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COMPREHENSIVE PHASE WORKBOOK LEADERSHIP MANAGEMENT NOVEMBER 2024 Philippine Nurse Licensure Examination Review 1. Nurse Polita is a member of the ethics review committee. Which of the following is the purpose of ethical review committee? A. Decrease public security of health care provider's action B. Increase individual's responsibility C. Enhance health care provider's liability D. Promote implementation of general standards 2. Nurse Belinda is currently in the station receiving endorsements. While endorsing a patient to Nurse Delia, you detected an odor of alcohol on the attendant’s breath. You should plan to: A. Report to the senior nurse on duty B. Warn the nursing attendant that he should stay away from the clients C. Monitor his performance closely D. Tell the nursing attendant that he should go home immediately 3. Nurse Fely observed that Nurse Yellie administered the antibiotic drip several hours after scheduled time. Nurse Yellie just charted as if the medication was given on time. You reported to your senior nurse and expected the following steps will be done. Arrange the following steps in chronological order using all options. i. The senior nurse will schedule a private meeting to discuss the observation ii. The concerned staff nurse will be encouraged to take responsibility iii. The senior nurse will clearly inform the concerned staff that her behavior is unethical iv. If with resistance, the charge nurse will be informed v. The senior nurse will approach the concerned staff in a calm and professional manner A. 5, 3, 2, 1, 4 B. 5, 1, 3, 2, 4 C. 3, 2, 1, 5, 4 D. 2, 3, 5, 1, 4 4. Patient XYZ was discharged post-craniotomy. During your discharge planning, he informed you that he took the remote control, as their souvenir. The appropriate thing for you to do is to: A. Implement hospital policy accordingly B. Ignore the situation C. Call the security to deal with the case D. Instruct the client to pay the item the cashier 5. Patient XYZ has been waiting for six hours for his wife to fetch him. He told you that he wants to go home alone. Your FIRST appropriate action would be to: A. Inform the surgeon B. Prepare for ambulance conduction C. Refer the client’s case to the head nurse D. Allow him to go after signing a waiver 6. Nurse Yumi is a charge nurse in the surgical unit. She suspects that a male nursing attendant is abusing chemicals while on duty. Irregular reports on narcotics medications sheet are noted when she is on duty. Which of the following should be the appropriate action of the nurse? A. Report to the nurse supervisor in a confidential manner B. Pretend not to know the situation C. Personally call her attention in private D. Write an incident report and submit to administration 7. In order to confirm Nurse Yumi’s suspicion that the male nursing attendant has a substance abuse disorder. It is imperative for the nurse to assess which of the following substance abuse indicators? i. Defensive when questioned on the discrepancies in the narcotic control sheet ii. Excessive work-related tardiness, absences, and accidents iii. Accurate but sloppy documentation iv. Social Isolation A. 1, 2, 3 and 4 B. 2 and 4 C. 1 and 3 D. 1, 2 and 4 8. Mr. Greg Larrazabal, a patient with end stage renal disease, signed a DNR. In this situation, which of the following should be the responsibility of the nurse? A. Know and follow the patients wishes regarding resuscitation and the application of life support system B. Ascertain that a written order DNR from the physician is in place C. Explain to the family the consequence of DNR D. Follow strictly the physician’s order 9. Student nurse Marielle has been assigned to Mr. Larrazabal. You are currently conducting a ward class and is currently discussing about Mr. Larrazabal’s DNR. You discuss which of the following that the nurse take into consideration when the client has DNR order? A. The DNR order is not separate from other aspects of client’s care B. The order of the physician is final and not subjected to explicit discussion C. The competent client’s values and choices should always be given the highest priority D. Consider the views of the family who are against DNR 10. The chief nurse has asked the head nurses of the different wards to send a list of staff nurses who shall attend the EBP seminar organized by the nursing division. Which of the following refers to this type of program? A. Seminar workshop in evidence-based practice B. Continuing education in evidence-based practice C. In-service education program D. Scientific forum in evidence-based practice SITUATION: Due to the shortage of nurses, some nurses need to float to other units in order to augment the workforce. Which patient is more appropriate to be assigned to the following nurses? 11. Nurse Terry is from Psychiatric Ward and will float to the Emergency Department. A. Client with PICC line B. Client with end stage renal disease C. Client with GCS:3 D. Confused drunk client TOP RANK REVIEW ACADEMY, INC. Page 1 | 7
12. Nurse Maricel is from OB Ward and will float to the Oncology Ward. A. Post-hysterectomy client for discharge this morning B. Client with Crohn’s disease C. Client with greenstick fracture D. Client with breast cancer receiving granulocyte therapy 13. Nurse Graziella is from Medical-Surgical Unit floated to the Labor Room A. Patient on precipitous labor B. Patient on prolonged labor C. Patient with fetus on sacral presentation D. Patient on eclampsia 14. Nurse Danielle is an OB nurse floated to the Central ICU. A. Client with hyperglycemic hyperosmolar state B. Client receiving pRBC transfusion C. Client receiving medications through CVAD D. Client who had undergone colon surgery, having dysrrhythmias 15. Nurse Veronica from the Medical Surgical Unit floated to the ER. A. Client with acute abdominal pain due to appendicitis B. Client with widely dilated pupils and apnea C. Pediatric client with ARDS in respiratory distress D. Client with chronic heart failure NYHA Classification: Class IV 16. Nurse Arizona from the Pediatric Unit floated to OB Department A. Postpartum client who has an inverted nipple B. Postpartum client who has Raynaud’s phenomenon C. Postpartum client who had vaginal birth D. Postpartum client who had anti-phospholipid syndrome 17. Nurse Jean is a chief nurse in the hospital. Along with other administrators, they are discussing about the creation of a strategic plan. Which of these statements is true about a strategic plan? A. Requires focus on the mission and vision of the organization B. Should not be done during financial crises C. Requires an assessment of the environment for opportunities D. Needs to be revisited periodically 18. Nurse Maya is demonstrating to students how a collaborative role is performed in the hospital. She shows it by showing that: A. The nurse plans care with the patient B. The nurse works with other members of the health care team from other units. C. The nurse initiates nursing action with co-workers D. The nurse defends rights of patients. 19. Mr. Fred Hallare reports to the station at 2 am that he has difficulty sleeping because of the noises in the hallway. When evaluating the effect the setting has on the quality of care provided to the client evaluation being done is called: A. Quality assurance B. Quality improvement C. Structure Evaluation D. Outcome Evaluation 20. Upon admission, the patient’s history was assessed, admitting orders were carried out wherein a tepid sponge bath was given, neuro vital signs were monitored q1h, and medications were given. The evaluation care provided to him by the nurse is referred to as: A. Nursing audit B. Process evaluation C. Outcome evaluation D. Quality improvement 21. Nurse Carmencita, as a chief nurse, has a critical role in planning, implementing and evaluating patient care outcomes. All of the following are beneficial to the management of patient care in the hospital, except: A. Integration of patient information management into the system B. Assess patient acuity and prepare appropriate care C. Focus of care in patient population rather than individual patient D. Equal allocation of resources in all service units 22. Nurse Cathy is a new nurse in the unit and her performance appraisal is coming up. She feels anxious about it. She asks Nurse Gerry, her senior, about the performance appraisal. Which of the following statements is true? A. Informing the staff about the specific impressions of their work help improve their performance. B. A verbal appraisal is an acceptable substitute for a written report C. Patients are the best source of information regarding personnel appraisal. D. The outcome of performance appraisal rests primarily with the staff. 23. Which pattern of nursing care involves the care given by a group of paraprofessional workers led by a professional nurse who take care of patients with the same disease conditions and are located geographically near each other? A. Case method B. Modular nursing C. Nursing case management D. Team nursing 24. Nurse Nenita goes in an outing with other medical interns on her days off. What type of organizational structure is this? A. Formal B. Informal C. Staff D. Line 25. Nurse Kelly, as an administrator, develops the standards to be followed. Among the following standards, which is considered as a structure standard? A. The patients verbalized satisfaction of the nursing care received B. Rotation of duty will be done every four weeks for all patient care personnel. C. All patients shall have their weights taken recorded D. Patients shall answer the evaluation form before discharge 26. Nurse Jasmine has been newly promoted as the nursing division chief. One function of management that she needs to focus on is on controlling and optimizing quality. The following are basic steps in the controlling process of the department. Which of the following is NOT included? A. Measure actual performance B. Set nursing standards and criteria C. Compare results of performance to standards and objectives D. Identify possible courses of action 27. Nurse Xeena is attending an orientation regarding the patient care delivery system in her unit. She was told that the nursing model is a team nursing approach. A. a task approach method is used to provide care to clients B. managed care concepts and tools are used in providing client care C. an RN leads nursing personnel in providing care to a group of clients D. a single RN is responsible for providing nursing care to a group of clients 28. During Nurse Xeena’s orientation, the critical path was introduced. Which of the following statements, if made by TOP RANK REVIEW ACADEMY, INC. Page 2 | 7
Xeena, indicates a need for further understanding regarding critical paths? A. they are developed through the collaborative efforts of all members of the health care team B. they provide an effective way of monitoring care and for reducing or controlling the length of hospital stay for the client C. they are developed based on appropriate standards of care D. they are nursing care plans and use the steps of the nursing process 29. Nurse Miranda plans to shift the care delivery from functional nursing to primary nursing. A form of resistance is expected. Which technique should the nurse use in implementing this change? A. introduce the change gradually B. confront the individuals involved in the change process C. use coercion to implement the change D. manipulate the participants in the change process 30. Elisa J complains of 10/10 pain despite opiod medications whenever Nurse Rebecca is the one in charge of administering the medication. The appropriate action for the nurse to take is to: A. Reassign the nurse to the care of clients not receiving opioids B. notify the physician that the client needs an increase in opioid dosage C. Review the client's medication administration record immediately and discuss the observations with the nursing supervisor D. Confront the nurse with the information about the client having pain control problems and ask if the nurse is using the opioids personally 31. Nurse Mandy is monitoring the performance of a new nurse in the ward. Which of the following would indicate the need for further action and analysis? A. A client can perform wound cleaning on post-op site B. Purulent drainage is noted from a postoperative wound incision C. A 1-day postoperative client has a temperature of 98.8F D. A client newly diagnosed with hypertension monitors his BP 32. Nurse Helen advises her colleague to consider shifting to transformational leadership to boost performance of the team. Which of the following statements best describes this type of leadership? A. The leader uses visioning as the essence of leadership. B. The leader serves the followers rather than being served. C. The leader maintains full trust and confidence in the subordinates. D. The leader possesses innate charisma that makes others feel good in his presence. 33. Despite shifting to transformational leadership, the staff still underperforms. Nurse Helen introduced the Path Goal theory. Which of the following behaviors is manifested by the leader who uses this theory? A. Recognizes staff for going beyond expectations by giving them citations B. Challenges the staff to take individual accountability for their own practice C. Admonishes staff for being laggards. D. Reminds staff about the sanctions for non-performance. 34. Nurse Sandra was newly recruited into the hospital as a staff nurse. The organization mission is “Quality is priority”. Which of the following statements support this mission? A. Requiring competence and diligence in meeting the goals of the organization. B. Making the smallest error or overlooking details can have negative impact on quality. C. Performing one’s job to the best of one’s ability guided by principles. D. Contributing to quality improvement throughout the organization to highest degree 35. Nurse Heidi is in the middle level management. Planning is one of her functions. She knows it involves analyses of both external and internal factors affecting the process. External factors include: A. Strength B. Strength and weakness C. Opportunities D. Opportunities and threats 36. The staff of a local hospital have formed a task force to develop new protocol for safe evacuation during an earthquake. However, this protocol haven’t been reviewed, approved or shared with all personnel. When a intensity 6.5 earthquake hit the area, the task force members push for evacuating the unit using the new procedures. Which action should the nurse-manager take? A. Determine that the procedures currently in place must be followed and direct staff to follow them without question. B. Tell staff members to use whatever procedures they feel are best C. Ask staff members to quickly meet among themselves and decide what procedures to follow D. Tell staff members to assemble in the staff lounge; there the nurse-manager will quickly gather opinions about evacuation procedures before deciding what to do. 37. Primary nursing is the care delivery system currently used by Nurse Grace’s hospital. Which of the following activities is NOT done by a primary nurse? A. Collaborates with the physician B. Provides care to a group of patients together with a group of nurses C. Provides care for 5-6 patients during their hospital stay. D. Performs comprehensive initial assessment 38. Functional nursing is being advocated to be used in Nurse Je’s hospital due to staff shortage. Which of the following is a barrier to its implementation? A. Psychological and sociological needs are emphasized. B. Great control of work activities. C. Most economical way of delivering nursing services. D. Workers feel secure in dependent role 39. Team nursing is the current care delivery system in the unit. Nurse Teresita and her team need to assess the priority of care for a group of patients, which of the following should be a priority? A. Each patient as listed on the chart B. Patients who needs minimal care C. Patients who need transfusion D. Patients who need the most care 40. Nurse Adrian is currently looking at the hospital organizational chart. He expects to see all of the following EXCEPT.: A. Who has the legitimate power to make decisions B. It shows both formal and informal relationships in an organization. C. Suggests consistency in making decisions D. Dotted or broken lines on the organization chart represent staff positions. 41. Nurse Renesmee wants to revise the current process standards in nursing.The nurse manager prepares the process standards. Which of the ff. is NOT a process standard and therefore should be revised? A. Initial assessment shall be done to all patients within 24 hours upon admission B. Informed consent shall be secured prior to any invasive procedure TOP RANK REVIEW ACADEMY, INC. Page 3 | 7
C. Patient shall fill up the customer’s feedback prior to discharge D. Patient education about illness and treatment shall be provide for all patients and their families 42. Ms. Selena Reyes wants to have a single nurse to take care of her from the time of admission and even after discharge. Ms. Reyes wants which type of system of nursing care delivery? A. Primary Nursing B. Nursing case management C. Team Nursing D. Case Method 43. You are currently holding an orientation for the new nurses in the hospital. In order One of the new staff nurses wants to understand the channel of communication, span of control and lines of communication. A. Organizational structure B. Job description C. Policy D. Manual procedures 44. Nurse Yuri is a new nurse and is currently anxious about lawsuits. Which of the following conditions would prevent Yuri from a malpractice suit? A. She performs her duty as prescribed in her job description B. Her action resulted to an injury resulted from non-compliance to the standard of care C. The participation of the child’s parents resulted to an injury to the chilD. D. She is aware of the possibility of the injury to the patient 45. As a nurse manager, budgeting is one of your concerns. Which of the ff. articles is an example of operational budgets? A. Fee for the Internet Service Provider B. Purchase of a ventilator C. Additional locker room for OR D. New electrocautery machine 46. The Forty-Hour Week Law (Republic Act 5901), provides that employees will work only 40 hours a week provided that they are working in hospitals with a minimum of how many bed capacity: A. 50-bed capacity B. 75-bed capacity C. 100-bed capacity D. 150-bed capacity 47. Nurse Genna transitions to another form of care delivery. It is the most common delivery system where the nursing staff is divided into teams who are responsible for the care of a group of patients. A. Primary Nursing B. Functional Nursing C. Total Patient Care D. Team Nursing 48. Nurse Lilith wants to predict the future in which the plan will be executed. She should do: A. Setting Policies and Procedures B. Budgeting C. Forecasting D. Program Scheduling 49. A kind of nursing planning that includes the analysis of strengths, weaknesses, opportunities and strengths is also known as: A.Strategic Planning B. SWOT Planning C. Fiscal Planning D. Contingency Planning 50. Nurse Yule is the new nurse administrator of the hospital and during the long term planning, he suggested that one of the goals is “to expand and upgrade the hospital infrastructure to deliver quality care”. The hospital CEO becomes aware of the hospital needs and therefore allots a larger portion of the budget for the upgrades. Nurse Yule was able to successfully achieve what component of SWOT analysis? A.Strengths B. Weaknesses C. Opportunities D. Threats 51. Nurse Jellie introduced Theory Y during the ward conference. It is correctly described by all, but one, of the following statements: A. Applicable for people who enjoy work and have self-control B. Uses threats as a prime motivator C. Uses praise and recognition as the key motivators D. A guide for managers to develop the potential of each person 52. Chief Nurse Subillo is trying to implement a new style of staffing in the cancer unit. Nurses are now required to render 6 day workweeks instead of the usual 5 days a week. The nurse supervisor can effectively implement this change by choosing which course of action? A. Explain the purpose of the change and reinforce management decision B. Postpone the implementation of the new schedule to let the antagonistic feelings of the staff “cool down” C. Conduct a dialogue with the nursing staff and head nurses and involve them in planning the new schedule D. Avoid discussing the issue with the staff and implement the new schedule as planned 53. Nurse Marina is currently evaluating the. nursing staff nurses for their atitude and ethics. The manager determines that her staff nurse shows work accountability when the staff nurse: A. Performs tasks based on her job description B. Follows the standards of safe nursing practice C. Directs the work of her fellow nurses D. Answers for the consequences of her own decisions 54. Nurse Estudillo suggests following the principles of Total Quality Management. She emphasizes that it is the responsibility of which group to identify quality improvement opportunities? A. Administration B. Medical practitioners C. Nurse D. All health care personnel 55. As a part of the quality improvement program, process standards should be well-defined. Which of the following is NOT a process standard? A. Initial assessment shall be done to all patients within twenty four hours upon admission. B. Informed consent shall be secured prior to any invasive procedure C. Patients’ reports 95% satisfaction rate prior to discharge from the hospital. D. Patient education about their illness and treatment shall be provided for all patients and their families. 56. Yannie is a fresh graduate of nursing. She was informed about the need for continuing professional development units to renew her license. The objectives of continuing professional education programs in nursing are the following, EXCEPT: A. Protect and promote the general welfare of the public by attaining the highest standards and quality in the practice of profession B. Make the professional globally competitive by maintaining capability for delivering professional services C. Augment the nurse educational preparation for admission to the practice of his profession TOP RANK REVIEW ACADEMY, INC. Page 4 | 7