Tiêu đề CDC - PART B (NP3).pdf ✅

CLOSED DOOR COACHING PART 2 Nursing Practice 3 Situation: Growth and development refer to the physical, cognitive, emotional, and social changes that occur throughout an individual's lifespan. It encompasses various aspects of human development, from infancy to adulthood. 1. Which of the following infant reflex groups is present at birth and remains throughout adulthood? A. Rooting, blink, cough, gag B. Blink, sneeze, cough, gag C. Blink, cough, sneeze, stepping D. Rooting, sneeze, cough, swallowing 2. Which statement is true about the principles of growth and development? A. Gross motor skills are developed first before fine motor skills. B. Different children pass through the predictable stages at the same rates. C. All body systems develop at the same rate. D. Development proceeds from distal to proximal body parts. 3. According to Erikson, what should the nurse anticipate when assessing a toddler? A. Participating in school activities B. Questioning sexual identity C. Engaging in fantasy activities D. Taking pride in pulling off the lollipop wrapper 4. The mother of an 8-month-old told the nurse that her child continually cries whenever she goes to work. This attitude displayed by the infant is in what stage of Piaget’s Theory? A. Preoperational thought B. Concrete operational thought C. Sensorimotor stage D. Formal operational thought 5. In what stage of Kohlberg's theory of moral development is a person linked with obeying a law even if it is discriminatory towards a racial group? A. Society-maintaining orientation B. Social contract orientation C. Universal ethical principle orientation D. Instrumental relativist orientation 6. Railey, 4 years old believes that there is more chocolate milk in her sister’s tall thin glass than her short, wide glass. She has not yet achieved with of the following principles of Piaget? A. Conservation B. Object permanence C. Assimilation D. Accommodation 7. Which of the following best describes the cognitive development of an 18-month-old child? A. The child understands the concept of "forever" B. The child can name six body parts C. The child can follow one-part directions D. The child has an attention span of approximately 5 minutes 8. A nurse is assisting a client and her nine-month-old daughter. The mother says, "Sometimes, she is so naughty! I had to put her in time-out yesterday for throwing toys!" What is the nurse's most suitable response? A. “Where do you place her when she goes to time-out?” B. “Remind her not to throw toys but don't discipline her for this behavior." C. “Keep doing that to teach her the right way; eventually she will stop throwing toys." D. “At this age, she should stay in time-out for nine minutes." Situation: Nursing ethical and moral issues encompass dilemmas that arise in patient care, involving conflicts between professional duties, patient rights, and moral principles. 9. What is the best practical guide for nurses to use when they encounter ethical dilemmas in a clinical setting? A. PRC Oath for Professionals B. Code of Ethics C. Theological Doctrine D. Florence Nightingale Oath 10. What should the healthcare team prioritize in the case of Mr. Carpenter, 63 years old, who has been admitted with chest pain from atherosclerotic plaque and is classified as high-risk for cardiovascular surgery due to his diabetes and hypertension? A. Consult the family members and let them give their decision. B. Proceed with the planned surgery, as this will save the patient. C. Consult the Ethics Committee on what to do with the patient. D. Discuss with Mr. Carpenter his health status & let him decide. 11. What type of ethical behavior is demonstrated when Nurse Gigi refers to Mrs. Pattie, a 77-year-old with dementia exhibiting unruly behavior, as "That awful, dirty old woman in Bed 14" in her shift report? A. Stigma B. Ageism C. Gender bias D. Depersonalization 12. Mr. TJ, who is at the end stage of life and has a "Do Not Resuscitate" order, passed away during your shift. He was declared dead by the physician at 8:30 AM. What should be your primary nursing action in this situation? A. Prepare the death certificate for the physician’s signature. B. Allow the family to have private time with the deceased. C. Ask your nurse attendant to immediately contact the funeral home. D. Clean the body and remove all the IV lines, tubes and other medical equipment. 13. When a nurse fully supports a patient's safety and personal rights during their hospital stay, which ethical principle is she upholding? A. Responsibility B. Empathy C. Advocacy D. Accountability Situation: A manager from an accounting firm is hospitalized due to severe abdominal pain and the presence of bloody stools. Following various diagnostic tests and lab evaluations, the physician has
recommended an exploratory laparotomy. You are the nurse assigned to care for him that day. 14. During your assessment, you need to identify which organs are located in the epigastric region? A. A portion of duodenum & jejunum, left kidney, appendix & ovary B. Duodenum, pancreas, portion of the liver and pyloric end of the stomach. C. Stomach, spleen, tail of pancreas and adrenal gland. D. Gallbladder, duodenum, gallbladder and portion of the right kidney. 15. What is the appropriate question to ask during a pre-operative nursing history regarding the patient's health perception and health management? A. Do you feel that your wounds heal quickly? B. Do you experience shortness of breath during physical activity? C. Are you familiar with the risk factors associated with your condition? D. Have you noticed any changes in your weight recently? 16. The patient was seen by the anesthesiologist, who explained the anesthesia options for his upper abdominal surgery. What type of anesthesia would you anticipate being ordered? A. Spinal B. Caudal C. Local D. General 17. What pre-operative medications are administered to the patient to reduce intra-operative anesthetic requirements and manage pain? A. Celebrex (Celecoxib) B. Ibuprofen (Motrin) C. Acetaminophen (Tylenol) D. Demerol (Meperidine HC1) 18. Ensuring patient safety in the operating room is essential for all members of the surgical team. Which of the following Universal Safety Protocols are implemented and confirmed before surgery? I. Patient's identity II. Surgical procedure III. Surgical site IV. Surgical equipment A. II & III B. I & II C. I, II & IV D. I, II & III Situation: Crisostomo, a 40-year-old employee, has been experiencing painful and difficult urination for nearly a week. He noticed some fresh blood in his urine but was hesitant to consult a physician. Instead, he sought help from a neighbor who is a herbalist. After a week of worsening symptoms, his wife took him to a community clinic. 19. A community clinic provides primary care for patients. Who typically manages this type of facility? A. Physician B. Barangay health workers C. Nurse D. Midwife 20. During the assessment, the patient was promptly referred to a hospital with a 25-bed capacity that lacks the ability to perform intensive diagnostic tests. As a nurse in this facility, you recognize that it is a LEVEL _________. A. 3 B. 1 C. 4 D. 2 21. At the tertiary hospital to which the patient was referred, he was classified as an emergency case. The nurse promptly contacted a specialist who is ________. A. Neurologist B. Urologist C. Phlebotomist D. Nephrologist 22. Following a comprehensive evaluation by the physician-specialist, an order for an immediate stonogram was issued. The nurse was directed to contact which section of the hospital? A. Operation Room B. Laboratory C. Rehab D. CT scan 23. After the procedure the patient was ordered for Lithotripsy, under spinal anesthesia. The nurse has to call the department of ________. A. Internal medicine B. Anesthesia C. Surgery D. Imagery Situation: A 67-year-old woman with diabetes mellitus, who is alert, is being discharged from the hospital. She has been referred to a community nursing agency, and you are tasked with reinforcing the teaching program that began during her hospital stay. The patient is taking the sulfonylurea medication tolbutamide (Orinase). 24. When the patient reached 69 years old, Orinase was stopped, and NPH insulin was prescribed. After several months, she was found to be experiencing the Somogyi effect. What condition is most likely to occur when the patient receives excessive insulin? A. Developing an elevation of the blood glucose level B. Producing even more insulin C. Becoming resistant to insulin D. Conserving excessive amount of fluid 25. A few days later, the patient arrives at the emergency department on an ambulance stretcher and has a blood sugar level of 800 mg/dL. There are no ketones in her urine, she is dehydrated, and her mental status is altered. Given this information, what specific medical condition is she most likely experiencing? A. Hyperosmolar nonketotic coma (HNKC) B. Diabetic retinopathy C. Acute renal failure D. Diabetic ketoacidosis (DKA) 26. During the interview, the patient mentioned that she frequently felt nauseous, restless, excessively sweaty, fatigued, and often hungry in her younger years. What do these symptoms indicate? A. Diabetic nephropathy B. Hyperglycemia C. Hypoglycemia
D. Diabetic retinopathy 27. During the assessment, you observed several scratches on her right ankle, which had led to an infection and cellulitis. When you inquired about the scratches, the patient replied, "Oh, my cat must have been using my leg as a scratching post again, and I didn't even notice." What diabetic complications might this suggest the patient is experiencing? A. Neuropathy B. Macroangiopathy C. Retinopathy D. Ephropathy 28. You should assess the patient for potential disturbed thought processes due to decreased metabolism and changes in cardiovascular and respiratory status. What is the reasoning behind orienting the patient to the time, place, date, and events? A. Shows improved cognitive functioning B. Provides reality orientation to patient C. Permits evaluation of the effectiveness of treatment D. Lets the patient identify the time, place, date and events correctly Situation: Nurse Pepper, along with five licensed graduate nurses from various regions, is starting her first day of orientation at a large healthcare facility. The nurse educator began the session by presenting the organizational structure of the medical center. 29. What is the PRIMARY PURPOSE of an organizational structure? It is a ______. A. blueprint illustrating committees for delegating roles and functions B. flow chart depicting interactions among major and minor groups C. framework outlining the relationships among units, departments, and communication channels D. design that clarifies roles, collaboration, and interdependence among functions of personnel 30. Line and staff functions are highlighted in the organizational chart. What does line authority refer to? A. Staff relationships within the organization are primarily advisory. B. The staff consists of personnel who report to the "Boss." C. Decisions are made in a bottom-up manner within the organization. D. There is direct responsibility for a subordinate within the organization. 31. Which of the following statements correctly characterizes the nursing service system in healthcare? A. Informed leaders are more effective than formal leaders within an organization. B. Shared governance often tends to be controlling and offers less autonomy. C. Institutional policies serve as a more powerful tool in nursing practice compared to laws and regulations. D. A situational leadership style is an effective approach for achieving patient outcomes. 32. The approach to nursing service delivery is being reassessed in light of patient outcomes. Which of the following statements about the manager's role in the healthcare delivery system is NOT TRUE? A. Provides direct nursing care when needed. B. Manages resource utilization. C. Act as a liaison in litigation cases in court. D. Collaborates with members of the healthcare. 33. Budgeting is a crucial component of financial management. When a unit manager assigns funds for supplies, inventory, and medical-surgical materials, this is referred to as _________. A. Cash budget B. Operational budget C. Capital budget D. Flexible budget. Situation: Saturn, a 68-year-old patient, was admitted to the hospital due to a reduced appetite, fatigue, dehydration, and a weight loss of approximately 15 pounds over the past few weeks. After a physician's examination, she was recommended for admission. You are the nurse responsible for her care. 34. The physician has ordered Total Parenteral Nutrition (TPN) for Ms. Saturn. What is your INITIAL step to take BEFORE this intervention? A. Determine if the family can afford the whole treatment. B. Evaluate the tolerance of the patient to glucose. C. Identify allergies of patient to the supplemental nutrition. D. Assess the basic understanding of the patient regarding TPN 35. Choose from the following the primary goals of TPN? I. Promote weight gain II. Improve nutritional status 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 36. When a patient is receiving TPN, it's essential to keep a close watch for the _______. A. Serum creatinine B. Potassium level C. Serum glucose level D. Sodium level 37. While Mrs. Saturn is receiving TPN, she suddenly reports mild chest pain, shortness of breath, and shows signs of cyanosis. What potential IMMEDIATE complication do you suspect she is experiencing? A. Sepsis due to IV line B. Air embolism C. Hyperglycemia D. Allergic reaction to TPN 38. What should be the PRIORITY nursing action in response to the patient's current clinical symptoms? A. Report to the physician status of the patient at once.
B. Take blood pressure and respiratory rate. C. Temporarily stop TPN D. Administer O2 inhalation. Situation: Ms. Alice is a retired Community Health Nurse in Bamban, Tarlac. Due to her commitment to the nursing profession, she has volunteered in their community to conduct health education classes. One Saturday morning, several patients who are hypertensive and with pulmonary health problems attended her session. 39. Mang Dong has recently been diagnosed with Chronic Obstructive Pulmonary Disease (COPD). What are the key teaching instructions that should be prioritized for him regarding 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. 40. Which of the following health interventions should be included in your teaching plan for Mang Dong? 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. 41. Pulmonary rehabilitation for COPD lasts a minimum of four to twelve weeks. What should be avoided during this program? A. Pursed lip breathing B. Smoking cessation C. Aerobic, upper and lower body conditioning. D. Peripheral muscle wasting 42. Weight loss and malnutrition are commonly observed among patients with COPD. They should be taught to avoid ________. A. Have a 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 43. Which of the following energy-conserving strategies should be avoided by patients with COPD? A. Exhale when pushing or exerting effort when doing daily activities B. Assume tripod position with elbows supported on the table when 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 presenting with jaundice, abdominal pain, nausea, and a bloated feeling was taken to the hospital. The physician examined her and recommended admission due to a suspected gallbladder stone. You are the nurse on duty that day. 44. What is the BEST initial question to ask a patient who is experiencing pain during an interview? A. How frequently do you experience the pain? B. How would you characterize your pain? C. Have you taken any medication to alleviate the pain? D. When did you first notice the abdominal pain? 45. Which of the following imaging tests that utilizes a transducer is most likely to be ordered by the physician to identify gallstones? A. Computed Tomography B. Abdominal X-ray C. Abdominal Ultrasound D. Doppler sonography 46. The test indicated the presence of gallstones and an inflamed gallbladder. The patient was recommended to have an open cholecystectomy. This procedure, in comparison to laparoscopic cholecystectomy, is _________. 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 47. Two hours after the operation, the nurse noted reddish drainage from the patient's surgical site. What is the FIRST nursing action you should take? 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. 48. After several days in the hospital, the physician has ordered the patient to be discharged. What is the PRIORITY restriction you should emphasize for the patient when they go 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, an 18-year-old bank teller, was admitted to a tertiary hospital due to hypertension and frequent bruising on her lower extremities whenever she bumps herself at work. After examining her, the physician suspected she has Cushing's disease. 49. Which of the following characteristics of Cushing disease is correct? I. The condition typically affects women aged 20 to 40. II. The use of corticosteroids for various immune disorders contributes to the disease. III. The condition is worsened by the overproduction of ACTH. IV. The preferred surgical treatment is transsphenoidal hypophysectomy. A. II & III B. I, II, & III C. I, II, III, & IV D. I & II 50. When someone has Cushing's disease, the specific structure affected is the __________.