November 2008 NLE Practice III - CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONSNURSING PRACTICE III – CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS

Situation I: Leo lives in the squatter area. He goes to nearby school. He helps his mother gather molasses after school. One day, he was absent because of fever, malaise, anorexia, and abdominal discomfort.

1. Upon assessment, Leo was diagnosed to have hepatitis A. Which mode of transmission has the infection agent taken?a. Fecal oralb. Dropletc. Airborned. Sexual contact

2. Which of the following is concurrent disinfection in the case of Leo?a. Investigation of contactb. Sanitary disposal of feces, urine and bloodc. Quarantine of the sick individuald. Removing all detachable objects in the room, cleaning lighting and air duct surfaces in the ceiling and cleaning everything downward to the floor

3. Which of the following must be emphasized during mother’s class to Leo’s mother?a. Administration of immunoglobulin to familiesb. Thorough had washing before and after eating and toiletingc. Use of attenuated vaccinesd. Boiling of food especially meat

4. Disaster control should be undertaken when there are 3 or more hepatitis A cases. Which of these measures is a priority?a. Eliminate fecal contamination from foodsb. Mass vaccination of uninfected individualsc. Health promotion and education to families and opportunities about the disease, its cause and transmissiond. Mass administration of Immunoglobulin

5. What is the average incubation period of Hepatitis A?a. 30 daysb. 60 daysc. 50 daysd. 14 days

Situation 2: As a nurse researcher, you must have a very good understanding of the common terms of concept used in research.

6. The information that an investigator collects from the subjects or participants in a research study is usually calleda. Hypothesisb. Datac. Variabled. Concept

7. Which of the following usually refers to the independent variables in doing research?a. Resultb. Causec. Outputd. Effect

8. The recipients of experimental treatment is an experimental design or the individuals to be observed in a non-experimental design are calleda. Settingb. Subjectsc. Treatmentd. Sample

9. The device or techniques an investigator employs to collect data is calleda. Sampleb. Instrumentc. Hypothesisd. Concept

10. The use of another person’s ideas or workings without giving appropriate credit results from inaccurate or incomplete attribution of materials to its sources. Which of the following is referred to when another person’s idea is inappropriately credited as one’s own?a. Plagiarismb. Quotationc. Assumptiond. Paraphrase

Situation 3: Mrs Pichay is admitted to your ward. The MD ordered “prepare for thoracentesis this pm to remove excess air from the pleural cavity.”11. Which of the following nursing responsibilities is essential in Mrs. Pichay who will undergo thracentesis?a. Support and reassure client during the procedureb. Ensure that informed consent has been signedc. Determine if client has allergic reaction to local anesthesiad. Ascertain if chest x-rays and other tests have been prescribed and completed

12. Mrs. Pichay who is for thoracentesis is assigned by the nurse to which of the following positions?a. Trendelenburg positionb. Supine position

c. Dorsal recumbent positiond. Orthopneic position

13. During thoracentesis, which of the following nursing intervention will be most crucial?a. Place patient in a quiet and cool roomb. Maintain strict aseptic techniquec. Advise patient to sit perfectly still during needle insertion until it has been withdrawn from the chestd. Apply pressure over the puncture site as soon as the needle is withdrawn

14. To prevent leakage of fluid in the thoracic cavity, how will you position the client after thoracentesis?a. Place flat in bedb. Turn on the unaffected sidec. Turn on the affected sided. On bed rest

15. Chest x-ray was ordered after thoracentesis. When your client asks what is the reason for another chest x-ray, you will explaina. To rule out pneumothoraxb. To rule out any possible perforationc. To decongestd. To rule out any foreign body

Situation 4: A computer analyst, Mr. Ricardo J. Santos, 25, was brought to the hospital for diagnostic workup after he had experienced seizure in his office.

16. Just as the nurse was entering the room, the patient who was sitting on his chair begins to have a seizure. Which of the following must the nurse do first?a. Ease the patient to the floorb. Lift the patient and put him on the bedc. Insert a padded tongue depressor between his jawsd. Restrain patient’s body movement

17. Mr. Santos is scheduled for CT Scan for the next day, noon time. Which of the following is the correct preparation as instructed by the nurse?a. Shampoo hair thoroughly to remove oil and dirtb. No special preparation is needed. Instruct the patient to keep his head still and steadyc. Give a cleansing enema and give fluids until 8AMd. Shave scalp and securely attach electrodes to it

18. Mr. Santos is placed on seizure precaution. Which of the following would be contraindicated?a. Obtain his oral temperatureb. Encourage to perform his own personal hygienec. Allow him to wear his own clothingd. Encourage him to be out of bed

19. Usually, how does the patient behave after his seizure has subsided?a. Most comfortable walking and moving about

b. Becomes restless and agitatedc. Sleeps for a period of timed. Say he is thirsty and hungry

20. Before, during and after seizure, the nurse knows that the patient is ALWAYS placed in what position?a. Low fowler’sb. Modified trendelenburgc. Side lyingd. Supine

Situation 5: Mrs. Damian, an immediate post-op cholecystectomy and choledocholithotomy patient, complained of severe pain at the wound site.

21. Choledocholithotomy isa. The removal of the gallbladderb. The removal of the stones in the gallbladderc. The removal of the stones in the common bile ductd. The removal of the stones in the kidney22. The simplest pain relieving technique isa. Distractionb. Taking aspirinc. Deep breathing exercised. Positioning

23. Which of the following statement on pain is TRUE:a. Culture and pain are not associatedb. Pain accompanies acute illnessc. Patient’s reaction to pain variesd. Pain produces the same reaction such as groaning and moaning

24. In pain assessment, which of the following condition is a more reliable indicator?a. Pain rating scale of 1 to 10b. Facial expression and gesturesc. Physiological responsesd. Patient’s description of the pain sensation

25. When a client complains of pain, your initial response is:a. Record the description of painb. Verbally acknowledge the painc. Refer the complaint to the doctord. Change to a more comfortable position

Situation 6: You are assigned at a surgical ward and clients have been complaining of post pain at varying degrees. Pain as you know is very subjective.

26. A one-day post-operative abdominal surgery client has been complaining of severe throbbing abdominal pain described as 9 in a 1-10 pain rating. Your assessment reveals bowel sound on all quadrants and the dressing is dry and intact. What nursing intervention would you take?a. Medicate client as prescribed

b. Encourage client to do imageryc. Encourage deep breathing and turningd. Call surgeon stat

27. Pentoxidone 5mg IV every 8 hours was prescribed for post-abdominal pain. Which will be your priority nursing action?a. Check abdominal dressing for possible swellingb. Explain he proper use of PCA to alleviate anxietyc. Avoid overdosing to prevent dependence/toleranced. Monitor VS, more importantly RR

28. The client complained of abdominal distention and pain. Your nursing intervention that can alleviate pain is?a. Instruct client to go to sleep and relaxb. Advise the client to close the lips and avoid deep breathing and talkingc. Offer hot and clear soupd. Turn to sides frequently and avoid too much talking

29. Surgical pain might be minimized by which nursing action in the O.R.?a. Skill of surgical team and lesser manipulationb. Appropriate preparation for the scheduled procedurec. Use of modern technology in closing the woundd. Proper positioning and draping of clients

30. Inadequate anesthesia is said to be one the common cause of pain both in intra and post op patients. If general anesthesia is desired, it will involve loss of consciousness. Which of the following are the 2 general types of GA?a. Epidural and spinalb. Subarachnoid block and intravenousc. Inhalation and regionald. Intravenous and inhalation

Situation 7: Nurse’s attitudes toward the pain influence the way they perceive and interact with clients in pain.

31. Nurses should be aware that older adults are at risk of underrated pain. Nursing assessment and management of pain should address the following beliefs EXCEPT:a. Older patients seldom tend to report pain than the younger onesb. Pain is a sign of weaknessc. Older patients do not believe in analgesics, they are tolerant.d. Complaining of pain will lead to being labeled a “bad” patient

32. Nurses should understand that when a client responds favorable to a placebo, it is known as the ‘placebo effect.’ Placebos do not indicate whether or not a client hasa. Conscienceb. Real painc. Diseased. Drug tolerance

33. You are the nurse in the pain clinic where you have client who has difficulty

specifying the location of pain. How can you assist such clients?a. The pain is vagueb. By charting it hurts all overc. Identify the absence and presence of paind. Ask the client to point to the painful area by just one finger

34. What symptom more distressing than pain should the nurse monitor when giving opioids especially among elderly clients who are in pain?a. Forgetfulnessb. Constipationc. Drowsinessd. Allergic reaction like pruritus

35. Physical dependence occurs in anyone who takes opioid over a period of time. What do you tell a mother of a ‘dependent’ when asked for advice?a. Start another drug and slowly lessen the opioid dosageb. Include in recreational outdoor activitiesc. Isolate opioid dependent to a restful resortd. Instruct slow tapering of the drug dosage and alleviate physical withdrawal symptoms

Situation 8: The nurse is performing health education activities for Janevi Segovia, a 30 year-old dentist with insulin dependent diabetes mellitus.

36. Janevi is preparing a mixed dose of insulin. The nurse is satisfied with her performance when shea. Draw insulin from the vial of clear insulin firstb. Draw insulin from the vial of the intermediate acting insulin firstc. Fill both syringes with the prescribed insulin dosage then shake the bottle vigorouslyd. Withdraw the intermediate acting insulin first before withdrawing the short acting insulin first

37. Janevi complains of nausea, vomiting, diaphoresis and headache. Which of the following nursing intervention are you going to carry out first?a. Withhold the client’s next insulin injectionb. Test the client’s blood glucose levelc. Administer Tylenol as orderedd. Offer fruit juice, gelatin and chicken bouillon

38. Janevi administers regular insulin at 7 am and the nurse should instruct Jane to avoid exercising at arounda. 9 – 11 amb. After 8 hoursc. Between 8 am to 9 amd. In the afternoon after taking lunch

39. Janevi was brought at the emergency room after four months because she fainted in her clinic. The nurse should monitor which of the following test to evaluate the overall therapeutic compliance of a diabetic patient?a. Glycosylated hemoglobinb. Fasting blood glucose

c. Ketone levelsd. Urine glucose levels

40. Upon the assessment of Hba1c of Mrs. Segovia, the nurse has been informed of a 9% Hba1c result. In this case, she will teach the patient to:a. Avoid infectionb. Take adequate food and nutritionc. Prevent and recognize hyperglycemiad. Prevent and recognize hypoglycemia

41. The nurse is teaching a plan of care for Jane with regards to proper foot care. Which of the following should be included in the plan?a. Soak feet in hot waterb. Avoid using mild soap on the feetc. Apply a moisturizing lotion to dry feet but not between the toesd. Always have a podiatrist to cut your toe nails. Never cut them yourself

42. Another patient was brought to the emergency room in an unresponsive state and a diagnosis of hyperglycemic hyperosmolar non-ketotic syndrome is made. The nurse immediately prepared to initiate which of the following anticipated physician’s order?a. Endotracheal intubationb. 100 units of NPH insulinc. Intravenous infusion of normal salined. Intravenous infusion of sodium bicarbonate

43. Jane eventually developed DKA and is being treated in the emergency room. Which finding would the nurse expect to note as confirming this diagnosis?a. Comatose stateb. Decreased urine outputc. Increased respiration and an increase in pHd. Elevated blood glucose level and low plasma bicarbonate level

44. The nurse teaches Jane to know the difference between hypoglycemia and ketoacidosis. Jane demonstrates understanding of the teaching by stating that glucose will be taken if which of the following symptoms develops?a. Polyuriab. Shakinessc. Blurred visiond. Fruit breath odor

45. Jane has been schedule to have a FBS taken in the morning. The nurse tells Jane not to eat or drink after midnight. Prior to taking the blood specimen, the nurse noticed that Jane is holding a bottle of distilled water. The nurse asked Jane if she drank any, and she said “yes.” Which of the following is the best nursing action?a. Administer syrup of ipecac to remove the distilled water from the stomachb. Suction the stomach content using NGT prior to specimen collectionc. Advise to physician to reschedule to diagnostic examination next dayd. Continue as usual and have the FBS analysis performed and specimen be taken

Situation 9: Elderly clients usually produce unusual signs when it comes to different diseases. The aging process is a complicated process and the nurse should understand that it is an inevitable fact and she must be prepared to care for the growing elderly population.

46. Hypoxia may occur in the older patients because of which of the following physiologic changes associated with aging?a. Ineffective airway clearanceb. Decreased alveolar surfaced areac. Decreased anterior-posterior chest diameterd. Hyperventilation

47. The older patient is at higher risk for incontinence because ofa. Dilated urethrab. Increased glomerular filtration ratec. Diuretic used. Decreased bladder capacity

48. Merle, age 86, is complaining of dizziness when she stands up. This may indicate:a. Dementiab. A visual problemc. Functional declined. Drug toxicity

49. Cardiac ischemia in an older patient usually produces:a. ST-T wave changesb. Very high creatinine kinase levelc. Chest pain radiating to the left armd. Acute confusion

50. The most dependable sign of infection in the older patient is:a. Change in mental statusb. Feverc. Paind. Decreased breath sounds with crackles

Situation 10: in the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all these to safeguard the safety and quality of patient delivery outcome.

51. Which of the following should be given highest priority when receiving patient in the OR?a. Assess level of consciousnessb. Verify patient identification and informed consentc. Assess vital signsd. Check for jewelry, gown, manicure, and dentures

52. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but considered ‘dirty cases’. When are there procedures best scheduled?a. Last case

b. In between casesc. According to availability of anesthesiologistd. According to the surgeon’s preference

53. OR nurses should be aware that maintaining the client’s safety is the overall goal of nursing care during the intraopertive phase. As the circulating nurse, you make certain that throughout the procedurea. The surgeon greets his client before induction of anesthesiab. The surgeon and anesthesiologist are in tandemc. Strap made of strong non-abrasive materials are fastened securely around the joints of knees and ankles and around the 2 hands around an arm boardd. Client is monitored throughout the surgery by the assistant anesthesiologist

54. Another nursing check that should not be missed before the induction of general anesthesia isa. Check for presence of underwearb. Check for presence of denturesc. Check patient’s IDd. Check baseline vital signs

55. Some lifetime habits and hobbies affect post-operative respiratory function. If you client smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate increased risk fora. Perioperative anxiety and stressb. Delayed coagulation timec. Delayed wound healingd. Post-operative respiratory infection

Situation 11: Sterilization is the process of removing ALL living microorganism. To be free of ALL living microorganism is sterility.

56. There are 3 general types of sterilization used in the hospital. Which one is not included?a. Steam sterilizationb. Chemical sterilizationc. Sterilizationd. Sterilization by boiling

57. Autoclave of steam under pressure is the most common method of sterilization in the hospital. The nurse knows that the temperature and time is set to the optimum level to destroy not only the microorganism, but also the spores. Which of the following is the ideal setting of the autoclave machine?a. 10,000 degrees Celsius for 1 hourb. 5,000 degrees Celsius for 30 minutesc. 37 degrees Celsius for 15 minutesd. 121 degrees Celsius for 15 minutes

58. It is important that before a nurse prepares the material to be sterilized, a chemical indicator strip should be placed above the package, preferable Muslin sheet. What is the color of the stripe produced after autoclaving?a. Blackb. Blue

c. Grayd. Purple

59. Chemical indicators communicate thata. The items are sterileb. That the items had undergone sterilization process but not necessarily sterilec. The items are disinfectedd. That the items had undergone disinfection process but not necessarily disinfected

60. If a nurse will sterilize a heat and moisture labile instrument, it is according the AORN recommendation to use which of the following method of sterilization?a. Ethylene oxide gasb. Autoclavingc. Flash sterilizerd. Alcohol immersion

Situation 22: Nurses hold a variety of roles when providing care to a perioperative patient.

61. Which of the following role would be the responsibility of the scrub nurse?a. Assess the readiness of the client prior to surgeryb. Ensure that the airway is adequatec. Account for the number of sponges, needles, supplies used during the surgical procedured. Evaluate the type of anesthesia appropriate for the surgical client

62. As a peiroperative nurse, how can you best meet the safety need of the client after administering pre-operative narcotic?a. Put side rails up and ask the client not to get out of bedb. Send the client to OR with the familyc. Allow client to get up to go to the comfort roomd. Obtain consent form

63. It is the responsibility of the pre-op nurse to do skin prep for patient undergoing surgery. If hair at the operative site is not shaved, what should be done to make suturing easy and lessen chance of incision infection?a. Drapeb. Pulledc. Clippedd. Shampooed

64. It is also the nurse’s function to determine when infection is developing in the surgical incision. The perioperative nurse observe for what signs of impending infection?a. Localized heat and rednessb. Serosanguinous exudates and skin blanchingc. Separation of the incisiond. Blood clots and scar tissue are visible

65. Which of the following nursing interventions is done when examining the incision would and changing the dressing?

a. Observe the dressing and type and odor of drainage if anyb. Get patient’s consentc. Wash handsd. Request the client to expose the incision wound

Situation 13: The pre-operative nurse collaborates with the client significant others, and healthcare providers.

66. To control environmental hazards in the OR, the nurse collaborates with the following departments EXCEPT:a. Biomedical divisionb. Chaplaincy servicesc. Infection control committeed. Pathology department

67. An air crash occurred near the hospital leading to a surge of trauma patient. One of the last patients will need surgical amputation but there are no sterile surgical equipments. In this case, which of the following will the nurse expect?a. Equipments needed for surgery need not be sterilized if this is an emergency necessitating life saving measuresb. Forwarding the trauma client to the nearest hospital that has available sterile equipments is appropriatec. The nurse will need to sterilize the item before using it to the client using the regular sterilization setting at 121 degree Celsius in 15 minutesd. In such cases, flash sterilizer will be used at 132 degrees Celsius in 3 minutes

68. Tess, the PACU nurse, discovered that Malou, who weighs 110 lbs. prior to surgery, is in severe pain 3 hours after cholecystectomy. Upon checking the chart, Malou found out that she has an order of Demerol 100mg I.M. prn for pain. Tess should verify the order witha. nurse supervisorb. anesthesiologistc. surgeond. intern on duty

69. Rosie, 57, who is diabetic, is for debridement for incision of wound. When the circulating nurse checked the present IV fluid, she found out that there is no insulin incorporated as ordered. What should the circulating nurse do?a. Double check the doctor’s order and call the attending MDb. Communicate with the ward nurse to verify if insulin was incorporated or notc. Communicate with the client to verify if insulin was incorporatedd. Incorporate insulin as ordered

70. The documentation of all nursing activities performed is legally and professionally vital. Which of the following should NOT be included in the patient’s chart?a. Presence of prosthetoid devices such as dentures, artificial limbs, hearing aid, etc…b. Baseline physical, emotional, and psychosocial datac. Arguments between nurses and payments regarding treatmentsd. Observed untoward signs and symptoms and interventions including contaminant intervening factors

Situation 14: Team effort is the best demonstrated in the OR.

71. If you are the nurse in charge for scheduling surgical cases, what important information do you need to ask the surgeon?a. Who is your internist?b. Who is your assistant and anesthesiologist, and what is your preferred time and type of surgery?c. Who are your anesthesiologist, internist and assistant?d. Who is your anesthesiologist?

72. In the OR< the nursing tandem for every surgery is:a. Instrument technician and circulating nurseb. Nurse anesthetist, nurse assistant, and instrument technicianc. Scrub nurse and nurse anesthetistd. Scrub and circulating nurses

73. While team effort is needed in the OR for efficient and quality patient care delivery, we should limit the number of people in the room for infection control. Who comprises this team?a. Surgeon, anesthesiologist, scrub nurse, radiologist, orderlyb. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologistc. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologistd. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

74. Who usually act as an important part of the OR personnel by getting the wheelchair or stretcher, and pushing them towards the operating room?a. Orderly/clerkb. Nurse supervisorc. Circulating nursed. Anesthesiologist

75. The breakdown in teamwork is often times a failure ina. Electricityb. Inadequate supplyc. Leg workd. Communication

Situation 15: Basic knowledge on Intravenous solutions in necessary for care of clients with problems with fluid and electrolytes.

76. A client involved in a motor vehicle crash presents to the emergency department with severe internal bleeding. The client is severely hypotensive and unresponsive. The nurse anticipates which of the following intravenous solutions will most likely be prescribed to increase intravascular volume, replace immediate blood loss and increase blood pressure?a. 0.45% sodium chlorideb. Normal saline solutionc. 0.33% sodium chlorided. Lactated ringer’s solution

77. The physician orders the nurse to prepare an isotonic solution. Which of the

following IV solution would the nurse expect the intern to prescribe?a. 5% dextrose in waterb. 10% dextrose in waterc. 0.45% sodium chlorided. 5% dextrose in 0.9% sodium chloride

78. The nurse is making initial rounds on the nursing unit to assess if the condition of assigned clients. The nurse notes that the client’s IV site is cool, pale, and swollen and the solution is not infusing. The nurse concludes that which of the following complications has been experienced by the client?a. Infectionb. Phlebitisc. Infiltrationd. Thrombophlebitis

79. A nurse reviews the client’s electrolyte laboratory report and notes that the potassium level is 3.2 mEq/L. Which of the following would the nurse note on the electrocardiogram as a result of the laboratory value?a. U wavesb. Absent P wavesc. Elevated T wavesd. Elevates ST segment

80. One patient had a runaway IV of 50% dextrose. To prevent temporary excess of insulin or transient hyperinsulin reaction, what solution you prepare in anticipation of the doctor’s order?a. Any iv solution available to KVOb. Isotonic solution c. Hypertonic solutiond. Hypotonic solution

81. An informed consent is required fora. Closed reduction of a fractureb. Insertion of intravenous catheterc. Irrigation of the external ear canald. Urethral catheterization

82. Which of the following is not true with regards to the informed consent?a. It should describe different treatment alternativesb. It should contain a thorough and detailed explanation of the procedure to be donec. It should describe the client’s diagnosisd. It should give an explanation of the client’s prognosis

83. You know that the hallmark of nursing accountability is thea. Accurate documentation and reportingb. Admitting your mistakesc. Filling an incidence reportd. Reporting a medication error

84. A nurse is assigned to care for a group of clients. On review of the client’s medical records, the nurse determined that which client is at risk for excess fluid

volume?a. The client taking diureticsb. The client with renal failurec. The client with an ileostomyd. The client who requires gastrointestinal suctioning

85. A nurse is assigned to care for a group of clients. On review of the client’s medical records, the nurse determines that which client is at risk for deficient fluid volume?a. A client with colostomyb. A client with congestive heart failurec. A client with decreased kidney functiond. A client receiving frequent wound irrigation

Situation 16: As a perioperative nurse, you are aware of the correct processing methods for preparing instruments and other devices for patient use to prevent infection.

86. As an OR nurse, what are your foremost considerations for selecting chemical agent for disinfection?a. Material compatibility and efficiencyb. Odor and availabilityc. Cost and duration of disinfection processd. Duration of disinfection and efficiency

87. Before you use a disinfected instrument, it is essential that youa. Rinse with tap water followed by alcoholb. Wrap the instrument with sterile waterc. Dry the instrument thoroughlyd. Rinse with sterile water

88. You have a critical heat labile instrument to sterilize and are considering to use high level disinfectant. What should you do?a. Cover the soaking vessel to contain the vaporb. Double the amount of high level disinfectantc. Test the potency of the high level disinfectantd. Prolong the exposure time according to manufacture’s direction

89. To achieve sterilization using disinfectants, which of the following is used?a. Low level disinfectants immersion in 24 hoursb. Intermediate level disinfectants immersion in 12 hoursc. High level disinfectants immersion in 1 hourd. High level disinfectant immersion in 10 hours

90. Bronchoscope, thermometer, endoscope, ET tube, cytoscope are all BEST sterilized using which of the following?a. Autoclaving at 121 degree Celsius in 15 minutesb. Flash sterilizer at 132 degree Celsius in 3 minutesc. Ethylene oxide gas aeration for 20 hoursd. 2% glutaraldehyde immersion for 10 hours

Situation 17: The OR is divided into three zones to control traffic flow and

contamination.

91. What OR attires are worn in the restricted area?a. Scrub suit, OR shoes, head capb. Head cap, scrub suit, mask, OR shoesc. Mask, OR shoes, scrub suitd. Cap, mask, gloves, shoes

92. Nursing intervention for a patient on low dose IV insulin therapy includes the following EXCEPT:a. Elevation of serum ketones to monitor ketosisb. Vital signs including BPc. Estimates serum potassiumd. Elevation of blood glucose levels

93. The doctor ordered to incorporate 1000 “u” insulin to the remaining on going IV. The strength is 500/ml. How much should you incorporate into the IV solution?a. 10 mlb. 2 mlc. 0.5 mld. 5 ml

94. Multiple vial-dose-insulin when in use should bea. Kept at room temperatureb. Kept in the refrigeratorc. Kept in narcotic cabinetd. Store in freezer

95. Insulins using insulin syringe are given using how many degrees of needle insertion?a. 45b. 180c. 90d. 15

Situation 18: “Maintenance” of sterility is an important function a nurse should perform in any OR setting.

96. Which of the following is true with regards to sterility?a. Sterility is time related. Items are not considered sterile after a period of 30 days of being not usedb. For 9 months, sterile items are considered sterile as long as they are covered with sterile muslin cover and stored in a dust proof coversc. Sterility is event related, not time relatedd. For 3 weeks, items double covered with muslin are considered sterile as long as they have undergone the sterilization process

97. 2 organizations endorsed that sterility are affected by factors other than the time itself. These are:a. The PNA and the PRCb. AORN and JCAHOc. ORNAP and MCNAP

d. MMDA and DILG

98. All of this factors affect the sterility of the OR equipments. These are the following except:a. The material used for packagingb. The handling of the materials as well as its transportc. Storaged. The chemical or process used in sterilizing the material

99. When you say sterile, it means:a. The material is cleanb. The material as well as the equipments are sterilized and had undergone a rigorous sterilization processc. There is a black stripe on the paper indicatord. The material has no microorganism nor spores present that might cause an infection

100. In using liquid sterilizer versus autoclave machine, which of the following is true?a. Autoclave is better in sterilizing OR supplies versus liquid sterilizerb. They are both capable of sterilizing the equipments, however, it is necessary to soak supplies in the liquid sterilizer for a longer period of timec. Sharps are sterilized using autoclave and not cidexd. If liquid sterilizer is used, rinsing it before using is not necessary

ANSWER KEY:

1. A2. B3. B4. C5. A6. B7. B8. B9. B10. A11.D12. D13. C14. B15. A16. A17. B18. A19. C20. C21. C22. D

23.C24. D25. B26. A27. D28. D29.B30. D31.C32. B33.D34. D35.D 36. A37. B38.A39. A40. C41.C42.C43. D44.B45.D46.B47.D48.C49.D50.C51. B52. A53. C54. D55. D56. D57. D58. A59. B60. A61. C62. A63. C64. A65. A66. B67. D68. C69. A70. C71. B72. D73. B74. A

75. D76. D77. A78. C79. A80. C81. A82. B83. A84. B85. A86. A87. D88. D89.D90. D91. B92. A93. B94. A95. A96. C97. B98. D99. D100. B