Final Coaching - PALMR PDF

1 SITUATION 1 - Nurse Libra has just passed the Nurses’ Licensure Examination (NLE). She directly needs to refresh herself regarding the law that governs the practice of nursing the Philippines 1. By virtue of Section 16 of the Philippine Nursing Law, the first step Nurse Libra needs to do after...

1 SITUATION 1 - Nurse Libra has just passed the Nurses’ Licensure Examination (NLE). She directly needs to refresh herself regarding the law that governs the practice of nursing the Philippines 1. By virtue of Section 16 of the Philippine Nursing Law, the first step Nurse Libra needs to do after passing the NLE is to: A. Apply for the Certificate of Registration/Professional License. B. Get an official copy of her board rating from the PRC office C. Apply for a Professional Identification Card. D. Take oath of profession before the Philippine Regulatory Board 2 2. Which government body has the power to revoke or suspend Nurse Libra's certificate of registration/professional license, should she commit unprofessional and unethical conduct in the future? A. Philippine Nurses Association B. Professional Regulation Commission C. Commission on Higher Education D. Professional Regulatory Board of Nursing 3  3. Nurse Libra just received her brand-new professional ID card. In the new format of the Professional Regulation Commission (PRC) ID, which of the following information are still present? I. Professional license number II. Date of birth of licensed professional III. Last date of validity of ID card IV. Official seal of the commission V. Recent grayscale photograph of the licensed professional A. I, II, III C. I, III B. II, III, V D. I, II, VI 4 4. What is the primary goal for establishing licensure of nurses? a. Guarantee high-quality nurses. b. Increase tax revenues for the state. c. Set a minimum level of competency to protect the public. d. Maintain high numbers of nurses in the profession. 5 5. Leo, Nurse Libra’s boyfriend, is a BSN graduate but did not take the NLE. He is in desperate need of money so he applied and was accepted in a health facility. As a nurse, Leo submitted a fake PRC license in order to be given the job. Leo is liable to be charged of _______________. A. false statement B. misrepresentation C. fraud and deceit D. malpractice 6 SITUATION 2 - The Code of Ethics of Registered Nurses in the Philippines was promulgated by the Professional Regulatory Board of Nursing (PRBON) in consultation with national nursing organizations. 6. Article II of the Code outlines ethical principles governing the Registered Nurses and the People. In relation to this, nurses must observe the following, EXCEPT: A. In the event of conflicts, culture and values take precedence over welfare and safety. B. Respect the spiritual beliefs and practices regarding diet and treatment. C. Consider the individuality and totality of patients when giving care D. Uphold the dignity and rights of individuals. 7  7. As a citizen and a member of society, the nurse must: I. Be involved in community concerns and projects II. Be equipped with knowledge of community health resources III. Lead their lives in conformity with the principles of right conduct. IV. Project an image that will uplift the nursing profession at all times. V. Be on guard that her/his words, actions are always agreeable with others A. II, III, V C. II, III, IV, V B. I, II, III D. I, II, III, IV 8 8. In the said Code of Ethics for Nurses, the nurse in relation to her profession is expected to do the following, EXCEPT A. Participate actively in the growth, development of nursing profession B. Strictly adhere to the nursing standard set by the Board of Nursing C. Strive to secure equitable, socio-economic, work conditions for nurses. D. Be a member of the accredited professional organization, the International Council of Nurses. 9 9. As a professional, the nurse must conduct herself appropriately at all times. Which of the following behaviors does NOT correspond to this statement? A. Avoid any abuse of the privilege relationship which exists with patients. B. Accept gift, hospitality from any person in exchange for requested favor C. Not demand & receive any commission, fee, emolument for referrals made. D. Not allowing themselves to be used in ads 10 10. The registered nurse who works in the obstetrics department is walking by the emergency department waiting room when a person cries out, "Help me! My mother is not breathing!" Does this nurse have a duty to assist? A. Yes, the general duty of care exists to help in times of crisis or imminent harm. B. Yes, the nurse has the duty to provide the same standard of care as an emergency department nurse. C. No, the nurse has no more duty to assist in this situation than a lay person. D. No, the nurse is out of the normal working environment and should not interfere. 11 SITUATION 3 - Ethical issues on a day-to-day basis often involve patient communication and advocacy. It may also include questions about end-of-life care. Nurses are often the ones working closest with patients and families while administering care. 11. What is the appropriate approach for the community/public health nurse in balancing individual privacy and autonomy and the community’s needs for safety and security? A. Fulfill agency policies first B. Implement professional standards of nursing practice C. Remember that group needs outrank individual needs D. Seek a balance between individuals’ needs and the community’s needs 12 12. In regard to informed consent, which of the following statements is TRUE? A. Client may not be told about costs and alternatives to treatment. B. Consent must be voluntary. C. Only parents themselves should give consent for minor children. D. Legally incompetent adults can give consent. 13 13. The client has a “living will” in which he states he does not want to be kept alive by artificial means even at home. The client’s family wants to disregard the client’s wishes and have him maintained on artificial life support. The most appropriate initial course of action for the nurse would be to: A. Allow the family to ventilate their feelings and concerns, while maintaining the role of client advocate. B. Tell the family that they have no legal rights. C. Report the situation to the hospital’s Ethics Committee D. Advise the family that they have the right to ignore the living will as the patient cannot speak. 14 14. During a routine visit, the nurse noted that Maya Pinion, 20-year-old wife and mother, has several bruises at various stages of healing. She tells the nurse that she fell down. Failure to report your findings is an example of: A. malpractice B. reasonable prudence C. maleficence D. negligence 15 15. Which of the following examples would indicate observance of client confidentiality? A. Reading a friend’s chart in another health care facility B. Describing a difficulty with a client in a health team conference C. Using a client’s name in a social conversation D. Talking about the client’s symptoms in front of family members 16 SITUATION 4 - Thorough, accurate documentation reflects the patient experience and is crucial for goal-directed patient care and evaluation of outcomes 16. Lanja Ray, a patient who is being transferred to another facility asks the nurse if she can take home her chart, since it’s her record. The nurse responds correctly by saying: A. “You’ll have to ask your doctor for permission to do that.” B. “Actually, the original record is the property of the hospital, but you are welcome to copies of your records.” C. “We’ll make sure that all of your records are sent ahead to the rehab hospital, so you don’t really have to worry about those details.” D. “There’s a new law that protects your records, so you’re not going to be able to have access to them.” 17 17. After classroom discussion regarding confidentiality policies and laws protecting client records, a student asks why its permissible for them to review and have access to client records in the clinical area. The nurse educator responds correctly by stating that: A. Confidentiality and privacy laws don’t apply to students. B. Most students review so many records and charts that they could not possibly remember details from any one of them. C. Records are used in educational settings and for learning purposes, but the student is bound to hold all information in strict confidence. D. As long as the clinical instructor is in the area, accessing client records is part of the education process. 18 18. A client did not meet the goal of walking unassisted, without assistive devices, by discharge from rehabilitation. The case manager using a critical pathway would identify this as which of the following? a. An unattainable goal b. A variance c. An error in care planning d. An error in intervention implementation 19 19. When documenting care and assessments using the charting by exception system, the nurse may not address all of the sections on a clients flow sheet, especially if the client did not require this particular care. In order for the nurse to identify that these areas were addressed, but no care was needed, the best action is to: a. Leave them blank. b. Leave them blank, but then add an extensive explanation in the progress notes section of the chart. c. Write N/A on the flow sheet in the areas that are not applicable to that client. d. Make sure this information gets passed along in the shift report. 20 20. A newly licensed RN complains to the preceptor about the amount of time spent documenting in the medical record. What is the preceptor's best response? A. "The most important reason we document is to help us communicate the patient's condition to the rest of the health care team" B. "Since you just took a course in nursing research, you should realize the value of accurate documentation as a source of research data" C. "We have to document so that charges are clear to third-party payers" D. "The medical record protects us as if a lawsuit is filed" 21 SITUATION 5 - Nurse Sybil Rayts attends to patient Violet Thor who is pregnant when a pelvic sonogram was conducted on her revealing fetal distress. Nurse Sybil Rayts advised the patient Violet Thor to have a follow up visit to their clinic after a week, but the patient only returned when she started to suffer contractions. Upon examination, the doctor discovered fetal demise. Worse, patient Violet Thor had to be ligated, deeming her barren and sterile. 22 21. Frustrated, patient Violet Thor filed legal charges against all people concerned. Who among the following will be accountable to the patient? A. None, all health care team performed their professional duties on the patient. B. Only the doctor but not the nurse because the latter was just following orders C. The doctor and the nurse because of a possibility of their failure to perform their perspective duties with diligence and care. D. The doctor and the hospital administrator because of command responsibilities on the treatment and care to the patient. 23 22. Under the situation, if the physician and the nurse are liable over the consequence of the treatment and care of the patient, what applicable legal doctrine will this be? A. Respondeat Superior B. Patient's Proximate Negligence C. Captain of Ship Doctrine D. Res Ipsa Loquitor 24 23. If Nurse Sybil Rayts is called to testify on the alleged surgical procedure performed to the patient to determine whether there was lack of necessary care and diligence, the nurse should testify only on matters which are ___________________. A. within her personal knowledge B. advised by her lawyer C. documented in the chart D. being asked by the court 25 24. Medical records have legal implications. In as much as the nurse failed to chart the discharge instructions, what principle in records management was violated? A. "If it was not documented, it was not done." B. "Completion of chart should be within 48 hours." C. "No document, no discharge." D. "Not all documented data are true." 26 25. A nurse tells several friends and coworkers that a client, who is also a physician, is unsafe for medical practice because he is paralyzed from the waist down and acts "slightly silly." What type of tort does the nurse's action represent? A. Libel B. Slander C. Fraud D. Malpractice 27 SITUATION 6 - Nurses are guided by bio-ethical principles as they practice their chosen profession. 26. The nurse values autonomy above all other principles. Which patient assignment will the nurse find most difficult to accept? A. Older-adult patient who requires dialysis B. Teenager in labor who requests epidural anesthesia C. Middle-aged father of three with an advance directive declining life support D. Family elder who is making the decisions for a young-adult female member 28 27. Each person has a responsibility to take care of his/her body. In case a part is defective, it can be removed for the benefit of the remaining parts. What bio-ethical principle is this? A. Totality B. Solidarity C. Stewardship D. Fidelity 29 28. As member of the health team, nurses are expected to collaborate with other health care professionals for unity and cooperation. What bio-ethical principle is this? A. Fidelity B. Solidarity C. Stewardship D. Totality 30 29. When another person or entity intrudes in the affairs of the patient to promote what that person is best for the patient, what principle does he/she promote? A. Welfare B. Justice C. Stewardship D. Paternalism 31 30. Four patients in labor all request epidural analgesia to manage their pain at the same time. Which ethical principle is most compromised when only one nurse is on call? A. Justice B. Fidelity C. Beneficence D. Nonmaleficence 32 SITUATION 7 - A 13-year-old- girl named Stormie Weather tells the nurse at the pediatric clinic that she took a pregnancy test and it was positive. She tells the nurse that her grandfather, with whom she, her younger siblings, and her mother live, has repeatedly molested her for the past 3 years. When the nurse asks Stormie if she has told this to anyone, she replies: "Yes, my mother." 31. As the nurse's legal responsibility, which is the APPROPRIATE agency should she notify FIRST? A. City Health office to do a vaginal examination to confirm the pregnancy B. Board members of Child Protective Services for proper intervention C. Philippine National Police concerning a possible sex crime D. The parents to get consent 33 32. Place the following phases of sexual abuse among children in the proper order. 1) Sexual interaction 4) Disclosure 2) Secrecy 5) Suppression 3) Engagement A. 3-1-2-4-5 B. 1-3-4-2-5 C. 5-1-2-3-4 D. 1-2-3-4-5 34 33. Rape is a crime against: 1) children. 2) women by their husbands 3) elderly 4) men A. AOTA B. NOTA C. ALL EXCEPT 4 D. ALL EXCEPT 2 35 34. When a patient like Stormie allegedly has been sexually abused, the nurse should be aware that legal proceedings may be necessary. Because of this possibility, which of the following actions is MOST important to be done by the nurse? A. Determining if there are other injuries such as bruises and hematomas. B. Asking the parents for their approval for diagnostic examinations for the child. C. Assessing the child's physical, intellectual and emotional developmental levels. D. Documenting physical findings and interactions during admission. 36 35. All of the following are laws that specifically provide protection against various forms of abuse to children in the Philippines, EXCEPT: A. Republic Act No. 9262 B. Republic Act No. 9775 C. Republic Act No. 7610 D. Republic Act No. 8504 37 COMPLETE THE TABLE by filling up the spaces provided with the appropriate number of the law pertinent to nursing practice TITLE OF THE LAW LAW NO. Local Government Code of 1991 Continuing Professional Development Act of 2016 Data Privacy Act of 2012 38 Anti-Violence Against Women and their Children Act of 2004 Traditional and Alternative Medicine Act of 1997 Law on Reporting of Communicable Diseases of 1929 39 Special Protection of Children Against Abuse, Exploitation and Discrimination Act of 1992 The Anti-Rape Law of 1997 Responsible Parenthood and Reproductive Health Law of 2012 40 COVID-19 Vaccination Program Act of 2021 41 SITUATION 8 – Nurse Rana Marathon is on 7-3 shift in the ER. The unit is crowded with patients and relatives. She is attending to two patients, Walker, who is having chest pains and Hiker, who is with severe abdominal pains. The doctor ordered nitroglycerine 0.5mg sublingually for Walker but the nurse mistakenly administered the drug to Hiker. 36. Nurse Rana is liable to be charged with? A. tort B. non-maleficence C. negligence D. maleficence 42 37. Tess Tickle, a newly hired nurse was pulled out from the Pediatric Unit by the supervisor and assigned to surgical ward temporarily for the shift at 4 PM. She has to feed a post- operative patient who had a tracheostomy and NGT as well. The feeding was mistakenly infused to the tracheostomy instead of infusing it to the NGT. Tess Tickle can be liable for? A. malpractice B. negligence C. assault D. tort 43 38. Lucy Stoole is a staff nurse who was assigned in the medical ward. The physician ordered 20 units of insulin injection to a client with diabetes. Nurse Lucy administered 20cc of insulin instead. After 30 minutes, the client developed hypoglycemia and died. Nurse Lucy is liable for? A. tort B. malpractice C. negligence D. assault 44 39. A staff nurse was caught by her supervisor administering high doses of morphine to a patient with leukemia for a fee for P 25,000 given by the mother. The nurse is liable for? A. bribery B. assault C. malpractice D. tort 45 40. Nurse Mimi Imfurst is assigned to a cranky and demanding patient suffering from a peripheral neuropathy. One day the patient was chilling and needed blankets and a hot water bag (HWB). Nurse Mimi placed the HWB without cover and placed it directly to the patient’s foot. The patient suffered 2nd degree burns. Nurse Mimi may be sued by relatives for? A. breach of duty B. justice C. negligence D. malpractice 46 SITUATION 9 – Mr. Blake Deadly, 76 years old, a former chairman of the Board of Trustees of an academic institution had a severe chest pain and was rushed to the medical center by the members of the family. He was seen at the ER and was advised by the physician to be admitted. 41. After a comprehensive assessment and diagnostic tests, he was found out to have blockage of 2 coronary arteries. The wife and his 2 children, a nurse, and a doctor was trying to convince their father to undergo open heart surgery to relieve his discomforts. In this ethical decision, who should be followed? A. wife B. children C. patient D. doctor 47 42. The nurse observed that the dose of the PRN pain medication ordered by the physician to Mr. Blake Deadly is quite high for his age, so she suggested for a lower dose. What ethical behavior is being manifested by the nurse with this action? A. non-maleficence B. justice C. fidelity D. advocacy 48 43. Mr. Blake Deadly is on bed rest. When he uses the call bell for the nurse to assist him to be transferred to the commode and answered him to wait for 5 minutes and came on time is an example of what principle? A. fidelity B. non-maleficence C. maleficence D. advocacy 49 44. Identify the best method for a nurse to acknowledge a client's autonomy. A. Follow only the instructions of the client's family. B. Know and understand the state's laws that address living wills. C. Use the ethical principle of best interest when making decisions about the client's care needs. D. Incorporate the ethical principle of paternalism into all client care activities. 50 45. When considering legal issues the term "contract" is to "liable" as "standard" is to: A. Rights B. Negligence C. Malpractice D. Accountability 51 SITUATION 10 - You are a newly hired nurse in a tertiary hospital. You are required to attend an orientation activity on legal implications of nurse’s action. 46. You are aware that you need a license to practice nursing in the Philippines. Licensure is primarily required to protect which of the following? A. The patients under his/her care B. The school where the nurse obtained his/her nursing education and training C. The hospital where s/he is employed D. Nurses because they are vulnerable to lawsuits 52 47. The facilitators discuss negligence and malpractice. Which of the following factors is unique to malpractice? 1) There is a contractual relationship between the nurse and the patient 2) An inappropriate care is an act of commission 3) The patient is harmed as a result of care 4) The action of the nurse did not meet standards of care A. 1 & 2 B. 3 & 4 C. 3 only D. 1 only 53 48. The facilitator cites a situation. Nurse Rhea Aranged used a medical equipment improperly which harmed the patient. The nurse maybe charged with ____________: A. Assault B. Negligence C. Battery D. Malpractice 54 49. The facilitator gave an example of a nurse who gave the wrong medication to a patient. The result was severe allergic reaction. The nurse could be sued for __: A. Malpractice B. Negligence C. Battery D. Assault 55 50. The nurse could be sued for which of the following if s/he says to a patient, “If you don’t stop complaining, I will not allow you to see your family when they visit.” A. Battery B. Libel C. Negligence D. Assault 56 SITUATION 11 – The practice of nursing requires rules and regulations to ensure patient safety and competent level of behavior in the professional role as a nurse. The following questions are related to this statement. 51. Nurse Chloe Mydia attends a Halloween party dressed in white nurse uniform. She becomes drunk and begins talking about her colleagues in a demeaning manner. Which of the following will the nurse be considered? A. Not presenting a positive or professional image of a nurse B. A professional misconduct C. Someone who has the right to vent regarding her colleagues’ behavior D. Appropriate for the situation as it was a private party anyway 57 52. Two nurses, Nurse Cleo Torres and Nurse Sarah Vix, are talking about a specific client in the hospital cafeteria. These nurses are at risk of being accused of which of the following? 1) Professional misconduct 2) Gross incompetence 3) Behavior unbecoming of the profession 4) Breach of confidentiality A. 1,2,3 B. 1,2 C. 3,4 D. 1,3,4 58 53. If a patient to be discharged suggests to the nurse that she would like to get together again if she feels depressed, what should the nurse’s response be? A. Agree to meet with patient at her convenience B. Provide the patient with information about crisis centers C. Suggest they go to the gym together to exercise D. It’s okay as long as they meet in a public place 59 54. Keeping your promise as a nurse to a patient to return in 30 minutes develops? A. Closure B. Trust C. Sympathy D. Empathy 60 55. Nurse Sham Payne observes a patient driving his car. Nurse Sham Payne knows the patient has seizure disorder and his driver’s license has been suspended. What should Nurse Carlo do? A. Call the patient and ask whether he has been driving B. Follow the patient home and call the police C. Discuss the observation from the doctor D. Notify the police department of the observation 61 SITUATION 12 – Knowledge of legal terms, concepts, and accountability is very important to a professional nurse. These serve as guide for her personal as well as professional life. 56. You are assigned in the ICU of the Neurological Unit of the hospital. The attending physician ordered a one-on-one nursing care for his CVA patient. This means that the nurse? A. Can leave the patient’s bedside for a maximum of 10 minutes B. Must leave the patient to restock the medicine supply C. Can leave the patient’s bedside to do personal things only D. Must remain at the patient’s bedside until relieved by another one-on-one nurse 62 57. A sentinel event for a fractured patient undergoing hip replacement occurred in the Operating Room. The surgeon may be held liable for the incident under which of the following legal doctrines? A. Respondeat superior B. Captain of the ship C. In flagrante derelict D. Force majeure 63 58. You are a staff nurse in a government hospital. An administrative case was filed against you. Which of the following government agencies prescribes the mechanism for the investigation and punishment for your case? A. Civil Service Commission B. Professional Regulation Commission C. Civil Court D. Ombudsman 64 59. You are a staff nurse in a private hospital. Your co-worker, Nurse Terra Hymen, spreads malicious rumors against you. Which of the following agencies will you file the case of unprofessional behavior against Nurse Terra Hymen? A. Department of Labor B. Civil Service Commission C. Philippines Nurses Association D. Professional Regulatory Board of Nursing 65 60. You are a staff nurse in the Neurology Unit of the hospital. You failed to report to duty due to typhoon Odette that hit your places causing massive destruction. Whatever sentinel event that may happen at the time of your absence, you may be exonerated from any liability under the legal doctrine of? A. Justice B. Respect for person C. Captain of the ship D. Force majeure 66 SITUATION 13 – Nurses perform duties that require physical assessments, critical thinking, and collaborative treatment plans, to name a few. Thus, nurses must understand the laws that affect their practice, as well as their legal responsibilities in their professional roles. 61. A nurse must follow laws that protect public health, safety, and welfare. Which law is the nurse following? A. Code of Ethics B. Standards of Practice C. Continuing Professional Development D. Nursing Practice Act 67 62. Which situation supports the charge of malpractice against a professional nurse? A. A failure on the part of the nurse to establish a therapeutic relationship with the patient B. A failure on the part of the nurse to ensure that patients only received care for which they could pay C. A failure on the part of the nurse to exercise reasonable and prudent care in treating a patient D. A failure on the part of the nurse to allay a patient’s fears about an upcoming procedure 68 63. What does the court consider in determining the nurse’s legal liability for standards of care? A. Professional education, experience, and specific conduct B. Professional experience, but not education or conduct C. Professional conduct, but not experience or education D. Professional education, but not experience or conduct 69 64. The Board of Nursing has brought action against a nurse’s license based upon violation of a regulation. What is TRUE about this scenario? A. Rules and regulations are internal to the Board, not the nurse B. Rules and regulations are only suggested standard of care and do not have to be followed C. These rules and regulations have the force of law D. Violation of a rule or regulation is not the same as violation of the Nursing Practice Act 70 65. A patient, injured at work, was seen by the factory occupational nurse. The nurse treated the wound and instructed the patient to get a tetanus antitoxin injection at the City Health Center. The patient failed to follow instructions, developed tetanus, and subsequently filed a suit against the nurse. What is the most likely result of the ensuing trial? The nurse is: A. Liable, because there was no follow-up to ensure patient received the injection B. Not liable for damages, because the nurse has a right to expect that instructions will be followed C. Liable, because tetanus is easily treatable after diagnosis D. Not liable, because tetanus is a reportable disease and the health center should have insisted on the treatment 71 SITUATION 14 – Hanna Conda is 19 years old, a Grade 12 student. She recently confessed to Nurse Kendall Gender that she had sexual intercourse with her boyfriend (BF), 18 years old and a classmate of hers. She believes that she is pregnant because she missed menstruating for 3 months. She also related that her BF has recently been confined for pneumonia after an on and off flu-like symptoms. She suspects he has HIV because of his “closeness to a guy who has overtly expressed his feelings on him.” 72  66. Hannah Conda wants to know his BF’s real diagnosis even through a private message in Facebook. The following information that all employees are enjoined to observe strictly. I. Operate and hold diagnosis under strict confidentiality II. Sign a non-disclosure agreement between nurses and their patients III. Abide with the institution’s privacy and security policies IV. Disclose only the result of the test to the patient himself In terms of legalities, which of the following should Nurse Kendall Gender explain to Hannah? A. II,III,IV C. I,II,III,IV B. I,II,III D. I,II,IV 73  67. Nurse Kendall Gender can also explain the purpose of security measures for data protection which is to maintain the availability, integrity, and confidentiality of personal data of all patients. Which of the following actions of anybody is against personal data protection? I. Unlawful destruction II. Alteration III. Disclosure IV. Unlawful processing A. I,II,III B. II,III,IV C. I,II,III,IV D. I,III,IV 74 68. To erase the doubt of Hannah Conda as to whether she has been infected with HIV by her BF, what is the BEST advice of the nurse? A. Wait until you have access to the diagnosis of your BF B. Test for Elisa considering window period C. Wait until the baby is born D. Go for Elisa Test immediately 75 69. How long should personal data of an HIV patient be stored on laptops or other portable devices which permits his identification? For as long as? A. The patient likes B. His doctor likes C. It is needed as part of an international or national research D. It is necessary for the purpose for which it was collected and processed 76 70. In case the personal data of Hannah’s BF has been accessed accidentally by “somebody”, who has the right to file a complaint? A. Hannah’s BF B. The other guy C. The parents D. Hannah Conda 77 SITUATION 15 – The following situations are related to workplace ethical & legal practices. 71. Farrah Fadala, a registered nurse, has signed a contract for two years in a medical center. A recruitment agency has offered her a “fat” salary foreign employment. If you are in the position Farrah, what should you do? A. Discuss your plans with your parents. B. Accept the recruitment offer and go on absence without official leave. C. Write a resignation letter to your employer 30 days before leaving. D. Accept recruiter’s offer and give an excuse to employer on behalf of her “sick” mother. 78 72. Auntie Biotic, an RN, was invited as a resource person in a nursing conference. The curriculum vitae she submitted to the PRC Continuing Professional Development Council reflects the word Masters of Arts in Nursing (MAN) after her name. She only completed academic requirements but not her thesis writing. Which of the following did Ms. Auntie Biotic violate? A. RA 9173 or Nursing Law B. Code of Professional Ethics for Teachers C. Magna Carta for Health Workers D. Code of Ethics for Registered Nurses 79 73. What ethical justification is observed when administering opioids despite the possibility of hastening death? A. rule of double effect B. maleficence C. rule of single effect D. justice 80  74. While vacationing in a different province, the nurse encounters an emergency in which a person needs immediate care. What should the nurse assume about the Good Samaritan law? Select all that apply. I. A Good Samaritan law does not exist in the Philippines. II. The nurse has a legal obligation to provide emergency care. III. The nurse will be protected by the Good Samaritan law. IV. There is a standard definition of what constitutes an emergency. A. I, II B. I only C. I, IV D. II, III 81 75. A federal or state statute setting the maximum time period during which a certain action can be brought or certain rights enforced. A. statute of limitations B. privileged communication C. right against double jeopardy D. res ipsa loquitur 82 SITUATION 16 – Nurse Tough C. Logue is assigned in the medical ward for 7 years. He is well appreciated by his colleagues and patients because he intercedes with patient’s needs, has good decision-making ability, and respect the patient’s rights and cultural practices. He helps colleagues beyond the call of duty. 76. A patient who had craniotomy was referred by Nurse Tough C. Logue to DSWD because he has a problem on paying his unsettled hospital bill amounting to P 80,000. The relatives are afraid the patient will not be discharged soon. Which BEST describes the action of Nurse Tough C. Logue? A. Advocate B. Educator C. Caregiver D. Clinician 83 77. Nurse Tough C. Logue noticed a colleague taking frequent breaks, working over-time, inaccurate drug accounts and displaying inappropriate behavior during meetings and conferences. Nurse Tough C. Logue suspects her colleague is: A. a victim of domestic violence B. with personality disorder C. on substance abuse D. not mindful of work output 84 78. Nurse Tough C. Logue is assigned on night shift and noted a co-worker with a tourniquet wrapped around the upper arm. The co-worker is about to insert a needle attached to a syringe containing a clear liquid into the antecubital area. Greg’s initial action is to call the: A. nurse supervisor B. security guard C. physician D. watcher 85 79. Nurse Tough C. Logue made a conference with a preoperative patient on important data related to her illness. To practice confidentiality of information, Nurse Tough C. Logue MUST consider which of the following? A. Documents the process of conversation to serve as proof for future reference. B. Apply technology for easier and faster communication and documentation. C. Conducts conference in a private place where conversation is not heard. D. Invites others to interpret the discussion if patient is deaf or unfamiliar with the language. 86  80. A nurse is served with a summons alerting him that he has been named in a malpractice lawsuit. What information can the nurse learn from this summons? Select all that apply. I. breaches in standards of care, injuries, or damages alleged by the defendant II. expected length of the trial III. names of any other defendants in the case IV. name of the plaintiff in the case V. date to appear before the court A. I, II B. I only C. III, IV, V D. II, III 87 SITUATION 17 – You are a nurse manager of a tertiary hospital. One of your responsibilities is to keep a record of all patients admitted in the hospital. 81. You are aware of the importance of keeping hospital records. Which of the following statements is not true about hospital records? A. Provide data on health information system B. Are a key source of data for medical research or statistical reports C. Provide personal information about the physicians and nurses assigned to care for the patients D. Provide evidence of a hospital’s accountability 88 82. You are oriented on the hospital policy that when a patient is readmitted, the patient’s file may be retrieved from the hospital records department. From which file may a readmitted patient’s record be retrieved? A. Physician’s ledger B. Master patient index file C. Civil service file D. Hospital library records 89 83. You orient your staff on the common system used in recording nursing interventions. The system used is a nursing card index or Kardex. What information is not included in the Kardex? A. Drug regimen of the patient B. Allergies, if any, of the patient C. Progress notes of the physician D. Dietary requirements of the patient 90 84. A patient’s record contains information of the medications and treatments administered, and observations of the patient’s condition. Which of the following data must be filled up in the patient’s chart when he/she is discharged from the hospital? A. Religion B. Nursing diagnosis C. Final medical diagnosis D. Education attainment 91 85. You are familiar with the ethical aspects of patients and hospital records. Which of the following statements is not true? A. Health records are the property of the locality where the patient is treated B. Hospital records may be released without the patient’s consent when required in investigation for serious criminal offense C. Confidential records must be protected against loss, damage, unauthorized access, modification, and disclosure D. Patients have the right to confidential treatment of information they provide to health professionals 92 SITUATION 18 – You are a staff nurse in a government hospital. In the tour of your duty, you encounter situations that have legal implications. 86. Mrs. Tia Kofi, an older adult with Dementia fell from her bed because the nurse on duty did not install the side rails. Which of the following criteria can establish a malpractice lawsuit against the nurse? A. The nurse owed a duty to the client B. The nurse on duty did not follow the protocol on the standards of care on the use of side rails C. The nurse on duty followed the protocol on the use of siderails D. The patient was not injured 93 87. Upon entering a patient's room to complete discharge instructions, the nurse discovers the patient in tears. The business office has stated that the patient cannot leave until someone pays a portion of the hospital bill. What should the nurse do? A. call social services to request an immediate financial evaluation B. continue preparations for discharge, comforting the patient as much as possible C. stop discharge preparations until the patient is cleared by the billing office D. cancel the discharge plans and notify the physician of the patient's status 94 88. You tell Mr. Brad Winner, “I will give your injection now, Mr. Brad Winner” He holds out his arms to you which means Mr. Brad Winner is giving/not giving you his? A. Permission B. Written consent C. Consent D. Implied consent 95 89. Which of the following is not a factor to be verified for a consent to be valid? The person giving the consent must? A. Be legally an adult B. Be mentally and physically competent C. Have a diagnosis of a communicable disease D. Be giving it voluntarily 96 90. Criminal charges have been brought against a nurse who made a medication error that resulted in a child's death. Which level of evidence is expected in this case? A. evidence beyond a reasonable doubt B. clear and convincing evidence C. discovery evidence D. preponderance of evidence 97 SITUATION 19 – As a new licensed nurse, you deem it appropriate to continuously gain competence in your professional practice and to enhance your personal growth. 91. Which of the following is the most important attribute of a true professional? A. Personal graces B. Critical thinking C. Assertiveness D. Self-regulation 98 92. You are committed to improve your competence in order to provide safe and quality care to your patients. Which of the following run counter with this personal desire? A. Participating in the activities of the professional nursing organization B. Taking the foreign examination for nurses as preparation to working abroad C. Joining the health workers’ union in your hospital and attending their safety education classes D. Attending relevant continuing education development programs 99 93. Which of the following situations do you consider your primary responsibility while performing your nursing duty? A. Attend to the call for help of a patient who needs total nursing care B. Assist the doctor in making rounds C. Delegate to the nursing assistant vital signs taking D. Answer the telephone call of the attending doctor 100 94. You have a professional duty to be a member of the accredited organization of nurses. This organization has the mission to undertake the following, except? A. Advocate for favorable policy positions to relevant government agencies B. Initiate public discussion on health issues and the nursing profession C. Explore foreign labor market for employment of Filipino nurses D. Adopt measures for the improvement of nursing practice 101 95. You dream of pursuing a career of becoming a clinical faculty. Which of the following qualifications is not mandatory? A. Member of good standing in the accredited professional organization B. Must have one year clinical practice in a field of specialization C. Must have five years of clinical practice in the field of nursing D. Be a registered nurse in the Philippines 102 SITUATION 20 – Below are situations which have some ethico-moral and legal implications to you as a professional nurse. 103  96. A plaintiff's attorney decides to use the doctrine of res ipsa loquitur in a case against the urologist who perforated a patient's urethra during a cystoscopy. What must the plaintiff prove? Select all that apply. I. This complication doesn't generally occur unless someone provided negligent care. II. The locality rules were in effect at the time of the procedure III. Several agencies, from the manufacturer to the physician, were involved in the negligence IV. The plaintiff had no control over the development of the perforation V. The event causing perforation was deliberate A. I, II C. III, IV, V B. I, IV D. I, III 104 97. You have a neurologic, elderly patient who needs to sign an informed consent for a lumbar puncture. You have doubts about the patient’s level of comprehension. Which of the following nursing actions is the most appropriate for this situation? A. Let the nearest relative sign the document B. Do not let the patient sign the informed consent and notify the attending physician C. Let the patient sign it as it is his right to be informed D. Let the head nurse sign the informed consent 105 98. Which nursing action is a violation of patient’s right to privacy? A. Knocking before entering the patient’s room B. Draping the patient appropriately during procedures and treatment C. Accessing patient’s electronic data D. Keeping the door of the patient’s room closed 106 99. You are a staff nurse in a regional military hospital in Western Mindanao. You overheard an involuntarily committed patient talking over the phone about the plot to assassinate the President. You reported this to the Commanding Officer of the Regional Command of the Philippines Army. The nurse was reprimanded for? A. Conduct unbecoming of the professional nurse B. Breach of confidentiality C. Violating of patient’s human rights D. Reporting an unverified information 107 100. The colloquial statement, “The nurse was given her day in court”, means that the nurse was given a/an? A. Opportunity to present her side B. Opportunity to present evidences C. Chance to be heard D. Due process 108 SITUATION 21 – The following questions deal about the nurse’s ability to manage legal issues. 101. Which situation supports the charge of malpractice against a professional nurse? A. a failure on the part of the nurse to allay a patient's fears about an upcoming procedure B. a failure on the part of the nurse to ensure that patients only received care for which they could pay C. a failure on the part of the nurse to establish a therapeutic relationship with the patient D. a failure on the part of the nurse to exercise reasonable and prudent care in treating a patient 109 102. A lawsuit has been filed claiming that a nurse's actions caused the death of a neonate. Why does the attorney for the plaintiff want to prove proximate cause? A. proximate cause determines how far the nurse's liability extends for consequences of the alleged negligent actions B. the need for expert witnesses is eliminated because harm can be approximated C. a direct line of causation, from incident to injury, is proved D. to identify if the harm could have been predicted to result from the action of the defendant 110 103. A caller becomes irate when the nurse cannot provide information over the telephone about a hospitalized friend. The caller says, "If you know what is good for you, you had better tell me." Has a civil assault occurred? A. yes, there is an indication that the caller has the physical strength to do harm B. yes, the threat of harm is assault C. no, actual physical contact must be made for it to be assault D. no, the caller cannot reach the nurse 111  104. Hospital administration requires that the committee seeking to change nursing policy and procedures review external sources for these standards. Where should the committee look for these standards? Select all that apply. I. current nursing literature II. individual nurse's experience and education III. international nursing standards IV. the hospital's position job descriptions V. nurse practice law A. I, III, & V only C. I & III only B. II & IV only D. I & V only 112  105. In which scenarios would the nurse assume that apparent consent has been provided? Select all that apply. I. the patient follows directions to swallow sips of water as the nurse inserts an NG tube II. the patient's family member signed the consent to treat III. the patient smiled and held out his arm when the nurse said, "I need to start an IV line" IV. the patient voluntarily signed a consent form for an invasive procedure V. an unconscious patient is brought to hospital following a car accident A. I, III, & V only C. I & III only B. II & IV only D. I & V only 113 COMPLETE THE TABLE by filling up the spaces with the corresponding number of credit units per CPD activity program under RA 10912. ACTIVITY PROGRAM NO. OF CREDIT UNITS Resource Speaker for a program under the Professional Track In-service training Panelist for a program under the Professional Track 114 Master’s degree Professorial chair Residency / externship Post graduate diploma Author of a technical/research paper published in a local journal Peer reviewer 115 Article in magazine or newspaper Medical mission and outreach programs Lifetime achievement awardee Invention 116 SITUATION 22 - Nurse Bini Gnit plans to enhance her personal and professional development 106. Choose an indicator that models personal and professional behavior and values. A. Utilizes communication and social media responsibly B. Attends conference C. Enrolls in school D. Joins civic organization 117 107. Nurses should have knowledge about professional organization. Which of the following is the accredited professional organization of nurses? a. Maternal child nursing b. Philippine Nurses Association, Inc. c. National League of Government Nurses of the Philippines d. Association Nursing Service Administration of the Philippines 118 108. A profession is characterized by the following except: A. Body of knowledge B. Code of ethics C. Member of professional organization D. Engages in research 119 109. Which of the following is an example of self-directed learning activity? A. Research at work B. Attends webinars C. Attendance to graduate school D. Resource person 120 110. Aside from attending seminars, all of the following are informal continuing education programs Nurse Bini Gnit may engage herself EXCEPT: A. Attending professional conventions B. Webinars C. Symposium D. Doing research as academic requirement 121 SITUATION 23 - Nurse Chad Michaels is fully aware that being a public health nurse requires that his work is guided by ethico-moral principles. 111. Which is the MAIN goal of ethical practice of the nursing profession including the community setting? A. To protect the nurse and co workers B. To prevent reprimand from physicians C. For the patients family satisfaction D. Centered on the welfare of clients and protect their rights 122 112. As a public health nurse, Nurse Chad Michaels makes sure all the supplies and medicines needed for the care of community are available. This is an example of the principle of ___________________. A. justice B. respect C. fair treatment D. beneficence 123 113. Select nurses’ action in keeping with principle of confidentiality. A. Hides identity of patient B. Shares information from patient chart in public C. Keeps all matters about the patient as a secret D. Discusses the case of patient with others 124 114. Nurse Chad Michaels is always guided by the principle of beneficence in all that he does to his patients. Which of the following nursing actions is aligned with principle of the beneficence? A. Equal and fair allocation of resources to all B. Getting informed consent C. Keep records of patient from public viewing D. Promoting patients safety at all times 125 115. Nurse Chad Michaels tap all the newly hired nurses to be members of her new project. She is observing the ethical principle of _____. A. justice B. autonomy C. nonmaleficence D. respect 126 SITUATION 24- At present the public knows their rights in health care. Nurse Anne Lee Rice should be confident and safe in the practice of her profession. 116. Nurse Anne Lee Rice has a complaint from a patient for administering the wrong dose of vaccine to the child. The act is a form of: A. battery B. assault C. negligence D. malpractice 127 117. When nurse Ace submitted a report to the physician that she committed an error in medication. This is an example of ______. A. Responsibility B. Accountability C. commitment D. delegation 128 118. Who among the following is the BEST of sign an informed consent during a surgical procedure of a child? A. The 26-year-old brother who is a drug addict B. The father who is 40 years old and illiterate C. The sister who is 21 years old and undergoing dialysis D. The mother who is 35 years old with seizure disorder. 129 119. A nurse administers an extra dose of vaccine to a child and the patient developed adverse reaction and died. She can be sued for ____. A. Negligence B. Malpractice C. tort D. battery 130 120. A patient was for transfer to a tertiary hospital because of severe asthma, but the nurse does not prepare the patient right away and the patient dies. Which of the following the nurse is liable? A. Malpractice B. Assault C. murder D. battery END OF MATERIAL BELIEVE YOU CAN AND YOU ARE HALFWAY THERE. 131 1 SITUATION 1 - Controlling is a management function in which performance is measured and corrective action is taken to ensure the accomplishment of goals. 1. What is the PRIMARY task of the nurse manager to have an effective control system? A. Make an interpretation about strengths and weaknesses B. Identify structure, process, and outcome standards. C. Measure actual performances D. Identify corrective action. 2 2. Which of the following is NOT included in the controlling process? A. Discipline of personnel B. Performance appraisal C. Quality assurance D. Staff scheduling 3 3. Controlling is effective when? A. Physicians are contented B. Clients are satisfied C. There is an increase in admission D. Goals, objectives & plans are accomplished 4 4. Which of the following characteristics of standards is NOT included? A. They are subjective measurements B. They are established by authority C. They need to be accepted by people affected by them. D. They are predetermined 5 5. Among the following standards, which is considered a structure standard? A. All patients have their vital signs taken and recorded B. Clients verbalized satisfaction of the nursing care received. C. Staff mix and number are determined by the PHN supervisor. D. Health teaching are provided to pre-natal mothers 6 SITUATION 2 - During a staff meeting in the Intensive Care Unit, the nurse manager reported a list of procedures that need to be reviewed and updated. One of these procedures is the precautionary measures related to ventilator- associated pneumonia. 6. While brainstorming, the group mentioned the use of evidence-based methods. Which statement does not refer to this? a. “Let us ask for the preferences of our patients.” b. “Review of related literature will be very helpful.” c. “The experiences of the nurses must be obtained.” d. “We must agree on a common procedure.” 7 7. The nurse manager assigned a group to develop a project intended to improve the existing procedure related to the prevention of ventilator-associated pneumonia among ICU patients. A team leader was selected by the group. Which of the following will the team leader do FIRST? a. Tell the group to state their objectives. b. Set a target. c. Formulate a list of desired outcomes. d. Delegate tasks to each member of the group. 8 8. Which of the following data will be MOST helpful to the group to ensure continuous process improvement? a. Non-conformances to suctioning procedure b. Incidences of ventilator associated pneumonia during the last month c. Experiences of nurses when managing care of intubated patients d. Documentation of observations of intubated patients 9 9. Which of the following actions of the team leader reflect organization? The team leader: a. Assigned tasks to each member b. Checked assignments of each group member c. Eliminated non-performing members d. Determined which actions will be done first 10 10. The group developed revisions to existing procedure. Before the procedure could be implemented as a standard procedure, which of the following will be done FIRST? a. Gather relevant data. b. Plan for implementation of the procedure. c. Check if procedure is effective via feedback. d. Do the procedure on selected patients. 11 SITUATION 3 – Nurse Chapell is a manager of a medical unit in a tertiary hospital. She is responsible for the supervision of staff nurses and other health care personnel. 11. Nurse Chapell reminds the nursing staff to safeguard and improve the quality of care given to the patients. Which is a PRIORITY to safeguard nursing practice? Nurses should ________________. A. know their strengths and weaknesses B. understand their professional, legal and ethical obligations and responsibility. C. document care accurately D. practice nursing competently 12 12. Nurse Chapell in collaboration with maintenance personnel prepares a safety program which includes periodic inspections of electrical equipment, conduct of fire drills and proper disposal of hazardous wastes. Which component of a quality program do these activities illustrates? A. Quality Improvement Program B. Quality Assurance Program C. Total Quality Program D. Risk Management Program 13 13. Nurse Chapell reviews a report on the number of patients who slipped on a wet floor and other forms of fall incidents. Which is an APPROPRIATE approach for Nurse Chapell to manage the situation? A. Apply risk management principles B. Implement a system approach C. Implement Quality assurance measure D. Apply total quality management principles 14 14. Nurse Chapell receives a report that Nurse Roan administered a drug incorrectly to a diabetic patient who needed more than one type of insulin. Nurse Roan’s action however did not cause a negative effect on the patient. Which is the most appropriate action for Nurse Chapell to take? A. Instruct Nurse Roan to write an incident report. B. Refer the nurse to the quality assurance committee of the hospital. C. Report Nurse Roan to the attending physician. D. Refer the nurse to the risk management committee of the hospital. 15  15. A patient is admitted for episodes of seizures. Sometimes during the night, the patient fell off from the bed. The night nurse found the patient on the floor. Nurse Beyonce instructs the night nurse to explain what happened. Which of the following BEST describes an incident report? An incident report _______. I. serves as a record of facts surrounding the event II. identifies the people involved, the date, time, and location of the event III. is a part of the patient’s medical record IV. can be used in a court of law A. II, III, IV C. I, II, IV B. I, III, IV D. I, II, III, IV 16 SITUATION 4 – You are employed as a staff nurse in a tertiary government hospital in Quezon City and had a training program with the Red Cross on Disaster Preparedness Management before deciding to work back home in Bukidnon. One day, there was a strong typhoon that hit your place. 17 16. You are assigned in the surgical ward with 10 patients and across your ward is the Pediatric Unit with 12 patients, but their nurses did not report for duty. Your immediate supervisor ordered you to cover both units temporarily. Which of the following priority actions should you do in this situation? A. Identify and cluster patients according to their needs B. Request the watchers to assist you with patients on ventilators C. Ask if you can go home early, so you can help your family too D. Call the medical director to augment the staffing with more nurses 18 17. Your supervisor is aware that you have a previous experience in the Pediatric Unit. She instructed you to take care of the children while she will take care of the surgical patients. How should you respond? A. Accept this assignment as you have the competency to take care of the children B. Do not accept this assignment as the Pediatric Ward is in disarray and patients are with varying illnesses C. Do not accept responsibility as there is a possibility for you to commit a mistake D. Argue with your supervisor that this is not correct as your nursing license will be at stake 19 18. After a week, the medical director has organized an assembly to recognize the health care personnel who were on duty during the typhoon incident. You were given a certificate of appreciation and a trip to Tagaytay for an advanced training on Disaster and Preparedness program. This incentive is a form of? A. promotional activity B. personal and professional development C. personal and research development D. quality improvement 20 19. In line with your career pathway, you decided to enroll in the graduate program leading to clinical specialization. You were offered to become a staff-development coordinator by the chief nurse. What is your appropriate response to this offer? A. accept the job as this is a promotion you have been waiting for B. accept the position right away even without a written contract C. talk to the chief nurse, and inform her you are still finishing your graduate studies D. do not accept offer as this will entail a lot of responsibilities 21  20. Management of resources is a core competency that must be developed by every graduate nurse in the health care facility. Which of the following are the key elements that will facilitate effective and efficient health care? I. workload of staff II. financial resources III. positive practice environment IV. proper functioning of equipment A. I, II, III, and IV C. I, II, and III B. I and III D. I and II 22 SITUATION 5 - Leadership in the community is a basic requirement for people in barangays need direction for them to become self-reliant in the future. 21. The nurse is reviewing another model for depicting leadership called the managerial grid. She is correct in saying that which leadership style promotes low employee satisfaction and low organizational output? A. Country Club C. Impoverished B. Produce or perish D. Middle of the Road 23 22. Research on managerial attitudes identified that which approach emphasized attention to the people’s needs to affect the satisfaction of relationships? A. Authority-obedience C. Organization man B. Team D. Country club 24 23. If you applied the concepts of Theory Y to describe nurses, which would best describe it? A. Nurses prefer to be directed and want job security more than other things. B. Nurses use self-direction and self-control to achieve work objectives. C. Nurses have a hard time accepting tasks, but they learn to do this over time. D. Nurses don’t really want to work and would quit if they could. 25 24. Before she makes a request, the nurse leader comments on how suitable the uniforms are of the staff and how pleasant the “aura” of the staff is. The nurse leader is practicing which strategy of influence? A. Rationality C. Upward Appeal B. Ingratiation D. Coalition 26  25. Interpersonal strategies that are useful in helping the nurse develop collegial relationships include which of the following? I. Integrity IV. Dependence II. Internalizing V. Sense of humor II. Respect A. I, II, & III only C. I, III, & V only B. I & III only D. III only 27 SITUATION 6 - Nurses working on the Medical Unit are experiencing difficulty stabilizing the client’s nasogastric tube. In order to offer the client’s best choices of care the nurses should do data gathering. 26. Before data gathering which of the following should be initiated by the nurse? a. Secure consent from the clients for their involvement b. Begin with a concept and seek how to implement the concept into client care c. Develop the question or problem statement that best defines the need d. Organize a team to conduct the study and obtain their commitment 28 27. The next step that nurses should do is to: a. Define the problem b. Analyze extant literature c. Formulate framework d. Secure evidence 29 28. Following the review and evaluation of the date, the nurses should: a. Recommend measures to meet the need b. Choose the most relevant information c. Extrapolate information d. Decide the level of evidence 30 29. With the information obtained and to promote evidence-based practice the nurses should: a. Make recommendation and apply it to NGT practices in the unit b. Apply findings to client with NGT c. Conduct a pilot study to selected clients in several units of the hospital d. Communicate findings to nurses in the other units 31 30. Following the success in stabilizing NGT tube in their unit, the nurses share the literature found on NGT stabilization with nurses in the intensive care unit. In order to reflect currently published knowledge, which of the following appropriate actions should critical care nurses do? a. Conduct similar research in the intensive care unit b. Review all the studies, summarize findings and completely revise NGT stabilization policy c. Gather enough evidence to substantiate the findings of nurses in the medical unit d. Revise practice-based guidelines and procedures of clinical intervention 32 SITUATION 7 - According to Peter Drucker “Management is doing things right.” Resource management is the process by which the manager manages their resources effectively. These resources can be intangible (people and time) and tangible (equipment, materials, and finances). It involves planning so that right resources are assigned to the right tasks. 33  31. Currently, patients in the unit are bathed in the morning between 8 to 11 in the morning. The nursing staff is considering changing the schedule to bathing the patients in the evening between 7 to 9pm. Which statement reflects an assumption that might affect the nursing staff’s ability to think critically about the change? I. “The day shift just wants to shift work onto the evening shift.” II. “Everyone likes to bathe right before bed.” III. “If we let them change this, they will want to make lots of other changes” IV. “I read a research article that reported that clients sleep better if they have been bathed right before bedtime.” A. III, IV C. I, II, III B. II, III, IV D. I, II 34 32. A serious disagreement has arisen between two staff nurses. The head nurse chose not to make a decision regarding the disagreement until more evidence is collected. Which part of the nursing process does this head nurse’s critical thinking reflect? A. Evaluation C. Planning B. Assessment D. Diagnosis 35  33. A nurse supervisor who is retiring is helping the new supervisor learn about the position. As part of this education, the current supervisor makes all the decisions that can be made under certainty. What conditions will these decisions have in common? I. There is a risk associated in decision II. The alternatives are known III. The conditions of each alternative are clear IV. The decision is complex and dynamic A. I, II C. III, IV B. II, IV D. II, III 36  34. A disagreement has arisen between two staff nurses. Both have discussed the situation with the head nurse. The head nurse feels that the problem is likely self-solving. How should the head nurse approach this situation? I. Allow sometime to pass to see if the situation resolves II. Support both nurses as they work thru this issue III. Provide any resources the nurses may need to help solve the problem IV. intervene if the problem begins to affect client care A. II, III, IV C. I, IV B. I, II, III, IV D. I, II, III 37  35. Which statement by a formal leader of a surgical unit reflects the personality required to energize the staff and promote creativity? I. “This is the decision I have made, and there is no room for discussion.” II. “I would like to thank everyone for you hard work and dedication while we have been short staffed.” III. “I am certain that our new assignment system is going to make workload more equitable.” IV. “I know this week has been rough.” A. III, IV C. I, II, III B. II, III, IV D. I, II 38 SITUATION 8 - If managers are to direct employees effectively and maximize other resources, they must first be able to find the time to do so. In other words, both must become experts at time management. 36. One of the most precious commodities of a nurse manager especially in the community is time. Why? A. People cannot buy time since it is priceless. B. The manager’s time is limited. C. Time lost is lost forever and can never be recovered. D. More time rendered for work means higher salaries. 39  37. What are aspects of good time management? I. increased productivity II. decreased stress II. ensure high income IV. appropriate prioritization V. enhance satisfaction with care provided A. All except III C. All of the above B. All except II D. All except V 40 38. The first step in time management is: A. Allow time for planning, and establish priorities. B. Complete the highest-priority task whenever possible, and finish one task before beginning another. C. Reprioritize based on remaining tasks and on new information received. D. Develop job descriptions. 41 39. Which of the following is a time waster coming from an external source? A. Procrastination C. Failure to plan B. Socializing D. Lack of objectives 42 40. A Gantt chart is one of the most popular and useful ways to handle the manager’s time. All statements are true, EXCEPT: A. Usually, on the right of the chart is a list of the activities and along the top is a suitable time scale. B. This chart is commonly used in project management. C. Each activity is represented by a bar; the position and length of the bar reflects the start date, duration and end date of the activity. D. The first thing the manager needs before setting up a Gantt chart is a detailed project plan. 43 44 SITUATION 9 - Professional and personal developments are required in order to maintain and enhance professional standards and to provide quality, competent, and safe patient care. 41. Identify the element that is the BEST indicator of increasing accountability in the profession of nursing: A. Increasing salary scale for nurses B. Improved public image of nurses in social media C. Increasing number of nurses with doctoral degree D. Demonstration of competency and high-quality care 45 42. Which of the following is the MOST important element in nursing’s attempt to gain full autonomy of practice? A. Maintaining the education system for nurses as it is now B. Economic well-being and welfare of nurses C. Restricting the latitude of decisions made by nurses D. Gaining and maintaining control of nursing practice by nurses 46 43. The nurse manager is reviewing information about power to include in a staff presentation on empowerment. Which type of power does the manager possess? A. Reward C. Referent B. Expertise D. Legitimate 47 44. What allows a nurse to exert legitimate power over a client when providing nursing care? A. The ability to perform procedures to alleviate patient’s discomfort B. The ability to provide the client and family incentives and for self-care C. The power given to the nurse by reason of licensure examination and registration D. The establishment of a professional and personal relationship with the client 48 45. A nurse is employed by a health care agency that provides an informal training session on how to properly use a new vital sign monitor. Which type of education did the nurse receive? A. Career counseling B. Continuing education C. Pre employment education D. In-service education 49 COMPLETE THE TABLE. Recalling your knowledge on LEADERSHIP STYLES, complete the table below by putting an X mark on the correct style of leadership listed on the first column. AUTOCRATIC DEMOCRATIC LAISSEZ- FAIRE Dictatorial & authoritative Highest degree of leader control Highest degree of staff freedom 50 Best used when the staff are experts “Let others decide” Decides with the group Best used in crisis Conducive to use in emergency departments 51 SITUATION 10 – The Public Health Foundation, an NGO, defines quality improvement in public health as “the use of a deliberate and defined improvement process, such as the PDSA which is focused on activities that are responsive to community needs and improving population health.” Public Health Nurse Billie learned this management process during her undergraduate studies in Nursing. 46. The acronym for PDSA stands for? A. Plan-Do-Study-Act B. Program-Design-Seek-Act C. Plan-Draft-Staff-Act D. Prepare-Do-Show-Act 52  47. Nurse Billie will use the PDSA when: I. Working towards continuous improvement II. Implementing any change III. Developing a new design of a process or service IV. Completing a designed project V. Planning data collection and analysis to prioritize problems A. I, II, IV C. I, III, IV, V B. II, III, IV D. I, II, III, V 53 48. Using the PDSA cycle as a model for defining most of the work processes, the following are some areas of its applications, EXCEPT: A. Needs analysis B. Overall strategic planning C. Staff goal setting and evaluation D. Delegation of work to lower levels 54 49. Nurse Billie knows that the purpose of continuous quality improvement is to? A. Provide opportunity for staff members to participate in self-governance B. Restructure health care delivery to improve cost savings C. Deliver appropriate nursing care at tertiary level of service D. Monitor processes involved in the provision of save, effective client care 55 50. To perform the PDSA cycle, Nurse Billie will resort to the use of specific tools for continuous quality improvement, which includes: 1) Flowcharts 2) Regression analysis 3) Cause and effect diagram 4) Pareto chart 5) Run Chart A. All except 5 C. All except 4 B. All of the above D. All except 2 56 SITUATION 11 – Lizzo, head nurse at the OB-DR ward, is planning to have an in-service training for 25 staff nurses. Based from needs assessment, the training will be about essential newborn care for 3 days. 51. In order to make the activity a success, which of the following resources would be MOST important? A. Number of speakers B. Location of venue C. Number of participants D. Budget allocation 57 52. Which of the following resources should be requisitioned as TRAINING MATERIAL/SUPPLY? A. Bond paper C. Food and drinks B. Sound system D. Tables and chairs 58 53. Based from studies, which among the following is the MOST needed resource of nurses in order to attend in-service training programs? A. Clothes C. Drinks B. Time D. Notebooks 59 54. Evaluation of the training is an important form of feedback in order to improve future offerings. Which of the following should be given MOST emphasis? A. Taste and amount of food served B. Discipline of participants C. Convenience of the venue D. Knowledge and skills gained 60 55. When asking mothers to become real models for demonstrating breastfeeding, the nurse’s MOST important responsibility is which of the following? A. Word of thanks C. Priority care B. Stipend/honorarium D. Free services 61 SITUATION 12 – Mr. Sam Smeth, a post-operative patient, was given amoxicillin at midnight by the nurse on duty (NOD). The physician asked the patient during his rounds if he has received the drug and the patient answered, “No.” The physician clarified the claim from the chart and the NOD. 56. 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 62 57. Which is the primary reason why the physician wanted to clarify? A. Measures the turnaround time of medication B. Better communication with the patient about the results of care C. Identify the gap in medication administration D. Improve care management in drug administration 63 58. While the medical director is conducting his rounds, he observed the presence of scattered supplies and equipment along the corridor as well as O2 tank not properly secured. The Quality Circle (QC) team was informed about this observation. Which of the following is the BEST strategy 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. 64 59. The approach adopted by the 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 C. Process flow chart B. Radar chart D. Gantt chart 65 60. 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 66 SITUATION 13 – Sabrina is assigned as charge nurse at the Obstetrical ward in a Medical Center. There are 20 patients, classified as follows: 2 total care (TC), 1 partial care (PC) and 9 ambulatory care. The ward’s morning duty are 3 staff nurses and 2 nursing assistants. 67 61. How will Sabrina distribute the patients to the 3 Registered Nurses and 2 Nursing Assistants? A. 2 Registered Nurses for Total Care Patients, 1 Registered Nurse and 1 Nursing Assistant for Ambulatory Care Patients B. 1 Registered Nurse and 1 Nursing Assistant for Total Care Patients, 1 Registered Nurse and 1 Nursing Assistant for Partial Care patients, 1 Registered Nurse for Ambulatory Care Patients C. 2 Registered Nurses for Total Care Patients, 2 Nursing Assistants for Partial Care Patients, 1 Registered Nurse for Ambulatory Care Patients D. 1 Registered Nurse for Total Care Patients, 1 Registered Nurse and 1 Nursing Assistant for Partial Care Patients, 1 Registered Nurse and 1 Nursing Assistant for Ambulatory Care Patients. 68  62. In as much as this is an Obstetrical Ward, what basic equipment/materials should be always available? I. Doppler monitor II. Stirrups III. Oxygen source IV. Intravenous stand A. I, II, & IV only C. I, II, & III only B. I, II, III & IV D. I, III, & IV only 69  63. Which of the following emergency medicines should be available at the emergency cart at the labor room? I. Oxytocin II. Calcium gluconate III. Magnesium sulfate IV. Lidocaine A. I & III only C. II & IV only B. I & IV only D. III & IV only 70  64. When stocking fluids in the emergency cart, what should Nurse Sabrina instruct nurses? I. Put the recently-delivered at the back of the old stock. II. Put the old stock in front of the newly- delivered ones. III. Check the fluids for sediments and discoloration. IV. Keep the fluids inside a cooler. A. I & II only C. III & IV only B. II & IV only D. II & III only 71 65. How will Nurse Sabrina arrange the patients in the ward? 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’ station and the Ambulatory Care farthest. D. Ambulatory Care patients near the Total Care ones. 72 SITUATION 14 – You are a newly promoted charge nurse of a department in a tertiary hospital. You review management concepts to prepare you for the position. The following questions pertain to management of resources. 73  66. You are oriented on health care economics. The study of economics focuses on how choices are made to overcome a scarcity of resources. Which of the following statements best illustrated health care economics? I. Providing less health care services that is optimal in order to contain costs II. Using individual with less knowledge and skill to perform health care services usually performed by people with advanced knowledge and training II. Taking economic risks as a health care provider IV. Providing adequate or appropriate care minimize risk of expensive utilization A. I and II C. I and IV B. III and IV D. II and III 74 67. Which of the following statements is true regarding health care economics? A. Contemporary health care is characterized as a business struggling to balance cost and quality B. Profit in health care is synonymous with billing privileges C. Health care economics is a new concept in nursing D. Health care is becoming affordable and clients are demanding quality care 75 68. You understand that a key factor that influence client care is the cost involved in the delivery of health services. Which of the following resources is not required to support the services delivered by nurses? A. Time C. People B. Client’s environment D. Equipment 76 69. You are aware that there is a need for you to understand how to manage the cost of client care as it relates to clinical practice. Which of the following are nurses accountable for? A. Decision regarding cost effective practices B. The client’s hospital charges C. Distribution and consumption of resources such as time, supplies, drugs, staff, and personnel D. Financial viability of nursing department 77 70. While touring the department where you are assigned, you noticed that the supply room is stacked with medical supplies and equipment. Which of the following is the best action you will take? A. Create a task force to assess the situation and report the findings B. Take an inventory of the supplies and equipment C. Request maintenance to sort out the supplies and check the medical equipment to determine if they are still functional D. Call for a staff meeting and discuss how best to utilize the available resources 78 SITUATION 15 – The head nurse of a trauma unit introduces changes to improve the quality of care of trauma patients. 71. The head nurse presented a set of goals to the staff nurses. Which of the following goals is not relevant to improving quality of care? No ____: A. Legal suits B. Needless deaths C. Waste of resources D. Needless pain or suffering 79 72. The head nurse reviews reports on nurse staffing. The following findings result to better patient outcomes EXECPT: A higher____ A. Nurse to patient ratio shorten lengths of patient stay in the hospital B. Nurse to patient ratio results to reduced patient mortality C. Number of nurses, infection rates fall D. Nurse to patient ratio increases costs 80 73. The head nurse determines to reduce medication errors in the trauma unit. She recognizes that medication errors often occur in relation to the following EXECPT: A. Preparing the wrong concentration and administering the medication via the correct route B. Failure to question unclear medication errors C. Lack of knowledge about a medication D. Failure to identify non-therapeutic client responses 81 74. The head nurse suggests that to reduce medication errors, several measures will be instituted. Which of the following is most appropriate? A. Use point-of-care technology to access drug reference information B. Use of drug index C. Nurses must help educate patients and their families regarding proper medication administration D. Patients must become more involved in managing their care 82 75. The head nurse is aware that managing and improving quality care in the trauma unit requires which of the following? A. Personalized attention to patient’s needs and their families B. A blame-free environment C. All of the choices D. A clean and orderly trauma unit 83 SITUATION 16 – Nurse Sza is a nurse manager of a trauma unit. She supervises the staff nurses and regularly holds conferences with them and other unit personnel. In one meeting, she reorients the staff nurses on their various functions. She cites clinical situations related to a nurses’ dependent, interdependent, independent, and collaborative functions. 76. An interdependent function of a nurse is when the nurse _________: A. Irrigates a feeding tube that appears obstructed B. Gives ice chips to a client who has an order of NPO C. Applies a dry sterile dressing to an abdominal incision D. Helps a client choose foods rich in protein from an ordered diet 84 77. A nurse decides to give a partial bath to a client instead of a complete bath. The nurse is working ______: A. Independently C. Dependently B. Interdependently D. Collaboratively 78. A nurse works with a skin care team. The nurse is functioning __________: A. Dependently C. Independently B. Interdependently D. Dependently 79. Nurse Sza initiates a visit from member of the clergy for a terminally ill client. The nurse is functioning ______: A. Interdependently C. Independently B. Collegially D. Dependently 85 80. When a nurse uses a straight catheter to obtain a urine specimen for laboratory test, the nurse is functioning ________: A. Dependently C. Independently B. Interdependently D. Collegially 86 SITUATION 17 – The nurse’s work environment plays a vital role in her ability to provide quality patient care. Inadequate resources in health care and unhealthy conditions in the workplace results to nurse’s work stress. 81. Burnout is a phenomenon that is best characterized by? A. Emotional exhaustion, depersonalization, and reduced personal accomplishment B. Growing dissatisfaction among nurses due to changing career expectations C. Increased absenteeism and fast turnover of nurses due to toxic work environment D. Conflict between demands of work & family 87 82. A common response to unhealthy work environment is physical tension. This can be overcome by progressive muscle relaxation, which basically involves? A. Focusing on an image to relax B. Active physical exercise like aerobics C. Releasing muscle from tension D. Listening to a relaxation audio program 88 83. Bio-behavioral interventions are being used increasingly by both nurses and patients in stress management. The following are examples of such interventions, EXECPT? A. Progressive muscle relaxation B. Pharmacotherapy C. Guided imagery D. Mindful meditation 89 84. Ace, a young overweight nurse, is smoking 5 to 10 sticks of cigarettes a day. He claimed that he learned to smoke to relieve his stress caused by toxic assignments in the ward. Along with smoking, he became a stress-eater. He decided to undergo a lifestyle modification, which begins with? A. Eating the right kind of foods B. A recognition of the impact of unhealthy habits C. Doing a regular daily exercise D. A constructive and positive attitude in life 90 85. Ace has come to realize the need for him to change his ways about smoking. This activity would be considered which stage of change? A. Refreezing C. Moving B. Unfreezing D. Drift 91 SITUATION 18 - Dr. Pia Alba, a Ph.D graduate in Nursing, has been appointed as a consultant in a tertiary hospital to help administration of coming up to strategies that will further enhance culture of team work and quality improvement (QI) among health personnel in the workplace. One day while conducting her rounds, Dr. Pia Alba observed a charge nurse (CN) facilitating a team on reducing post operative complications in her unit of assignment. The nurse was emphasizing the four (4) essential steps of the QI process 86. The FIRST phase of this activity is: A. Review cause/s of the problems B. Conduct root cause analysis C. List problems & prioritize D. Analyze the problems carefully 92 87. While undergoing the QI process, three (3) members of the team where having conflict in what management to do. Which of the following can be an EFFECTIVE strategy to resolve this conflict? A. Reprimand the three members of the team of their behavior B. Assign the three members of the team in the different shifts C. Assign an administration to solve the conflict. D. Have the three members confront each other properly. 93 88. The CQI team have observed that the incidence of FALL among older persons have increased by 50%. This data has reached Dr. Pia Alba and have instructed the team to conduct which one of the following PRIORITY measures? A. Provide a cash incentive for units with 0 incidence of fall. B. Intensify the in-service program for the unit with the highest incidence of fall. C. Identification of the root cause of falls. D. Decrease the benefits of those personnel who are involved in the fall incidence. 94 89. Dr. Pia Alba was initiating some innovative activities in the medical center for a continuous Quality improvement (CQI) in patient care services policy has been adopted for nursing staff every shift to conduct an hourly rounds for patients with PRIORITY health problems and attached policy was being complied with by the nurses however, she found out in the succeeding dates, it was no longer followed. What is the PRIORITY action of Dr. Pia Alba in this situation? A. Assign one nurse per shift to conduct the hourly rounds. B. Conduct a general meeting with the staff and determine why such policy is not complied with. C. Conduct a general meeting with the staff and explain the benefits of the hourly rounds. D. Call to the office nurses who fail to comply the hourly rounds. 95 90. There are several approaches and tools in (QI). One of there is the Fishbone diagram, Developed by K. Ishikawa. Which BEST describes the Fishbone diagram? It is A. cause-and-effect diagram B. a holistic approach in problem solving C. used in interview sessions D. useful in focusing on problem symptoms 96 SITUATION 19 - The chief nurse of a large labor and delivery facility in Luzon is tasked to perform budgeting. 91. A budget is: A. Amount spent on items that have value to the working of an organization B. A plan for the distribution of the organization’s resources and a control for making sure that results support that plan C. A 12-month period used for calculating an annual report to explain expenses and project needs regarding the delivery of services D. A document that typically includes direct payment for hours worked, benefits received, and taxes paid by employees. 97 92. Budgets may be developed in various formats depending on how the organization is structured. Nursing units are typically considered to be: A. cost centers. C. revenue centers. B. investment centers. D. profit centers. 98 93. Which cost would be considered an indirect cost to the delivery of maternity care at an acute care hospital? A. The cost of maintaining a security system to protect against abductions B. The cost of antibiotics given to newborns C. The cost of nursing salaries D. The cost of replacement linens 99 94. The chief nurse must include all staff providing services on the unit to the budget. Indirect cost expenditures in the operating budget would include A. housekeeping. C. patient assistants. B. unit secretary. D. patient technicians. 100 95. An expensive variable in salary budgets is overtime pay. Which of the following is a viable option to reduce overtime? A. Reducing the number of beds B. Refusing to pay overtime C. Using per diem workers D. Limiting overtime for highly paid workers 101 SITUATION 20 - As nurse supervisor of the health center Nurse Ellen intends to enhance her competencies regarding resource management and care of the environment. 96. Which type of planning should the nurse employ to assess the strengths and weakness of the organization? A. Nursing care C. Strategic B. Operation D. Program 102 97. Which BEST describes the planning function of Nurse Ellen in her role as nurse manager? A. Get and develop people to do the work. B. Distributes and arranges work to ensure smooth operation of the unit. C. Determines the actual performance compared with the desired output. D. Determine how to achieve the mandate of work. 103 98. To assist them to enhance their performance at work, the nurse manager should review regularly pertaining to the staff’s A. Number of submitted incident report B. Academic performance in college C. Job description D. Family dynamics 104 99. Doing year end performance evaluation of the staff is an example of A. Planning C. Organizing B. Controlling D. Staffing 105 100. Which is the MOST important criterion in budgeting? A. Flexibility C. Consistency B. Standardized D. Cost effectiveness 106 SITUATION 21 - Even if still a staff Nurse, Minda, can well contribute to the management of the resources and environment of her unit. 101. The electric fan in the unit sparks occasionally but continues to function relatively well. Nurse Minda though knows that she ______. A. Has to ask one of the staff to preliminary check it B. Will just wait until the fan stops to function C. Should alert the unit staff to closely observe the fan D. Must have it checked by the maintenance Department immediately 107 102. The electric fan now stops every now and then and continue to spark at intervals. The best thing to DO NEXT is to ________. A. Turn off the fan immediately B. Call the maintenance immediately C. Let it continue to function D. Request for another fan as soon as possible 108 103. The last fire in the hospital was due to