1.

Upon assessment, Leo was

A. Administration of immunoglobulin to

A. 30 days

diagnosed to have hepatitis A.

families

B. 60 days

Which mode of transmission has

B. Thorough hand washing before and

C. 50 days

the infection agent taken?

after eating and toileting

D. 14 days

C. Use of attenuated vaccines

A. Fecal oral

D. Boiling of food especially meat

B. Droplet

Situation 2: As a nurse researcher you

must have a very good understanding

C. Airborne

4. Disaster control should be

of the common terms of concept used

D. Sexual contact

undertaken when there are 3 or

in research.

more hepatitis A cases. Which of

2. Which of the following is

these measures is a priority?

concurrent disinfection in the case

of Leo?

6. The information that an

investigator collects from the

A. Eliminate fecal contamination from

subjects or participants in a

foods

research study is usually called:

A. Investigation of contact

B. Mass vaccination of uninfected

B. Sanitary disposal of feces, urine and

individuals

A. Hypothesis

blood

C. Health promotion and education to

B. Data

C. Quarantine of the sick individual

families and communities about the

C. Variable

D. Remove all detachable objects in

disease its cause and transmission.

D. Concept

the room.

D. Mass administration of
immunoglobulin

3. Which of the following must be

7. Which of the following usually

refers to the independent variables

emphasized during mothers class

5. What is the average incubation

to Leos mother?

period of Hepatitis A?

in doing research?
A. Result
B. Cause

C. Output

inaccurate attribution of materials to

reaction to local anesthesia

D. Effect

its sources. Which of the following

D. Ascertain if chest x-rays and other

is referred to when another persons

tests have been prescribed and

8. The recipients of experimental

idea is inappropriate credited as

completed

treatment is an experimental design

ones own?

or the individuals to be observed in

12. Mrs. Pichay who is for

a non experimental design are

A. Plagiarism

thoracentesis is assigned by the

called:

B. Quotation

nurse to which of the following

C. Assumption

positions?

A. Setting

D. Paraphrase

B. Subjects

A. Trendelenburg position

C. Treatment

Situation 3: Mrs. Pichay is admitted to

B. Supine position

D. Sample

your ward. The MD ordered Prepare

C. Dorsal Recumbent position

for thoracentesis this pm to remove

D. Orthopneic position

9. The device or techniques an

excess air from the pleural cavity.

investigator employs to collect data

is called?

13. During thoracentesis, which of

11. Which of the following nursing

the following nursing intervention

responsibilities is essential in Mrs.

will be most crucial?

A. Sample

Pichay who will undergo

B. Instrument

thoracentesis?

C. Hypothesis
D. Concept

A. Place patient in a quiet and cool

room

A. Support and reassure client during

B. Maintain strict aseptic technique

the procedure

C. Advice patient to sit perfectly still

10. The use of another persons

B. Ensure that informed consent has

during needle insertion until it has been

ideas or wordings giving

been signed

withdrawn from the chest

appropriate credit results from

C. Determine if client has allergic

D. Apply pressure over the puncture

he had experienced seizure in his

still and stead.

site as soon as the needle is withdrawn

office.

C. Give a cleansing enema and give

until 8 AM

14. To prevent leakage of fluid in the

16.Just as nurse was entering the

D. Shave scalp and securely attach

thoracic cavity, how will you

room, the patient who was sitting on

electrodes to it

position the client after

his chair begins to have a seizure.

thoracentesis?

Which of the following must the

18. Mr. Santos is placed on seizure

nurse do first?

precaution. Which of the following

A. Place flat in bed

would be contraindicated?

B. Turn on the unaffected side

A. Ease the patient to the floor

C. Turn on the affected side

B. Lift the patient and put him on the

A. Obtain his oral temperature

D. On bed rest

bed

B. Encourage to perform his own

C. Insert a padded tongue depressor

personal hygiene

15. Chest x-ray was ordered

between his jaws

C. Allow him to wear his own clothing

after thoracentesis. When your

D. Restrain patients body movement

D. Encourage him to be out of bed.

17. Mr. Santos is scheduled for CT

19. Usually, how does the patient

SCAN for the next day, noon time.

behave after his seizure has

A. to rule out pneumothorax

Which of the following is the correct

subsided?

B. to rule out any possible perforation

preparation as instructed by the

C. to decongest

nurse?

client asks what is the reason for

another chest x-ray, you will explain:

D. to rule out any foreign body

A. Most comfortable walking and

moving about.

A. Shampoo hair thoroughly to remove

B. Becomes restless and agitated.

Situation 4: A computer analyst, Mr.

oil and dirt

C. Sleeps for a period of time

Ricardo J. Santos, 25 was brought to

B. No special preparation is needed.

D. Say he is thirsty and hungry.

the hospital for diagnostic workup after

Instruct the patient to keep his head

20. Before, during and after seizure.

22. The simplest pain relieving

25. When a client complains of pain,

The nurse knows that the patient is

technique is:

your initial response is:

A. Distraction

A. Record the description of pain

A. Low fowlers

B. Taking aspirin

B. Verbally acknowledge the pain

B. Modified trendelenburg

C. Deep breathing exercise

C. Refer the complaint to the doctor

C. Side Lying

D. Positioning

D. Change to a more comfortable

ALWAYS placed in what position?

D. Supine

position
23. Which of the following statement

Situation 5: Mrs. Damian an immediate

on pain is true?

post op cholecystectomy and

Situation 6: You are assigned at the

surgical ward and clients have been

choledocholithotomy patient,

A. Culture and pain are not associated

complaining of post pain at varying

complained of severe pain at the

B. Pain accomplished acute illness

degrees. Pain as you know is very

wound site.

C. Patients reaction to pain varies

subjective.

D. Pain produces the same reaction

21. Choledocholithotomy is:

such as groaning and moaning

26. A one-day postoperative

abdominal surgery client has been

A. The removal of the gallbladder

24. In a pain assessment, which of

complaining of severe throbbing

B. The removal of the stones in the

the following condition is a more

abdominal pain described as 9 in 1

gallbladder

reliable indicator?

10 pain rating. Your assessment

C. The removal of the stones in the

reveals bowel sounds on all

common bile duct

A. Pain rating scale of 1 10

quadrants and the dressing is dry

D. The removal of the stones in the

B. Facial expression and gestures

and intact. What nursing

kidney

C. Physiological responses

intervention would you take?

D. Patients description of the pain

sensation

A. Medicate client as prescribed

and avoid deep breathing and talking

A. Epidural and Spinal

B. Encourage client to do-imagery

C. Offer hot and clear soup

B. Subarachnoid block and intravenous

C. Encourage deep breathing exercise

D. Turn to sides frequently and avoid

C. Inhalation and Regional

D. Call surgeon stat

too much talking

D. Intravenous and inhalation

27. Pentoxide 5 mg IV every 8 hours

29. Surgical pain might be

Situation 7: Nurses attitudes toward

was prescribed for post abdominal

minimized by which nursing action

the pain influence the way they

pain, which will be your priority

in the O.R.

perceive and interact with clients in

pain.

nursing action?
A. Skill of surgical team and lesser
A. Check abdominal dressing for

manipulation

31. Nurses should be aware of that

possible swelling

B. Appropriate preparation for the

older adults are at risk of underrated

B. Explain the proper use of PCA to

scheduled procedure

pain. Nursing assessment and

alleviate anxiety

C. Use of modern technology in closing

management of pain should address

C. Avoid overdosing to prevent

the wound

the following beliefs EXCEPT:

dependence/tolerance

D. Proper positioning and draping of

D. Monitor VS, more importantly RR

client.

A. Older patients seldom tend to report

pain than the younger ones

28. The client complained of

30. Inadequate anesthesia is said to

B. Pain is a sign of weakness

abdominal distention and pain. Your

be one of the common cause of pain

C. Older patients do not believe in

nursing intervention that can

both in intra and post-op patients. If

analgesics, they are tolerant.

alleviate pain is:

general anesthesia is desired, it will

D. Complaining of pain will lead to

involve loss of consciousness.

being labelled a bad patient

A. Instruct client to go to sleep and

Which of the following are the 2

relax

general types of GA?

B. Advice the client to close the lips

32. Nurses should understand that

when a client responds favourably

to a placebo, it is known as the

among elderly clients who are in

Segovia, a 30 years old Dentist with

placebo effect. Placebos do not

pain?

Insulin dependent diabetes Mellitus.

A. Forgetfulness

36. Jane is preparing a mixed dose

A. Conscience

B. Constipation

of insulin. The nurse is satisfied

B. Real pain

C. Drowsiness

with her performance when she:

C. Disease

D. Allergic reactions like pruritus

indicate whether or not a client has:

D. Drug tolerance

A. Draw insulin from the vial of clear

35. Physical dependence occurs in

insulin first

33. You are the nurse in the pain

anyone who takes opiods over a

B. Draw insulin from the vial of the

clinic where you have client who

period of time. What do you tell a

intermediate acting insulin first

has difficulty specify the location of

mother of a dependent when asked

C. Fill both syringes with the prescribed

pain. How can you assist such

for advice?

insulin dosage then shake the bottle

vigorously

client?
A. Start another drug and slowly lessen

D. Withdraw the intermediate acting

A. The pain is vague

the opioid dosage

insulin first before withdrawing the

B. By charting-it hurts all over

B. Indulge in recreational outdoor

short acting insulin first.

C. Identifying the absence and

activities

presence of pain

C. Isolate opioid dependent to a restful

37. Jane complains of nausea,

D. Ask the client to point to the painful

resort

vomiting, diaphoresis and

are by just one finger.

D. Instruct slow tapering of the drug

headache. Which of the following

dosage and alleviate physical

nursing intervention are you going

withdrawal symptoms.

to carry first?

Situation 8: The nurse is performing

A. Withhold the clients next insulin

health education activities for Jane

injection

34. What symptom more distressing

than pain, should the nurse monitor
when giving opioids especially

B. Test the clients blood glucose level

C. Ketone levels

D. Always have a podiatrist to cut your

C. Administer Tylenol as ordered

D. Uirne glucose level

toe nails; never cut them yourself

40. Upon the assessment of HbA1C

42. Another patient was brought to

of Mrs. Segovia. The nurse has been

the emergency room in an

38. Jane administered regular

informed of a 9 % HbA1C result. In

unresponsive state and a diagnosis

insulin at 7 A.M. and the nurse

this case, she will teach the patient

of hyperglycaemic hyperosmolar

should instruct Jane to avoid

to:

nonketotic syndrome is made. The

D. Offer fruit juice, gelatine and chicken

bouillon

exercising at around:

nurse immediately prepare to initiate

A. Avoid infection

which of the following anticipated

A. 9 to 11 A.M.

B. Take adequate food and nutrition

physicians order?

B. After 8 hours

C. Prevent and recognize

C. Between 8 A.M. to 9 A.M.

hypoglycaemia

A. Endotracheal intubation

D. In the afternoon, after taking lunch.

D. Prevent and recognize

B. 100 units of insulin

hypoglycaemia

C. Intravenous infusion of normal

saline

39. Jane was brought at the

emergency room after four month

41. The nurse is teaching plan of

D. Intravenous infusion of sodium

because she fainted in her clinic.

care for Jane with regards to proper

bicarbonate

The nurse should monitor which of

foot care. Which of the following

the following test to evaluate the

should be included in the plan?

overall therapeutic compliance of a

43. Jane eventually developed DKA

and is being treated in the

A. Soak feet in hot water

emergency room. Which finding

B. Avoid using mild soap on the feet

would the nurse expect to note as

A. Glycosylated Hemoglobin

C. Apply a moisturizing lotion to dry

confirming this diagnosis?

B. Fasting blood glucose

feet but not between the toes

diabetic patient?

A. Comatose state

distilled water. The nurse asked

46. Hypoxia may occur in the older

B. Decreased urine output

Jane if she drink any, and she said

patients because of which of the

C. Increased respiration and increase

yes. Which of the following is the

following physiologic changes

in pH

best nursing action?

associated with aging.

A. Administer syrup of ipecac to

A. Ineffective airway clearance

remove the distilled water from the

B. Decreased alveolar surfaced area

44. The nurse teaches Jane to know

stomach.

C. Decreased anterior-posterior chest

the difference between

B. Suction the stomach content using

diameter

hypoglycaemia and ketoacidosis.

NGT prior to specimen collection

D. Hyperventilation

Jane demonstrates understanding

C. Advice to physician to reschedule to

of the teaching by stating that

diagnostic examination next day

47. The older patient is at higher risk

glucose will be taken of which of the

D. Continue as usual and have the

for incontinence because of:

following symptoms develops?

FBS analysis performed and specimen

D. Elevated blood glucose level and

plasma bicarbonate level

be taken.
A. Heavy breathing

A. dilated urethra
B. increased glomerular filtration rate

B. Shakiness

Situation 9: Elderly clients usually

C. diuretic use

C. Blurred vision

produce unusual signs when it comes

D. decreased bladder capacity

D. Foul breath odor

to different diseases. The ageing

process is a complicated process and

48. Merle, age 86, is complaining of

45. Jane has been scheduled to

the nurse should understand that it is

dizziness when she stands up. This

have a FBS taken in the morning.

an inevitable fact and she must be

may indicate:

The nurse tells Jane to eat or drink

prepared to care for the growing elderly

after midnight. Prior to taking the

population.

blood specimen, the nurse noticed

that Jane is holding a bottle of

A. dementia
B. a visual problem

C. functional decline

51. Which of the following should be

overall goal of nursing care during

D. drug toxicity

given highest priority when

the intraoperative phase. As the

receiving patient in the OR?

circulating nurse, you make certain

49. Cardiac ischemia in an older

patient usually produces:

that throughout the procedure:

A. Assess level of consciousness
B. Verify patient identification and

A. the surgeon greets his client before

A. ST-T wave changes

informed consent

induction of anesthesia

B. Very high creatinine kinase level

C. Assess vital signs

B. the surgeon and anesthesiologist

C. Chest pain radiating to the left arm

D. Check for jewelry, gown, manicure,

are in tandem

D. Acute confusion

and dentures

C. strap made of strong non-abrasive

materials are fastened securely around

50. The most dependable sign of

52. Surgeries like I and D (incision

the joints of the knees and ankles and

infection in the older patient is:

and drainage) and debridement are

around the 2 hands around an arm

relatively short procedures but

board.

A. change in mental status

considered dirty cases. When are

D. Client is monitored throughout

B. fever

these procedures best scheduled?

the surgery by the assistant

C. pain

anaesthesiologist

D. decreased breath sounds with

A. Last case

crackles

B. In between cases

54. Another nursing check that

C. According to availability of

should not be missed before the

Situation 10 In the OR, there are

anaesthesiologist

induction of general anesthesia is:

safety protocols that should be

D. According to the surgeons

followed. The OR nurse should be well

preference

versed with all these to safeguard the

A. check for presence underwear

B. check for presence dentures

safety and quality of

53. OR nurses should be aware that

C. check patients ID

patient deliveryoutcome.

maintaining the clients safety is the

D. check baseline vital signs

55. Some lifetime habits and

57. Autoclave or steam steam under

C. Gray

hobbies affect postoperative

pressure is the most common

D. Purple

respiratory function. If your

method of sterilization in the

client smokes 3 packs of cigarettes

hospital. The nurse knows that the

59. Chemical indicators

a day for the past 10 years, you will

temperature and time is set to the

communicate that:

anticipate increased risk for:

optimum level to destroy not only

the microorganism, but also the

A. The items are sterile

A. perioperative anxiety and stress

spores. Which of the following is the

B. That the items had undergone

B. delayed coagulation time

ideal setting of the autoclave

sterilization process but not necessarily

C. delayed wound healing

machine?

sterile

D. postoperative respiratory function

C. The items are disinfected

A. 10,000 degree Celsius for 1 hour

D. That the items had undergone

Situation 11: Sterilization is the process

B. 5,000 degree Celsius for 30 minutes

disinfection process but not necessarily

of removing ALL living microorganism.

C. 37 degree Celsius for 15 minutes

disinfected

To be free of ALL living microorganism

D. 121 degree Celsius for 15 minutes

is sterility.

60. If a nurse will sterilize a heat and

58. It is important that before a

moisture labile instruments, it is

56. There are 3 general types of

nurse prepares the material to be

according to AORN

sterilization use in the hospital

sterilized. A chemical indicator strip

recommendation to use which of the

which one is not included?

should be placed above the

following method of sterilization?

package, preferably, Muslin sheet.

A. Steam sterilization

What is the color of the striped

A. Ethylene oxide gas

B. Chemical sterilization

produced after autoclaving?

B. Autoclaving

C. Autoclaving
D. Sterilization by boiling

C. Flash sterilizer
A. Black
B. Blue

D. Alcohol immersion

Situation 12 Nurses hold a variety of

comfort room

C. Separation of the incision

roles when providing care to a

D. Obtain consent form

D. Blood clots and scar tissue are

perioperative patient.

visible
63. It is the responsibility of the pre-

61. Which of the following role

op nurse to do skin prep for patients

65. Which of the following nursing

would be the responsibility of the

undergoing surgery. If hair at the

interventions is done when

scrub nurse?

operative site is not shaved, what

examining the incision wound and

should be done to make suturing

changing the dressing?

A. Assess the readiness of the client

easy and lessen chance of incision

prior to surgery

infection?

B. Ensure that the airway is adequate

A. Observe the dressing and type and

odor of drainage if any

C. Account for the number of sponges,

A. Draped

B. Get patients consent

needles, supplies, used during the

B. Pulled

C. Wash hands

surgical procedure.

C. Clipped

D. Request the client to expose the

D. Evaluate the type of anesthesia

D. Shampooed

incision wound

64. It is also the nurses function to

Situation 13: The preoperative nurse

62. As a perioperative nurse, how

determine when infection is

collaborates with the client significant

can you best meet the safety need

developing in the surgical incision.

others, and healthcare providers.

of the client after administering

The perioperative nurse should

preoperative narcotic?

observe for what signs of impending

66. To control environmental

infection?

hazards in the OR, the nurse

appropriate for the surgical client

A. Put side rails up and ask the client

collaborates with the following

not to get out of bed

A. Localized heat and redness

B. Send the client to OR with the family

B. Serosanguinous exudates and skin

C. Allow client to get up to go to the

blanching

departments EXCEPT:

A. Biomedical division

use at 132 degree Celsius in 3

A. Double check the doctors order and

B. Chaplaincy services

minutes.

call the attending MD

C. Infection control committee

D. Pathology department

B. Communicate with the ward nurse to

68. Tess, the PACU nurse

verify if insulin was incorporated or not

discovered that Malou, who weighs

C. Communicate with the client to

67. An air crash occurred near the

110 lbs prior to surgery, is in severe

verify if insulin was incorporated

hospital leading to a surge of

pain 8 hours after cholecystectomy.

D. Incorporate insulin as ordered

trauma patient. One of the last

Upon checking the chart, Malou

patients will need surgical

found out that she has an order

70. The documentation of all

amputation but there are no sterile

of Demerol 100 mg I.M. prn for pain.

nursing activities performed is

surgical equipments. In this case,

Tess should verify the order with:

legally and professionally vital.

which of the following will the nurse

expect?

Which of the following should NOT

A. Nurse supervisor

be included in the patients chart?

B. Anesthesiologist
A. Equipments needed

C. Surgeon

A. Presence of prosthetic devices such

for surgery need not be sterilized if this

D. Intern on duty

as dentures, artificial limbs hearing aid,

is an emergency necessitating life

etc.

saving measures

69. Rosie, 57, who is diabetic is for

B. Baseline physical, emotional, and

B. Forwarding the trauma client to the

debridement if incision wound.

psychosocial data

nearest hospital that has available

When the circulating nurse checked

C. Arguments between nurses and

sterile equipment is appropriate

the present IV fluid, she found out

residents regarding treatment

C. The nurse will need to sterilize the

that there is no insulin incorporated

D. Observed untoward signs and

item before using it to the client using

as ordered. What should the

symptoms and interventions including

the regular sterilization setting at 121

circulating nurse do?

contaminant intervening factors.

degree Celsius in 15 minutes.

D. In such cases, flash sterilizer will be

Situation 14 Team efforts is best

73. While team effort is needed in

C. Circulating Nurse

demonstrated in the OR.

the OR for efficient and quality

D. Anesthesiologist

patient care delivery, we should

71. If you are the nurse in charge for

limit the number of people in the

75. The breakdown in teamwork is

scheduling surgical cases, what

room for infection control. Who

often times a failure in:

important information do you need

comprise this team?

A. Electricity

to ask the surgeon?

A. Surgeon, anesthesiologist, scrub

B. Inadequate supply

A. Who is your internist?

nurse, radiologist, orderly

C. Leg work

B. Who is your assistant and

B. Surgeon, assistants, scrub nurse,

D. Communication

anesthesiologist, and what is your

circulating nurse, anesthesiologist

preferred time and type of surgery?

C. Surgeon, assistant surgeon,

Situation 15: Basic knowledge on

C. Who are your anesthesiologist,

anesthesiologist, scrub nurse,

Intravenous solutions is necessary for

internist, and assistant?

pathologist

care of clients with problems with fluids

D. Who is your anesthesiologist?

D. Surgeon, assistant surgeon,

and electrolytes.

anesthesiologist, intern, scrub nurse

72. In the OR, the nursing tandem
for every surgery is:

76. A client involved in a motor

74. Who usually act as an important

vehicle crash presents to the

part of the OR personnel by getting

emergency department with severe

A. Instrument technician and circulating

the wheelchair or stretcher, and

internal bleeding. The client is

nurse

pushing/pulling them towards the

severely hypotensive and

B. Nurse anesthetist, nurse assistant,

operating room?

unresponsive. The nurse anticipates

and instrument technician

which of the following intravenous

C. Scrub nurse and nurse anesthetist

A. Orderly/clerk

solutions will most likely be

D. Scrub and circulating nurses

B. Nurse Supervisor

prescribed to increase intravascular

volume, replace immediate blood

infusing. The nurse concludes that

transient hyperinsulin reaction what

loss and increase blood pressure?

which of the following

solution you prepare in anticipation

complications has been experienced

of the doctors order?

A. 0.45 % sodium chloride

by the client?

B. Normal saline solution

A. Any IV solution available to KVO

C. o.33% sodium chloride

A. Infection

B. Isotonic solution

D. Lactated ringers solution

B. Phlebitis

C. Hypertonic solution

C. Infiltration

D. Hypotonic solution

77. The physician orders the nurse

D. Thrombophlebitis

to prepare an isotonic solution.

81. An informed consent is required

Which of the following IV solution

79. A nurse reviews the clients

would the nurse expect the intern to

electrolytes laboratory report and

prescribe?

notes that the potassium level is 3.2

A. Closed reduction of a fracture

mEq/L. Which of the following would

B. Insertion of intravenous catheter

A. 5 % dextrose in water

the nurse note on the

C. Irrigation of the external ear canal

B. 10 % dextrose in water

electrocardiogram as a result of the

D. Urethral catheterization

C. 0.45 % sodium chloride

laboratory value?

D. 0.5 % dextrose in 0.9% sodium

chloride

for:

82. Which of the following is not true

A. U waves

with regards to the informed

B. P waves

consent?

78. The nurse is making initial

C. Elevated T waves

rounds on the nursing unit to

D. Elevated ST segment

A. It should describe different treatment

alternatives

assess the condition or assigned

clients. The nurse notes that the

80. One patient has a runaway IV of

B. It should contain a thorough and

clients IV site is cool, pale and

50 % dextrose. To prevent

detailed explanation of the procedure

swollen and the solution is not

temporary excess of insulin or

to be done

C. It should describe the clients

85. A nurse is assigned to care for a

C. Cost and duration of disinfection

diagnosis

group of clients. On review of the

process

D. It should given an explanation of the

clients medical records, the nurse

D. Duration of disinfection and

clients prognosis

determines that which client is at

efficiency

risk for deficient fluid volume?

83. You know that the hallmark of
nursing accountability is the:

87. Before you used disinfected

A. A client with colostomy

instrument it is essential that you:

B. A client with congestive heart failure

A. Accurate documentation and

C. A client with decreased kidney

A. Rinse with tap water followed by

reporting

function

alcohol

B. Admitting your mistakes

D. A client receiving frequent wound

B. Wipe the instrument with sterile

C. Filing an incidence report

irrigation

water

D. Reporting a medication error

C. Dry the instrument thoroughly

Situation 16: As a perioperative nurse,

D. Rinse with sterile water

84. A nurse is assigned to care for a

you are aware of the correct

group of clients. On review of the

processing methods for preparing

88. You have a critical heat labile

clients medical records the nurse

instruments and other devices for

instrument to sterilize and are

determines that which client is at

patient use to prevent infection.

considering to use high level of

risk for excess fluid volume?

disinfectant. What should you do?

86. As an OR nurse, what are your

A. The client taking diuretics

foremost considerations for

A. Cover the soaking vessel to contain

B. The client with renal failure

selecting chemical agents for

the vapour

C. The client with an ileostomy

disinfection?

B. Double the amount of high level of

D. The client who requires

gastrointestinal suctioning

disinfectant
A. Material compatibility and efficiency

C. Test the potency of the high level of

B. Odor and availability/

disinfectant

D. Prolong the exposure time

hours

A. Elevation of serum ketones to

according to manufacturers direction

D. 2% Glutaraldehyde immersion for

monitor ketosis

10 hours

B. Vital signs including BP

C. Estimate serum potassium

89. To achieve sterilization using

disinfectants, which of the following

Situation 17: The OR is divided in three

is used?

zones to control traffic flow and

contamination.

A. Low level disinfectants immersion in

D. Elevation of blood glucose levels

93. The doctor ordered to
incorporate 1000 u insulin to the

24 hours

91. What OR attires are worn in the

remaining ongoing IV. The strength

B. Intermediate level disinfectants

restricted area?

is 500/ml. How much should you

immersion in 12 hours

incorporate into the IV solution?

C. High level disinfectants immersion in

A. Scrub suit, OR shoes, head cap

1 hour

B. Head cap scrub suit, mask, OR

A. 10 ml

D. High level disinfectants immersion in

shoes

B. 2 ml

10 hours

C. Mask, OR shoes, scrub suit

C. 0.5 ml

D. Cap, Mask, gloves, shoes

D. 5 ml

Endoscope, ET tube, Cystoscope

92. Nursing intervention for a

94. Multiple vial-dose-insulin when

are all BEST sterilized using which

patient on low dose IV insulin

in use should be:

of the following?

therapy includes the following

90. Bronchoscope, Thermometer,

EXCEPT:

A. Kept at room temperature

A. Autoclaving at 121 degree Celsius in

B. Kept in the refrigerator

15 minutes

C. Kept in narcotic cabinet

B. Flash sterilizer at 132 degree

D. Store in the freezer

Celsius in 3 minutes
C. Ethylene Oxide gas aeration for 20

95. Insulin using insulin syringe are

with muslin are considered sterile as

A. The material is clean.

given using how many degrees of

long as they have undergone the

B. The material as well as the

needle insertion?

sterilization process

equipments are sterilized and had

undergone a rigorous sterilization

A. 45

97. Two (2) organizations endorsed

process

B. 180

that sterility are affected by factors

C. There is a black stripe on the paper

C. 90

other that the time itself, these are:

indicator

D. 15

D. The material has no microorganism

A. The PNA and the PRC

nor spores present that might cause an

Situation 18: Maintenance of sterility is

B. AORN and JCAHO

infection

an important function a nurse should

C. ORNAP and MCNAP

perform in any OR setting.

D. MMDA and DILG

100. In using liquid sterilizer or

autoclave machine, which of the

96. Which of the following is true

98. All of these factors affect the

with regards to sterility?

sterility of the OR equipment, these

are the following except:

A. Sterility is time related items are not

following is true?
A. Autoclave is better in sterilizing OR
supplies versus liquid sterilizer

considered sterile after a period of 30

A. The material used for packaging

B. They are both capable of sterilizing

days of being not in use.

B. The handling of the materials as well

the equipments, however, it is

B. for 9 months sterile items are

as its transport

necessary to soak supplies in the liquid

considered sterile as long as they are

C. Storage

sterilizer for a longer period of time.

covered with sterile muslin cover and

D. The chemical or process used in

C. Sharps are sterilized using

stored in a dust proof covers.

sterilizing the material

autoclave and not cidex.

C. Sterility is event related, not time

related.
D. For 3 weeks, items double covered

D. If liquid sterilizer sterilization

99. When you say sterile, it means:

process is used, rinsing it before using

is not necessary.

Answers
Here are the answers for the exam.
Unfortunately, rationales are not
given. If you need clarifications or
disputes, please direct them to the
comments section and well be glad
to give you an explanation.
1.

A. Fecal oral

2.

B. Sanitary disposal of
feces, urine and blood

3.

B. Thorough hand
washing before and after
eating and toileting

4.

C. Health promotion and

education to families and
communities about the
disease its cause and
transmission.

5.

A. 30 days

6.

B. Data

7.

B. Cause

8.

A. Setting

9.

B. Instrument

10. A. Plagiarism
11. D. Ascertain if chest xrays and other tests have
been prescribed and
completed
12. D. Orthopneic position
13. C. Advise patient to sit
perfectly still during needle
insertion until it has been
withdrawn from the chest
14. A. Place flat in bed
15. A. to rule out
pneumothorax
16. A. Ease the patient to the
floor
17. B. No special preparation

21. C. The removal of the

stones in the common bile
duct
22. D. Positioning
23. C. Patients reaction to
pain varies
24. D. Patients description of
the pain sensation
25. B. Verbally acknowledge
the pain
26. A. Medicate client as
prescribed
27. D. Monitor VS, more
importantly RR
28. D. Turn to sides
frequently and avoid too
much talking
29. B. Appropriate

is needed. Instruct the

preparation for the

patient to keep his head

scheduled procedure

still and steady.

18. A. Obtain his oral
temperature
19. C. Sleeps for a period of
time
20. C. Side Lying

30. D. Intravenous and

inhalation
31. C. Older patients do not
believe in analgesics, they
are tolerant.
32. B. Real pain

33. D. Ask the client to point

to the painful are by just
one finger.
34. D. Allergic reactions like
pruritus
35. D. Instruct slow tapering
of the drug dosage and
alleviate physical
withdrawal symptoms.
36. A. Draw insulin from the

44. B. Shakiness
45. D. Continue as usual and

55. D. postoperative
respiratory function

have the FBS analysis

56. D. Sterilization by boiling

performed and specimen

57. D. 121 degree Celsius for

be taken.
46. B. Decreased alveolar
surfaced area
47. D. decreased bladder
capacity
48. C. functional decline

15 minutes
58. A. Black
59. B. That the items had
undergone sterilization
process but not necessarily
sterile

vial of clear insulin first

49. D. Acute confusion

60. A. Ethylene oxide gas

37. B. Test the clients blood

50. A. change in mental

61. C. Account for the

glucose level
38. A. 9 to 11 A.M.
39. A. Glycosylated
Hemoglobin
40. C. Prevent and recognize
hypoglycaemia
41. C. Apply a moisturizing

status
51. B. Verify patient

number of sponges,
needles, supplies, used

identification and informed

during the surgical

consent

procedure.

52. A. Last case

53. C. strap made of strong
non-abrasive materials are

62. A. Put side rails up and

ask the client not to get out
of bed

lotion to dry feet but not

fastened securely around

63. C. Clipped

between the toes

the joints of the knees and

64. A. Localized heat and

42. C. Intravenous infusion of

normal saline
43. D. Elevated blood glucose
level and plasma
bicarbonate level

ankles and around the 2

hands around an arm
board.
54. D. check baseline vital
signs

redness
65. A. Observe the dressing
and type and odor of
drainage if any
66. B. Chaplaincy services

67. D. In such cases, flash

78. C. Infiltration

sterilizer will be use at 132

79. A. U waves

degree Celsius in 3

80. C. Hypertonic solution

minutes.

81. A. Closed reduction of a

68. C. Surgeon
69. A. Double check the

fracture
82. B. It should contain a

91. B. Head cap scrub suit,

mask, OR shoes
92. A. Elevation of serum
ketones to monitor ketosis
93. B. 2 ml
94. A. Kept at room

doctors order and call the

thorough and detailed

attending MD

explanation of the

95. A. 45

procedure to be done

96. C. Sterility is event

70. C. Arguments between

nurses and residents
regarding treatment
71. B. Who is your assistant
and anesthesiologist, and
what is your preferred time
and type of surgery?
72. D. Scrub and circulating
nurses
73. B. Surgeon, assistants,
scrub nurse, circulating
nurse, anesthesiologist
74. A. Orderly/clerk
75. D. Communication
76. D. Lactated ringers
solution
77. A. 5 % dextrose in water

83. A. Accurate

temperature

related, not time related.

documentation and

97. B. AORN and JCAHO

reporting

98. D. The chemical or

84. B. The client with renal

failure
85. A. A client with colostomy
86. A. Material compatibility
and efficiency
87. D. Rinse with sterile water
88. D. Prolong the exposure

process used in sterilizing

the material
99. D. The material has no
microorganism nor spores
present that might cause
an infection
100. B. They are both capable

time according to

of sterilizing the equipment,

manufacturers direction

however, it is necessary to

89. D. High level disinfectants

soak supplies in the liquid

immersion in 10 hours
90. D. 2% Glutaraldehyde
immersion for 10 hours

sterilizer for a longer period

of time.