Nursing Practice (Integrated Exam) with Answer Keys
Degree of Question’s Difficulty
(3) – Difficult question
(2) – Average question
(1) – Easy question
Situation 1: Mr. Santiago has a long history of smoking; he is currently diagnosed
with COPD. He is admitted for a pulmonary work up.
1. His arterial blood gas results are PO2 of 85, PCO2 of 40 and HCO3 of 24. Which
of the following should be initiated? (3)
a. Administer O2 at 2L to prevent him from becoming hypoxic.
b. No action is necessary; this is within normal range for a COPD client.
c. Anticipate the development of metabolic acidosis and administer Na HCO3.
d. Position him in high Fowler’s and anticipate him to need assisted ventilation
2. He finds that after smoking or exercise, he experiences difficulty of breathing,
headaches and nausea. These are symptoms of: (2)
a. Increased level of carbon dioxide
b. Decreased level of arterial oxygen
c. Decreased level of carbon dioxide
d. Very rapid breathing and metabolic acidosis
3. To encourage proper breathing exercises, which of the following should the nurse
teach? (1)
a. Encourage pursed lip breathing
b. Inhalation should be 2 to 3x that of exhalation
c. Encourage high abdominal breathing using the muscles of the diaphragm
d. Inhale through the mouth and out through the nose.
4. Which set of blood gases would indicate respiratory acidosis? (2)
a. pH 7.0; PCO2 42mmHg; HCO3 21mEq/L
b. pH 7.46; PCO2 38mmHg; HCO3 28mEq/L
c. pH 7.35; PCO2 44mmHg; HCO3 25mEq/L
d. pH 7.32; PCO2 48mmHg; HCO3 22mEq/L
5. He is to receive an IV of Lactated Ringer’s, 1000 cc to run for 8 hours. The drip
factor is 10 gtt/cc. How many drops per minute should you regulate the IV? (1)
a. 24 gtt/min
b. 12 gtt/min
,c. 21 gtt/min
d. 30 gtt/min
Situation 2: Nurse Jeddah is the staff nurse assigned in the Medical Ward of a
secondary hospital.
6. The physician ordered reverse isolation for Mr. Perez with second degree burns.
While performing reverse isolation technique, Nurse Freud should understand that:
(2)
a. it is not necessary to use sterile linen if the linen has been properly washed.
b. only some persons who come in direct contact with the client need to wear gloves
andmask
c. sterile gown and gloves must be worn while caring for Mr. Perez
d. it is not necessary to wear a mask
7. During the stage of diuresis, there is resorption of fluid into the intravascular
compartment and increase urinary output. Which electrolyte imbalance is most
frequently associated with this stage? (3)
a. hypernatremia, hyperkalemia, carbonic acid deficit
b. hyponatremia, hyperkalemia, bicarbonate excess
c. hyponatremia, hypokalemia, bicarbonate deficit
d. hypernatremia, hypokalemia, carbonic acid excess
8. The priority nursing care for patient suffering from stroke during acute phase is
to: (3)
a. maintain respiratory and cardiac functions
b. prevent contracture and deformities
c. maintain optimal nutrition
d. provide sensory stimulation
9. The nurse in the clinic would assess a 4-month-old who is in acute respiratory
distress when which of the following is observed? (2)
a. resting respiratory rate of 35 breaths/min
b. flaring of nares
c. diaphragmatic respiration
d. bilateral breath sounds
10. In assessing patient for signs of impending respiratory failure, an early symptom
that the nurse should look for is: (1)
a. Kussmaul’s respiration
b. cyanosis
c. tachypnea
d. bradypnea
Situation 4: Nurse Kitchie is caring to clients with tuberculosis at San Lazaro
, Hospital
11. Which of the following symptoms is common in clients with tuberculsosis? (1)
a. Mental status changes
b. Increased appetite
c. Dyspnea on exertion
d. Weight loss
12. Nurse Kitchie obtains a sputum specimen from a client for laboratory study.
Which of he following laboratory techniques is most commonly used to identify
tubercle bacilli in sputum? (1)
a. Dark-field illumination
b. Sensitivity Testing
c. Acid – fast staining
d. Agglutination
13. A client has a positive Mantoux test. Nurse Kitchie correctly interprets this
reaction to mean that the client has: (2)
a. active tuberculosis
b. had contact with Mycobacterium tuberculosis
c. developed a resistance to tubercle bacilli
d. developed passive immunity to tuberculosis
14. Nurse Kitchie should teach clients that the most common route of transmitting
tubercle bacilli from person to person is through contaminated: (1)
a. dust particles
b. droplet nuclei
c. water
d. eating utensils
15. The client is to be discharged home with a community health nursing follow –
up. Of the following interventions, which would have the highest priority? (2)
a. Offering the client emotional support
b. Teaching the client about the disease and treatment
c. Coordinating various agency services
d. Assessing the clients environment for sanitation
Situation 5
Mang Tomas with advanced chronic obstructive pulmonary disease (COPD)
reports steady weight loss and being “is too tired from just breathing to eat, is
admitted in the hospital.
Degree of Question’s Difficulty
(3) – Difficult question
(2) – Average question
(1) – Easy question
Situation 1: Mr. Santiago has a long history of smoking; he is currently diagnosed
with COPD. He is admitted for a pulmonary work up.
1. His arterial blood gas results are PO2 of 85, PCO2 of 40 and HCO3 of 24. Which
of the following should be initiated? (3)
a. Administer O2 at 2L to prevent him from becoming hypoxic.
b. No action is necessary; this is within normal range for a COPD client.
c. Anticipate the development of metabolic acidosis and administer Na HCO3.
d. Position him in high Fowler’s and anticipate him to need assisted ventilation
2. He finds that after smoking or exercise, he experiences difficulty of breathing,
headaches and nausea. These are symptoms of: (2)
a. Increased level of carbon dioxide
b. Decreased level of arterial oxygen
c. Decreased level of carbon dioxide
d. Very rapid breathing and metabolic acidosis
3. To encourage proper breathing exercises, which of the following should the nurse
teach? (1)
a. Encourage pursed lip breathing
b. Inhalation should be 2 to 3x that of exhalation
c. Encourage high abdominal breathing using the muscles of the diaphragm
d. Inhale through the mouth and out through the nose.
4. Which set of blood gases would indicate respiratory acidosis? (2)
a. pH 7.0; PCO2 42mmHg; HCO3 21mEq/L
b. pH 7.46; PCO2 38mmHg; HCO3 28mEq/L
c. pH 7.35; PCO2 44mmHg; HCO3 25mEq/L
d. pH 7.32; PCO2 48mmHg; HCO3 22mEq/L
5. He is to receive an IV of Lactated Ringer’s, 1000 cc to run for 8 hours. The drip
factor is 10 gtt/cc. How many drops per minute should you regulate the IV? (1)
a. 24 gtt/min
b. 12 gtt/min
,c. 21 gtt/min
d. 30 gtt/min
Situation 2: Nurse Jeddah is the staff nurse assigned in the Medical Ward of a
secondary hospital.
6. The physician ordered reverse isolation for Mr. Perez with second degree burns.
While performing reverse isolation technique, Nurse Freud should understand that:
(2)
a. it is not necessary to use sterile linen if the linen has been properly washed.
b. only some persons who come in direct contact with the client need to wear gloves
andmask
c. sterile gown and gloves must be worn while caring for Mr. Perez
d. it is not necessary to wear a mask
7. During the stage of diuresis, there is resorption of fluid into the intravascular
compartment and increase urinary output. Which electrolyte imbalance is most
frequently associated with this stage? (3)
a. hypernatremia, hyperkalemia, carbonic acid deficit
b. hyponatremia, hyperkalemia, bicarbonate excess
c. hyponatremia, hypokalemia, bicarbonate deficit
d. hypernatremia, hypokalemia, carbonic acid excess
8. The priority nursing care for patient suffering from stroke during acute phase is
to: (3)
a. maintain respiratory and cardiac functions
b. prevent contracture and deformities
c. maintain optimal nutrition
d. provide sensory stimulation
9. The nurse in the clinic would assess a 4-month-old who is in acute respiratory
distress when which of the following is observed? (2)
a. resting respiratory rate of 35 breaths/min
b. flaring of nares
c. diaphragmatic respiration
d. bilateral breath sounds
10. In assessing patient for signs of impending respiratory failure, an early symptom
that the nurse should look for is: (1)
a. Kussmaul’s respiration
b. cyanosis
c. tachypnea
d. bradypnea
Situation 4: Nurse Kitchie is caring to clients with tuberculosis at San Lazaro
, Hospital
11. Which of the following symptoms is common in clients with tuberculsosis? (1)
a. Mental status changes
b. Increased appetite
c. Dyspnea on exertion
d. Weight loss
12. Nurse Kitchie obtains a sputum specimen from a client for laboratory study.
Which of he following laboratory techniques is most commonly used to identify
tubercle bacilli in sputum? (1)
a. Dark-field illumination
b. Sensitivity Testing
c. Acid – fast staining
d. Agglutination
13. A client has a positive Mantoux test. Nurse Kitchie correctly interprets this
reaction to mean that the client has: (2)
a. active tuberculosis
b. had contact with Mycobacterium tuberculosis
c. developed a resistance to tubercle bacilli
d. developed passive immunity to tuberculosis
14. Nurse Kitchie should teach clients that the most common route of transmitting
tubercle bacilli from person to person is through contaminated: (1)
a. dust particles
b. droplet nuclei
c. water
d. eating utensils
15. The client is to be discharged home with a community health nursing follow –
up. Of the following interventions, which would have the highest priority? (2)
a. Offering the client emotional support
b. Teaching the client about the disease and treatment
c. Coordinating various agency services
d. Assessing the clients environment for sanitation
Situation 5
Mang Tomas with advanced chronic obstructive pulmonary disease (COPD)
reports steady weight loss and being “is too tired from just breathing to eat, is
admitted in the hospital.
