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III. maintain muscle mass IV. establish nitrogen balance V. enhance healing process A. I, II, & III B. I, II, III, & IV C. I& II D. I, II, III, IV & V 28. When a patient is undergoing TPN, you have to monitor closely for the _______. A. serum creatinine B. potassium level C. serum glucose level D. sodium level 29. While Mrs. Mely is on TPN she suddenly complained of slight chest pain, dyspnea and appears cyanotic. You suspect that she is experiencingwhat possible IMMEDIATE complication? A. Sepsis due to IV line B. Air embolism C. Hyperglycemia D. Allergic reaction to TPN 30. What PRIORITY nursing action should you do with the presentingclinical manifestations of the patient? A. Report to the physician status of the patient at once. B. Take Blood pressure and respiratory rate. C. Stop temporarily the Total Parenteral Nutrition D. Administer Oxygen inhalation. Situation: Ms. Monina is a retired Community Health nurse in barangay SanPablo. Due to her commitment to the nursing profession, she has volunteered in their community to conduct health educationclasses. One Saturday morning, several patients who are hypertensive and with pulmonary health problems attended hersession. 31. Mang Luis, is a newly diagnosed patient with Chronic Obstructive LungDisease (COPD). Which of the following PRIORITY teaching instructionsshould he be given in relation to his condition? A. He should assume supine position when resting. B. Know early signs of respiratory infection. C. He has to be taught how to do Bronchial clapping. D. Family should be advised that patient should sleep in a warmroom. 32. Which of the following health interventions should be included in yourteaching plan for Mang Luis? A. Be on prolonged corticosteroid therapy. B. Lung exercises must be done with longer inhalation than exhalation. C. Reduce risk for infection. D. Have a high flow of oxygen administration. 33. Pulmonary Rehabilitation for COPD has a duration of at least 4 to 12weeks. Which of the following should be avoided while patient is having this program? A. Pursed lip breathing B. Smoking cessation C. Aerobic, upper and lower body conditioning D. Peripheral muscle wasting 34. Weight loss and Malnutrition are commonly observed among patients withCOPD. They should be taught to avoid ________. A. have full stomach even when in dyspneic condition B. keeping body mass between 21-25 kg C. a high caloric and high protein diet D. exercise one hour before and after eating 35. Which of the following energy conserving strategies should NOT be done by COPD patients? A. Exhale when pushing or exerting effort when doing daily activities B. Assume tripod position with elbows supported on the tablewhen shaving or combing C. Inhale when resting, sitting and lying down. D. Stand in front of the mirror while shaving or combing hair Situation: A housewife, appearing jaundice, complaining of abdominal pain,nausea and bloated sensation was rushed to the hospital. Thepatient was examined by the physician and ordered for admissiondue to a suspected stone in the gall bladder. You are the nurseon duty that day. 36. When performing an interview, which is the BEST initial question shouldyou ask when a patient is on pain? A. How often do you feel the pain? B. How would you describe your pain? C. Did you take any drug to relieve the pain? D. When did you first feel the abdominal pain? 37. Which of the following imaging test that uses transducer will be likely be ordered by the physician to detect gallstones? A. Computed Tomography B. Abdominal X-ray C. Abdominal Ultrasound D. Doppler sonography 38. The test revealed presence of gallstones and inflamed gall bladder. Thepatient was advised to undergo open cholecystectomy. This operationcompared to laparoscopic cholecystectomy are _________. I. invasive II. less pain III. longer recovery IV. shorter hospital stay A. I, II, & IV B. I & II C. I, II & III D. I & III 39. After 2 hours post-operatively, the nurse observed reddish drainage from the operative area of the patient. Which of the following nursingactions should you performed FIRST? A. Check if stitches from the operation have come apart. B. Check where is the source of possible bleeding. C. Cover the operative area with sterile gauze bandage. D. Put hand as a pressure on the operative area. 40. After several days in the hospital, the physician ordered for thepatient to be discharged. Which of the following is PRIORITYrestriction that you should emphasize when he goes home? A. Stool softener to induce bowel elimination. B. Driving while using narcotic drug. C. Take shower even if still with surgical drain. D. Lifting of objects not more than 10 lbs. Situation: Sarah, 18 year old, a teller from a bank is admitted to a tertiary hospital due to hypertension and frequent hematoma of the lower extremities every time she bumps herself in the workplace. The physician who examined her gave an impression of Cushingdisease. 41. Which of the following characteristics of Cushing disease is TRUE? I. The disease occurs in women between 20 to 40 year of age. II. The use of corticosteroids for multiple immune conditions is a cause of the disease process. III. Condition is aggravated by excessive production of ACTH. IV. The surgical treatment of choice in Transphenoidalhypophysectomy A. II & III B. I, II, & III C. I, II, III, & IV D. I & II 42. When one has a Cushing disease the focal structure affected is the __________. A. hypothalamus B. pituitary gland C. adrenal gland D. para thyroid gland 43. Which of the following clinical manifestations will NOT be a complaintfrom Sarah's condition? A. Edema of the extremities B. Poor wound healing C. Decrease libido D. Absence of growth in the pubic area 44. The attending physician ordered a Magnetic Resonance Imaging (MRI) topatient Sarah in order to validate the medical impression. This imaging technique is done to detect ________. A. hemorrhagic injury in the brain 3 | Page

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