrying out nursing procedures for clients d. Quasi-experimental 69. Democratic leadership empowers subordinates. Which of the 56. To perform a procedure on a client without informed consent may following actions would develop empowered nurses? lead to the nurse to commit which of the following charges? I. They are involved in decision making a. Assault and battery II. Nurses follow standard operating procedures b. Fraud III. They follow all orders of their superiors c. Harassment IV. Nurses can voice their opinions to their superiors d. Breach of confidentiality a. I and II 57. Which of the following is NOT included in the Operational budget? b. I, II and IV a. Repair and maintenance costs c. I and IV b. Purchase of major equipment d. I and IV c. Purchase of consumable supplies 70. What is the appropriate Nurse to patient ratio as recommended by d. Nurses salary the Department of Health? 58. Nurse Debbie was asked to respond to an issue within the unit, she a. 1: 12 responds “I don’t have time for that now, let’s discuss it later in my b. 1: 25 office”. What strategy of conflict resolution did Nurse Debbie use? + c. 1: 50 a. Compromising d. 1: 5 b. Smoothing c. Restriction d. Avoidance COMMITMENT.EXCELLENCE.QUALITY 3 71. A research entitled, “The Effects of the Nurse counselor role in the 83. Which of the following is NOT an accurate statement describing Reduction of Anxiety in Patients to Undergo Catheterization” was pure experimental research? conducted. Which of the following is the independent variable? a. There is an experimental group a. Nurse counselor role b. There is a control group b. Patients c. There is a careful selection of subjects in the control c. Reduction of anxiety group d. Catheterization d. The selection of subjects in the control group is 72. The dependent variable? randomized a. Catheterization 84. Mr. Garcia is a 72-year old client tells the nurse. “I signed the b. Patients documents for the research study because the doctor was very c. Reduction of anxiety insistent, and I want him to continue taking care of me.” Which of d. Nurse counselor role the following client’s rights is violated? + 73. In the Primary Nursing care delivery system, what is the role of the a. Right to privacy and confidentiality associate nurse? b. Right to full disclosure a. patient advocate in the health care team c. Right to self determination b. over-all manager of the unit d. Right to fair treatment c. responsible for the over-all care of the patient during off 85. Nurse Michael is conducting a study on how Anne, a client with days of primary nurse breast cancer, lives her life. Which of the following is the most d. coordinator of comprehensive, holistic patient care appropriate research design? + 74. Jack’s diet is primarily composed of fatty food. You want to a. Historical determine what will be the effect of high cholesterol food on Jack in b. Case study the next ten years. Which of the following research designs is most c. Phenomenological appropriate? d. Ethnographic a. Comparative 86. A group of nurses at an RHU are to conduct a study on the b. Longitudinal relationship of the number of household members and the utility c. Correlational bills. Which of the following is the best research design for this d. Historical study? 75. The following are methods of staff evaluation, EXCEPT I. Exploratory a. Performances Evaluation sheet II. Descriptive b. Performance Checklist III. Correlational c. Ranking Device IV. Comparative d. Nursing Audit V. Experimental 76. Nurse Fatima is the head nurse and tells Nurse Fatima her staff a. I and II nurse what to do. What kind of communication is this? b. III and IV a. Diagonal communication c. I and V b. Upward communication d. II and III c. Downward communication 87. Paul has an authorized role within the organization because he was d. Lateral communication officially appointed, his makes Paul what kind of leader? 77. Ms. Valdez organizes the process standards. Which of the following a. Informal is NOT a process standard? b. Situational a. Initial assessment shall be done to all patients within 24 c. Traditional hours upon admission. d. Formal b. Informed consent shall be secured prior to any invasive 88. Danielle recognizes that she needs to work on her attitudes and procedure. behavior. Which of the following responses indicates that she is an c. Patients’ reports 95% satisfaction rate prior to discharge aggressive leader? from the hospital. a. “Thank you; I'll try my hardest to support the d. Patient education about their illness and treatment shall department's objectives.” be provided for all patients and their families. b. “I feel fortunate. I'll work my best to maintain my 78. Nurse Ava is caring for a client to undergo surgery for a mitral performance at the standard required.” valve replacement. Who of the following is legally responsible for c. “I honestly don’t know how I got the promotion. They just securing the patients consent? probably like me” a. Dr. Sanchez, the anesthesiologist d. “I predicted this was going to happen. I am aware that I b. Dr. Ramirez, the cardiothoracic surgeon outperformed everyone else.” c. Mr. Alvarez, the head nurse of the unit 89. Nurse Aby is a Nurse manager at a hospital. She decides to d. Nurse Ava, the nurse assigned to care for the client illustrate the company’s organizational chart. The following are 79. Ms. Consejo passed the examination and is waiting to be issued her components included in the chart, EXCEPT: certificate to practice nursing. To whom does this responsibility a. Span of control primarily belong to? b. Lines of communication a. Board of Nursing c. Delegation of responsibility b. Civil Service Commission d. Level of authority c. Office of the President 90. Effective techniques for addressing interpersonal conflicts include: d. Professional Regulatory Commission 1. Allow ample time for both parties 80. A 10-blade was found liable in the abdominal cavity of a post-op 2. Focus on the issue and not on the persons involved client. By which of the following doctrines holds the Surgeon liable 3. Give back-handed, condescending compliments for the incident? 4. Don’t blame the problem on anyone a. Epikia 5. Facilitate open communication of everyone b. Two-fold effect a. 1, 2, 3 c. Res ipsa loquitor b. 2, 4, 5 d. Respondeat superior c. All except 4 81. A client comes to your clinic and offers a large sum of money for an d. All except 3 abortion because she is a graduating student. The procedure was 91. Which of the following tasks can be delegated by the staff nurse to refused as it was deemed unethical. The action of the nurse if Nursing assistant? considered under which bioethical principle? a. Taking of history upon admission a. Veracity b. Vital signs taking of a stable patient b. Nonmaleficence c. Administration of medications prepared by the registered c. Beneficence nurse d. Autonomy d. Initial transfer of a post-op client 82. When a client falls from bed, what is the nurse’s initial action? 92. Understanding the principles of delegation. Which of the following a. Put the patient back to bed is the most important consideration to be made by a manager in b. Determine injury or harm selecting the person to whom the task will be delegated to; c. Refer to the attending physician on duty a. Qualification and preparedness to perform the task d. Report the incident to the head nurse b. The financial cost of delegation COMMITMENT.EXCELLENCE.QUALITY 4  c. Prior experience of the person about the task d. Rotation of task assignments 93. Nurse Mike Is conducting a research study where his data involves ranking and classifying respondents according to their degrees earned; bachelor’s, master’s and doctorate degrees correspond to measure on which of the following scales: a. Ratio b. Ordinal c. Nominal d. Interval 94. The level of measurement which allows the researcher to add, subtract, multiply and divide a. Ratio b. Interval c. Nominal d. Ordinal 95. A researcher compared the level of anxiety experienced by nurses working the Day, and Night shift of the Emergency room, will likely use which statistical test: a. ANOVA b. T-test c. Correlation coefficient d. Factor analysis 96. In qualitative research, which of the following is used to determine the ideal number respondent to represent a group? a. Slovin’s Formula b. Power analysis c. Saturation d. T-test 97. Nurse Milan is a researcher conducting a qualitative study. She screens potential participants based on their capability to contribute valuable data to her study. Nurse Milan is using which sampling technique? a. Cluster sampling b. Snowball sampling c. Purposive sampling d. Stratified random sampling 98. Mr. Dela Cruz has been invited to participate in a research study, the client fully understood and signed the consent. Midway through the study, the client decides to refuse participation. What is the nurse’s appropriate response? a. “you can’t refuse now, were almost done with the study” b. “I understand you want to refuse, would you like a monetary compensation?” c. “you signed the consent, you have to participate” d. “I see; would you like to discuss the reason for your refusal?” 99. A researcher is to use a 5 point 30-item Likert scale. Which of the following indicates the possible range of score? a. 5 to 30 b. 15 to 150 c. 30 to 150 d. 30 to 300 100. A new staff nurse is to attend training on IV Therapy offered by the Nursing department of the hospital she is working in. What type of education is indicated above? a. Continuing Professional Development b. Formal education c. In-service training d. Self-directed education COMMITMENT.EXCELLENCE.QUALITY 5