PALMAR Answer Keys 2021 PDF

NOVEMBER 2021 PALMR QUESTIONS Situation – Nurse Bella takes charge of handling the Mental Health Promotion program in the midst of the ongoing health crisis due to the COVID 19 PANDEMIC. 1. Teaching the families on promoting mental health at home in this pandemic time should focus on the following EXCEPT: a. Seeking community support b. Observing open communication c. Engaging social media the whole day d. Reaching out to friends Republic Act 110361 Basis: Declaration of Policies. United Nations Declaration of Human Rights, the Convention on the rights of Persons with Disabilities Republic Act 7277: Magna Carta for Disabled. Recovery-Based Approach refers to an approach to intervention and treatment centered on the strengths of a service user and involving the active participation, as equal partners in care, of persons with lived experiences in mental health. This requires integrating a service user's understanding of his or her condition into any plan for treatment and recovery. Attack it in the perspective of collaboration!!! NOTE OF THE SALIENT POINTS Section 8. All persons, including service users, person with disabilities, and minors, shall be presumed to possess legal capacity for the purpose of this Act or any other applicable law, irrespective of the nature or effects of their mental health conditions or disability. Children shall have the right to express their views on all matters affecting themselves and have such views given due consideration in accordance with their age and maturity. Section 9. Advance Directive. - A service user may set out his her preference in relation to treatment through a signed, dated, and notarized advance directive executed for the purpose. An advance directive may be revoked by a new advance directive or by a notarized revocation. Section 10. Legal Representative. - A service user may designate a person of lega; age to act as his or her legal representative through a notarized document executed for that purpose. (2) Act as substitute decision maker when the service user has been assessed by a mental health professional to have temporary impairment of decision-making capacity POWER TO DECLINE AN APPOINTMENT. WHO TO INFORM: Service User and the attending Mental Health Professional Health Worker FAILURE TO APPOINT: SPOUSE: unless permanently separated from service user or abandoned (NOT YET COME TO AN END) Non_Minor Children, Parents (Minor Service User) Chief Administrator, Medical Director of Mental Health Care Facility Court Appointed 1 https://doh.gov.ph/national-mental-health-program INTERNAL REVIEW BOARD T treatment Restraint Confinement Service D-OH C-HR PCFMH-Philippine Council for Mental Health-accredited organization REPRESENTING SERVICE USERS AND THEIR FAMILY MEMBERS. IRR-Designated OTHER members Section 13. Exceptions to Informed Consent. - During psychiatric or neurologic emergencies, or when there is impairment or temporary loss of decision-making capacity in whether physical or chemical, may be administered or implemented pursuant to the following safeguards and conditions: (a) In compliance with the service user's advance directives, if available, unless doing so would pose an immediate risk of serious harm to the patient or another person; (b) Only to the extent that such treatment or restraint is necessary, and only while a psychiatric or neurologic emergency, or impairment or temporary loss of capacity, exists or persists; (c) Upon the order of the service user's attending mental health professional, which order must be reviewed by the internal review board of the mental health facility where the patient is being treated within fifteen (15) days from the date such order was issued, and every fifteen (15) days thereafter while the treatment or restraint continues; and (d) That such involuntary treatment or restraint shall be in strict accordance with guidelines approved by the appropriate authorities, which must contain clear criteria regulating the application and termination of such medical intervention , and fully documented and subject to regular external independent monitoring , review, and audit by the internal review boards established by this Act. Relate it to the LOCAL GOVERNMENT CODE: Concept of Devolution. 2. During this pandemic time, which of the following roles of Nurse Bella should she significantly intensify to prevent more cases of mental problems in the community? a. Case finder - by the community health nurse - involves identifying individual cases or occurrences of specified diseases or other health-related conditions requiring services. b. Case manager - A health professional who coordinates and directs the selection and use of health care services to meet client needs, maximize resource utilization, and minimize the expense of care c. Researcher d. Surveyor Section 21. Suicide Prevention. - Mental health services shall also include mechanisms for suicide intervention, prevention, and response strategies, with particular attention to the concerns of the youth. Twenty-four seven (24/7) hotlines, to provide assistance to individuals with mental health conditions, especially individuals at risk of committing suicide, shall be set up, and existing hotlines shall be strengthened. Note of the National Center for Mental Health Case Managers Case managers are health service professionals who work toward the goal of bettering the life and needs of their clients. Case managers will work with clients, the client’s family, community members, and other health professionals to address their clients’ individual and specific needs. Case managers are responsible for making sure their clients have the resources they need to meet their agreed-upon goals. As health professionals, case managers must also advocate on behalf of their clients as these individuals are often not in a position to advocate for themselves. Note of the Levels of Case Management Level One: Intake eye toward creating an accurate picture of the client’s current situation. Level Two: Needs Assessment: This is level, the case manager assesses all of the information at their disposal and develops an understanding with the client about what their needs and goals are what the road may look like to achieving those. Level Three: Service Planning: A plan is put together by the case manager that takes into account all of the information that was gathered in levels one and two. The plan is often subject to input from the client’s support system and their other health providers. Level Four: Monitoring and Evaluating: to evaluate the efficacy of the plan and to make sure that the client’s specific needs are being met by the case manager and the organization. Case Management Case managers must be able to track a group of clients—the caseload. Software programs allow the case manager to enter client data and integrate this with predesigned care-tracking templates. In addition, the case manager must keep abreast of the latest regulations affecting eligibility for health care bene- fits, the reporting requirements of the payer agencies, and de- tailed facts about the variety of service providers the client may need to access. All of these data can be placed in integrated com- puter software programs. Finally, the case manager must docu- ment quality; that is, demonstrate client outcomes related to dollars spent. Situation – As community health nurse it is expected that she is competent in performing core competency standards on Record Management. 3. Nurse Ana is aware that the domain of record management entails which of the following except: A. Write in the Kardex what was to be endorsed B. Keep human resources updated at all times C. Report to MD orally wrong use of drug D. Ensure entries in patient record is signed What is not documented, though done is deemed not done. 4. Improvement of Nursing service as well as patient satisfaction is also a concern of the nurse manager. Which of the following strategies can be adopted to achieve this goal A. Hold regular meeting with staff (process-centered) B. Make chart audit (process and outcome-centered) C. Plan suggestion box (process-centered) D. Conduct regular rounds of patients (patient-centered) Audit is a systematic and official examination of a record, process, structure, environment, or account, to evaluate performance. Auditing in health care organizations provides managers with a means of applying the control processes to determine the quality of services rendered. 5. A physician in the health facility has forgotten to change antibiotics of the patient and make phone call order to Nurse ANA. What should be the APPROPRIATE action of the nurse in this situation? A. Ensure that the order will be signed by the physician as soon as he is in the facility. B. Have any physician in the facility sign the order C. Carry all phone orders and bring chart to the doctor for signing D. Call back MD to give feedback (Health Insurance Portability and Accountability Act. ) 6. Which of the following is PRIMARY purpose of accurate, updated and reliable document? A. Use from the shift report of nurse and doctor B. Protect nurse from doctors’ reprimand C. Serve as evidence of legal matters D. Audit frequency of medication utilization Chart is a legal document. Medical Records are also considered as legal documents. (discuss disposal system) 7. Which of the following is the rationale why team work is ESSENTIAL in health care A. Helping one another B. Makes work lighter C. Patient safety D. Promotes camaraderie Note that the object of the question pertains to the rationale and not the meaning of teamwork itself. 8. What is the MAIN component of collaboration? A. Shared vision (SHARED DECISION-MAKING POWERS) B. Achievement of goals C. Working together D. Partnership All parties set aside their original goals and work together to establish a supra-ordinate goal. In doing so, the all parties accept mutual responsibility for reaching the supra-ordinate goal (NOT GOALS). Note of NEGOTIATION: GOAL: To make the other party feel satisfied with the outcome. Note that there is no rule that both parties must give up equal rights; otherwise it may be considered as compromise. 9. Nurse Roy as member of the health team describes himself as good team player, Which of the following is the BEST characteristics of good team player? 1. Sense of humor 2. Good listener 3. Inspires others 4. Proactive thinking A. 1,2,3,4 B. 1,2,3 C. 1,2 D. 3,4 Showing a genuine interest in others, being considerate of other people’s needs and wants, and offering others support whenever possible are all part of a successful team building. These interpersonal skills are part of emotional intelligence. 10. Which of the following is an ESSENTIAL element of effective collaboration? A. Communication B. Belong to one team C. Networking D. Delegation True collaboration requires mutual respect, open and honest communication; and equitable, shared decision making powers. 11. Nurse Roy in his dealings with his co-workers instills collaborative partnership in doing their task which is the aim of this type of partnership? A. Make work faster and easier B. Shared goals C. Change and influence group behavior D. Staffs’ satisfaction A collaborative partnership is an alliance among people and organizations from multiple sectors, such as schools and businesses, working together to achieve a common purpose. In public health, collaborative partnerships attempt to improve conditions and outcomes related to the health and well being of entire communities. When the focus is a community, those affected may include people who share a common place, such as a rural community or an urban neighborhood, or an experience, such as being a child or living in poverty. 12. Which of the following is an important tool of assessing quality in the delivery of health services? a. research b. standards c. nursing process d. legislation Standard is a predetermined level of excellence that serves as guide for practice. PREDETERMINED; ESTABLISHED BY AUTHORITIES; COMMUNICATED TO AND ACCEPTED BY THE PEOPLE AFFECTED BY THEM. 13. Choose the key words that best describes quality improvement in public health. a. status quo b. improvement process c. very conventional d. perfect health facility QA Models target currently existing quality. QI models target ongoing continually improving quality. 14. Choose the description that quality exists at the health center a. patient satisfaction b. selected delivery of services c. controlled by local officials d. rapid turnover 15. Nurse Elisa would like to enhance the process standard at the health center. which should be her priority nursing initiative ? a. revise manual for operation b. hire more new graduate c. upgrade the health equipment d. reduce operational expenses A: Process B. Structure C. Structure D. Structure Process Audits measure how nursing care is provided. Critical Pathways and Clinical Guidelines are examples of efforts to standardize the process of care. Process audits tend to be Trask oriented and focus on whether practice standards are bring fulfilled. Process Standards may be documented in patient care plans, procedural manuals or nursing protocol statements. OUTCOME: Patient reported outcome measures attempt to capture whether the services provided actually improved patient’s health and sense of well-being. STRUCTURE: a relationship exists between quality care and appropriate structure. It includes resource inputs such as environment in which health care is delivered. EG. Staffing ratios, staffing mix, emergency department wait times, availability of fire extinguishers. 16. Identify to whom Nurse Elisa would seek help to improve health resources like medicines in order to provide quality nursing care at the health center. a. head of the church b. secretary of health c. mayor d. governor Section 17(b)(2)(iii) of the LGC BASIC SERVICES AND FACILITIES. (iii) Subject to the provisions of Title Five, Book I of this Code, health services which include the implementation of programs and projects on primary health care, maternal and child care, and communicable and non-communicable disease control services, access to secondary and tertiary health services; purchase of medicines, medical supplies, and equipment needed to carry out the services herein enumerated; (iv) Social welfare services which include programs and projects on child and youth welfare, family and community welfare, women's welfare, welfare of the elderly and disabled persons; community-based rehabilitation programs for vagrants, beggars, street children, scavengers, juvenile delinquents, and victims of drug abuse; livelihood and other pro-poor projects; nutrition services; and family planning services; Situation – Nurse Elisa has been promoted as nurse manager in the health unit. Her functions include management of resources and environment and budgeting. 17. As nurse manager, which should she consider important when preparing the budget needed for the operation of the unit. A. All things and equipment need to be new yearly B. Budget is implemented with or without money at hand C. Cost effectiveness and efficiency are important D. Budget is not essential for quality assurance A budget is a financial plan that includes the estimated expenses as well as income for a set of period of time. Note of the Scale of Budget ALLOCATION: Personnel 2. Operational COST-CONTAINMENT refers to the effective and efficient delivery of services while generating needed revenues for operations. COST-EFFECTIVE: producing good results for the money spent. RESPONSIBILITY ACCOUNTING: essential feature of fiscal planning. Each organization’s revenues, expenses, assets, and liabilities is someone’s responsibility. 18. In the process of planning, which of the following, Nurse Elisa should use the plan that would review the strengths and weakness of the organization A. Operational B. Nursing care C. Strategic D. Program Developed by Albert Humprey of Stanford University. It defines the desired end state or objective. 19. For cost effectiveness measure, which of the following is the best nursing action A. All things should be kept at the supervisors office B. Identify resources needed to accomplish task (PROPORTIONALITY) C. Assign the utility worker to keep track D. Allow everyone to take responsibility Letter D is more of responsibility accounting. 20. Nurse Elisa advocates for safe staffing pattern at the health center. Which best practice she should instill from the staff? A. Delegate task B. Give all freedom to be honest in their attendance C. Staffing pattern not important in community setting D. Requires staff to report on time Minimum criteria for safe Staffing. 1. Decisions made must meet state and federal labor laws and organizational policies. 2. Staff must not be demoralized or excessively fatigued by frequent or extended overtime. 3. Long term as well as short term solutions must be sought. 4. Patient must not be jeopardized. 21. Which of the following is a measure of safe work environment? 1. Complies with standards 2. Observe protocols 3. Adheres to policies 4. Observe quality A. 2,3,4 B. 1,2 C. 3,4 D. 1,2,3,4 Situation - Nurse Telly is planning to conduct a qualitative research about the life experiences of teenage mothers in the community. 22. Which “appropriate” research design Nurse Telly should use in her planned study? A. Grounded theory B.phenomenology C.case study D. Ethnography PHENOMENOLOGY: What is the essence of this phenomenon as experienced by the people and what does it mean? PHENOMENOLOGIST ASSUME THAT THER IS AN ESSENCE-AN ESSENTIAL STRUCTURE that can be understood, much as ethnographers assume that culture exists. DESCRIPTIVE PHENOMENOLOGY: Insists on the ordinary portrayal of ordinary conscious experience of every day life. INTERPRETATIVE PHENOMENOLOGY: interpreting, not just describing human experience. (hermeneutics literally means understanding). Grounded theory: tries to account for the people’s actions from the perspective of those involved. Ethnography: description and interpretation of of a culture and cultural behaviour. 23. After she has decided to conduct the study, which of the following nursing action she should do next? A. Create conceptual framework B.make a research proposal C.decide for the data analysis D.plan for data collection 24. Which is the “appropriate” means to present qualitative data? A.themes B.bar graph C.pie graph D.linear graph Phenomenologist share their insights in rich, vivid, reports they describe as “themes” The results sections in a phenomenological report should help readers “see” something in a different way. 25. Which of the following nursing actions Nurse Telly must do in doing data saturation of qualitative data A.do resurvey B.use case study C.do interview more than once D.seek advice of expert Data Saturation: Involves sampling until no new information is obtained and redundancy is achieved. The broader the scope of the question, the more the participants will likely be needed. 26. One of the study questions in the proposed study is about needs of teenage mothers.in choosing framework to make the topic more stable, which theory Nurse Telly should adopt in her study? A.ROY- adaptation Model B.MASLOWS C.OREM-Self- Care Deficit D.KINGS-Goal Attainment Situation - Nurse Erica is fully aware that being a public health nurse her work is guided by ethico- moral principles. 27. 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 BON Resolution No. 220 Series of 2004. The Code of Ethics for Nurses: Preservation of health! 28. As public health nurse Nurse Erica 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.benificence Distribution of Resources/Allocation 29. Select nurses action in keeping with principle of confidentiality A.hides identity of patient B.shares information from patients chart in public C.keeps all matters about the patient as a secret D.discusses the case of patient with others A is anonymity. 30. Nurse Erica is always guided by the principle of beneficence in all that she does to all her patients. Which of the following nursing action is aligned with principle of beneficence. A. Equal and fair allocation of resources to all B.getting informed consent C.keep records of patients from public viewing D.promoting patients safety at all times 31. Nurse erica 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 Situation - Nurse Levy reviews all pertinent laws that affects Public Health Nursing. 32. Ra 9173 is otherwise known as the Philippine Nursing Act of 2002. Which is the primary aim of this law? A. To enhance the competence of professional nurses. B. To regulate practice of professional nursing in the country C. To facilitate mobility of nurses to other countries D. To promote well – being of health workers. Sec. 2. Declaration of Policy. It is hereby declared the policy of the State to assume responsibility for the protection and improvement of the nursing profession by instituting measures that will result in relevant nursing education, humane working conditions, better career prospects and a dignified existence for our nurses. The State hereby guarantees the delivery of quality basic health services through an adequate nursing personnel system throughout the country. 33. The nurse closely monitors the work she delegated to the barangay health worker. She is legally guided by this principle A. Respondent superior B. The good samaritan C. Res ipsa loquitor D. Jurisprudence 34. This law promotes the wellbeing and living conditions of health workers especially those from the government managed facilities ________. A. Continuing professional development B. Magna carta for health workers C. Philippine qualifications framework D. Local government code Republic Act 7305 SEC. 2. Declaration of the Policy. - The State shall instill health consciousness among our people to effectively carry out the health programs and projects to the government essential for the growth and health of the nation. Towards this end, this Act aims: (a) to promote and improve the social and economic well-being of the health workers, their living and working conditions and terms of employment; (b) to develop their skills and capabilities in order that they will be more responsive and better equipped to deliver health projects and programs; and (c) to encourage those with proper qualifications and excellent abilities to join and remain in government service. Note: Philippine Qualifications Framework PQF-NCC No. 2014-01 22 July 2014 DepEd, TESDA, CHED,PRC, DOLE, CHED.2 35. It mandates the compulsory immunization of children below 8 years A. PD 996 B. Ra 11223 RA 11223: Universal Health Care Health Care Act C. Ra 8173 RA 8173: An Act Granting All Citizens' Arms Equal Opportunity To Be Accredited By The Commission On Elections, Amending For The Purpose Republic Act Numbered Seventy-One Hundred And Sixty-Six, As Amended D. Ra 10912 Continuing Professional Development Act of 2016. 36. This law allows every Filipino to avail of affordable medicines. a. A. Local government code b. Primary health care c. Universal health care d. Generic drug act Section 3. of RA 11332 General Objectives. - This Act seeks to: (a) Progressively realize universal health care in the country through a systemic approach and clear delineation of roles of key agencies and stakeholders towards better performance in the health system; and (b) Ensure that all Filipinos are guaranteed equitable access to quality and affordable health care goods and services, and protected against financial risk. Situation – alaia, a patient with nevere proeclampsia, is admitted to the hospital. She is a student from one of the local universities, she insists of continuing her studies while in the hospital despite being instructed to rest. The patient studies approximately 10 hours a day and has numerous visits from fellow students, family, and friends. Situation – Alaia, a patient with Severe preeclampsia, is admitted to the hospital. She is a student from one of the local universities, she insists on continuing her studies while in the hospital despite 2 https://pqf.gov.ph/Home/Details/4 being instructed to rest. The patient studies approximately 10 hours a day and has numerous visits from fellow students, family, and friends.. 37. Nurse Isabelle is concerned about the patient’s welfare and her ability to comply with the doctor’s instructions. What should be the appropriate action? A. Include a significant other in helping the patient. Understand the need for rest. B. Instruct the patient that the baby’s health is more important than her studies at this time. C. Develop a routine with the patient to balance her studies and her rest needs. D. Ask her why she is not complying with the prescription for bed rest. 38. Nurse alaia is now in a dilemma. This occurs when. A. There is a conflict between the nurse’s decision and that of his/her superior B. Choices are unclear C. There is a conflict of two or more ethical principles D. A decision had to be made quickly under a stressful Situation 39. Which of the ethical principles stipulates that the nurse is responsible for providing all patients with care, attention and information? A. Beneficence c. Nonmaleficence B. Advocacy d. Veracity Situation - Ashley a postpartum patient, who has delivered a stillborn wants to leave the hospital without a physician’s order. The patient is still hooked to an intravenous fluid(IVF) and is on closed postpartum monitoring. 40. To avoid liability, which of the following is an appropriate action by Nurse Valerie? A. Notify nursing supervisor of the patient’s plans to leave. B. Arrange medication prescriptions at the patient’s preferred pharmacy. C. Notify directly the attending obstetrician. D.ask the patient about the transportation plans from the hospital. 41. After the fire was put off, the patient was found to have absconded. What is the ethico-legal responsibility of the attending nurse? a. Autonomy b. Nonmaleficence c. Beneficence d. Justice Code Black If a patient is identified as absconding or missing when receiving care within CHS, reasonable steps must be undertaken to attempt to locate and ensure their safety. 42. Absconding is inevitable in any health care facility. Who will be informed immediately if the patient found out the absconded? A. Attending physician B. Security guard on duty C. Resident on duty D. Nursing staff Situation - the group of nurses assigned in the delivery room is interested in conducting a study on the experiences of pregnant women in labor. They are thinking of qualitative research. 43. In the presentation of results of qualitative research, the nurse research uses as a reference in the write-up _____ person. a. First b. Second c. Fourth d. Third Less subjectivity and it removes direct reference to the writer. 44. Nursing, as a human science, deals with the critical and fundamental differences in attitude toward their respective phenomena. Which of the following is an aim of human sciences? a. Construct prediction b. Seek causal explanation c. Sets control d. makes meaningful interpretation All are quantitative except D. 45. The group was observant as to the activities taking place in the delivery room. One of the activities involved social processes, which can be better explored. Which of the following qualitative research method should be used? A. Grounded theory B. Historical research C. Descriptive phenomenology D. Case study GROUNDED THEORY: researchers seek to identify a main concern or problem then to understand the behavior designed to resolve it-the core variable. BASIC SOCIAL PROCESS: GENERATES CONCEPTUAL CATEGORIES and integrate them in to a substantive theory grounded on data. 46. After the data analysis of their study, experiences of pregnant women in labor, they returned to the participants to determine the accuracy of the emerged themes. Which criteria of trustworthiness in the group doing? A. Confirmability. Objectivity: The data represent the information participants provided that the interpretations of those data represent the information participants provided and that the interpretations of those data are not imagined by the inquirer. B. Credibility refers to the confidence in the truth value of the data and interpretations of them. Checking if the interpretation of the evidence is judged as accurate by both the research participants and also independent clinicians or scholars. C. Transferability Generalizability. D. Dependability Stability/ reliability of data over time and over conditions. Authenticity: emerges in the report when it conveys the feeling tone of participants’ lives as they are lived. 47. The group used an audio record to capture what transpired during the interview. After the transcription, which of the following action is appropriate for the group to do with audiotape? A. Keep the audiotape in a vault and dispose of it a year after. B. Submit the audiotape to their research adviser. C. throw it in the trash bin immediately after it was used. D. post the recording on their university research website for other to listen. Note of the Confidentiality Procedures by ARS Saturation - Marie Ob-Gyn head nurse, conducted an in-service program on staff development. 48. Head Nurse Marie discussed that the most frequently neglected area in management is _____. a. Managerial knowledge b. Professional development c. Clinical skills d. Successful communication 49. A critical component of the supervisory process is delegation. Which of the following in the most empowering to staff? a. Effective delegation does not require nurses to know the abilities and weakness of their staff. b. Delegation frees the manager to do other tasks while empowering staff. c. Delegation fosters the responsibility of staff while increasing professional growth. d. Delegation starts at top management down to subordinates. 50. Head Nurse Marie discussed negotiation. The focus of negotiation is to create a___________. A. Soothing situation Allow cooling off periods. B. Third-party consultation C. Trade-off D. Win-win situation 51. Supervision occurs after delegation. What is the primary purpose of supervision? a. Influences the organization’s approach in recruitment promotion, and personnel evaluation. b. Improves staff compliance with policy and procedures individual. c. assigns appropriate work tasks to the best-qualified individual. d. enhances the delivery of quality nursing care. 52. Delegation involves the transfer of care to an individual. What is the best criterion when delegating staff? A. Responsibility c. Flexibility B. Adaptability d. Competence COMPETENCE: Having the abilities to meet the requirements for a specific role. 53. Which of the following cannot be delegated: A. Responsibility c. Accountability B. Authority d. Personality 54. Which of the following is not jointly shared by the delegator and the delegate? A. Responsibility c. Accountability B. Authority d. Task Situation - nurse sandy is a member of the research team in a cardiovascular health facility. One of the research priority problems in her unit is on the “EFFECTS OF PERSONALIZED CARE MANAGEMENT STRATEGIES ON STRESS AFTER AN ACUTE MYOCARDIAL INFECTION (MI) 55. What type of sampling while nurse sandy adopts if when every third (3rd) patients with mi are selected after a random start? a. Simple random b. Systematic c. Stratified d. Cluster 56. Nurse sandy distributed the coded questionnaires to the respondents of the study without their names on it. What ethical safeguard is being employed in this practice? a. Confidentially b. Truthfulness c. Trustworthiness d. Anonymity 57. When the findings of the study can be applied to all patients with MI under stress patients in the whole Philippines, it satisfied which of the following criteria in research? a. Reliability b. Validity c. Generalizability d. Transferability 58. Nurse sandy has completed the study and started to make a report to the research department. A written brief summary is submitted which is known as _________. a. Narrative b. Abstract c. Critical appraisal d. Monograph Situation - In today’s nursing practice, roles have been expanded to include legal responsibilities and accountability in workplace. 59. Nurse Lina is on duty at the ER and has been very busy that morning resulting to the administration of penicillin injection which is ordered to another patient. With this error, the nurse can be charged of ______. a. Malpractice b. Negligence c. Assault d. Battery 60. Nurse Edna admits a patient from the ER to the medical unit. The patient is very restless with IV lines and a urinary catheter. She was put to bed and the nurse applied a body restraint without the doctor’s order. Nurse EDNA’S action can be liable for ______. A. Invasion of privacy c. Battery B. Non- maleficence d. Neglect 61. Ms. Cruz is a supervisor of the hospital on night shift. Several nurses did not report due to jeepney strike. When the supervisor is executing proper allocation of nurses to the priority wards to address this concern, she is observing what type of principle? A. Beneficence c. Justice B. Non- maleficence d. Fidelity Situation – Ethical dilemma is becoming a common scenario in the health care delivery system brought about by the advance technological changes on health care. 62. Which of the following is the example of an ethical dilemma? A. A nurse providing demonstration of the possible risk if a chest tube drainage of a patient is pulled out. B. Family members having ambivalent feelings whether their father will undergo amputation of a diabetic leg. C. A nurse is overheard by the daughter that if her mother will not take her insulin injection she will not serve her food tray. D. The physician signs the medical directives of a terminally- ill patient admitted in the hospital with his spouse. 63. A 70- year- old has been rushed to the hospital due to bradycardia and palpitation. The physician suggested that pacemaker be inserted to correct the symptoms. The patient voluntarily decides not to have the pacemaker inserted. This is respected by the family. This is an example of what ethical principle? A. Beneficence c. Fidelity B. Autonomy d. Justice 64. The ER nurse clarifies the doctor’s prescription on the dose of the pain medication base on the pain scale assessment and patient’s age. Which ethical principle is applied? A. Fidelity c. Justice B. Truthfulness d. Non- maleficence 65. Nurse Pat promised to a post- surgical team, that she would come back to assist in his ambulation after carrying out the physician’s order. This follows the principle of______. A. Beneficence c. Autonomy B. Justice d. Fidelity 66. When a nurse supports the welfare of the patient in relation to health , safety and personal rights, the ethical principle followed is ______. A. Responsibility c. Autonomy B. Accountability d. Advocacy Situation - collaboration and team work are critical to the success of health care operations 67. Which of the following statements is incorrect of collaboration in health care setting? a. Trust and respect are core values of a collaborative organization. b. a shared vision is essential for collaboration in any health care operations. c. Successful conflict resolution can help collaborative teams overcome differences. d. Inter professional collaboration and multidisciplinary collaboration can be used interchangeably. Note that the options are technical in character. 68. Nurse Lyn received an order from attending physician of Patient Pillar who was having a severe abdominal pain of almost a double dose of MORPHINE SO4. The nurse consulted her and tell the manager and the pharmacist regarding the order which was also questioned. The nurse called the attention of the physician regarding the dose of the drug and changed the order to an acceptable level what relevant principle of collaboration is applied in this case? I.SHARED VISION II.RESPECT AND TRUST III.COMMUNICATION IV.INTERPERSONAL RELATIONSHIP A.I,II, III, AND IV B.III, AND IV C.I AND II D.I,II, AND III 69. In a tertiary hospital where GIO works as unit manager, an interdisciplinary team model is adopted on collaboration of care, with this type of model how is decision making made? A. Shared responsibility of the group for the problem-solving final decision B. One person makes the final decision for the treatment. C. Partnership with the patient and team for the final decision. D. All members work together for both alternative and final decision. 70. Nurse Ime, is a member of the quality assurance team of the hospital and has been always rated as very assertive. Which of the following is not a characteristic of an assertive person? A. Intervene with the situation calmly and confidently B. She stands up with what she believes and push control on others C. Articulate clearly the importance of nursing perspective. D. Use “i” when stating thought and feeling and “you” when persuading others. 71. A patient is going for a coronary artery bypass graft (CABG) due to a 4 black arterial blood vessels. A surgical team has been formed with the cardiac surgeon as the head. Who is a member of the health team that prepares the preoperative orders for the patient? a. Cardiologist b. Anesthesiologist c. Surgeon d. Medical internist 72. Delegation is a critical component of leadership and governance which of the following empowering activities should the unit manager applies in delegation? a. In delegation facilitating professional growth and development of a staff is necessary. b. When delegating a responsibility to a nursing staff modification of standards of care is permitted. c. Delegation of responsibility in patient care has to start from top management to the staff nurse level. d. Delegation requires responsibility with corresponding accountability of staff nurse. 73. Nurse Gayle is guided that the initial step of delegation is? a. Demonstrate the task and let the staff continue the next activities b. Assess the capability of the staff change him if not performing c. determine the competency level of the staff-for the task being given d. explain the task to be done with the companying job description 74. The unit manager is planning to take her regular official business leave for the year-she has written a letter of recommendation to her immediate supervisor for her assistant unit manager to assume her position while she is on leave. This is example of delegation by______: A.rank B.authority C.succession D. Authority Principles Of Delegation the right task. the right circumstance. the right person. the right direction/communication. the right supervision. Situation – Jen is an active member of the quality assurance (QA) team in a health facility where the major role is setting quality standards. 75. Which of the following statements is true of quality improvement? A. Focuses on the organizational structure than patient care. B. Continually improve every process in the organization. C. Centered on people rather than processes. D. An approach that is externally driven by the stakeholders. 76. As a QA nurse, which of the following can Nurse Jen adopts as a concurrent evaluation of patient’s outcomes in the unit? I. Direct observation of patient’s condition. II. Patient’s interview in the unit. III. Face to face interview with nursing staff. IV. Nursing audit from the patient’s chart. A. III & IV B. I, II, & III C. I, II, III,& IV D. I, & II 77. Nurse Jen, distributed the patient satisfaction form to the admitted patients in the hospital, this tool is in compliance to the ______ quality standards. A. Human resource B. Organizational structure C. Patient care D. Legal – ethical 78. The QA team was alerted by the administration, that they have to anticipate for a possible earthquake in the forthcoming days. As part of the SAFE PRACTICE ENVIRONMENT (SPE) Standards, which of the following are to be given priority attention by the team? 1. Electrical wires 2. Combustible materials of the building 3. Entry , exit 4. Infected waste materials A. I, II, III, & IV B. II,. & II C. I, & II D. I, II, & III 79. The QA team has bombarded by complaints of patients on their long waiting period in the OPD , before the health care professionals are examining them. In response to this concern, which type of quality assessment should the team implement? A. Outcome evaluation B. Process evaluation C. Ongoing evaluation D. Structure evaluation Outcome measures: these reflect the impact on the patient and demonstrate the end result of your improvement work and whether it has ultimately achieved the aim(s) set. Examples of outcome measures are reduced mortality, reduced length of stay, reduced hospital acquired infections, adverse incidents or harm, reduced emergency admissions and improved patient experience. Process measures: these reflect the way your systems and processes work to deliver the desired outcome. For example, the length of time a patient waits for a senior clinical review, if a patient receives certain standards of care or not, if staff wash their hands, recording of incidents and acting on the findings and whether patients are kept informed of the delays when waiting for an appointment. Structure measures: these reflect the attributes of the service/provider such as staff to patient ratios and operating times of the service. These are otherwise known as input measures. Situation - Research is a vital endeavor nurses must engage into in order to contribute to nursing science 80. When the nurse researcher collects data at more than one point over an extended period, which design is applied? a. Cross-sectional b. Time-related c. Time sequenced d. Longitudinal Time-series analysis (TSA) is a statistical methodology appropriate for longitudinal research designs that involve single subjects or research units that are measured repeatedly at regular intervals over time. TSA can be viewed as the exemplar of all longitudinal designs. 81. If a research study involves an intervention and “blinding” which research design is being referred to? a. Non-descriptive b. Phenomenological c. Experimental d. Descriptive 82. Which of the following statements is least descriptive of a qualitative research design? a. Researchers become involved. b. Gather data from one collection strategy. c. It is flexible and elastic. d. Strives for an understanding of the whole strategy. 83. Qualitative researchers should choose their participants who can best meet the objectives of the study. Who of the following best qualifies? a. Cooperative person in the community b. Those readily available thus convenient for the researcher. c. Able to articulate and reflect on the phenomenon that they experienced. d. Parsons referred by friends. 84. A “full understanding” in research should be understood by the nurse researcher as___. a. Ensuring that participants are not placed at risk b. Explaining the study including risks and benefits c. The right to decide voluntarily d. Not exploiting information shared by participants Situation – management of records is very vital in any health care facility. The nurse must ensure there is due diligence in the task. 85. Nurse Gay is assigned in the medical unit. She is guided that in documentation, she should use abbreviation that is ____. a. Used automatically to save precious time. b. Reduced to the minimum in all units. c. Approved standard list by the hospital. d. Not used at all because it can be misinterpreted. 86. One error in record-keeping is illegible handwriting. What is the appropriate action by the nurse in this situation? a. Request the senior nurse to read the order for you. b. Let the resident-on-duty in the nurses station interpret it. c. Call the physician who made the order. d. Report the lapse to the quality assurance committee. 87. The QA nurse conducts a regular audit of the medical records. The primary purpose of conducting audit in a health facility is to _____. a. Identify errors made by health personnel. b. Identify areas for improvement c. Ensure that standards are met. d. Promote risk management. Situation - Nursing Student Myra decides to do a qualitative phenomenological study on how the stigma of AIDS affects the patients. She has previously identified 6 participants 3 teenage boys and 3 teenage girls. 88. What is the best way for Myra to collect data from these participants? a. Focus group discussion b. Survey, questionnaire c. Individual interview d. Observation 89. 17. What kind of sampling method should she apply? a. Network (AIDS) b. Random c. Stratified d. Purposive 90. The statements of the findings of the study that will be formulated by Myra should be by_______. a. Summarizing the sharings of the participants of both sexes b. Identifying the answers of the males and the females c. Describing answers of the males and females by percentages d. Extracting meanings and themes from significant statements 91. Informed consent in this study will be obtained by myra from the______. a. Six participants only b. Parents only c. Six participants and available relative d. Six participants and their parents DISCUSS VULNERABLES! 92. What is not important for Myra to do when listening to tape recordings? a. Do the listening as soon as possible after the interview. b. Note for the voice tone and voice inflection. c. Listen when she feels the motivation for a more productive time. d. Take notice of the pauses of the participants. Situation – it is necessary that records are well-recorded and properly kept if they are to serve the organization and the requesting public well. 93. Incident reports (IRS) shall be collected for the day and due investigation, the IRS _____. a. Must be completed and stored on the open cabinet b. Can be stored on the table top for easy retrieval c. Must be summarized monthly and stored in a secured cabinet CONFIDENTIAL!!! d. Classified by date so they can be easily accessibility DISCUSSED THE RULE OF CONFIDENTIALITY AND THE CHART> 94. The patient record (charts) are collected every three nights from the various departments. The night nurse is expected to do the following, except, _____. a. Ensure the correct order of the chart b. See to the completeness of the chart pages c. Bind the charts as they are d. Tape or repair torn pages 95. When patient record reach the medical records, the assigned staff will _____. a. Store the charts in their respective shelves b. Separate the medico-legal charts c. Check the completeness of the charting of the doctors and nurses d. Bind the chart immediately 96. The charts are stored in the medical records or storage room for at least _____years. a. 3 – 5 years b. 1 – 5 years c. 5 – 10 years d. 1 – 3 years 97. 30. How many years are medico-legal charts stored? a. 8 years b. 10 years after the case is closed c. 5 years d. 10 years Situation – The quality department has received numerous complaints, some of them on patient falls. 98. Nonah who is an 86-year-old patient is admitted for fever fell from the bed despite the presence of a watcher. The head nurse was concerned since a fall protocol has been formulated for some time now. To avoid similar incident, which of the following is most effective? a. Interview the patient b. Interview the nurse-on-duty c. Investigate everyone d. Do a root cause analysis 99. The nurse informed the head nurse that the lock in the side rails does not work properly at times and might have gotten loose in the night thus the incident of fall. What is the appropriate thing for the head nurse to do in this regards? a. Penalized all the nurses for not having reported such defect. b. Make a memo to the maintenance department to check involved bed and the rest of the beds. c. Punish the nurse-on-duty for not reporting such observation before the incident. d. Warn every one this is not going to be tolerated in the future. 100. The quality improvement officer – in – charge of the unit plans to conduct a meeting with the staff. The most important thing to tackle is to _____. a. Inform them of their punishment b. Review the protocol BUREAUCRATIC c. Inform them their lapses d. Scold those involved 101. What is the initial action that the nurse should do immediately after the fall to mitigate the situation? a. Document the incident right away. b. Phone the head nurse to report the incident c. Wait for the head nurse’s advice. d. Have a doctor assess the patient immediately. 102. What lesson will the nurse learn from this incident? a. Tell the others to cover her up. b. Safety first – report even trivial but relevant observation. c. Deny any error or omission. d. Never get caught in her omissions. Situation - Sins of omission and commission may be committed by the nurse the course of her duty. She must therefore be extra careful. 103. The patient for breast biopsy is very anxious and seemed not to understand her ordered surgery, radical mastectomy. What is the appropriate action by the nurse? a. Call the supervisor to explain the procedure. b. Have the available resident explain the surgery further. c. Request the doctor to give the patient more information. d. Supply the information missed to be explained by the doctor 104. The patient refused his intramuscular injection but the nurse proceeded to administer it anyway. What con the nurse be accused of? A. Moral distress B. Trespass to person C. Assault D. Battery 105. The staff nurse was doing prescribed modified steam inhalation to a pediatric patient which resulted to burns. What is not a relevant statement to establish negligence? a. There is a duty to care. b. There is a breach in the standard. c. The breach caused the harm. d. It was a verbal order by the physician. 106. Staff nurse a told her co-workers That Staff B is suffering from gonorrhea. What can staff a sued for? a. Defamation b. Slander c. Discrimination d. Libel 107. The surgical patient, a Jehovah’s witness, reiterated non-acceptance to a blood transfusion. The nurse defied it and the patient was transfused intraoperatively. What case can be filed by the patient? A. Moral distress B. Battery C. Trespass to person D. Assault Situation – nurses must closely adhere to the ethical principles and rules, and not only to the laws. 108. When the nurse ensures that patients have consented to all treatments and procedure, she is true to which ethical principle? A. Fidelity B. Beneficence C. Veracity D. Autonomy 109. If the nurse will refuse to perform duties for which she is not qualified, she is practising _____. A. Veracity B. Beneficence C. Respect D. Non-maleficence 110. The code of ethics stipulates that human life is inviolable. Which statement correctly translates the principle to the situation of the Filipino nurse as a professional? A. It is okay to participate in euthanasia provided there is a doctor’s order. B. Participation is permissible when patient, family, and doctor’s order. C. After the patient, doctor and hospital administrator have agreed, nurses may choose to participate D. Nurses shall not participate in euthanasia. 111. When the physician insists that his cancer patient undergoes radiation, in addition to chemotherapy which is contrary to the patient’s and family’s wishes, the physician is exercising _____. A. Veracity B. Autonomy C. Fidelity D. Paternalism 112. An Iranian was admitted to the hospital for kidney transplantation. He claims his donor is a Filipino relative as required by the law. However, it was discovered later that his claim was not true. Should the doctor fail to act accordingly to the wrong information, the nurse is obligated to refer the case to, which of the following? A. Medical director B. Administrator C. Chief executive officer D. Ethics committee Situation – Nurses must continually grow as a person and as a professional. 113. As a newly licensed nurse employed in a tertiary hospital, you are required to attend continuing professional development (CPD) program. When the training program is for the enhancement of the competencies of nurses employed in the hospital, it is called _____. a. Self-directed b. In-service training program c. Informal training program d. Formal education program 114. The professional career development of a nurse can be achieved through various ways, such as_____. a. Participating in political rallies b. Attending culinary courses c. Attendance in socio-civic activities d. Engaging in CPD programs 115. When nurses are projected in a television advertisement as sex symbols, what appropriate action is expected from a concerned nurse? a. Go to the street to manifest displeasure of the nurses’ portrayal. b. Report to the concerned agency c. Condemn the issues in the radio program. d. Keep your silence, it is the television station’s prerogative. 116. The nurse’s application to Canada has finally been approved and she was advised to depart in three months. She is currently enrolled in the graduate school. Moreover, her mother has just been discharged from the hospital. Which of the following actions is best? a. Inform family that the money spent in graduate school can be easily earned in Canada. b. Inform the agency that she could go anytime as they wish. c. Share with friends that this is her escape from her sad life with her family. d. Request the recruiter to give her more time to settle her personal concerns. 117. Nurses may be privy to very personal information of patients and should make every effort to make it confidential, otherwise she can be charged of _____. a. Negligence b. Malpractice c. Invasion of privacy d. Defamation Situation – quality improvement must be embraced by every health institution if ti aims for safe and quality care. The medical director of Camiguin Medical Center made random rounds for five consecutive days to all areas of the hospital to assess its services. 118. Which of the following is not a characteristic of quality improvement that the medical director is interested in? a. The leader is the empowered b. Problem-solving is by everyone c. The employees are treated as customers d. Reacts to correct or bad situation 119. A risk is any event that causes problems or benefits on the healthcare institution. The medical director knows that potential risks must be identified across the hospital in order to prevent the following, except _____. A. Financial loss B. Incident reports C. Accidents D. Injuries Note that Incident reports are for risk management policies itself, Not the risk. 120. Based on patient survey, a number of complaints have been tracked. Which of the following is not a preventive activity in the practice of the medical director’s risk management? A. Fostering good administration-personnel relations. B. Providing safe environment every time. C. Tracking patient complaints at irregular intervals. D. Satisfying patient needs and desires. 121. The medical director, with the chief nurse and other officers, of the hospital believe that patient relations is important in risk management which is not the way to handle complaints? A. Let the patient express himself B. Be sure to rebut the patient point by point C. Staff should not be defensive. D. Listen to the patient’s cue carefully. Situation – Nurses provide their patients information they need to give informed consent, only if it is within their scope of nursing practice and nursing knowledge. Consent is the patients acknowledgement and acceptance of medical treatment. 122. In emergency situation when a patient is unable to give consent for life saving treatment, what type of consent allows to assume appropriate medical treatment? a. Implied consent b. Informed consent c. Express consent d. Involuntary consent 123. Which of the following are essential components of informed consent? i.Explanation of the procedure and alternatives to the procedure ii.Discussion of potential risks and benefits of the procedure iii.Confirmation that the patient understands the risks, benefits, and any alterations a. I, III b. I, II c. II, III d. I, II, III 124. Treatment of a patient without consent can constitute ______, which is defined as intentional and unwanting touching. a. Battery b. Slander c. Negligence d. Tort 125. Whose responsibility is it to obtain informed consent? a. Nurse manager b. Anesthesiologist c. Physician d. Midwife 126. Bioethical issue should be described as _______________________. a. The withholding of food and treatment at the request of the patient in a written advance directive given before a patient acquired permanent brain damage from an accident b. The physician’s making all decisions of client management without getting input from the patient c. After the patient gives permission, the physician’s disclosing all information to the family for this support in the management of the patient d. A research project that included treating all regular employed personnel and not treating all casual employed to compare the outcomes of specific drug therapy his discipline is concerned about the determination of the rightness or wrongness of the discoveries and developed technologies in science, as well as the incorporation of human rights and values to health and life. Bioethics refers to the study and evaluation of the decisions done in scientific research and medicine to touch upon the health and lives of people, as well as the society and environment. 127. A nurse is caring for a 72-year-old male patient who requires insertion of a central venous catheter. Who is responsible for obtaining informed consent? a. Physician who will insert the catheter b. Charge nurse c. Attending physician d. The nurse assisting with the procedure 128. A nurse reports that a patient coughs frequently after taking anything by mouth. The dietitian recommends a swallow evaluation for the patient in which the physician participating in the team rounds writes the order. This is an example of collaboration of client care _____. a. With the ancillary care providers b. Between the physician and the dietary department c. With the risk management team because of risk for aspiration d. Among members of the multidisciplinary group 129. Before delegating to a new nurse the task of giving a shower to a paraplegic elderly, the charge nurse should first ensure that the new nurse _____. a. Has demonstrated competency for the task b. Has received the assignment during endorsement time c. Is supervised at all times d. Provides companion to the patients 130. Which of the following tasks would be appropriate for the nurse to delegate to nursing aide? a. Assist a new postoperative patient to the bathroom b. Teach a patient how to administer discharge medications. c. Change a central line dressing. d. Assist the patient during meal time. DISCUSSED CRITICAL THINKING AND DECISION MAKING. Situation – the nurse abides with ethico-moral principles. 131. When the nurse placed the patient in restraints before using other methods of intervention, she/he violated the patient’s rights to _____. a. Receive confidential and respectful care b. Provide informed consent c. Receive treatment in the least restrictive environment d. Refuse treatment 132. Which of the following in not covered in patient’s bill of rights? a. Refusal to treatment c. Right to treatment b. Informed consent d. Civil commitment 133. A patient has been advised by the psychiatrist that he needs inpatient hospitalization. The patient agrees, signs the admission forms, and agrees to receive treatment. What type of admission is this? a. Formal c. Informal b. Voluntary d. Involuntary Am I a formal patient or an informal patient? A. If you decide to seek treatment and have admitted yourself to hospital, you are a voluntary or “informal” patient. If two physicians examine you and find that you are: (i) suffering from a mental disorder, (ii) likely to cause harm to self or others or to suffer substantial mental or physical deterioration or serious physical impairment, and (iii) unsuitable for admission to a facility other than as a formal patient, you will have been hospitalized as a formal patient on the authority of two “admission certificates”. The hospital will: provide you with the reasons, in simple language, why these admission certificates were issued, give you copies of the certificates and tell you how to apply to the review panel if you want to have the certificates cancelled, give you a brochure about how the review panels work, and provide you with the name and address of the Chair of the review panel for the facility where you are a patient. Q. Can my status as a formal or informal (voluntary) patient change from time to time? A. Yes. Your status as a formal patient will end when: the certificates expire, unless a physician and a psychiatrist each issue a renewal certificate, a physician cancels the certificates, the review panel cancels the certificates, or Court of Queen’s Bench cancels the certificates. 134. Disclosure of client information beyond the interdisciplinary team without consent of the client is a breach of _____. a. Confidentiality c. Duty b. Beneficence d. Veracity Situation – Nursing research is conducted to answer a question or resolve problems on the relevance of the nursing profession. 135. The nurse develops the following hypothesis: elderly women receive less aggressive treatment for terminally-ill spine patients than younger women. Which variable would be considered to be the independent variable? a. Degree of treatment received (DEPENDENT) b. Age of the patients c. Use of inpatient treatment d. Type of complications being treated 136. The following are considered qualitative research process except. a. Sample c. Hypothesis b. Literature review d. Data collection 137. Which of the following is an example of a primary source in a research study? a. A textbook of medical-surgical nursing b. A doctoral dissertation that critiques all research in the area of attention deficit disorder c. A published commentary on the findings of another study. d. A journal article about a study that used large, previously unpublished databases generated. 138. What is the best source to use when conducting a level one (1) systematic meta-analysis of the literature? a. An electronic database and doctoral dissertations b. An electronic database c. Doctoral dissertations d. The cochrane statistical methods Cochrane Collaboration is a premiere organization for creating and disseminating reviews of research evidence, most reviews in Coachrane Collaboration database involve meta analysis. Systematic Review: researchers carefully and transparently integrate research evidence about a specific research question. 139. Which type of research allows researchers to be neutral observers? a. Quantitative research c. Case studies b. Ethnographic research d. Qualitative researcher 140. Which of the following is the highest on the hierarchy of Evidence-based practice? a. Systematic Review of Randomized Clinical Trial b. Systematic Review Non-Randomized Clinical Trial c. Cohort and Time Series Management d. Opinions of Respected Authorities. 141. In nursing, Nurse Trining explained that the MAIN goal of conducting a research is to A. Justify is the role of nurses as health care provider B. Establish a credible body of evidence to support and improve the delivery of care C. Identify research priorities that will justify the oversupply of nurses D. Develop a body of knowledge to address non-nursing problem 142. In conducting a study on sleep, Nursing Trining was asked which of the types of research will be used should it involve collecting numerical data which is most often under considerable control. Her answer should be: A. Ethnographic B. Phenomenological C. Qualitative D. Quantitative 143. Should a 24 hour period clinical observations and activities be considered in conducting the research on sleep, the type of study that training will be conducting is? A. Quantitative B. Descriptive C. Ethnological D. Exploratory In a descriptive research the data is collected through primary data collection methods such as case studies, observational method, and surveys. This kind of data collection provides us with rich information and can be used for future research as well. Observational studies Observational studies are ones where researchers observe the effect of a risk factor, diagnostic test, treatment or other intervention without trying to change who is or isn’t exposed to it. Cohort studies and case control studies are two types of observational studies. Cohort study: For research purposes, a cohort is any group of people who are linked in some way. For instance, a birth cohort includes all people born within a given time frame. Researchers compare what happens to members of the cohort that have been exposed to a particular variable to what happens to the other members who have not been exposed. Case control study: Here researchers identify people with an existing health problem (“cases”) and a similar group without the problem (“controls”) and then compare them with respect to an exposure or exposures. Experimental studies Experimental studies are ones where researchers introduce an intervention and study the effects. Experimental studies are usually randomized, meaning the subjects are grouped by chance. Randomized controlled trial (RCT): Eligible people are randomly assigned to one of two or more groups. One group receives the intervention (such as a new drug) while the control group receives nothing or an inactive placebo. The researchers then study what happens to people in each group. Any difference in outcomes can then be linked to the intervention. SITUATION 3 – Sienna, a patient with severe preeclampsia is admitted to the hospital. She is a student from one of the local universities and insists on continuing her studies while in the hospital, despite being instructed to rest. The patient studies approximately 10 hours a day and numerous visits from fellow students, family and friends. 144. When the researcher would like to determine the possible risk factors of one Princess Mikaela in developing pre-eclampsia, along with the appropriate interventions that can be done to address the disease process, what type of research design will suit the inquiry? A. Case study B. Methodological C. Descriptive D. Observational Studies 145. In the hierarchy of evidence-based practice, which of the following is the most credible source of guiding every nurse’ clinical decision making process? A. Systematic Review Observational Studies B. Systematic Review Physiologic Studies C. Systematic Review Non Randomized Clinical Trial D. Systematic Review Descriptive Studies Situation 13 – Nurse Mae is a new supervisor of the health center. Her program thrusts include excellent and quality provision of services and performance of the staff. 146. What is BARS? a) Behaviorally-anchored rating scales b) Behavioral Expectation Scales c) Both d) None of the Above A person is rated on a series of dimensions or qualities. Evaluates the behavior related t specific demands of the job. 147. To ensure that the staff adheres to their job responsibilities which should be the appropriate tool should Nurse Mae utilize in evaluation staff performance? a. Memorandum b. Performance evaluation c. Incident report d. Anecdotal report (recording of observations but there is no rigid structure.) Most health care organizations, however use the term of performance appraisal because this term implies an appraisal of how well employees perform duties of their job as delineated by the job description or some other prespecified criteria. It ultimately results Performance Evaluation: the term evaluation implies that personal values are being placed on the performance review. Methods of Performance appraisal: Anecdotal Notes: Objective description of behavior, no rigid structure. Systematic means for recording observations. Checklists, Rating scales, BARS, BES, Behavioral Observational Scales, Ranking, Management by Objectives, Self-Appraisal, Peer Review, 360 Degree. 148. Which is the simple meaning of standards of nursing care? a. What protects the nurse b. How the nurse will behave c. How much work is done d. What to do Standards of Care: organizational policy and procedure statements, job descriptions and student guidelines. The "medical standard of care" is typically defined as the level and type of care that a reasonably competent and skilled health care professional, with a similar background and in the same medical community, would have provided under the circumstances that led to the alleged malpractice. 149. Which is the BEST strategy that Nurse should employ to give feedback on patient’s evaluation of health services? a. Put the evaluation at supervisor’s office b. Send letter to all c. Conduct staff meeting d. Through bulletin board Situation 15 – Nurse Rica finds effective communication as the key to successful community– health nursing. 150. When writing a memorandum, which of the following is the MOST important guideline a. Purpose is included b. Content Clear c. Friendly tone d. One topic at one time Marquis and Houston, 2021 151. Which of the following is an INDICATOR of effective communication? a. Receiver b. Feedback c. Sender d. Non verbal communication SITUATION 5 - Nurse Pat is a newly hired Registered Nurse together with 5 licensed graduate nurses coming from different regions. It is their first day of orientation in a big health facility. The continuing nurse educator started the session by projecting the organizational structure of the the medical center. 152. Which of the following is the MAJOR PURPOSE of an organizational structure? It is a: A. Blueprint representing committees for delegation of roles and functions B. Flow chart that shows interaction among members of major and minor groups C. Framework of relationship of units, departments and channels of communication D. Design that identifies roles, collaboration, interdependence between functions of people. Tomey: The organizational structure furnishes the framework within which, management process takes place. Marquis and Houston: Max Weber is the father of organizational theory. NB: Centrality: where a position falls on the organizational chart, is determined by organizational distance. Employees with relatively small organizational distance can receive more information than those who are more peripherally located. Middle manager has a large degree of centrality because this manager receives information upward, downward and horizontal: Marquis and Houston p. 302. Interesting: PRINCIPAL’S SYNDROME: “panic when called upon by the principal.” (Note of the break in the chain of communication. Level of Managers: TOP MIDDLE LOW unit’s workflow. Every registered nurse is a FIRST LEVEL MANAGER. TOP MIDDLE FIRST PERSONNEL Chief Nursing Officer Unit Supervisor Charge Nurse Department Head Team Leader Director Primary Nurse Scope of Look at the Integrating unit Focus on the day to day needs Responsibility organization as a level day to day at unit level. whole. needs with the organizational needs Planning Strategic Long and Short Operational range Communication Top-down Centrality Upward ( relies on the middle Flow level management) 153. Line and staff functions are identified in the presented organizational chart. What does line authority mean? A. Staff relationship in the organization is advisory in nature B. Staff mix of personnel reporting to the “Boss” C. Decisions are made from bottom to top in an organization D. Direct responsibility over a subordinate within an organization. Note of the difference between responsibility and accountability. Organization Chart depicts authority (Official power to act), it does not define responsibility (duty or an assignment) and accountability. Situation 2 – Collaboration is being able to work cooperatively and efficient with co-workers and any other people the nurse may have to interact with. This includes other health professionals, clients, and their families and communities. 154. Which of the following is NOT recognized as part of the nurse’s role as member of the health team? a. Care manager and supervisor b. Provider of care and educator c. Patient advocate and supporter d. Performing physician’s functions with supervision 155. The health team has brainstormed for ideas in creating a more collaborative environment in a health care facility. Which idea or action would be the BEST to develop further? a. Develop a plan for the different team members to follow and show impact of their work b. Emphasize that no one profession has all the necessary competence to provide all care c. Hold education sessions regarding collaboration for each unit d. Institute collaborative strategies that are traditionally practiced 156. Which patient scenario describes the BEST example of professional collaboration? a. The nurse, physician, and physical therapist have all visited separately with the patient b. The nurse mentions to the physical therapist that the patient may benefit from a muscle strengthening evaluation c. The nurse and physician discuss the patient’s muscle weakness and initiate a referral for physical therapy d. The nurse, physical therapist, and physician have all developed separate care plans for the patient 157. The mode of nursing service delivery system is being revisited in respond to patient’s outcome. Which of the following is NOT TRUE of the manager’s role in the health care delivery system? A. Provides direct nursing care when needed B. Manages resource utilization C. Act as a liaison in litigation cases in court D. Collaborates with members of the health 158. Budgeting is an important aspect of financial management. When a unit manager allocates expenses for unit supplies, stocks and medical-surgical supplies. This is considered? A. Cash budget B. Operational budget C. Capital budget D. Flexible budget (ELEMENT OF VARIABILITY) IF THERE IS NONE: FIXED. SITUATION 12 - Nurse Eileen has just passed the Board Examination for Nurses and set her goals for her Nursing Career for the next 5 years. She is aspiring to become a Diabetes Nurse Educator after completing her 2 years as a bedside nurse. 159. Which of the following can Nurse Eileen adopt to visualize her future? A. Flow chart B. Program Evaluation Review Technique C. Gantt chart D. Decision grid Graphic method that can help managers to visualize the available alternatives, outcomes, risks and information needs for a specific problem over a period of time. (Short term and medium- range planning but speculative for long term plans. Decision Tree: decisions are tied to outcomes of other events. Decision Grid: visually examine the alternatives and compare each against the same CRITERIA. Same criteria are used to analyzed each alternative. Grid analysis is a valuable method for decision making, and is particularly useful when there are a large number of options, with several issues that should be considered. Program Evaluation Review Technique: network system model. Key activities and assignment of duration of events. (one of a kind project) Critical Path Method. Single time estimate for each activity. (longest possible time) NURSING ALERT! Common flaw in making decisions: TO BASE DECISIONS ON FIRST IMPRESSION. This typically leads to confirmation bias! (This is to affirm one’s initial impression and preferences as other alternatives are evaluated. 160. She started to create her personal and professional portfolio as a preparation for her application to a university medical center in Metro Manila. Which of the following is NOT a major purpose of keeping a portfolio? A. Keep on ongoing records of skills development B. Create a system for documenting accomplishments C. Set career and educational goals D. Set system for a possible shift to another job Professional Portfolio: collection of materials that document a nurse’s competencies and illustrate the expertise of the nurse. A portfolio is a compilation of materials that exemplifies your beliefs, skills, qualifications, education, training and experiences. It provides insight into your personality and work ethic. 161. One area of the professional portfolio is to indicate one’s philosophy of life. Which of the following workplace values should Nurse Eileen consider as NOT favorable to be written in her portfolio? A. Customer service based on acceptance, empathy and selfless duty. B. Time and compensation limiting her pursuit of excellence in her job C. Commitment to continual life long and self-directed learning. D. Challenges which can lead to growth, responsibility and accountability 162. In order for Nurse Eileen to be active as a bedside nurse, she has to comply with the renewal of PRC ID by undertaking continuing professional development (CPD) as mandated by the CPD law. The purposes of which are _______. I Promote and upgrade the practice of the profession. II Improve the competence of the professional III International alignment of competence. IV Develop quality assurance for accreditation A. I & III B. I, II & III C. I, II, III. IV D. I & II Republic Act 10912 or the Continuing Professional Development Act of 2016: Section 2. Declaration of Policy. - It is hereby declared the policy of the State to promote and upgrade the practice of professions in the country. Towards this end, the State shall institute measures that will continuously improve the competence of the professionals in accordance with the international standards of practice, thereby, ensuring their contribution in uplifting the general welfare, economic growth and development of the nation. Xxx Note that the IV category is not part of RA 10912. 163. Nurse Eileen is aware that her personal and professional portfolio has to include and keep up to date the following EXCEPT? A. Certificate of CPD attended B. Letter of reference C. Photographs D. Confidential information from past employers SITUATION 13 – Mr. Reynaldo is tasked to conduct a study to determine the level of patient satisfaction on the care they received from the hospital. In doing so, he plans to include all adult patients admitted from May-October, first admission, with an average length of hospital confinement of 4-5 days, and with no complications. 164. Which of the following is an EXTRANEOUS variable of the study? A. Age of patients B. Absence of complications C. Length of stay 4-5 days D. Date of admission January-March The extra 165. Which of the following variables will he likely EXCLUDE in his study? A. Salary of nurses B. Caring attitude of nurses C. Responsiveness of staff D. Competence of nurses Salary of nurses is not an indicator of patient satisfaction, hence need not be included as a variable in the study. 166. He plans to used likert scale to determines A. Compliance to expected standards B. Degree of agreement and disagreement C. Level of satisfaction D. Degree of acceptance Likert scale is a 5-point summated scale used to determine the degree of agreement or disagreement of the respondents to a statement in a study. 167. Which criterion refers to the ability of the instrument to detect fine differences among the subjects being studied? A. Reliability B. Sensitivity C. Objectivity D. Validity Sensitivity is an attribute of the instrument that allow the respondents to distinguish differences of the options where to choose from. 168. This technique refers to the use of multiple referents to draw conclusions about what constitutes the truth? A. Delphi technique B. Meta-analysis C. Triangulation D. Experiment SITUATION 14 – Nurse Tarly, the research coordinator of a Tertiary hospital where there was a growing concern of patients and family complaints that Nurses are “rude and cranky”. In response to this, She organized a core group to conduct a study on the “Caring behavior of Staff-Nurses and satisfaction of Women with Ostomy”. 169. Based on the research statement, what is the independent variable in the study? A. Staff-Nurses B. Caring behavior C. Women with ostomy D. Satisfaction 170. What is the dependent variable in the study? A. Staff-Nurses B. Ostomy C. Degree of satisfaction D. Caring behavior 171. What are the relevant related literatures that Nurse Tarly and her groupmates can utilize in this study? I Caring behavior III Ostomy pathogenesis III Contentment and satisfaction IV Concept of body image A. III & IV B. I, II & III C. I & III D. I, II, III and IV 172. If Nurse Tarly and her core group decide to formulate a directional hypothesis it will be? A. There is an increase relationship between the caring staff nurses and degree of satisfaction of ostomized patients B. The caring behaviors of the staff nurses is related to increased satisfaction of ostomized patients C. The staff nurses behaviors has an effect on the patients satisfaction with ostomized patients D. A significant relationship exist between the caring behaviors of the staff – nurses and degree of satisfaction of ostomized patients. Caring behavior of Staff-Nurses and satisfaction of Women with Ostomy”. 173. Based on the research problem, what is the Reseach design of the study? A. Quasi – experimental B. Descriptive C. Expost – facto D. Experimental SITUATION 1 - The Hospital Research Coordination is discussing the basics of research with the members of the Research facility as part of continuing Education. Questions and answer are also part of the program. 174. During the open forums, the Hospital Research Coordination raised the question as to, who among the following, provides information in the questionnaire. A. Participants B. Key informants C. Respondents D. Subjects 175. One of the members of the Research Committee wishes to conduct a study involving an interdisciplinary colleague. This study is termed as _________. A. Clinical B. Exploratory C. Collaborative D. Applied 176. In conducting qualitative research, a nurse should follow logical reasoning process termed as, which of the following? A. deductive B. Intuition C. Causal D. Inductive 177. The lecturer reminded the committee members that bias in an influence that distorts the study results. In qualitative research, which will eliminate bias? A. Trustworthiness (degree of confidence qualitative researchers have in their data and analysis often assessed using credibility, transferability, dependability and confirmability. B. Credibility inspire confidence that results are truthful and accurate. C. Randomness D. Triangulation (multiple sources or referrents to draw conclusions about what constitutes the truth) 178. One of the committee members raised the question on how to make an abstract. The question was followed by how many words are required in an abstract should (APA) style be followed? What is the correct answer? A. 450-550 B. 250-350 C. 150-250 D. 350-450 Situation: Knowledge of research in Nursing is an important must in promoting the profession of Nursing. 179. Which of the following is a probability sampling? a. Quota b. Convenience c. Cluster d. Purposive 180. In a research study, 30 men and 30 women admitted in the ER were being studied. What sampling method was used? a. Quota sampling c. Convenient sampling b. Fishbowl method d. Purposive sampling Situation. Research in Nursing is a continuing saga, an important criteria for any profession, most especially in Nursing to expand knowledge and improve patient care. The nurse must be knowledgable of the basic knowledge in research. 181. A measure of variability of scores or values about the mean is the: a. Standard deviation c. Mode b. Range d. Median 182. Another name for the manipulated variable is: a. Dependent variable c. Independent variable b. Criterion variable d. Controlled variable 183. The Hawthorne effect is best illustrated, in which one of the following groups? a. Experimental c. Standardization b. Control d. Norm 184. A factor to consider when determining whether or not a problem could be searched is the: a. Importance of the problem c. Cost kind of instrument needed b. Time factor d. All of the above 185. When initiating the library research for current work, the nurse researcher should first use: a. Abstracts and indexes c. Books b. Card catalog d. Reader’s guide to periodical literature 186. Guidelines for developing an instrument include: a. Instrument should be valid and reliable c. Should be free of bias b. Must be suitable for its function d. All of the above 187. If a nurse researcher wishes to assess what activities are considered as health-promoting in order to importance to a particular group of persons, which technique would be used? a. Checklist c. Q-sort b. Stimulation d. Rating Scale Q SORT: A type of comparative scale where respondents are asked to sort between 60-90 objects (usually) into piles according to some criteria. It is a useful technique for sorting relatively large numbers of objects quite quickly. 188. Statistical analysis of the data utilizes several measures to estimates the chances that the findings can be generalized to the larger population. These may include: a. mean c. mode b. median d. the standard deviation 189. The interview schedule that is read to a respondent is known as: a. Standardized c. Semi-standardized b. Non-standardized d. None of the above 190. The selection of statistical approach depends on all of the following factors except: a. The purpose of the study c. The Hypothesis b. The conclusions of the study d. The size of Sample 191. A pilot study and case study are design used which type of research? a. Non-experimental c. Historical b. Explanatory d. Descriptive 192. The most common type of data-collecting instrument is: a. The questionnaire c. The interview b. The survey d. The critical incident 193. The process that takes place after data are analyzed and includes generalization about the findings is the: a. Evaluation c. Recommendation b. Conclusion d. Implication 194. The following explanations are found in the review literature, EXCEPT: a. Awareness of the most recent development in the area of interests both in content and methods b. To demonstrate the researcher’s comprehensive understanding of issues related to research problem c. All written materials published or unpublished local or foreign pertinent to the topic investigated d. Either to define or revise research problem, instruments or some feature of previous study 195. The purpose of a research report is to: a. Prove hypothesis c. Suggests topics for further research b. Communicate what was done with the study d. Gain recognition as a scholar for the writes Situation: As a nurse researcher, you must have a very good understanding of the common terms of concept used in research. 196. Initially, the students’ started with 50 subjects. In the ensuing days, it started to drop to 30 subjects. This may be a threat to: a. External validity b. Internal validity c. Content validity d. Construct validity 197. Which of the following constitute a threat to external validity? a) A shocking event causes a change in the BP of subjects after treatment b) The undue influence/effect of the experimenter being too domineering c) The long duration of the study causing the progress of health concerns of the subjects d) The decreasing number of subjects 198. After the analysis of the data which of the following steps shall be taken by the researcher? a. Interpret the data b. Write the conclusion and recommendation c. Organize the data using frequency distributions d. Disseminate the results of the study 199. In a certain study, the researcher was asked to consider the gender. Gender is classified in what scale of measurement? a. Nominal b. Ordinal c. Internal d. Ratio 200. The variable that may create uncertainty in the result of research refers to: a. Independent variable b. Dependent variable c. Extraneous variable d. None of the above 2018 PALMR QUESTIONS Situation 2: As a nurse, knowledge of the legal aspects in nursing is essential to safeguard self and clients from legal complications. Clients are becoming increasingly aware of their health rights, thus you should recognize your professional boundaries and consequences of nonconformity. 1. Your co-worker got a thank you card from a patient’s family with an accompanying photo of her with the family. She asked you if it would be alright to post the post on facebook. Which would be your BEST response? a. “I think that would be okay, but you should ask permission from our head.” b. “Yes, as long as you ask the family if that would be okay.” c. “No, that could lead to a malpractice suit by the patient or family.” d. “No, posting pictures of patients and families on social media is not acceptable.” 2. Identify which action is acceptable as an exception to a nurse’s obligation regarding confidentiality. a. Leaving printouts of lab reports on the desk in the physicians’ lounge b. Discussing a patient’s care with someone who is not involved in patient care c. Discussing a patient’s condition in a public place as long as his name is not mentioned d. Reporting certain disease to public health authority 3..The central question in any charge of malpractice is whether the prevailing standard of care was met. Which of the following statements are TRUE about standards of nursing care? 1. Basic prudent nursing care is a standard. 2. Any health care provider can determine standards of care. 3. Standards of care are never changing. 4. Standards are based on the ethical principle of non- maleficence. 5. National standards of nursing practice are standards for all nurses. a. 1,3,4 b. 2,3,5 c. 1,4,5 d. 2,4,5 4. Select the nursing responsibility which can NEVER be delegated. a. Rotation schedule b. Evaluation c. Accountability d. Complex Procedure 5. For safe nursing practice, you should observe some of the do’s and do not’s in performing your professional duty. Which ones are NOT acceptable standard of actions by the nurse? 1. Keeping current year license to practice 2. Being a witness to a patient’s will 3. Following policies and procedures 4. Protecting patients from injuring themselves 5. Accepting money or gift from patients 6. Giving practical advice contrary to the doctor’s orders * a. 1,4, 6 b. 1,3,4 c. 2,4,5 d. 5,6 Situation 3: Nurse Betty knows that ethics is important in community health nursing practice and that ethical decisions are conducted in a universal and standard framework. 6. One step in ethical decision- making is to place an ethical issue or dilemma within a meaningful context. The rationale for this step is: a. The nature of ethical issues and dilemmas determines the specific ethical approach used. b. People cannot make sound ethical decision if they cannot identify ethical issues and dilemmas c. Multiple factors affect the interpretation and justification of the ethical issues and dilemmas d. Health professionals cannot avoid choice and action in applying ethics in their work setting. 7. The historical character in nursing whose work in environmental health, providing care to destitute people, and disease prevention establishing the nurse as a leader and community- oriented was _______. a. Lilian Wald b. Virginia Henderson c. Margaret Sanger d. Florence Nightingale 8. Ethical decision making is the component of ethics that focuses on ____. a. The result of the decision b. The process of how decision are made c. The factors impinging on making the decision d. Who makes the decision 9. The ethical principle that empowers the client (groups or communities) to make knowledgeable decision is _. a. Act in accordance to client’s wishes b. Act in client’s best interest c. Offer franks and independent advice d. Keep the client properly informed 10. When nurse betty cannot meet a need of the client, it is most appropriate for her to: a. Refer the client to an agency that may be able to give assistance b. Suggest that the client discuss the need with the physician. c. Encourage the client to pay someone to meet that need. d. Inform the client that insurance will not pay for the care. Situation 5: Interdisciplinary teamwork is an important model for delivering health care to patients. Integrating services among many health providers leads to better outcomes delivered to underserved populations and communities with limited access to health care. 11. Professional group productivity and member satisfaction are best achieved by which of the following leadership styles? a. Democratic b. Authoritarian c. Laissez-faire d. Autocratic 12. As a member of a professional work-related group you know that: a. Functional goals are assigned by management b. The leader is responsible for overall functioning c. The members summarize progress and allocate assignments d. The cooperation of all members is required. 13. The nurse is making a referral for the client. What should be the first consideration for the nurse to do? a. Acceptability of the referral to the client b. Cost of the referral service c. Barriers to making a referral d. Client’s eligibility for the service 14. Group with a laissez faire leader are likely to be ___. a. More structured in format b. Less productive c. More productive d. More satisfying to members 15. You have volunteered to be part of a work group whose purpose is to look at ways to prevent medication error. You know that: a. Teamwork enhances the probability of goal achievement b. Group process is not important in a task c. The leader assumes responsibility for the overall group functioning d. The goal should be set by management Situation 10 – In public health, quality improvement (QI) techniques are used to improve performance and service delivery. 16. PDCA is the basic structure for most quality improvement (QI) process. In public health, PDCA is focused on activities that are responsive to community needs and improving population health. PDCA stands for: a. Perform-Document-Correct-Act b. Perform-Do-Check-Analyze c. Plan-Document-Check-Analyze d. Plan-Do-Check-Act 17. There are several

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