Love for Eternity- Lammuel Abrigo

Love for Eternity

March 2000

Imagine being wrapped up in your arms

and feeling your heart beatings

And do find myself lonngging to hold you closed

it's how i feel

co'z ive been through a lot these years and i have

lost the count of my tears

until the end of time, Im longging for your love

And if you feel the same, then show me your love

I'll give you everything that money can't buy

and i promised Ill be right by your side.

If only you could tell me whats on my mind

and show you how it feel

and i wonder where you are heading this time

and where you belong

Co'z i know that if you would be here

Ill do anything coz my love is real

Eventhough moments are sad

Look into my eyes and know this love

will last

a love would last for eternity

Tell me why i have to suffer- Daisy Mae Dolores

Tell me why i have to suffer

March 2000

Sometimes I ask myself,

why i have to suffer because of you

I'm thinking about how to hold on tight

Because im afraid to live again

I didn't mean to hurt you but

you always hurt my feelings

Even if you say you love me, I can't Feel

I have given you everything but you don't want

to feel because of selfish minds

That's not the way to hate you

but I dont know what will i do

Just say you'll love me and I'll stay

But I'm telling you that not all the time

Im saying an I LOVE YOU

Co'z my love for you certainly has end

But as long as i do live and has breath

My love can stay forever as you pleased

That's why I don't know the words why

I have to suffer for you?

Endless love- Mike anthony Pedong

Endless Love

march 2000

Something changes

something don't

but my feelings for you certainly won't

something changes

like colors of the sky

but my love for you will never die

something changes like night and day

but you'll always be special to me

in everyway

Something changes like love at first sight

but eventhough your faraway

I'll hold on tight

something changes

like passion that burns

but my passion to you will always be firm

Dahil Ikay Mahal- By Jocelyn De guzman

Dahil Ika'y Mahal

March 2000

Aking Mahal nais kong malaman mo na ikaw ang aking buhay

Bakit ba hindi maramdaman ang iyong pagmamahal

Hanggang kelan ako ganito

hanggang kelan ang paghihintay na

masabing mahal mo ako

Hangad ko'y iyong kaligayahan

kaya't kahit masakit tinitignan na lamang

sa isang saglit na hindi ko na makaya

ngumingiti at tumatawa na lamang na parang walang problema

subalit sa loob nito'y isang pasakit na hindi makaya

Isang hiling na kahit isang saglit

Ikay kapiling at ang pagibig mo'y para sa akin

Subalit napakalayo na ikay magkagusto

sapagkat ang tanging alam mo ay kaibigan lang ang turing sayo

pero hindi ito totoo ikay mahal ng higit pa sa inaakala mo

ngunit salamat sa pagmamahal mo kahit pangkaibigan lang

ito'y intindi ko dahil ika'y mahal ko

sanay makatagpo ka ng hindi ka papaluhain

lahat ay tanggap kahit masakit sa akin

sapagkat ika'y mahal ng higit

saan pa man, ikay mahal ng higit pa sa buhay ko

fanatic Love- By Rowena Esmilla

FANATIC LOVE

march 2000

Creators of heaven and peace

Love for person and love for idols

Men and women in the business and ideals

How can i Love them nor can i loved.

Deeds and works are the categories

looks management of style are welt to me

Original style and japorms are admired

See how my heart do feels

Fanatic love I feel

With this person I truly admired

Is this love last or it will throw me

to somebody i dont know

addison's disease

Addison’s Disease
Etiology and Pathophysiology

■ An adrenocortical disorder exhibited by↓secretion of adrenocortical hormones → ↓glucocorticoids, mineralocorticoids (aldosterone), and androgens, which → ↓stress response

■ Occurs secondary to surgical removal of adrenal glands, autoimmune or idiopathic causes, abrupt cessation of steroid therapy, or infection

Signs and Symptoms
■ ↑K, ↓Na, dehydration, ↓serum glucose, weakness, diarrhea, confusion
■ ↓BP, ↓weight, bronze-colored skin
■ ↑ACTH, ↓serum cortisol, ↓17-ketosteroids, ↓17-hydroxysteroids
■ Addisonian crisis:
Pallor or cyanosis,
anxiety,
↑P, ↑R, ↓BP
secondary toacute stress (surgery, emotions, cold exposure, infection)

Treatment■
Glucocorticoid and mineralocorticoid replacement (↑dose under stress to ↓risk of Addisonian crisis)
■F&E replacement

Nursing Management
■ Monitor for S&S of Addisonian crisis
■ Encourage ↑protein and ↑carbohydrate diet with added salt
■ Schedule rest periods
■ Teach need for lifelong therapy, avoidance of stress, and use of medicalalert band

MAP (NCLEX Testing Center Makati)

An NCLEX-RN test center is finally here in Manila. Although the center officially opens last August 23, when the first NCLEX exam in the Philippines will be conducted, applicants may now schedule their test date. All the exam slots in the Hong Kong test center from July to October were all booked, numerous slots have opened from late July onwards. It was about time that a Manila test center opened, for such a long time Filipinos have had tremendous difficulty scheduling test dates there, so many had to resort to extreme measures such as taking the NCLEX in Saipan, Taiwan, South Korea, and even Japan. More importantly, the opening of the Manila test center is a great financial relief to many Filipino nurses who don't have the resources to pay for plane fare, food, and hotel accommodations outside the country.The Manila test center conducted a successful examination venue, and now if you want to know where it's located so you can scout transportation routes and nearby hotels, you can check out the map I've made.

my college days picture

types of surgery

Types of Surgery

Surgery is a medical technology consisting of a physical intervention on tissues. As a general rule, a procedure is considered surgical when it involves cutting of a patient’s tissues or closure of a previously sustained wound. Other procedures that do not necessarily fall under this rubric, such as angioplasty or endoscopy, may be considered surgery if they involve “common” surgical procedure or settings, such as use of a sterile environment, anesthesia, antiseptic conditions, typical surgical instruments, and suturing or stapling. All forms of surgery are considered invasive procedures; so-called “noninvasive surgery” usually refers to an excision that does not penetrate the structure being excised (i.e. laser ablation of the cornea) or to a radiosurgical procedure (i.e. irradiation of a tumor).

Surgery is a unique experience of a planned physical alteration encompassing three phases:

PREOPERATIVE, INTRAOPERATIVE AND POSTOPERATIVE.

These 3 phases are together referred to as the PERIOERATIVE PERIOD.

Surgical procedures are commonly grouped according to:

A. Purpose

Diagnostic
Confirms or establishes a diagnosis; Example - biopsy of a mass in a breast.

Palliative
Relieves or reduces pain or symptoms of a disease; it does not cure; Example - resection of nerve roots.

Ablative
Removes a diseased body part; Example - removal of a gallbladder (cholecystectomy)

Constructive
Restores function or appearance that has been lost or reduced; Example - breast implant

Transplant
Replaces malfunctioning structures; Example - hip replacement

B. Degree of Urgency

Emergency Surgery
Is performed immediately to preserve function or the life of the client. Example - surgeries to control internal hemorrhage

Elective Surgery
Is performed when surgical intervention is the preferred treatment for a condition that is not imminently life threatening (but may ultimately threaten life or well being) or to improve the client’s life. Example - cholecystectomy for chronic gallbladder disease, plastic surgery procedures such as breast reduction surgery

C. Degree of Risk

Major Surgery
It involves a high degree of risk, for a variety of reasons: It may be complicated or prolonged, large losses of blood may occur, vital organs may be involved, or postoperative complications may be likely. Example - organ transplant, open heart surgery, removal of kidney

Minor Surgery
It involves little risk, produces few complications, and is often performed in a “day surgery”. Example - breast biopsy, removal of tonsils, knee surgery.
The degree of risk involved in a surgical procedure is affected by the client’s age, general health, nutritional status, use of medications, and mental status.

Age
Very young and elder clients are greater surgical risks than children and adults.The physiologic response of an infant to surgery is substantially different from an adult’s.The blood volume in an infant is small, and its fluid reserves limited.The older adult often has fewer physiologic reserves to meet the extra demands caused by surgery.The older adult may be poorly nourished, which can impair healing.

General Health
Surgery is least risky when the client’s general health is good. Common health problems that increase surgical risk and may lead to the decision to postpone or cancel surgery are malnutrition, cardiac conditions, blood coagulation disorders, renal diseases, diabetes mellitus, liver diseases, etc.

Nutritional Status
Adequate nutrition is required for normal tissue repair.Obesity contributes to postoperative complications such as pneumonia, wound infection and wound separation.Obese and underweight client are vulnerable to pressure ulcer formation due to positioning required for surgery.A malnourished client is at risk for delayed wound healing, wound infection and fluid and electrolyte alterations.

Medications
The following medication can increase surgical risk:Anticoagulants increase blood coagulation time.Tranquilizers may interact with anesthetics, increasing the risk of respiratory depression.Corticosteroids may interfere with wound healing and increase the risk of infection.Diuretics may affect fluid and electrolyte balance.

Mental Status
Clients with dementia may have difficulty understanding proposed surgical procedures and may respond unpredictably to anesthetics.Extreme anxiety also increases surgical risk and interferes with the client’s ability to process information and respond appropriately to instructions.

pharmacological Terms and definitions

Pharmacology Terms & Definitions, Clinical Conditions, and Associated Signs and Symptoms

afterload
resistance that ventricles must work against to eject blood into the aorta during systole.

agranulocytosis
sudden drop in leukocyte count; often followed by a severe infection manifested by high fever, chills, prostration, and ulcerations of mucous membrane such as in the mouth, rectum, or vagina.

akathisia
extrapyramidal symptom manifested by a compelling need to move or pace, without specific pattern, and an inability to be still.

analeptic
restorative medication that enhances excitation of the CNS without affecting inhibitory impulses.

anaphylactoid reaction
excessive allergic response manifested by wheezing, chills, generalized pruritic urticaria, diaphoresis, sense of uneasiness, agitation, flushing, palpitations, coughing, difficulty breathing, and cardiovascular collapse.

anticholinergic actions
inhibition of parasympathetic response manifested by dry mouth, decreased peristalsis, constipation, blurred vision, and urinary retention.

bioavailability
fraction of active drug that reaches its action sites after administration by any route. Following an IV dose, bioavailability is 100%; however, such factors as first-pass effect, enterohepatic cycling, and biotransformation reduce bioavailability of an orally administered drug.

blood dyscrasia
pathological condition manifested by fever, sore mouth or throat, unexplained fatigue, easy bruising or bleeding.

cardiotoxicity
impairment of cardiac function manifested by one or more of the following: hypotension, arrhythmias, precordial pain, dyspnea, electrocardiogram (ECG) abnormalities, cardiac dilation, congestive failure.

cholinergic response
stimulation of the parasympathetic response manifested by lacrimation, diaphoresis, salivation, abdominal cramps, diarrhea, nausea, and vomiting.

circulatory overload
excessive vascular volume manifested by increased central venous pressure (CVP), elevated blood pressure, tachycardia, distended neck veins, peripheral edema, dyspnea, cough, and pulmonary rales.

CNS stimulation
excitement of the CNS manifested by hyperactivity, excitement, nervousness, insomnia, and tachycardia.

CNS toxicity
impairment of CNS function manifested by ataxia, tremor, incoordination, paresthesias, numbness, impairment of pain or touch sensation, drowsiness, confusion, headache, anxiety, tremors, and behavior changes.

congestive heart failure (CHF)
impaired pumping ability of the heart manifested by paroxysmal nocturnal dyspnea, cough, fatigue or dyspnea on exertion, tachycardia, peripheral or pulmonary edema, and weight gain.

Cushing’s syndrome
fatty swellings in the interscapular area (buffalo hump) and in the facial area (moon face), distension of the abdomen, ecchymoses following even minor trauma, impotence, amenorrhea, high blood pressure, general weakness, loss of muscle mass, osteoporosis, and psychosis.

dehydration
decreased intracellular or extracellular fluid manifested by elevated temperature, dry skin and mucous membranes, decrease tissue turgor, sunken eyes, furrowed tongue, low blood pressure, diminished or irregular pulse, muscle or abdominal cramps, thick secretions, hard feces and impaction, scant urinary output, urine specific gravity above 1.030, an elevated hemoglobin.

disulfiram-type reaction
Antabuse-type reaction manifested by facial flushing, pounding headache, sweating, slurred speech, abdominal cramps, nausea, vomiting, tachycardia, fever, palpitations, drop in blood pressure, dyspnea, and sense of chest constriction. Symptoms may last up to 24 hours.

enzyme induction
stimulation of microsomal enzymes by a drug resulting in its accelerated metabolism and decreased activity. If reactive intermediates are formed, drug-mediated toxicity may be exacerbated.

first-pass effect
reduced bioavailability of an orally administered drug due to metabolism in GI epithelial cells and liver or to biliary excretion. Effect may be avoided by use of sublingual tablets or rectal suppositories.

fixed drug eruption
drug-induced circumscribed skin lesion that persists or recurs in the same site. Residual pigmentation may remain following drug withdrawal.

half-life (t½)
time required for concentration of a drug in the body to decrease by 50%. Half-life also represents the time necessary to reach steady state or to decline from steady state after a change (i.e., starting or stopping) in the dosing regimen. Half-life may be affected by a disease state and age of the drug user.

heat stroke
a life-threatening condition manifested by absence of sweating; red, dry, hot skin; dilated pupils; dyspnea; full bounding pulse; temperature above 40° C (105° F); and mental confusion.

hepatic toxicity
impairment of liver function manifested by jaundice, dark urine, pruritus, lightcolored stools, eosinophilia, itchy skin or rash, and persistently high elevations of alanine amino-transferase (ALT) and aspartate aminotransferase (AST).

hyperammonemia
elevated level of ammonia or ammonium in the blood manifested by lethargy, decreased appetite, vomiting, asterixis (flapping tremor), weak pulse, irritability, decreased responsiveness, and seizures.

hypercalcemia
elevated serum calcium manifested by deep bone and flank pain, renal calculi, anorexia, nausea, vomiting, thirst, constipation, muscle hypotonicity, pathologic fracture, bradycardia, lethargy, and psychosis.

hyperglycemia
elevated blood glucose manifested by flushed, dry skin, low blood pressure and elevated pulse, tachypnea, Kussmaul’s respirations, polyuria, polydipsia; polyphagia, lethargy, and drowsiness.

hyperkalemia
excessive potassium in blood, which may produce lifethreatening cardiac arrhythmias, including bradycardia and heart block, unusual fatigue, weakness or heaviness of limbs, general muscle weakness, muscle cramps, paresthesias, flaccid paralysis of extremities, shortness of breath, nervousness, confusion, diarrhea, and GI distress.

hypermagnesemia
excessive magnesium in blood, which may produce cathartic effect, profound thirst, flushing, sedation, confusion, depressed deep tendon reflexes (DTRs), muscle weakness, hypotension, and depressed respirations.

hypernatremia
excessive sodium in blood, which may produce confusion, neuromuscular excitability, muscle weakness, seizures, thirst, dry and flushed skin, dry mucous membranes, pyrexia, agitation, and oliguria or anuria.

hypersensitivity reactions
excessive and abnormal sensitivity to given agent manifested by urticaria, pruritus, wheezing, edema, redness, and anaphylaxis.

hyperthyroidism
excessive secretion by the thyroid glands, which increases basal metabolic rate, resulting in warm, flushed, moist skin; tachycardia, exophthalmos; infrequent lid blinking; lid edema; weight loss despite increased appetite; frequent urination; menstrual irregularity; breathlessness; hypoventilation; congestive heart failure; excessive sweating.

hyperuricemia
excessive uric acid in blood, resulting in pain in flank; stomach, or joints, and changes in intake and output ratio and pattern.

hypocalcemia
abnormally low calcium level in blood, which may result in depression; psychosis; hyperreflexia; diarrhea; cardiac arrhythmias; hypotension; muscle spasms; paresthesias of feet, fingers, tongue; positive Chvostek’s sign. Severe deficiency (tetany) may result in carpopedal spasms, spasms of face muscle, laryngospasm, and generalized convulsions.

hypoglycemia
abnormally low glucose level in the blood, which may result in acute fatigue, restlessness, malaise, marked irritability and weakness, cold sweats, excessive hunger, headache, dizziness, confusion, slurred speech, loss of consciousness, and death.

hypokalemia
abnormally low level of potassium in blood, which may result in malaise, fatigue, paresthesias, depressed reflexes, muscle weakness and cramps, rapid, irregular pulse, arrhythmias, hypotension, vomiting, paralytic ileus, mental confusion, depression, delayed thought process, abdominal distension, polyuria, shallow breathing, and shortness of breath.

hypomagnesemia
abnormally low level of magnesium in blood, resulting in nausea, vomiting, cardiac arrhythmias, and neuromuscular symptoms (tetany, positive Chvostek’s and Trousseau’s signs, seizures, tremors, ataxia, vertigo, nystagmus, muscular fasciculations).

hypophosphatemia
abnormally low level of phosphates in blood, resulting in muscle weakness, anorexia, malaise, absent deep tendon reflexes, bone pain, paresthesias, tremors, negative calcium balance, osteomalacia, osteoporosis.

hypothyroidism
condition caused by thyroid hormone deficiency that lowers basal metabolic rate and may result in periorbital edema, lethargy, puffy hands and feet, cool, pale skin, vertigo, nocturnal cramps, decreased GI motility, constipation, hypotension, slow pulse, depressed muscular activity, and enlarged thyroid gland.

hypoxia
insufficient oxygenation in the blood manifested by dyspnea, tachypnea, headache, restlessness, cyanosis, tachycardia, dysrhythmias, confusion, decreased level of consciousness, and euphoria or delirium.

international normalizing ratio
measurement that normalizes for the differences obtained from various laboratory readings in the value for thromboplastin blood level.

leukopenia
abnormal decrease in number of white blood cells, usually below 5000 per cubic millimeter, resulting in fever, chills, sore mouth or throat, and unexplained fatigue.

liver toxicity
manifested by anorexia, nausea, fatigue, lethargy, itching, jaundice, abdominal pain, dark-colored urine, and flu-like symptoms.

metabolic acidosis
decrease in pH value of the extracellular fluid caused by either an increase in hydrogen ions or a decrease in bicarbonate ions. It may result in one or more of the following: lethargy, headache, weakness, abdominal pain, nausea, vomiting, dyspnea, hyperpnea progressing to Kussmaul breathing, dehydration, thirst, weakness, flushed face, full bounding pulse, progressive drowsiness, mental confusion, combativeness.

metabolic alkalosis
increase in pH value of the extracellular fluid caused by either a loss of acid from the body (e.g., through vomiting) or an increased level of bicarbonate ions (e.g., through ingestion of sodium bicarbonate). It may result in muscle weakness, irritability, confusion, muscle twitching, slow and shallow respirations, and convulsive seizures.

microsomal enzymes
drug-metabolizing enzymes located in the endoplasmic reticulum of the liver and other tissues chiefly responsible for oxidative drug metabolism, e.g., cytochrome P450.

myopathy
any disease or abnormal condition of striated muscles manifested by muscle weakness, myalgia, diaphoresis, fever, and reddish-brown urine (myoglobinuria) or oliguria.

nephrotoxicity
impairment of the nephrons of the kidney manifested by one or more of the following: oliguria, urinary frequency, hematuria, cloudy urine, rising BUN and serum creatinine, fever, graft tenderness or enlargement.

neuroleptic malignant syndrome (NMS)
potentially fatal complication associated with antipsychotic drugs manifested by hyperpyrexia, altered mental status, muscle rigidity, irregular pulse, fluctuating BP, diaphoresis, and tachycardia.

orphan drug
(as defined by the Orphan Drug Act, an amendment of the Federal Food, Drug, and Cosmetic Act which took effect in January 1983): drug or biological product used in the treatment, diagnosis, or prevention of a rare disease. A rare disease or condition is one that affects fewer than 200,000 persons in the United States, or affects more than 200,000 persons but for which there is no reasonable expectation that drug research and development costs can be recovered from sales within the United States.

ototoxicity
impairment of the ear manifested by one or more of the following: headache, dizziness or vertigo, nausea and vomiting with motion, ataxia, nystagmus.

prodrug
inactive drug form that becomes pharmacologically active through biotransformation.

protein binding
reversible interaction between protein and drug resulting in a drug-protein complex (bound drug) which is in equilibrium with free (active) drug in plasma and tissues. Since only free drug can diffuse to action sites, factors that influence drug-binding (e.g., displacement of bound drug by another drug, or decreased albumin concentration) may potentiate pharmacological effect.

pseudomembranous enterocolitis
life-threatening superinfection characterized by severe diarrhea and fever.

pseudoparkinsonism
extrapyramidal symptom manifested by slowing of volitional movement (akinesia), mask facies, rigidity and tremor at rest (especially of upper extremities); and pill rolling motion.

pulmonary edema
excessive fluid in the lung tissue manifestied by one or more of the following: shortness of breath, cyanosis, persistent productive cough (frothy sputum may be blood tinged), expiratory rales, restlessness, anxiety, increased heart rate, sense of chest pressure.

renal insufficiency
reduced capacity of the kidney to perform its functions as manifested by one or more of the following: dysuria, oliguria, hematuria, swelling of lower legs and feet.

serotonin syndrome
manifested by restlessness, myoclonus, mental status changes, hyperreflexia, diaphoresis, shivering, and tremor.

Somogyi effect
rebound phenomenon clinically manifested by fasting hyperglycemia and worsening of diabetic control due to unnecessarily large p.m. insulin doses. Hormonal response to unrecognized hypoglycemia (i.e., release of epinephrine, glucagon, growth hormone, cortisol) causes insensitivity to insulin. Increasing the amount of insulin required to treat the hyperglycemia intensifies the hypoglycemia.

superinfection
new infection by an organism different from the initial infection being treated by antimicrobial therapy manifested by one or more of the following: black, hairy tongue; glossitis, stomatitis; anal itching; loose, foul-smelling stools; vaginal itching or discharge; sudden fever; cough.

tachyphylaxis
rapid decrease in response to a drug after administration of a few doses. Initial drug response cannot be restored by an increase in dose.

tardive dyskinesia
extrapyramidal symptom manifested by involuntary rhythmic, bizarre movements of face, jaw, mouth, tongue, and sometimes extremities.

vasovagal symptoms
transient vascular and neurogenic reaction marked by pallor, nausea, vomiting, bradycardia, and rapid fall in arterial blood pressure.

water intoxication (dilutional hyponatremia)
less than normal concentration of sodium in the blood resulting from excess extracellular and intracellular fluid and producing one or more of the following: lethargy, confusion, headache, decreased skin turgor, tremors, convulsions, coma, anorexia, nausea, vomiting, diarrhea, sternal fingerprinting, weight gain, edema, full bounding pulse, jugular vein distension, rales, signs and symptoms of pulmonary edema.

adverse effect
unintended, unpredictable, and nontherapeutic response to drug action. Adverse effects occur at doses used therapeutically or for prophylaxis or diagnosis. They generally result from drug toxicity, idiosyncrasies, or hypersensitivity reactions caused by the drug itself or by ingredients added during manufacture, e.g., preservatives, dyes, or vehicles.

acute dystonia
extrapyramidal symptom manifested by abnormal posturing, grimacing, spastic torticollis (neck torsion), and oculogyric (eyeball movement) crisis.

Perioperative nursing care

PRE OPERATIVE and POST OPERATIVE RESPONSIBILITIES
PERIOPERATIVE NURSING CARE

A. Definition
Perioperative Period – Refers to events during the entire surgical period from preparation for surgery to recovery from the temporary effects of surgery and anesthesia.

B. PHASES of PERIOPERATIVE NURSING
1) Pre Operative Phase – begins when the decision for surgical intervention is made and ends with transfer of the client to the operating room.

2. INTRA OPERATIVE PHASE – begins when the client is transferred to the operating room bed and ends when the client is admitted to the post anesthesia recovery area or recovery room.

3. POST OPERATIVE PHASE – begins with the admission to the recovery room and ends with the resolution of surgical sequel
NURSING CARE RESPONSIBILITIES
A. Pre Operative Phase :
a) Nurse obtain a pre operative history and perform a physical assessment, gathering information about the patient.

C A R E P L A N S
C - current symptoms and discomfort
A - age
R - responses of family members / religious affiliations
E - Electrolyte and Fluid balance
P - previous surgery and anesthesia
L - liver function
A - allergies and reaction
N - nutritional status
S - social history

PRE OPERATIVE PHASE
•Carry out written order of surgeon
•Inform Staff (send OR slip on triplicate form)
•Carry out pre op orders of Anesthesiologist and suggestions of OR Nurse (consent, NPO time, hygiene, blood, clearance, meds, materials, ICU accomodation, etc.)

Common Pre Op Orders
•NPO time
4 hours before…….. Below 6 months
6 hours…………………. 6 months to 3y/o
8 hours…………………. 3 y/o and above
2. BLOOD ( consent and units)
3. ANTIBIOTICS (if a patient is for Exlap at 7:00am, the nurse must perform a skin test at 5:30am, ROD will read the result at 6:00am and give the initial dose if reading is negative.

4. IVF – must always be inserted at the upper extremities and must use the appropriate IV Catheter sizes.
5. Anesthesia orders
6. CP Clearance
7. ICU accommodation and ventilator if indicated
8. Frozen Section, IOC

Day of Surgery
•Give Antibiotics ANST / Doctor’s Order
•Accomplish pre-op checklist
•OR Nurse will fetch patient 30 minutes prior to schedule
INTRA OPERATIVE PHASE
•RR Nurse will inform the ward Nurse re: Patient’s transfer
•Ward Nurse Prepare (IV Stand, droplight, perfusor machine, O2 / vent set up )

POST OPERATIVE PHASE
Ward Nurse accompanies post op patient to room and makes initial assessment of the client after transfer:
1. Respiratory status
2. Cardiovascular status
3. Neurological status
4. surgical wound
5. Intravenous lines
6. Tubes (CTT, PD cath.,NGT/OGT, IFC, JP Drain)
7. positioning
8. Level pain
III. Goals and Intervention
A. Restore Homeostasis and Prevent Complications
•Monitor Vital signs
•Monitor wound for signs and symptoms of infection
•Monitor for shock
B. Maintain and Promote adequate airway and respiratory function
•Assist with turning, coughing and deep breathing every 1-2 hours

•Encourage and assist with early ambulation
•Monitor color consistency and odor of any sputum production
C. Maintain adequate cardiac function and Promote tissue perfusion
•Monitor for s/s of thrombophlebitis
•Monitor for s/s of M.I.
•Monitor for s/s of blood loss


D. Maintain Adequate Electrolyte and Fluid Balance and Adequate Renal Function
•Monitor I & O
•Report Abnormal serum electrolytes values
•Maintain patency of NGT / OGT
•Obtain an order for anti emetic if patient develops nausea and vomiting
•Administer replacement fluids as prescribed
•Monitor patency of urinary catheter
•Monitor signs / symptoms of UTI
•Monitor for bladder distention if urinary catheter is not present

•Promote Comfort and Rest
•Change client position, straighten bed linens or give a back rub
•Provide prescribed analgesics and assess effectiveness
•Promote Adequate Nutrition and Elimination
•Assess for return of bowel sounds
•Advanced prescribed diet as tolerated (DAT)
•Monitor for paralytic ileus

•Promote Wound Healing
•Assess wound for signs of infection
•Observe the wounds for signs of edema, bleeding or change in color
•Observe the wound for approximation of suture line
•Monitor drains and assess the color, consistency and amount of drainage
•Maintain strict asepsis when coming in contact with the wound
•Monitor for Wound Dehiscence

•Promote and Maintain Activity and Mobility
•Have client flex ankles and legs and reposition in bed if not contra indicated
•Encourage and assist with early ambulations as prescribed

•Provide Emotional Support and Foster Positive Body Image
•Provide Empathetic listening and encourage expression of feelings
•Provide specific written instructions

•Plan for Discharge
•Provide specific written instructions regarding
•Wound Care (signs of infections)
•Activity restrictions
•Dietary Instructions
•Post operative medication instruction
•Personal hygiene
•Follow up appointments with surgeon or Clinic.

TONSILLECTOMY

Tonsillectomy

blade #12

5 allis

2 mixters

2 bobcock

2 cherries

2 needle holder

1 silk

CA set

10cc syringe

mouth ret

shoulder padst

marycautery

mnemonics

Mag Sulfate

( Sung to the tune of "Achy,Breaky Heart")

Decreased BP,

Decreased Pee Pee,

These are toxic signs of Mag Sulfate.

Drop in respiratory rate,

Patellar reflex there ain't,

Give antidote calcium gluconate!

Antidotes:

In Heaven,

there is Peace (Heparin - Protamine sulfate)

In War, there is Killing (Warfarin - Vit. K)

Spinal Meds:

Little Boys Prefers ToysLittle - Lidocaine,

Boys - Bupivicaine,

Prefer - Procaine,

Toys - TetracaineSide effects of steroids.

The 5 S's:

Sick- easier to get sick

Sad-causes depression

Sex-increases libido

Salt-retains more and causes weight gain

Sugar-raises blood sugar

Narcan is a NARCotic ANtagonist

pre board answers

pre board practice test

1. A woman in a child bearing age receives a rubella vaccination. Nurse Joy would give her which of the following instructions?
a. Refrain from eating eggs or egg products for 24 hours
b. Avoid having sexual intercourse
c. Don’t get pregnant at least 3 months
d. Avoid exposure to sun
2. Jonas who is diagnosed with encephalitis is under the treatment of Mannitol. Which of the following patient outcomes indicate to Nurse Ronald that the treatment of Mannitol has been effective for a patient that has increased intracranial pressure?
a. Increased urinary output
b. Decreased RR
c. Slowed papillary response
d. Decreased level of consciousness
3. Mary asked Nurse Maureen about the incubation period of rabies. Which statement by the Nurse Maureen is appropriate?
a. Incubation period is 6 months
b. Incubation period is 1 week
c. Incubation period is 1 month
d. Incubation period varies depending on the site of the bite
4. Which of the following should Nurse Cherry do first in taking care of a male client with rabies?
a. Encourage the patient to take a bath
b. Cover IV bottle with brown paper bag
c. Place the patient near the comfort room
d. Place the patient near the door
5. Which of the following is the screening test for dengue hemorrhagic fever?
a. Complete blood count
b. ELISA
c. Rumpel-leede test
d. Sedimentation rate
6. Mr. Dela Rosa is suspected to have malaria after a business trip in Palawan. The most important diagnostic test in malaria is:
a. WBC count
b. Urinalysis
c. ELISA
d. Peripheral blood smear
7. The Nurse supervisor is planning for patient’s assignment for the AM shift. The nurse supervisor avoids assigning which of the following staff members to a client with herpes zoster?
a. Nurse who never had chicken pox
b. Nurse who never had roseola
c. Nurse who never had german measles
d. Nurse who never had mumps
8. Clarissa is 7 weeks pregnant. Further examination revealed that she is susceptible to rubella. When would be the most appropriate for her to receive rubella immunization?
a. At once
b. During 2nd trimester
c. During 3rd trimester
d. After the delivery of the baby
9. A female child with rubella should be isolated from a:
a. 21 year old male cousin living in the same house
b. 18 year old sister who recently got married
c. 11 year old sister who had rubeola during childhood
d. 4 year old girl who lives next door
10. What is the primary prevention of leprosy?
a. Nutrition
b. Vitamins
c. BCG vaccination
d. DPT vaccination
11. A bacteria which causes diphtheria is also known as?
a. Amoeba
b. Cholera
c. Klebs-loeffler bacillus
d. Spirochete
12. Nurse Ron performed mantoux skin test today (Monday) to a male adult client. Which statement by the client indicates that he understood the instruction well?
a. I will come back later
b. I will come back next month
c. I will come back on Friday
d. I will come back on Wednesday, same time, to read the result
13. A male client had undergone Mantoux skin test. Nurse Ronald notes an 8mm area of indurations at the site of the skin test. The nurse interprets the result as:
a. Negative
b. Uncertain and needs to be repeated
c. Positive
d. Inconclusive
14. Tony will start a 6 month therapy with Isoniazid (INH). Nurse Trish plans to teach the client to:
a. Use alcohol moderately
b. Avoid vitamin supplements while o therapy
c. Incomplete intake of dairy products
d. May be discontinued if symptoms subsides
15. Which is the primary characteristic lesion of syphilis?
a. Sore eyes
b. Sore throat
c. Chancroid
d. Chancre
16. What is the fast breathing of Jana who is 3 weeks old?
a. 60 breaths per minute
b. 40 breaths per minute
c. 10 breaths per minute
d. 20 breaths per minute
17. Which of the following signs and symptoms indicate some dehydration?
a. Drinks eagerly
b. Restless and irritable
c. Unconscious
d. A and B
18. What is the first line for dysentery?
a. Amoxicillin
b. Tetracycline
c. Cefalexin
d. Cotrimoxazole
19. In home made oresol, what is the ratio of salt and sugar if you want to prepare with 1 liter of water?
a. 1 tbsp. salt and 8 tbsp. sugar
b. 1 tbsp. salt and 8 tsp. sugar
c. 1 tsp. salt and 8 tsp. sugar
d. 8 tsp. salt and 8 tsp. sugar
20. Gentian Violet is used for:
a. Wound
b. Umbilical infections
c. Ear infections
d. Burn
21. Which of the following is a live attenuated bacterial vaccine?
a. BCG
b. OPV
c. Measles
d. None of the above
22. EPI is based on?
a. Basic health services
b. Scope of community affected
c. Epidemiological situation
d. Research studies
23. TT? provides how many percentage of protection against tetanus?
a. 100
b. 99
c. 80
d. 90
24. Temperature of refrigerator to maintain potency of measles and OPV vaccine is:
a. -3c to -8c
b. -15c to -25c
c. +15c to +25c
d. +3c to +8c
25. Diptheria is a:
a. Bacterial toxin
b. Killed bacteria
c. Live attenuated
d. Plasma derivatives
26. Budgeting is under in which part of management process?
a. Directing
b. Controlling
c. Organizing
d. Planning
27. Time table showing planned work days and shifts of nursing personnel is:
a. Staffing
b. Schedule
c. Scheduling
d. Planning
28. A force within an individual that influences the strength of behavior?
a. Motivation
b. Envy
c. Reward
d. Self-esteem
29. “To be the leading hospital in the Philippines” is best illustrate in:
a. Mission
b. Philosophy
c. Vision
d. Objective
30. It is the professionally desired norms against which a staff performance will be compared?
a. Job descriptions
b. Survey
c. Flow chart
d. Standards
31. Reprimanding a staff nurse for work that is done incorrectly is an example of what type of reinforcement?
a. Feedback
b. Positive reinforcement
c. Performance appraisal
d. Negative reinforcement
32. Questions that are answerable only by choosing an option from a set of given alternatives are known as?
a. Survey
b. Close ended
c. Questionnaire
d. Demographic
33. A researcher that makes a generalization based on observations of an individuals behavior is said to be which type of reasoning:
a. Inductive
b. Logical
c. Illogical
d. Deductive
34. The balance of a research’s benefit vs. its risks to the subject is:
a. Analysis
b. Risk-benefit ratio
c. Percentile
d. Maximum risk
35. An individual/object that belongs to a general population is a/an:
a. Element
b. Subject
c. Respondent
d. Author
36. An illustration that shows how the members of an organization are connected:
a. Flowchart
b. Bar graph
c. Organizational chart
d. Line graph
37. The first college of nursing that was established in the Philippines is:
a. Fatima University
b. Far Eastern University
c. University of the East
d. University of Sto. Tomas
38. Florence nightingale is born on:
a. France
b. Britain
c. U.S
d. Italy
39. Objective data is also called:
a. Covert
b. Overt
c. Inference
d. Evaluation
40. An example of subjective data is:
a. Size of wounds
b. VS
c. Lethargy
d. The statement of patient “My hand is painful”
41. What is the best position in palpating the breast?
a. Trendelenburg
b. Side lying
c. Supine
d. Lithotomy
42. When is the best time in performing breast self examination?
a. 7 days after menstrual period
b. 7 days before menstrual period
c. 5 days after menstrual period
d. 5 days before menstrual period
43. Which of the following should be given the highest priority before performing physical examination to a patient?
a. Preparation of the room
b. Preparation of the patient
c. Preparation of the nurse
d. Preparation of environment
44. It is a flip over card usually kept in portable file at nursing station.
a. Nursing care plan
b. Medicine and treatment record
c. Kardex
d. TPR sheet
45. Jose has undergone thoracentesis. The nurse in charge is aware that the best position for Jose is:
a. Semi fowlers
b. Low fowlers
c. Side lying, unaffected side
d. Side lying, affected side
46. The degree of patients abdominal distension may be determined by:
a. Auscultation
b. Palpation
c. Inspection
d. Percussion
47. A male client is addicted with hallucinogen. Which physiologic effect should the nurse expect?
a. Bradyprea
b. Bradycardia
c. Constricted pupils
d. Dilated pupils
48. Tristan a 4 year old boy has suffered from full thickness burns of the face, chest and neck. What will be the priority nursing diagnosis?
a. Ineffective airway clearance related to edema
b. Impaired mobility related to pain
c. Impaired urinary elimination related to fluid loss
d. Risk for infection related to epidermal disruption
49. In assessing a client’s incision 1 day after the surgery, Nurse Betty expect to see which of the following as signs of a local inflammatory response?
a. Greenish discharge
b. Brown exudates at incision edges
c. Pallor around sutures
d. Redness and warmth
50. Nurse Ronald is aware that the amiotic fluid in the third trimester weighs approximately:
a. 2 kilograms
b. 1 kilograms
c. 100 grams
d. 1.5 kilograms
51. After delivery of a baby girl. Nurse Gina examines the umbilical cord and expects to find a cord to:
a. Two arteries and two veins
b. One artery and one vein
c. Two arteries and one vein
d. One artery and two veins
52. Myrna a pregnant client reports that her last menstrual cycle is July 11, her expected date of birth is
a. November 4
b. November 11
c. April 4
d. April 18
53. Which of the following is not a good source of iron?
a. Butter
b. Pechay
c. Grains
d. Beef
54. Maureen is admitted with a diagnosis of ectopic pregnancy. Which of the following would you anticipate?
a. NPO
b. Bed rest
c. Immediate surgery
d. Enema
55. Gina a postpartum client is diagnosed with endometritis. Which position would you expect to place her based on this diagnosis?
a. Supine
b. Left side lying
c. Trendelinburg
d. Semi-fowlers
56. Nurse Hazel knows that Myrna understands her condition well when she remarks that urinary frequency is caused by:
a. Pressure caused by the ascending uterus
b. Water intake of 3L a day
c. Effect of cold weather
d. Increase intake of fruits and vegetables
57. How many ml of blood is loss during the first 24 hours post delivery of Myrna?
a. 100
b. 500
c. 200
d. 400
58. Which of the following hormones stimulates the secretion of milk?
a. Progesterone
b. Prolactin
c. Oxytocin
d. Estrogen
59. Nurse Carla is aware that Myla’s second stage of labor is beginning when the following assessment is noted:
a. Bay of water is broken
b. Contractions are regular
c. Cervix is completely dilated
d. Presence of bloody show
60. The leaking fluid is tested with nitrazine paper. Nurse Kelly confirms that the client’s membrane have ruptures when the paper turns into a:
a. Pink
b. Violet
c. Green
d. Blue
61. After amniotomy, the priority nursing action is:
a. Document the color and consistency of amniotic fluid
b. Listen the fetal heart tone
c. Position the mother in her left side
d. Let the mother rest
62. Which is the most frequent reason for postpartum hemorrhage?
a. Perineal lacerations
b. Frequent internal examination (IE)
c. CS
d. Uterine atomy
63. On 2nd postpartum day, which height would you expect to find the fundus in a woman who has had a caesarian birth?
a. 1 finger above umbilicus
b. 2 fingers above umbilicus
c. 2 fingers below umbilicus
d. 1 finger below umbilicus
64. Which of the following criteria allows Nurse Kris to perform home deliveries?
a. Normal findings during assessment
b. Previous CS
c. Diabetes history
d. Hypertensive history
65. Nurse Carla is aware that one of the following vaccines is done by intramuscular (IM) injection?
a. Measles
b. OPV
c. BCG
d. Tetanus toxoid
66. Asin law is on which legal basis:
a. RA 8860
b. RA 2777
c. RI 8172
d. RR 6610
67. Nurse John is aware that the herbal medicine appropriate for urolithiasis is:
a. Akapulco
b. Sambong
c. Tsaang gubat
d. Bayabas
68. Community/Public health bag is defined as:
a. An essential and indispensable equipment of the community health nurse during home visit
b. It contains drugs and equipment used by the community health nurse
c. Is a requirement in the health center and for home visit
d. It is a tool used by the community health nurse in rendering effective procedures during home visit
69. TT4 provides how many percentage of protection against tetanus?
a. 70
b. 80
c. 90
d. 99
70. Third postpartum visit must be done by public health nurse:
a. Within 24 hours after delivery
b. After 2-4 weeks
c. Within 1 week
d. After 2 months
71. Nurse Candy is aware that the family planning method that may give 98% protection to another pregnancy to women
a. Pills
b. Tubal ligation
c. Lactational Amenorrhea method (LAM)
d. IUD
72. Which of the following is not a part of IMCI case management process
a. Counsel the mother
b. Identify the illness
c. Assess the child
d. Treat the child
73. If a young child has pneumonia when should the mother bring him back for follow up?
a. After 2 days
b. In the afternoon
c. After 4 days
d. After 5 days
74. It is the certification recognition program that develop and promotes standard for health facilities:
a. Formula
b. Tutok gamutan
c. Sentrong program movement
d. Sentrong sigla movement
75. Baby Marie was born May 23, 1984. Nurse John will expect finger thumb opposition on:
a. April 1985
b. February 1985
c. March 1985
d. June 1985
76. Baby Reese is a 12 month old child. Nurse Oliver would anticipate how many teeth?
a. 9
b. 7
c. 8
d. 6
77. Which of the following is the primary antidote for Tylenol poisoning?
a. Narcan
b. Digoxin
c. Acetylcysteine
d. Flumazenil
78. A male child has an intelligence quotient of approximately 40. Which kind of environment and interdisciplinary program most likely to benefit this child would be best described as:
a. Habit training
b. Sheltered workshop
c. Custodial
d. Educational
79. Nurse Judy is aware that following condition would reflect presence of congenital G.I anomaly?
a. Cord prolapse
b. Polyhydramios
c. Placenta previa
d. Oligohydramios
80. Nurse Christine provides health teaching for the parents of a child diagnosed with celiac disease. Nurse Christine teaches the parents to include which of the following food items in the child’s diet:
a. Rye toast
b. Oatmeal
c. White bread
d. Rice
81. Nurse Randy is planning to administer oral medication to a 3 year old child. Nurse Randy is aware that the best way to proceed is by:
a. “Would you like to drink your medicine?”
b. “If you take your medicine now, I’ll give you lollipop”
c. “See the other boy took his medicine? Now it’s your turn.”
d. “Here’s your medicine. Would you like a mango or orange juice?”
82. At what age a child can brush her teeth without help?
a. 6 years
b. 7 years
c. 5 years
d. 8 years
83. Ribivarin (Virazole) is prescribed for a female hospitalized child with RSV. Nurse Judy prepare this medication via which route?
a. Intra venous
b. Oral
c. Oxygen tent
d. Subcutaneous
84. The present chairman of the Board of Nursing in the Philippines is:
a. Maria Joanna Cervantes
b. Carmencita Abaquin
c. Leonor Rosero
d. Primitiva Paquic
85. The obligation to maintain efficient ethical standards in the practice of nursing belong to this body:
a. BON
b. ANSAP
c. PNA
d. RN
86. A male nurse was found guilty of negligence. His license was revoked. Re-issuance of revoked certificates is after how many years?
a. 1 year
b. 2 years
c. 3 years
d. 4 years
87. Which of the following information cannot be seen in the PRC identification card?
a. Registration Date
b. License Number
c. Date of Application
d. Signature of PRC chairperson
88. Breastfeeding is being enforced by milk code or:
a. EO 51
b. R.A. 7600
c. R.A. 6700
d. P.D. 996
89. Self governance, ability to choose or carry out decision without undue pressure or coercion from anyone:
a. Veracity
b. Autonomy
c. Fidelity
d. Beneficence
90. A male patient complained because his scheduled surgery was cancelled because of earthquake. The hospital personnel may be excused because of:
a. Governance
b. Respondent superior
c. Force majeure
d. Res ipsa loquitor
91. Being on time, meeting deadlines and completing all scheduled duties is what virtue?
a. Fidelity
b. Autonomy
c. Veracity
d. Confidentiality
92. This quality is being demonstrated by Nurse Ron who raises the side rails of a confused and disoriented patient?
a. Responsibility
b. Resourcefulness
c. Autonomy
d. Prudence
93. Which of the following is formal continuing education?
a. Conference
b. Enrollment in graduate school
c. Refresher course
d. Seminar
94. The BSN curriculum prepares the graduates to become?
a. Nurse generalist
b. Nurse specialist
c. Primary health nurse
d. Clinical instructor
95. Disposal of medical records in government hospital/institutions must be done in close coordination with what agency?
a. Department of Health
b. Records Management Archives Office
c. Metro Manila Development Authority
d. Bureau of Internal Revenue
96. Nurse Jolina must see to it that the written consent of mentally ill patients must be taken from:
a. Nurse
b. Priest
c. Family lawyer
d. Parents/legal guardians
97. When Nurse Clarence respects the client’s self-disclosure, this is a gauge for the nurses’
a. Respectfulness
b. Loyalty
c. Trustworthiness
d. Professionalism
98. The Nurse is aware that the following tasks can be safely delegated by the nurse to a non-nurse health worker except:
a. Taking vital signs
b. Change IV infusions
c. Transferring the client from bed to chair
d. Irrigation of NGT
99. During the evening round Nurse Tina saw Mr. Toralba meditating and afterwards started singing prayerful hymns. What would be the best response of Nurse Tina?
a. Call the attention of the client and encourage to sleep
b. Report the incidence to head nurse
c. Respect the client’s action
d. Document the situation
100. In caring for a dying client, you should perform which of the following activities
a. Do not resuscitate
b. Assist client to perform ADL
c. Encourage to exercise
d. Assist client towards a peaceful death
101. The Nurse is aware that the ability to enter into the life of another person and perceive his current feelings and their meaning is known:
a. Belongingness
b. Genuineness
c. Empathy
d. Respect
102. The termination phase of the NPR is best described one of the following:
a. Review progress of therapy and attainment of goals
b. Exploring the client’s thoughts, feelings and concerns
c. Identifying and solving patients problem
d. Establishing rapport
103. During the process of cocaine withdrawal, the physician orders which of the following:
a. Haloperidol (Haldol)
b. Imipramine (Tofranil)
c. Benztropine (Cogentin)
d. Diazepam (Valium)
104. The nurse is aware that cocaine is classified as:
a. Hallucinogen
b. Psycho stimulant
c. Anxiolytic
d. Narcotic
105. In community health nursing, it is the most important risk factor in the development of mental illness?
a. Separation of parents
b. Political problems
c. Poverty
d. Sexual abuse
106. All of the following are characteristics of crisis except
a. The client may become resistive and active in stopping the crisis
b. It is self-limiting for 4-6 weeks
c. It is unique in every individual
d. It may also affect the family of the client
107. Freud states that temper tantrums is observed in which of the following:
a. Oral
b. Anal
c. Phallic
d. Latency
108. The nurse is aware that ego development begins during:
a. Toddler period
b. Preschool age
c. School age
d. Infancy
109. Situation: A 19 year old nursing student has lost 36 lbs for 4 weeks. Her parents brought her to the hospital for medical evaluation. The diagnosis was ANOREXIA NERVOSA. The Primary gain of a client with anorexia nervosa is:
a. Weight loss
b. Weight gain
c. Reduce anxiety
d. Attractive appearance
110. The nurse is aware that the primary nursing diagnosis for the client is:
a. Altered nutrition : less than body requirement
b. Altered nutrition : more than body requirement
c. Impaired tissue integrity
d. Risk for malnutrition
111. After 14 days in the hospital, which finding indicates that her condition in improving?
a. She tells the nurse that she had no idea that she is thin
b. She arrives earlier than scheduled time of group therapy
c. She tells the nurse that she eat 3 times or more in a day
d. She gained 4 lbs in two weeks
112. The nurse is aware that ataractics or psychic energizers are also known as:
a. Anti manic
b. Anti depressants
c. Antipsychotics
d. Anti anxiety
113. Known as mood elevators:
a. Anti depressants
b. Antipsychotics
c. Anti manic
d. Anti anxiety
114. The priority of care for a client with Alzheimer’s disease is
a. Help client develop coping mechanism
b. Encourage to learn new hobbies and interest
c. Provide him stimulating environment
d. Simplify the environment to eliminate the need to make chores
115. Autism is diagnosed at:
a. Infancy
b. 3 years old
c. 5 years old
d. School age
116. The common characteristic of autism child is:
a. Impulsitivity
b. Self destructiveness
c. Hostility
d. Withdrawal
117. The nurse is aware that the most common indication in using ECT is:
a. Schizophrenia
b. Bipolar
c. Anorexia Nervosa
d. Depression
118. A therapy that focuses on here and now principle to promote self-acceptance?
a. Gestalt therapy
b. Cognitive therapy
c. Behavior therapy
d. Personality therapy
119. A client has many irrational thoughts. The goal of therapy is to change her:
a. Personality
b. Communication
c. Behavior
d. Cognition
120. The appropriate nutrition for Bipolar I disorder, in manic phase is:
a. Low fat, low sodium
b. Low calorie, high fat
c. Finger foods, high in calorie
d. Small frequent feedings
121. Which of the following activity would be best for a depressed client?
a. Chess
b. Basketball
c. Swimming
d. Finger painting
122. The nurse is aware that clients with severe depression, possess which defense mechanism:
a. Introjection
b. Suppression
c. Repression
d. Projection
123. Nurse John is aware that self mutilation among Bipolar disorder patients is a means of:
a. Overcoming fear of failure
b. Overcoming feeling of insecurity
c. Relieving depression
d. Relieving anxiety
124. Which of the following may cause an increase in the cystitis symptoms?
a. Water
b. Orange juice
c. Coffee
d. Mango juice
125. In caring for clients with renal calculi, which is the priority nursing intervention?
a. Record vital signs
b. Strain urine
c. Limit fluids
d. Administer analgesics as prescribed
126. In patient with renal failure, the diet should be:
a. Low protein, low sodium, low potassium
b. Low protein, high potassium
c. High carbohydrate, low protein
d. High calcium, high protein
127. Which of the following cannot be corrected by dialysis?
a. Hypernatremia
b. Hyperkalemia
c. Elevated creatinine
d. Decreased hemoglobin
128. Tony with infection is receiving antibiotic therapy. Later the client complaints of ringing in the ears. This ototoxicity is damage to:
a. 4th CN
b. 8th CN
c. 7th CN
d. 9th CN
129. Nurse Emma provides teaching to a patient with recurrent urinary tract infection includes the following:
a. Increase intake of tea, coffee and colas
b. Void every 6 hours per day
c. Void immediately after intercourse
d. Take tub bath everyday
130. Which assessment finding indicates circulatory constriction in a male client with a newly applied long leg cast?
a. Blanching or cyanosis of legs
b. Complaints of pressure or tightness
c. Inability to move toes
d. Numbness of toes
131. During acute gout attack, the nurse administer which of the following drug:
a. Prednisone (Deltasone)
b. Colchicines
c. Aspirin
d. Allopurinol (Zyloprim)
132. Information in the patients chart is inadmissible in court as evidence when:
a. The client objects to its use
b. Handwriting is not legible
c. It has too many unofficial abbreviations
d. The clients parents refuses to use it
133. Nurse Karen is revising a client plan of care. During which step of the nursing process does such revision take place?
a. Planning
b. Implementation
c. Diagnosing
d. Evaluation
134. When examining a client with abdominal pain, Nurse Hazel should assess:
a. Symptomatic quadrant either second or first
b. The symptomatic quadrant last
c. The symptomatic quadrant first
d. Any quadrant
135. How long will nurse John obtain an accurate reading of temperature via oral route?
a. 3 minutes
b. 1 minute
c. 8 minutes
d. 15 minutes
136. The one filing the criminal care against an accused party is said to be the?
a. Guilty
b. Accused
c. Plaintiff
d. Witness
137. A male client has a standing DNR order. He then suddenly stopped breathing and you are at his bedside. You would:
a. Call the physician
b. Stay with the client and do nothing
c. Call another nurse
d. Call the family
138. The ANA recognized nursing informatics heralding its establishment as a new field in nursing during what year?
a. 1994
b. 1992
c. 2000
d. 2001
139. When is the first certification of nursing informatics given?
a. 1990-1993
b. 2001-2002
c. 1994-1996
d. 2005-2008
140. The nurse is assessing a female client with possible diagnosis of osteoarthritis. The most significant risk factor for osteoarthritis is:
a. Obesity
b. Race
c. Job
d. Age
141. A male client complains of vertigo. Nurse Bea anticipates that the client may have a problem with which portion of the ear?
a. Tymphanic membranes
b. Inner ear
c. Auricle
d. External ear
142. When performing Weber’s test, Nurse Rosean expects that this client will hear
a. On unaffected side
b. Longer through bone than air conduction
c. On affected side by bone conduction
d. By neither bone or air conduction
143. Toy with a tentative diagnosis of myasthenia gravis is admitted for diagnostic make up. Myasthenia gravis can confirmed by:
a. Kernigs sign
b. Brudzinski’s sign
c. A positive sweat chloride test
d. A positive edrophonium (Tensilon) test
144. A male client is hospitalized with Guillain-Barre Syndrome. Which assessment finding is the most significant?
a. Even, unlabored respirations
b. Soft, non distended abdomen
c. Urine output of 50 ml/hr
d. Warm skin
145. For a female client with suspected intracranial pressure (ICP), a most appropriate respiratory goal is:
a. Maintain partial pressure of arterial oxygen (Pa O2) above 80mmHg
b. Promote elimination of carbon dioxide
c. Lower the PH
d. Prevent respiratory alkalosis
146. Which nursing assessment would identify the earliest sign of ICP?
a. Change in level of consciousness
b. Temperature of over 103°F
c. Widening pulse pressure
d. Unequal pupils
147. The greatest danger of an uncorrected atrial fibrillation for a male patient will be which of the following:
a. Pulmonary embolism
b. Cardiac arrest
c. Thrombus formation
d. Myocardial infarction
148. Linda, A 30 year old post hysterectomy client has visited the health center. She inquired about BSE and asked the nurse when BSE should be performed. You answered that the BSE is best performed:
a. 7 days after menstruation
b. At the same day each month
c. During menstruation
d. Before menstruation
149. An infant is ordered to recive 500 ml of D5NSS for 24 hours. The Intravenous drip is running at 60 gtts/min. How many drops per minute should the flow rate be?
a. 60 gtts/min.
b. 21 gtts/min
c. 30 gtts/min
d. 15 gtts/min
150. Mr. Gutierrez is to receive 1 liter of D5RL to run for 12 hours. The drop factor of the IV infusion set is 10 drops per minute. Approximately how many drops per minutes should the IV be regulated?
a. 13-14 drops
b. 17-18 drops
c. 10-12 drops
d. 15-16 drops