Final Coaching PALMR November 2016 PNLE Situation: Head nurses are unit managers and are expected to demonstrate administrative and managerial competence in running the operation of their respective units. 1.
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Having to deal with a lot of people, the nurse manager's most important important communication skill is is which of the following? a. Questioning b. Affirmation c. Assertiveness d. Listening You have been been promoted as head nurse in a new burn unit. Which of the following actions is BEST for you to do? a. Establish authority by sounding firm and and knowledgeable b. Delegate responsibility responsibility to staff nurses according to their abilities abilities c. Talk to the team leader leader of the staff nurses nurses and give her the best schedule d. Avoid seeking the advice of staff nurses nurses Which of the following is a major managerial responsibility of the head nurse? a. See to it that the ward is clean b. Join the doctors during their rounds c. Set standard of performance among the staff nurse nurse d. Provide bedside nursing care to selected patients Evaluation of staff performance is a regular activity in your unit. As a new head nurse, which of the following is expected of you? a. Perform an outcome evaluation b. Give the staff a good evaluation so that they will evaluate you fairly c. Give the nurse nurse average scores to make room for improvement d. Evaluate the nurse's performance according to their job description description With rapid turnover of of nurses nowadays, as a head head nurse, you are sometimes called to interview applicants for a staff nurse position. Which of the following questions is most appropriate to ask in order to get an idea of the applicant's incompetence? a. Are you willing to do overtime? b. Do you plan to go abroad? c. Where did you take up your B.S.N? d. What was your last nursing experience? A new staff nurse is being evaluated by the nurse supervisor for knowledge skills and attitudes at work. One aspect being rated is responsibility. Which action of the nurse denotes responsibility? a. The staff nurse offers suggestions for improvement in in the nursing unit b. The staff nurse adheres to the standards of nursing practice c. The staff nurse questions the policies of the administration d. The staff nurse shares her positive views with the rest of the staff When a manager makes decisions for the entire unit, directs the work of his subordinates, and approves the the staff’s leave schedules, he is said to be displaying a. Delegation b. Authority c. Accountability d. Responsibility
Situation: To carry out management functions in any healthcare setting, it is necessary for the nurse to integrate leadership skills that she has developed 8.
The hospital administration is revising the evacuation plan of the hospital to meet currently acceptable practices on emergency management. A selected committee was tasked to create
the new evacuation plan. The plan has been evaluated, although it has not been tested yet yet when the Hospital Director receives a bomb threat. Which of the following would be the best course of action? a. Gather the committee in a secure location and plan how to smoothly implement the revised evacuation plan on all units b. Ignore the bomb threat c. Implement the new evacuation plan immediately and instruct the staff to follow orders without question d. Call the NBI for instructions on how to implement an evacuation since they are experts in this situation 9. The chief nurse is trying to implement a new method of staff assignment in the unit. Nurses are now required to render 6 day workweeks instead of the usual 5 days a week. Majority of the staff resist the change, while a few other nurses who welcome the opportunity for extra income, are more willing to accept accept the change. The nurse supervisor can effectively implement this change change by choosing which course of action? a. Explain the purpose of the change and reinforce management decision b. Postpone the implementation of the new schedule to let the antagonistic feelings of the staff “cool off” c. Conduct a dialogue with the nursing staff and head nurses nurses and involve them in planning the new schedule d. Avoid discussing the issue with the staff and implement the new schedule as planned 10. To improve quality client care, the nurses created problem-solving committees headed by senior nursing staff to review standards of care and develop policies and procedures. Its desired result is best seen in: a. Continuous evaluation of nursing nursing practice/protocols practice/protocols in relation to desired patient outcomes b. Allowing changes in staff rotation plan to accommodate personal needs of the staff c. Increasing staff communication like providing a bulletin board for sharing information among personnel. d. More nurses participating in doctor’s rounds and giving immediate information to doctors regarding patient status 11. If, as a new nurse, you propose a change in a longstanding unit routine, you can expect: a. Support from the head nurse b. Resistance from your co-workers c. Resistance from anyone who is comfortable with the status quo d. Support from your co-workers 12. A nurse leader provides orientation to an upcoming change in wound care procedures. The leader builds relationships and supports the staff in implementing the new procedures. Which type of approach is the leader using to manage resistance to change? a. Normative re-educative b. Country club c. Power coercive d. Rational-emperical 13. A nurse reports in a staff meeting about being unaware of the status of the planned changed on the nursing unit. Which strategy should the nurse leader use to resolve this problem? a. Remain open and flexible to hearing the staff’s concerns about ch ange b. Maintain close contact with resisters to facilitate buy in to the change c. Communicate with the staff more frequently d. Acknowledge negative consequences to resisting the change 14. The nurse leader who is working to be a change agent on the nursing unit would be sure to do which of the following? a. Have firm, inflexible thoughts about how the change change should progress b. Communicate with staff in a vague manner c. Aggressively pursue getting buy in from the staff
d. Articulate to the staff a vision of the change 15. A nurse leader determines the effectiveness of the plan of change and modifies the plan. Which step in the change process does this represent? a. Evaluation b. Planning c. Implementation d. Organization 16. All of the following activities belong to the organizing phase of management. Which is not included a. Identifying hierarchy of positions in the nursing department b. Hiring managers for each nursing unit c. Defining duties and responsibilities of nursing personnel d. Supervising the activities of the nursing staff 17. The simplest and most direct type of organization in which each position in the organization has a direct authority over the lower positions is called a. Line organization b. Staff organization c. Informal organization d. Functional organization 18. The nursing department’s organizational chart illustrates the structure and relationships of the nursing leaders and staff of the organization. The following are the functions of organizational charts, except: a. Lists functions and duties of the staff b. Illustrates centrality of control in the organization and chain of command c. Indicates relationship of leaders to other management staff d. Identifies managerial levels 19. Total patient care is the oldest mode of organizing care wherein one nurse assumes total responsibility for the overall care of an assigned patient. All of the following are advantages of total patient care, except: a. Accountability is directly attributed to the nurse on duty b. Responsibility and autonomy are provided for nurses c. Requires highly skilled professionals who consequently requires higher pay d. Simplicity and directness of assigning client care 20. The nurses in the Operating Room are assigned according to specific aspects of peri-operative nursing. Communication and liaison is assigned to the circulating nurse, the scrub nurse assists the surgeon during the procedure, and nursing assistants are basically relegated to the task of doing clean-up after the procedure. This method of nursing assignment is an example of a. Functional nursing b. Total care nursing c. Primary nursing d. Case Method nursing 21. Primary nursing requires nursing staff that are made up of only RNs. In this modality, RNs assume 24-hour responsibility for her assigned group of patients from admission to discharge. All of the following statements are true about primary nursing, except a. The nurse is usually assigned to 6 patients at a time b. The primary nurse is responsible for direct care of patient during her work hours only c. An associate or secondary nurse takes over for the primary nurse d. It utilizes a modular approach to nursing care 22. The hospital is constructing a new wing and the Director of Nursing is asked to help design it. To achieve maximum efficiency in carrying out nursing activities, the Director of Nursing would consider which of the following conditions to be most helpful?
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Environmental factors such a current economic, legal, technological, and social influences that the organization must consider b. How the structural plan facilitates staff interaction and the rituals nurses use to conduct work c. Work flow where equipment, medication, and other items essential for patient care are stored and positioned d. Type of equipment and technology and its effects on how work tasks are designed and carried out 23. A new graduate nurse on a surgical unit does not take break or go to lunch and still cannot complete the work in a timely manner. Which statement would be the best recommendation to the new nurse? a. Do not skip the allowed breaks except during an emergency b. Start administering medications two hours earlier c. Suggest for the new graduate to look for a new position d. Check out at the end of the shift and then finish the charting 24. Time management is essential to provide quality care and prioritize work. The nurse finds the following practices helpful in managing time for patient care, except: a. Keeping telephone communications short b. Blocking out time to accomplish important activities c. Doing time and motion study to determine time utilization d. Dealing with interruptions openly and directly Situation: Nurses in the Medical unit are finding ways to improve collaborative relationship with the physicians. Efforts to identify factors that foster or impede nurse-physician collaboration are thoroughly examined. A review of antecedent environmental factors were taken. 25. A variety of factors collected have been linked to the quality of nurse-physician collaboration. Given this information, which of the following measures is appropriate to foster nurse-physician collaboration a. Present collected data to the physicians and those involved in health care. b. Nurse and physician should be willing to consider each other’s positions c. Consider both environmental and professional factors d. Arrange a meeting to discuss issues and concerns with the physicians and other members of the health team. 26. Information gathered by the nurses show the importance of nurse-physician communication. With the current recognition that many medical errors are caused by communication failure, which of the following is the most appropriate intervention a. Conduct in-service education for nurses to improve competencies to address the issues b. Organize a conference on medication error participated by nurses, physicians, and others c. Involve a form of communication where two parties engage in problem solving discussion d. Develop a policy where all members of the health care team can use it as a reference 27. Of the following nursing service staff, who are the most likely to engage in problem solving communication with the physician to ensure quality of communication and outcomes a. Nurses who are on the managerial level to ensure effective problem solving with physician b. A team of experienced nurses with less experienced staff nurses c. Any staff available for conference and collaboration d. Nurses assigned to the clients with identified problems 28. Given the above situation, which of the following actions should be done by both parties a. Continuous conference to keep track of the concerns of the clients b. Conduct weekly conferences for continuity of medical management
c. Encourage open communication for effective collaboration d. Design conditions to support desired levels of collaboration more effectively. 29. A diabetic client has been hospitalized. After a few days, his condition improved, and is now ready for discharge. Planning for patient care included teaching the client about nutritional regimen and encouraging compliance. The client will most likely be referred to a: a. Nutritionist b. Endocrinologist c. Dietitian d. Cardiologist Situation: The advent of computerization in the workplace has raised issues regarding health information privacy and portability. Nurses, however, must learn how to embrace technology and view them as allies in navigating the complexities of health care management. 30. The following are identified benefits of electronic record keeping, except: a. Prevents tampering with patient records b. Passwords secures accessing of the system c. Eliminates problems of illegible handwriting d. Increases time required for documenting 31. Because of increased incidence of medication error to wrong transcription of physician medication orders by nurses, a tertiary hospital utilized a computerized medication order system. Which of the following procedures may be done through the said system? a. Correct errors in the physician medication order b. Eliminate drug interaction c. Provide a list of drugs with their generic name d. Document drug administration 32. An advantage of automated or computerized client care system is: a. The nursing diagnoses for a client’s data can be accurately determined b. Cost of confinement will be reduced c. Information concerning the client can be easily updated d. The number of people to take care of the client will be reduced 33. Nurse Jane is new to the use of the electronic data base and was looking for a manual that can help orient her to the system. No manual is available in the nursing unit. This reflects management inadequacy in a. Planning b. Organizing c. Directing d. Controlling 34. Nurse Maya is reviewing hospital occurrence reports and notes that the nurse on the post-partum unit has documented three medication errors in the last two months. Which action should Nurse Maya implement first? a. Initiate a formal counseling procedure for multiple medication errors b. Continue to monitor the nurse for any further medication error c. Discuss the errors with the nurse to determine if there is medication system problem d. Arrange for the nurse to attend a medication administration review course 35. Medical records must be retained by government hospitals for a specified number of years. Which of the following statement is incorrect. a. b. c. d.
Birth Registers are retained permanently in the hospital record system Death Registers are retained permanently in the hospital record system In-patient records of adult patients are maintained for 25 years In-patient records of psychiatric patients are maintained for 25 years
Situation: Delegation is an essential skill that nurses must develop in order to manage their time while providing efficient client care while utilizing available human resources. The charge nurse in the medicalsurgical unit has a PM shift team composed of a nursing aide, two experienced organic nursing staff, a float nurse from the ER, and a newly-hired RN. 36. Which of the following patients can be safely delegated to the newly-hired RN who has just recently passed the board exam? a. A patient requiring peritoneal dialysis b. A post CABG surgery patient c. A patient who pulled out his central venous line d. A CVA patient scheduled for feeding 37. Which of the following activities would be most suited for the float nurse? a. Changing the dressings of a post pneumonectomy client b. Giving colostomy care instructions for an APR patient for discharge c. Transferring a patient from the PACU who underwent an appendectomy d. Monitoring a vehicular trauma patient for increasing ICP 38. Of the following activities, what can be safely delegated to the nursing aide? a. Changing IV infusions b. Applying oxygen via nasal cannula c. Oral suctioning d. Changing dressings on a burn patient 39. The charge nurse recognizes that the newly-hired RN needs to develop competencies in routine nursing procedures. Staff development activities that enable newly-hired nurses to comply with the hospital’s standard procedures and norms include all of the following, except: a. Orientation b. Shadowing c. In-service education d. Specialty course 40. Upon reporting to the unit the head nurse of the morning shift is overwhelmed with the following situations: failure of the staff to carry out medication order 2 days ago, and elder client pulled out his central venous line and a client wishes to be discharged immediate. Which of the following should be the course of action of the nurse? a. Increase the scope and responsibility of the staff nurse b. Recognize the capability of each team member and delegate appropriately c. Prepare an assignment of each team member and delegate appropriately dependent on the expertise of the member d. Assess the situation and delegate appropriately activities that recognize the unique expertise of each team member 41. Managers implement a variety of strategies to ensure effective delegation EXCEPT: a. Assess the situation and delineate the expected outcome b. Identify the skills and educational levels of the team necessary to complete the job c. Empower the person to whom you delegate the job d. Create job description and scope of responsibility Situation: The nursing service division is in the process of implementing quality assurance measures after having received low scores in client satisfaction and a reported increase in hospital-acquired infections over the past 6 months. 42. Quality control as a process involves a series of steps. The initial step in quality control is: a. Collecting information b. Analysing gathered data c. Setting a criterion or standard d. Taking corrective action
43. The nurse has a responsibility to perform nursing care activities based upon standards of practice. This means that: a. Minimum level of performance is accepted to ensure high quality care b. Nursing action performed by the nurse is based on scientific knowledge c. Nursing activities performed by the nurse to an acceptable level d. Practices observed by nurses ensure quality care 44. The ICU nurses are gathering data on probable causes of increased central line infections. As a member of the quality improvement team, which data would you consider to be the most appropriate to yield the most probable cause of central line infections? a. Nurse’s notes on hourly assessment of central line sites b. Performed central line care interventions as observed c. Daily, every-shift report of central line care measures from bedside nurses d. Incidence of central line infection as reported by the infection control nurse 45. The Medical Unit has the highest number of reported fall cases. The quality improvement team in the medical unit has identified probable causes. With the data analyzed and the findings organized, the quality improvement team should first a. Implement fall-prevention measures identified to be effective b. Propose a list of nursing actions intended to identify fall risks and preventive measures c. Do a pilot study of the fall-prevention measures to a small group of patients d. Brainstorm for a plan for appropriate action for change 46. In identifying possible causes of patient falls, the nursing department tried to identify issues that can be corrected. Which of the following is considered as process related? a. Defective side rails of hospital beds b. Lack of staff to assist patients with ambulation c. Failure of nurses to assess risk for falls d. Early ambulation of patients 47. The chief nurse is engaged in a meeting with the management team to identify probable causes of patient dissatisfaction in the unit. Certain process concerns were identified, which includes: a. Unlicensed nurses taking the place of RNs b. Knowledge of patient about his illness c. Not providing privacy during nursing care d. Inadequate supplies to perform nursing procedures 48. The Director of Nursing wants to improve quality of health care in the hospital. The following are examples of quality assurance measurements, except: a. Evaluating outcomes or end results of care provided to clients b. Asking clients to accomplish client satisfaction survey forms c. Measuring quality of care against established standards of nursing care d. Checking if emergency carts or medications are properly stocked 49. Incidents that have the potential to cause injury to patients should be properly reported by nurses to the quality assurance committee. The nurse knows that an incident report should consist of the following EXCEPT: a. Derogatory comments expressed by the client b. Report of pertinent factors relating to the incident c. Action taken immediately following the incident d. Description of the incident as factually as possible 50. The nurse hears a client calling out for help, hurries the hallway to the client’s room, and finds a client lying on the floor. The nurse performs a thorough assessment, assists the client back to bed, notifies the physician of the incident, and completes an incident report. Which of the following should the nurse document on the incident report? a. The client fell out of bed b. The client climbed over the side rails
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The client was found lying on the floor The client became restless and tried to get out of bed
PROFESSIONAL ADJUSTMENT
Situation: As nurses begin their professional obligations, their legal responsibilities begin as well. Their license to practice attests that they are qualified under the law to practice their profession. 51. A nurse and a teacher are discussing legal issues related to the practice of their profession. The teacher asks what are the functions of the Philippine Nursing Act of 2002 (RA 9173). The nurse will include which thoughts in a response? 1) Accredit schools of nursing 2) Protect the public 3) Define scope of nursing practice 4) Enforce ethical standards of behavior a. 2, 3 and 4 b. 1, 2 and 3 c. 2 and 3 d. 1 and 4 52. Which of the following may serve as the best guide for nurses to utilize as it defines the scope of nursing practice in the Philippines? a. RA 9173 b. RA 2382 c. RA 7160 d. RA 6713 53. A new registered nurse is being interviewed for a staff position in a private hospital. Which of the following statements indicates her understanding of the practice of nursing in the Philippines as provided by the nursing law. a. Only professional licensed nurses can practice nursing in the Philippines b. A registered nurse can practice professional nursing the hospital and community settings c. A nurse is certified to practice nursing in the Philippines d. A registered nurse license provides basis for professional nursing practice 54. As a nurse, you should know the scope of professional nursing practice. Which of the following professional is encroaching on professional nursing practice? a. A physician who administers parenteral medication b. A medical technologist who administers debutamine before a cardiac stress test c. A teacher who conducts lecture on health and nutrition d. A lawyer who acts as an advocate for a patient whose rights are violated 55. Over all what can a nurse do to reduce the risk of malpractice litigation? a. Do not discuss medication errors with patient and family b. Give value judgment when appropriate c. Be expert and competent in practice d. Secure an incident report on file 56. The Magna Carta for Public Health Workers state that Hazard Pay should be extended to health care workers assigned to areas that pose danger to health or safety. This benefit is applicable for assignment to any of the following areas, except: a. War zones b. National Center for Mental Health c. San Lazaro Hospital d. Squatter’s areas
Situation: The professional practice of a nurse is governed by laws, rules, and policies that are aimed at ensuring patient safety at all times. Observance of standards of care in the carrying out of our duties is the best way to avoid being sued in court for negligence.
57. The nurse does not act when a patient becomes hypotensive after surgery. The patient requires emergency surgery to stop postoperative bleeding later that night. Which type of prosecution does the nurse potentially face for failing to an act? a. Tort law b. Statutory law c. Felony d. Misdeamenor 58. A nursing staff tells the group that she thinks that the unit secretary has AIDS and proceeds to them that the secretary probably contracted the disease from her husband, who is supposedly a drug addict. Which legal tort has the nursing staff violated? a. Libel b. Assault’ c. Slander d. Negligence 59. Which of the following nursing actions could result in malpractice? 1) Questions a doctor about an illegible order 2.) Charts patient’s drug allergies 3) Do not follow up patient’s complaints 4) Forget to complete the assessment of patient 5) Learns about a new piece of equipment. a. 1,2 and 5 b. 3 and 4 c. 2,3 and 4 d. 1,4 and 5 60. Dr. Gomez prescribes one tablet but the nurse accidentally administers two. After notifying the doctor, the nurse monitors the patient carefully for untoward effects of which there are none. Is the patient likely to be successful in suing the nurse for malpractice? a. No, the patient was not harmed b. Yes, a breach of duty exists c. No, the nurse notified the doctor d. Yes, foreseeability is presen 61. The nurse leaves a patient who is elderly and confused to find someone to assist with transferring the patient to bed. While the nurse is gone, the patient falls and hurt s herself. The nurse is at fault because she hasn’t a. Properly educated the patient about safety measure b. Restrained the patient c. Documented that she left the patient d. Arranged for continual care of the patient 62. Which action should the nurse take when receiving a telephone order from a doctor? a. Inform the doctor that telephone orders are not permitted b. Write the order in the patient’s medical record immediately c. Write down the order and read back the complete order to the doctor d. Immediately carry out the doctor’s order 63. A nurse witnesses and automobile accident and provides care to the open wound of a young child at the scene of the accident. The grateful family insists that the nurse accept money as compensation for her work. The nurse accepts the money to avoid offending the family. The child soon develops an infection from the wound and was hospitalized, and the family files a lawsuit against the nurse. Which of the following statements is accurate? a. The Good Samaritan Law will protect the nurse b. The Good Samaritan Law will protect the nurse if the nurse was not negligent in her actions c. The Good Samaritan Law will not protect the nurse if the nurse accepted money for the care provided
d. The Good Samaritan Law applies only to persons who are not health care professionals 64. A patient refuses to take medication so the nurse discreetly ground up the tablet and mixed it with the client’s food. The client’s condition improved because of the medication. In this case the nurse’s action is: a. Appropriate since it resulted in t he client’s improved condition b. Legally liable for battery c. Ethical under the principle of autonomy d. Legally exempt from liability 65. An 18-year old client has been in the hospital for three days with chlamydia infections. While administering her 12:00 noon medications, the client tells the nurse that she has a secret which she wants the nurse to know but asked the nurse not to tell anybody. Which of the following the most appropriate response of the nurse? a. “What you will tell me will be properly documented.” b. “Yes, I promise to protect you when entrusting your secret to me.” c. “Yes, you can trust me not to divulge your secret.” d. “I cannot promise to keep a secret if it affects your health.” 66. A nurse assigned in the surgical unit visited the mother of her friend confined in the Medical unity. She was observed by the staff nurse in the unit reading the chart of the client. In this situation, the action of the nurse is described as: a. Acceptable, because she is known to the client b. Unethical, because of possible breach of confidentiality c. Appropriate, because she is part of the nursing staff of the hospital d. Inappropriate, because she is not assigned to the unit. 67. A student nurse asks permission from the head nurse to photocopy the record of the client that she is presently taking care of. She is to present a case study and needed information to substantiate her data. Which of the following should be the appropriate action of the head nurse? a. Tell the nursing student to ask permission from the attending physician b. Allow her to photocopy the pages related to the information needed c. Allow her to write down pertinent but not identifying information d. Do not allow photocopying due to confidentiality 68. A nurse researcher is conducting a research study on the concerns of the elderly regarding hospitalization. An elderly client was offered to participate in the study. She signed the consent but later decided to withdraw from the project. In this situation, the elderly client: a. May withdraw, as long as the family requests the withdrawal b. May withdraw at any time during the study c. Cannot withdraw, since the consent is a legal document and has been signed d. Cannot withdraw since the study has started. Situation: Because of the rapid proliferation of lawsuits over the years, there is now a higher probability that a nurse, at some time in his/her career will be involved in a suit, either as a witness or as a party to a malpractice action. Knowledge of the litigation process increases the nurse’s understanding of the way in which a nurse’s conduct is evaluated before the courts. 69. The patient’s family filed a complaint with the Board of Nursing for the obvious lack of competent care demonstrated by a nurse who failed to monitor the post-operative patient, resulting in respiratory arrest. Which of the following statements is incorrect in this situation? a. An administrative case against erring nurses that is filed with the PRC is investigated upon by the Board of Nursing b. Revocation or suspension of the license can be the outcome if the nurse was proven negligent/incompetent c. Practicing while under suspension would result to revocation of the nurse’s license
d. The nurse would have to pay a fine or be imprisoned if found guilty of the administrative charges 70. A high degree of education can aggravate the commission of a crime, while low degree of education can be a mitigating circumstance in a crime. By this nature, education is called a. An aggravating circumstance b. A justifying circumstance c. A neutral circumstance d. An alternating circumstance 71. A nurse expert is called to testify in lawsuit regarding professional nursing malpractice primaril y to testify? a. About standards of nursing care as they apply to the case b. With regards to the laws governing the practice of nursing c. For the prosecution d. For the defense 72. Nurse Caloy was summoned to appear and testify in court. In the witness stand Caloy mentioned only on what he knows based on the circumstances of the events. This is known as a. Testimony of opinion b. Testimony of truth c. Testimony of facts d. privilege spech against self-incrimination 73. When a nurse who is under oath gave false information on the case, he may be held for which of the following? a. Lying b. Contempt of the court c. Motto propio d. Perjury 74. Sit. 16: Mrs. Lilibeth Domingo delivered a normal baby boy by cesarean section at
Moonwalk General Hospital. Miss Prado was the scrub nurse and Miss Vitto was the circulating nurse. After the operation, Mrs. Domingo suffered severe infection of the abdominal cavity due to a forceps left inside the abdomen. Before the nurse will let the patient sign the consent for cesarean section, she must explain the procedure to the patient and this is referred to as: a. Formal consent b. Informed consent c. Individual consent d. Honest consent 75. The nurse in the situation above may be guilty of negligence based on the doctrine of: a. Res ipsa loquitor b. Force majeure c. Respondeat Superior d. Furza mayor 76. One of the following may also be held liable of negligence under the doctrine of respondent superior: a. Surgeon b. Hospital administrator c. Scrub nurse d. Circulating nurse 77. The patient may file a complaint addressed to the Board of Nursing for the revocation of the license of the nurses and this is referred to as: a. Criminal case b. Administrative case
Civil case Election case 78. The life of a license of nurse is: a. 5 years b. 3 years c. 5 months d. 4 years c. d.
Situation: In honoring the patient’s right to make healthcare decisions, healthcare agencies have policies for respecting advance directives and the legal implications they carry. As a nurse, we must act as client advocates by supporting our patient’s dec isions. 79. A physician asks a nurse to discontinue the feeding tube in a client who is in a chronic debilitated comatose state. The physician tells the nurse that the request is made by the client’s spouse and children. The nurse understands the legal basis for carrying out the order and first checks the client’s record for: a. A court approval to discontinue treatment b. A written order by the physician to remove the tube c. Authorization by the family to discontinue the treatment d. Approval by the institutional ethics committee 80. Health care providers need always to point out to clients and their significant others that the order of a “Do Not Resuscitate” (DNR) means all of the following, except a. Allowing natural death to happen b. Comfort measures are withheld c. Food and food supplements are sustained d. “no heroic measures” are done 81. The nurse must be aware that a living will is different from a DNR order because a living will: a. Designates the person who will decide for the patient in case he becomes incompetent b. Specifies certain treatments that the patient will allow in case he becomes incapacitated c. Forbids the use of extraordinary means of prolonging a patient’s life d. Lists down the distribution of patient’s property upon his death 82. Marissa is being prepared for emergency surgery and is asking to complete an advance directive. Which type of advance directive should the nurse recommend the patient complete at this time? a. Power of attorney b. DNR order c. Living will d. Durable power of attorney for health care Situation: The nurse is preparing the client, a 28-yearl old newly-wed for surgery following multiple traumatic injuries from a vehicular accident. Knowledge of proper obtaining of consent is essential: 83. A hierarchy exists as to who should sign the consent form in case a client is deemed incompetent. Priority should be given to obtain consent from: a. The spouse b. Either parent c. Brother or sister of legal age d. Surgeon 84. A married client is scheduled for a vasectomy within the next hour and the nurse notices that the informed consent has been signed by the client only. The nurse should: a. Have the spouse co-sign the consent form b. Inform the physician c. Obtain a verbal consent from the spouse d. Have the client explain to his spouse about the surgery 85. As a nurse, our legal role in the signing of the consent form is that of a. Advocate
b. Witness c. Interpreter d. Legal counsel 86. The nurse is caring for a patient admitted to the emergency department after a motor vehicular accident. Under the law, the nurse must obtain informed consent before treatment unless the patient a. Is mentally ill b. Is in emergency situation c. Refused to give consent d. Ask nurse to give substituted consent 87. In cases wherein there are no accompanying relatives,, and the patient must undergo emergency surgery, the acceptable legal principle is that of a. Paternalism b. Res ipsa loquitur c. Beneficence d. Respondeat superior 88. The right to informed consent requires that the client a. Gives consent before confidential information can be shared with other b. Signs a treatment permit consenting to each treatment to be carried out c. Be given complete information about a treatment before he consents to it d. Be provided with independent psychiatric examinations at his request Situation: Nurses are obliged to fulfill their responsibility and provide ethical and moral care that demonstrates respect for others. 89. The nurse manager is preparing staff development classes for new nurse. Which of the following should be included in relation to ethical decision making a. Ethical decisions arrived at for client care are based on the recommendations of the family and significant others b. Ethical decision making is based on knowledge, facts, and strong commitment to right or wrong c. Ethical decision making is the responsibility of the nurse alone d. Ethical decision making is based on the philosophy of individual values and beliefs 90. During a group discussion. Dora presented her ethical opinion regarding the behavior of a nurse in the given situation based on the theory of Deontology. Dora says behavior of the nurse is acceptable because: a. it benefits the majority b. it is in accordance with a given rule c. it primarily is based on respect of person d. its consequences are good 91. A nurse is in a quandary if she should carr y out the physician’s order for CPR when the client has a DNR order. Unable to do anything, she carried on with the procedure. The client was revived although is now in a comatose state. She asked her co-workers if this was correct and their reply was “That was always how it was done, here.” Which moral problem is the nurse experiencing? a. Moral dilemma b. Moral outrage c. Moral ambiguity d. Moral distress 92. Ria, daughter of the client, refuses to inform her father about his diagnosis. The nurse is concerned whether or not she will tell the client about his diagnosis. This is an example of an ethical: a. Conflict b. Concern c. Dilemma d. Issue
93. When the nurse finished performing foot care on the client, she was requested to come back to change the linen. The nurse changed the linen as requested by the client. The nurse is demonstrating which of the following ethical rules a. Non-maleficence b. Confidentiality c. Justice d. Fidelity 94. The morning shift is over and the outgoing nurse was about to leave the unit when the relative of the client called because the patient fell out of bed. The nurse hurriedly went in the client’s room to attend to the client. Which of the following ethical principles illustrate the action of the nurse? a. Justice b. Autonomy c. Beneficence d. Non-maleficence 95. The Senior Citizens Act advocates for the rights of the elderly to certain benefits such as discounts for essential goods and services. It displays the ethical principle of: a. Beneficence b. Non-maleficence c. Fidelity d. Justice 96. Violating the principle of nonmaleficence is most closely associated with which of the following? a. Being negligent b. Unfair in distributing goods c. Overriding patient’s choices d. Not doing good for others 97. Which one of the following responses best describes the essence of Code of Ethics for Nurses today? a. Serve as guideline for nurses’ ethical and legal actions in all areas of clinical practice as well as in other nursing roles b. Serve as clinical guideline for nursing actions in all areas of practice as well as other as in other nursing roles c. Focus on patient for nursing actions in all areas of clinical practice as well as in other nursing roles d. Patient centered code serve as guideline for nurses’ ethical actions in all areas of clinical practice as well as other nursing roles 98. The nurse makes a medication error. The patient was immediately assessed and no untoward effects of the error were identified. The nurse decides not to report the error because the patient did not experience any injury from it. Which ethical principle did the nurse violate? a. Autonomy. b. Justice. c. Veracity. d. Confidentiality 99. Arnel is with peripheral vascular disease and tells the nurse “I know my foot is bad and my doctor told me that I don’t have any choice and must have an amputation. I do not want it”. Which of the following nursing actions support the role of a nurse as a patient advocate? a. Support the medical treatment and recommend to have amputation b. Tell the patient that he will accompany him to discuss his decision with the doctor c. Recommend the patient to talk to his wife and children about his decision d. Explain that he has the right for a second opinion if he does not want an amputation
NURSING RESEARCH
Situation: Nedy, a new registered nurse, applied for work as a research assistant. A thorough understanding of the steps of the research process is important when doing a study. 100. Nurse Nedy knows that defining the purpose of the research project serves which function? a. States the focus of the research study b. Identifies population groups to be used c. Determines statistical treatment needed d. Explains why the problem is significant to study 101. Nurse Nedy was asked which type of research is intended to gain insight by discovering “meaning”. Her best reply is: a. Phenomenological research b. Qualitative research c. Quantitative research d. Anthropology-based research 102. A nurse tells Nedy that she performs hand washing eight times a day but cannot explain why, except to say, “I’ve always done it this way.” The nurse’s answer is an example of: a. Scientific knowledge b. Authoritative knowledge c. Unsubstantiated knowledge d. Traditional knowledge 103. Nurse Nedy is doing research on the effect of cholesterol on blood pressure. Blood pressure is what type of variable? a. Intervening variable b. Independent variable c. Exploratory variable d. Dependent variable 104. Information collected in research is called: a. Abstract b. Mean c. Data d. Subject 105. Qualitative research would be the best research design for which of the following research questions a. What is the effect of hydration on the occurrence of constipation among the elderly? b. How effective are Clinical Instructors with Masters Degrees in teaching compared to Cis with PhD? c. How do teenagers reconcile gender confusion in their adolescent years? d. Can garlic tablets effectively modify hypertension among women? 106. Which of the following statements is not true about qualitative research a. It usually uses a small sample size b. It can be done on just one person c. It explores subjective data d. It requires replicable, reliable, and accurate data 107. A researcher wants to study the role reversal and caregiver strain that happens in a family dealing with a father who had a stroke. The research is most likely a/an a. Phenomenological b. Ethnographic c. Case study d. Grounded theory 108. Quantitative research involves collection of objective data that can be measured. Which of the following statements is incorrect about quantitative research? a. It can be performed via experimental or non-experimental methods
b. c. d.
It requires hard, replicable, and reliable data It requires a deep insight into human nature It can be performed by longitudinal or cross-sectional methods 109. Quantitative research studies variables and how they are interconnected. Cause and effect, also called independent and dependent variables respectively, play out to produce certain phenomena. An independent variable can be all, but one, of the following a. Inborn characteristics b. Nursing interventions c. Patient outcome d. Experimental treatments Situation: A group of nurses decided to conduct a phenomenological research project on the lived experience of being isolated among patients who have been on preventive isolation. 110. In a phenomenological research, the research team understands that the experience of being isolated will be: a. Interpreted by the participant for the researcher b. Explained by the researcher to the participant c. Interpreted by the researcher for the participant d. Interpreted by the researcher with the participant 111. When determining the adequate number of participants, the research team will consider which of the following a. Sample size should be determined before the study b. Number of participants are considered adequate when data obtained are saturated c. Participants should be representative of the target population d. The convenience sampling method would be most appropriate for the study 112. The research team plans to utilize audio-recorded interviews as their method of collecting data. Select all the techniques that data obtained will be adequately analyzed: 1) simultaneously listen to the recordings and read the written transcript, then note observations 2) repeatedly listen to the audio recordings 3) make notations while listening to the audio recordings 4) transcribe audio-recorded interview word for word a. 1 only b. All of these c. 1 and 4 d. 1, 3, and 4 113. After the team has “dwelled wit h the data”, the team proceeded to do data reduction. Which of the following is the team expected to do? a. Classify data based on a theoretical perspective b. Eliminate data which are not related c. Break data into sub-parts and label accordingly d. Identify patterns in the gathered data 114. During the interpretation phase, the research team is expected to answer which of the following questions? a. What do the findings show? b. What is going on? c. What is the meaning of the experience of isolation? d. Are the themes justifiable and grounded from the data?
Situation: Nurse Claire was encouraged to do research in her clinical area and remembered The CVA cases with decubitus ulcer in the medical ward. She though that it would be good to study the healing if she applied a substance with lactobacilli and Yakult was in her mind. She is planning to determine the effects of Yakult in the treatment of decubitus ulcer among CVA patients. 115. The type of research appropriate for this study is a. Survey b. Ex post facto c. Evaluation d. Experimental 116. In the proposed study, the independent variable is a. Yakult b. CVA patients c. wound healing d. Decubitus ulcer 117. There is no significant differences in the rate of healing between decubitus ulcers of Group A and those in Group B is a statement of a. Alternative hypothesis b. Inductive hypothesis c. Null hypothesis d. Deductive hypothesis 118. Once Claire has collected the data needed for the study, the next step is to a. Interpret the data b. Organize the data c. Relate the data to hypothesis d. Draw the conclusions 119. The appropriate data collection method of this type of study is a. Interview b. Observation c. Content analysis d. Questionnaire Situation: A one-group, pre-test post-test design was used to evaluate the effectiveness of a newly developed training program for nurses working with electro-convulsive therapy (ECT) for psychiatric patients. 120. Subjects were selected because they happen to be available for participation in the study. The sampling method used is: a. Random sampling b. Convenience sampling c. Probability sampling d. Cluster sampling 121. The study was approved by the Health Services Ethics Committee Prior to completing questionnaires at the start of the training program, the consent would be provided by: a. Nurse supervisors b. Patients undergoing ECT c. Hospital medical director d. Nurse participants 122. An evaluation questionnaire included 14 True or False items which measured nurses’ knowledge of key components of assisting in ECT procedures. In this study, the participant’s knowledge is measured: a. Solely after the training b. Solely before the training c. Before and after the training d. In the middle of the training 123. Six items of evaluation questionnaire used a 10-point scale (from not at all confident to very confident) to measure nurses’ perceived level of confidence with setting up an appropriate ECT machine. The type of scale used is:
a. b. c. d.
Interval Ordinal Ratio Nominal 124. A frequency distribution was labeled: Changes in participants’ knowledge before and after the ECT Program (N=92). N=92 means that: a. 92% of the nurses responded correctly in the post-test b. 92 nurses participated in the study c. Number of nurses currently working in the field of ECT d. Percentage of nurses who completed both the pre-test and the post-test 125. Analyzing whether there was an improvement in the knowledge base of nurses after the training program has been implemented would make use of which statistical test? a. Pearson r b. T-test c. ANOVA d. Chi-square Situation: The nurse researcher determined the effect of therapeutic touch on the client’s comfort. Quasiexperimental design was used. 126. Of the following preliminary tasks, which of the following should the researcher do to obtain available knowledge in her area of interest? a. Review literature b. State the problems c. Identify the population d. Select the variables 127. When the researcher predicted that therapeutic touch significantly affects level of comfort of the client, the researcher was doing which step of the conceptual phase of the research process? a. Stating relationships of variables b. Delimiting the problem c. Formulating hypothesis d. Developing protocol for intervention 128. The researcher used an interview schedule to ascertain in the feelings of the client when touched therapeutically by a nurse. If you were the researcher who among the following will you consult to evaluate the content validity of the instrument? a. Researcher adviser b. Statistician c. Subjects of the study d. Experts in the field 129. Which of the following statements show the correct use of sampling principles in the selection of the sample size? a. The smaller the sample size, the more accurate the inferences drawn from a sample b. The greater the sample size the greater will be the uncertainty for a given sample size c. The greater the sample size, the more accurate will be the estimate of the true population mean d. The smaller the sample size, the more accurate the difference between the statistics and the true population mean 130. Which of the following is considered the final step of the research process? a. Communication of findings b. Recommendation and implication c. Research critique d. Putting research evidence into nursing practice Situation: A group of ICU nurses conducted a research study to describe the relationship between frequency of endotracheal suctioning and the incidence of infection among ventilator-assisted patients. The team selected the non-experimental design specifically, the prospective approach:
131. If you are a member of the research team. Which of the following will you consider as the independent variable when you formulate the research problem? a. Incidence of infection b. Relationship of endotracheal suctioning and incidence of infection c. Dependence of client’s on mechanical ventilation d. Frequency of endotracheal suctioning 132. Data regarding the study’s dependent variable will be collected by the research team through which of the following? a. Self-report techniques b. In vitro measures c. Projective techniques d. Available data in the patient’s chart 133. The research team is fully aware that measurement of variables is a very important consideration in obtaining quality data in the study. Which of the following statements will you accept as true? a. Reliability quality of an instrument is independent of its validity b. An instrument can be valid without being reliable c. A measuring device which is unreliable can be valid d. High reliability of an instrument provides no evidence of its validity 134. Taking into consideration the content of the written informed consent, which fo the following reflects the research team’s recognition of the participant’s right to privacy? a. Right to withdraw and withhold information b. Confidentiality pledge c. Voluntary consent d. Potential benefits and risks 135. The research team decided to conduct the study for three months. Utilizing the prospective approach, which of the following will the researcher appropriately do? a. Participants will be assigned to experimental and control groups an incicence of infections in the two groups will be compared b. During the period of three months, those venitilator assisted patients who developed infection will be included in the study. c. On the last day of the 3rd month, charts of participants will be reviewed and data collected regarding frequency of endotracheal suction and incidence of infection d. From day one to the last day of the 3rd month, data regarding frequency of endotracheal suctioning and incidence of infection will be collected. Situation: A group of students assigned in the ER witnessed a situation where in the resident on duty cannot be located within the hospital premises in the presence of patients requiring immediate medical services, resulting verbal abuse from patients or from their families. In line with this situation, the student nurses decided to research on the processes experienced by emergency room nurses in identifying and resolving ethical problems they encountered. 136.
Which of the following sub problems can be included in this research study? 1. What is verbal abuse? 2. How do ER nurses describe and define ethical problems? 3. What are the ER nurses definition and understanding of ethics? 4. How do staff nurses manage or resolve these ethical problems?
a. 1,2,3 b. 1,2,4 c. 1,3,4 d. 2,3,4 137. The appropriate qualitative method that guided the study design is: a. Phenomenological b. Grounded theory c. Critical social theory
d. Narrative inquiry 138. The sampling plan for this study will be: a. Purposive b. Systematic c. Snow ball d. Stratified 139. In this study the researcher used interview because of the following advantages: 1.Some topics can be pursued in depth 2.Misunderstandings can be minimized 3. Interpersonal relationship between subject and researcher is different for each interview 4.Greater flexibility is provided a. 1,2,3 b. 1,2,4 c. 1,3,4 d. 2,3,4 140. Which of the following characteristics of a clinical nursing problem is not a potential for research? a. Potential to change how nursing care is delivered in the unit b. Value laden and involves feelings and perceptions c. Reflects something that could be improved in clinical practice d. Problem that occurs frequently in a particular patient group Situation: One of the terminal competencies desired of graduates of the BSN curriculum in the development of positive attitudes towards research. 141. A researcher wants to conduct a descriptive study to find out if change in weight among teenage participants in a fitness camp has a consequent change in body image perceptions. The research design that would most be suited to obtain knowledge on this phenomenon would be a a. Survey b. Correlational Study c. Comparative Study d. Methodological Study 142. One nurse is interested to get the effects of having foods with fortified vitamins A and D in the development of children from pre-school to school age level. The type of sampling when a given group of subjects are studied for an extended period of time is called: a. Cross-sectional b. Longitudinal c. Purposive d. Cross-cultural 143. Qualitative research emphasizes developing new insights, theories and knowledge. Which term describes the researcher laying aside what is known about the experience being studied? a. Intuiting b. Saturation c. Bracketing d. Theoretical sampling 144. If you are to budget the time allotment for a particular study, about 75-80% would be allotted to? a. Collating and analyzing b. Writing the whole data c. Survey of interview or actual observation in a laboratory or clinical setting to gather data d. Identifying research problem, planning on the materials and research design to be used,
e.
and the subject to be used in the study
145. When the total population appears to be very large, the researcher may decide to get a representative sample and yet make the research findings still valid and acceptable.This type of sampling uses the technique whereby the population is divided into areas or section and then taking random sample from each section: a. Systematic b. Stratified sampling c. Cluster sampling d. Purposive sampling 146. Using the Slovin’s formula for calculating the appropriate sample size for a population of 3000 with a margin of error of 5% will yield a sample size of? a. 120 b. 353 c. 200 d. 897 147. A type 1 error of interpretation happens when a researcher a. Concluded that the independent variable produced an improvement in the dependent variable when, in fact there is none. b. Negates the effect of the independent variable since no noticeable improvement has happened in the dependent variable c. Collected the wrong sample for the target population in mind d. Concluded that the independent variable improved the dependent variable after careful consideration of its statistical significance 148. Research shows that the use of laundry soap as for dishwashing increases the likelihood of E.coli proliferation in dishwashing sponges by as much as 80% compared to use of dishwashing liquid (p=.001). This means that: a. Dishwashing liquid and laundry soap are equally effective in cleaning dishes b. There is a significant difference in E. coli levels in dishwashing sponges when we use laundry soap compared to dishwashing liquid. c. Dishwashing liquid has a high level of efficiency in eliminating all E. coli bacteria in dishwashing sponges d. There is no significant proof that dishwashing liquid is more effective than laundry soap for dishwashing 149. Findings in nursing research, to be considered as statistically significant, should be at a level of: a. p=.01 b. p=.10 c. p=.001 d. p=.05
