Here are the answers & rationale for Fundamentals of Nursing Comprehensive Exam: Illness, Infection, Asepsis (100 Items)
1. When the General adaptation syndrome is activated, FLIGHT OR FIGHT response sets in. Sympathetic nervous system releases norepinephrine while the adrenal medulla secretes epinephrine. Which of the following is true with regards to that statement?
A. Pupils will constrict
B. Client will be lethargic
C. Lungs will bronchodilate
D. Gastric motility will increase
Rationale:To better understand the concept : The autonomic nervous system is composed of SYMPATHETIC and PARASYMPATHETIC Nervous system. It is called AUTONOMIC Because it is Involuntary and stimuli based. You cannot tell your heart to kindly beat for 60 per minute, Nor, Tell your blood vessels, Please constrict, because you need to wear skirt today and your varicosities are bulging. Sympathetic Nervous system is the FIGHT or FLIGHT mechanism. When people FIGHT or RUN, we tend to stimulate the ANS and dominate over SNS. Just Imagine a person FIGHTING and RUNNING to get the idea on the signs of SNS Domination. Imagine a resting and digesting person to get a picture of PNS Domination. A person RUNNING or FIGHTING Needs to bronchodilate, because the oxygen need is increased due to higher demand of the body. Pupils will DILATE to be able to see the enemy clearly. Client will be fully alert to dodge attacks and leap through obstacles during running. The client’s gastric motility will DECREASE Because you cannot afford to urinate or defecate during fighting nor running.
2. Which of the following response is not expected to a person whose GAS is activated and the FIGHT OR FLIGHT response sets in?
A. The client will not urinate due to relaxation of the detrusor muscle
B. The client will be restless and alert
C. Clients BP will increase, there will be vasodilation
D. There will be increase glycogenolysis, Pancrease will decrease insulin secretion
Rationale:If vasodilation will occur, The BP will not increase but decrease. It is true that Blood pressure increases during SNS Stimulation due to the fact that we need more BLOOD to circulate during the FIGHT or FLIGHT Response because the oxygen demand has increased, but this is facilitated by vasoconstriction and not vasodilation. A,B and D are all correct. The liver will increase glycogenolysis or glycogen store utilization due to a heightened demand for energy. Pancrease will decrease insulin secretion because almost every aspect of digestion that is controlled by Parasympathetic nervous system is inhibited when the SNS dominates.
3. State in which a person’s physical, emotional, intellectual and social development or spiritual functioning is diminished or impaired compared with a previous experience.
A. Illness
B. Disease
C. Health
D. Wellness
Rationale:Disease is a PROVEN FACT based on a medical theory, standards, diagnosis and clinical feature while ILLNESS Is a subjective state of not feeling well based on subjective appraisal, previous experience, peer advice etc.
4. This is the first stage of illness wherein, the person starts to believe that something is wrong. Also known as the transition phase from wellness to illness.
A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role
Rationale:A favorite board question are Stages of Illness. When a person starts to believe something is wrong, that person is experiencing signs and symptoms of an illness. The patient will then ASSUME that he is sick. This is called assumption of the sick role where the patient accepts he is Ill and try to give up some activities. Since the client only ASSUMES his illness, he will try to ask someone to validate if what he is experiencing is a disease, This is now called as MEDICAL CARE CONTACT. The client seeks professional advice for validation, reassurance, clarification and explanation of the symptoms he is experiencing. client will then start his dependent patient role of receiving care from the health care providers. The last stage of Illness is the RECOVERY stage where the patient gives up the sick role and assumes the previous normal gunctions.
5. In this stage of illness, the person accepts or rejects a professionals suggestion. The person also becomes passive and may regress to an earlier stage.
A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role
Rationale:In the dependent patient role stage, Client needs professionals for help. They have a choice either to accept or reject the professional’s decisions but patients are usually passive and accepting. Regression tends to occur more in this period.
6. In this stage of illness, The person learns to accept the illness.
A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role
Rationale:Acceptance of illness occurs in the Assumption of sick role phase of illness.
7. In this stage, the person tries to find answers for his illness. He wants his illness to be validated, his symptoms explained and the outcome reassured or predicted
A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role
Rationale:At this stage, The patient seeks for validation of his symptom experience. He wants to find out if what he feels are normal or not normal. He wants someone to explain why is he feeling these signs and symptoms and wants to know the probable outcome of this experience.
8. The following are true with regards to aspect of the sick role except
A. One should be held responsible for his condition
B. One is excused from his societal role
C. One is obliged to get well as soon as possible
D. One is obliged to seek competent help
Rationale:The nurse should not judge the patient and not view the patient as the cause or someone responsible for his illness. A sick client is excused from his societal roles, Oblige to get well as soon as possible and Obliged to seek competent help.
9. Refers to conditions that increases vulnerability of individual or group to illness or accident
A. Predisposing factor
B. Etiology
C. Risk factor
D. Modifiable Risks
10. Refers to the degree of resistance the potential host has against a certain pathogen
A. Susceptibility
B. Immunity
C. Virulence
D. Etiology
Rationale:Immunity is the ABSOLUTE Resistance to a pathogen considering that person has an INTACT IMMUNITY while susceptibility is the DEGREE of resistance. Degree of resistance means how well would the individual combat the pathogens and repel infection or invasion of these disease causing organisms. A susceptible person is someone who has a very low degree of resistance to combat pathogens. An Immune person is someone that can easily repel specific pathogens. However, Remember that even if a person is IMMUNE [ Vaccination ] Immunity can always be impaired in cases of chemotherapy, HIV, Burns, etc.
11. A group of symptoms that sums up or constitute a disease
A. Syndrome
B. Symptoms
C. Signs
D. Etiology
Rationale:Symptoms are individual manifestation of a certain disease. For example, In Tourette syndrome, patient will manifest TICS, but this alone is not enough to diagnose the patient as other diseases has the same tic manifestation. Syndrome means COLLECTION of these symptoms that occurs together to characterize a certain disease. Tics with coprolalia, echolalia, palilalia, choreas or other movement disorders are characteristics of TOURETTE SYNDROME.
12. A woman undergoing radiation therapy developed redness and burning of the skin around the best. This is best classified as what type of disease?
A. Neoplastic
B. Traumatic
C. Nosocomial
D. Iatrogenic
Rationale:Iatrogenic diseases refers to those that resulted from treatment of a certain disease. For example, A child frequently exposed to the X-RAY Machine develops redness and partial thickness burns over the chest area. Neoplastic are malignant diseases cause by proliferation of abnormally growing cells. Traumatic are brought about by injuries like Motor vehicular accidents. Nosocomial are infections that acquired INSIDE the hospital. Example is UTI Because of catheterization, This is commonly caused by E.Coli.
13. The classification of CANCER according to its etiology Is best described as
1. Nosocomial
2. Idiopathic
3. Neoplastic
4. Traumatic
5. Congenital
6. Degenrative
A. 5 and 2
B. 2 and 3
C. 3 and 4
D. 3 and 5
Rationale:Aside from being NEOPLASTIC, Cancer is considered as IDIOPATHIC because the cause is UNKNOWN.
14. Term to describe the reactiviation and recurrence of pronounced symptoms of a disease
A. Remission
B. Emission
C. Exacerbation
D. Sub acute
15. A type of illness characterized by periods of remission and exacerbation
A. Chronic
B. Acute
C. Sub acute
D. Sub chronic
Rationale:A good example is Multiple sclerosis that characterized by periods of remissions and exacerbation and it is a CHRONIC Disease. An acute and sub acute diseases occurs too short to manifest remissions. Chronic diseases persists longer than 6 months that is why remissions and exacerbation are observable.
16. Diseases that results from changes in the normal structure, from recognizable anatomical changes in an organ or body tissue is termed as
A. Functional
B. Occupational
C. Inorganic
D. Organic
Rationale:As the word implies, ORGANIC Diseases are those that causes a CHANGE in the structure of the organs and systems. Inorganic diseases is synonymous with FUNCTIONAL diseases wherein, There is no evident structural, anatomical or physical change in the structure of the organ or system but function is altered due to other causes, which is usually due to abnormal response of the organ to stressors. Therefore, ORGANIC BRAIN SYNDROME are anatomic and physiologic change in the BRAIN that is NON PROGRESSIVE BUT IRREVERSIBLE caused by alteration in structure of the brain and it’s supporting structure which manifests different sign and symptoms of neurological, physiologic and psychologic alterations. Mental disorders manifesting symptoms of psychoses without any evident organic or structural damage are termed as INORGANIC PSYCHOSES while alteration in the organ structures that causes symptoms of bizaare pyschotic behavior is termed as ORGANIC PSYCHOSES.
17. It is the science of organism as affected by factors in their environment. It deals with the relationship between disease and geographical environment.
A. Epidemiology
B. Ecology
C. Statistics
D. Geography
Rationale:Ecology is the science that deals with the ECOSYSTEM and its effects on living things in the biosphere. It deals with diseases in relationship with the environment. Epidimiology is simply the Study of diseases and its occurence and distribution in man for the purpose of controlling and preventing diseases. This was asked during the previous boards.
18. This is the study of the patterns of health and disease. Its occurrence and distribution in man, for the purpose of control and prevention of disease.
A. Epidemiology
B. Ecology
C. Statistics
D. Geography
Rationale:Refer to number 17.
19. Refers to diseases that produced no anatomic changes but as a result from abnormal response to a stimuli.
A. Functional
B. Occupational
C. Inorganic
D. Organic
Rationale:Refer to number 16.
20. In what level of prevention according to Leavell and Clark does the nurse support the client in obtaining OPTIMAL HEALTH STATUS after a disease or injury?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
Rationale:Perhaps one of the easiest concept but asked frequently in the NLE. Primary refers to preventions that aims in preventing the disease. Examples are healthy lifestyle, good nutrition, knowledge seeking behaviors etc. Secondary prevention are those that deals with early diagnostics, case finding and treatments. Examples are monthly breast self exam, Chest X-RAY, Antibiotic treatment to cure infection, Iron therapy to treat anemia etc. Tertiary prevention aims on maintaining optimum level of functioning during or after the impact of a disease that threatens to alter the normal body functioning. Examples are prosthetis fitting for an amputated leg after an accident, Self monitoring of glucose among diabetics, TPA Therapy after stroke etc.
The confusing part is between the treatment in secondary and treatment in tertiary. To best differentiate the two, A client with ANEMIA that is being treated with ferrous sulfate is considered being in the SECONDARY PREVENTION because ANEMIA once treated, will move the client on PRE ILLNESS STATE again. However, In cases of ASPIRING Therapy in cases of stroke, ASPIRING no longer cure the patient or PUT HIM IN THE PRE ILLNESS STATE. ASA therapy is done in order to prevent coagulation of the blood that can lead to thrombus formation and a another possible stroke. You might wonder why I spelled ASPIRIN as ASPIRING, Its side effect is OTOTOXICITY [ CN VIII ] that leads to TINNITUS or ringing of the ears.
21. In what level of prevention does the nurse encourage optimal health and increases person’s susceptibility to illness?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
Rationale:The nurse never increases the person’s susceptibility to illness but rather, LESSEN the person’s susceptibility to illness.
22. Also known as HEALTH MAINTENANCE prevention.
A. Primary
B. Secondary
C. Tertiary
D. None of the above
Rationale:Secondary prevention is also known as HEALTH MAINTENANCE Prevention. Here, The person feels signs and symptoms and seeks Diagnosis and treatment in order to prevent deblitating complications. Even if the person feels healthy, We are required to MAINTAIN our health by monthly check ups, Physical examinations, Diagnostics etc.
23. PPD In occupational health nursing is what type of prevention?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
Rationale:PPD or PERSONAL PROTECTIVE DEVICES are worn by the workes in a hazardous environment to protect them from injuries and hazards. This is considered as a PRIMARY prevention because the nurse prevents occurence of diseases and injuries.
24. BCG in community health nursing is what type of prevention?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
25. A regular pap smear for woman every 3 years after establishing normal pap smear for 3 consecutive years Is advocated. What level of prevention does this belongs?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
26. Self monitoring of blood glucose for diabetic clients is on what level of prevention?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
27. Which is the best way to disseminate information to the public?
A. Newspaper
B. School bulletins
C. Community bill boards
D. Radio and Television
Rationale:An actual board question, The best way to disseminate information to the public is by TELEVISION followed by RADIO. This is how the DOH establish its IEC Programs other than publising posters, leaflets and brochures. An emerging new way to disseminate is through the internet.
28. Who conceptualized health as integration of parts and subparts of an individual?
A. Newman
B. Neuman
C. Watson
D. Rogers
Rationale:The supra and subsystems are theories of Martha Rogers but the parts and subparts are Betty Neuman’s. She stated that HEALTH is a state where in all parts and subparts of an individual are in harmony with the whole system. Margarex Newman defined health as an EXPANDING CONSCIOUSNESS. Her name is Margaret not Margarex, I just used that to help you remember her theory of health.
29. The following are concept of health:
1. Health is a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity.
2. Health is the ability to maintain balance
3. Health is the ability to maintain internal milieu
4. Health is integration of all parts and subparts of an individual
A. 1,2,3
B. 1,3,4
C. 2,3,4
D. 1,2,3,4
Rationale:All of the following are correct statement about health. The first one is the definition by WHO, The second one is from Walter Cannon’s homeostasis theory. Third one is from Claude Bernard’s concept of Health as Internal Milieu and the last one is Neuman’s Theory.
30. The theorist the advocated that health is the ability to maintain dynamic equilibrium is
A. Bernard
B. Selye
C. Cannon
D. Rogers
Rationale:Walter Cannon advocated health as HOMEOSTASIS or the ability to maintain dynamic equilibrium. Hans Selye postulated Concepts about Stress and Adaptation. Bernard defined health as the ability to maintain internal milieu and Rogers defined Health as Wellness that is influenced by individual’s culture.
31. Excessive alcohol intake is what type of risk factor?
A. Genetics
B. Age
C. Environment
D. Lifestyle
32. Osteoporosis and degenerative diseases like Osteoarthritis belongs to what type of risk factor?
A. Genetics
B. Age
C. Environment
D. Lifestyle
33. Also known as STERILE TECHNIQUE
A. Surgical Asepsis
B. Medical Asepsis
C. Sepsis
D. Asepsis
Rationale:Surgical Asepsis is also known as STERILE TECHNIQUE while Medical Asepsis is synonymous with CLEAN TECHNIQUE.
34. This is a person or animal, who is without signs of illness but harbors pathogen within his body and can be transferred to another
A. Host
B. Agent
C. Environment
D. Carrier
35. Refers to a person or animal, known or believed to have been exposed to a disease.
A. Carrier
B. Contact
C. Agent
D. Host
36. A substance usually intended for use on inanimate objects, that destroys pathogens but not the spores.
A. Sterilization
B. Disinfectant
C. Antiseptic
D. Autoclave
Rationale:Disinfectants are used on inanimate objects while Antiseptics are intended for use on persons and other living things. Both can kill and inhibit growth of microorganism but cannot kill their spores. That is when autoclaving or steam under pressure gets in, Autoclaving can kill almost ALL type of microoganism including their spores.
37. This is a process of removing pathogens but not their spores
A. Sterilization
B. Auto claving
C. Disinfection
D. Medical asepsis
Rationale:Both A and B are capable on killing spores. Autoclaving is a form of Sterilization. Medical Asepsis is a PRACTICE designed to minimize or reduce the transfer of pathogens, also known as your CLEAN TECHNIQUE. Disinfection is the PROCESS of removing pathogens but not their spores.
38. The third period of infectious processes characterized by development of specific signs and symptoms
A. Incubation period
B. Prodromal period
C. Illness period
D. Convalescent period
Rationale:In incubation period, The disease has been introduced to the body but no sign and symptom appear because the pathogen is not yet strong enough to cause it and may still need to multiply. The second period is called prodromal period. This is when the appearance of non specific signs and symptoms sets in, This is when the sign and symptoms starts to appear. Illness period is characterized by the appearance of specific signs and symptoms or refer tp as time with the greatest symptom experience. Acme is the PEAK of illness intensity while the convalescent period is characterized by the abatement of the disease process or it’s gradual disappearance.
39. A child with measles developed fever and general weakness after being exposed to another child with rubella. In what stage of infectious process does this child belongs?
A. Incubation period
B. Prodromal period
C. Illness period
D. Convalescent period
Rationale:To be able to categorize MEASLES in the Illness period, the specific signs of Fever, Koplik’s Spot and Rashes must appear. In the situation above, Only general signs and symptoms appeared and the Specific signs and symptoms is yet to appear, therefore, the illness is still in the Prodromal period. Signs and symptoms of measles during the prodromal phase are Fever, fatigue, runny nose, cough and conjunctivitis. Koplik’s spot heralds the Illness period and cough is the last symptom to disappear. All of this processes take place in 10 days that is why, Measles is also known as 10 day measles.
40. A 50 year old mailman carried a mail with anthrax powder in it. A minute after exposure, he still hasn’t developed any signs and symptoms of anthrax. In what stage of infectious process does this man belongs?
A. Incubation period
B. Prodromal period
C. Illness period
D. Convalescent period
Rationale:Anthrax can have an incubation period of hours to 7 days with an average of 48 hours. Since the question stated exposure, we can now assume that the mailman is in the incubation period.
41. Considered as the WEAKEST LINK in the chain of infection that nurses can manipulate to prevent spread of infection and diseases
A. Etiologic/Infectious agent
B. Portal of Entry
C. Susceptible host
D. Mode of transmission
Rationale:Mode of transmission is the weakest link in the chain of infection. It is easily manipulated by the Nurses using the tiers of prevention, either by instituting transmission based precautions, Universal precaution or Isolation techniques.
42. Which of the following is the exact order of the infection chain?
1. Susceptible host
2. Portal of entry
3. Portal of exit
4. Etiologic agent
5. Reservoir
6. Mode of transmission
A. 1,2,3,4,5,6
B. 5,4,2,3,6,1
C. 4,5,3,6,2,1
D. 6,5,4,3,2,1
Rationale:Chain of infection starts with the SOURCE : The etiologic agent itself. It will first proliferate on a RESERVOIR and will need a PORTAL OF EXIT to be able to TRANSMIT irslef using a PORTAL OF ENTRY to a SUSCEPTIBLE HOST. A simple way to understand the process is by looking at the lives of a young queen ant that is starting to build her colony. Imagine the QUEEN ANT as a SOURCE or the ETIOLOGIC AGENT. She first need to build a COLONY, OR the RESERVOIR where she will start to lay the first eggs to be able to produce her worker ants and soldier ants to be able to defend and sustain the new colony. They need to EXIT [PORTAL OF EXIT] their colony and crawl [MODE OF TRANSMISSION] in search of foods by ENTERING / INVADING [PORTAL OF ENTRY] our HOUSE [SUSCEPTIBLE HOST]. By imagining the Ant’s life cycle, we can easily arrange the chain of infection.
43. Markee, A 15 year old high school student asked you. What is the mode of transmission of Lyme disease. You correctly answered him that Lyme disease is transmitted via
A. Direct contact transmission
B. Vehicle borne transmission
C. Air borne transmission
D. Vector borne transmission
Rationale:Lyme disease is caused by Borrelia Burdorferi and is transmitted by a TICK BITE.
44. The ability of the infectious agent to cause a disease primarily depends on all of the following except
A. Pathogenicity
B. Virulence
C. Invasiveness
D. Non Specificity
Rationale:To be able to cause a disease, A pathogen should have a TARGET ORGAN/S. The pathogen should be specific to these organs to cause an infection. Mycobacterium Avium is NON SPECIFIC to human organs and therefore, not infective to humans but deadly to birds. An immunocompromised individual, specially AIDS Patient, could be infected with these NON SPECIFIC diseases due to impaired immune system.
45. Contact transmission of infectious organism in the hospital is usually cause by
A. Urinary catheterization
B. Spread from patient to patient
C. Spread by cross contamination via hands of caregiver
D. Cause by unclean instruments used by doctors and nurses
Rationale:The hands of the caregiver like nurses, is the main cause of cross contamination in hospital setting. That is why HANDWASHING is the single most important procedure to prevent the occurence of cross contamination and nosocomial infection. D refers to Nosocomial infection and UTI is the most common noscomial infection in the hospital caused by urinary catheterization. E.Coli seems to be the major cause of this incident. B best fits Cross Contamination, It is the spread of microogranisms from patient o patient.
46. Transmission occurs when an infected person sneezes, coughs or laugh that is usually projected at a distance of 3 feet.
A. Droplet transmission
B. Airborne transmission
C. Vehicle transmission
D. Vector borne transmission
47. Considered as the first line of defense of the body against infection
A. Skin
B. WBC
C. Leukocytes
D. Immunization
Rationale:Remember that intact skin and mucus membrane is our first line of defense against infection.
48. All of the following contributes to host susceptibility except
A. Creed
B. Immunization
C. Current medication being taken
D. Color of the skin
Rationale:Creed, Faith or religious belief do not affect person’s susceptibility to illness. Medication like corticosteroids could supress a person’s immune system that will lead to increase susceptibility. Color of the skin could affect person’s susceptibility to certain skin diseases. A dark skinned person has lower risk of skin cancer than a fair skinned person. Fair skinned person also has a higher risk for cholecystitis and cholelithiasis.
49. Graciel has been injected TT5, her last dosed for tetanus toxoid immunization. Graciel asked you, what type of immunity is TT Injections? You correctly answer her by saying Tetanus toxoid immunization is a/an
A. Natural active immunity
B. Natural passive immunity
C. Artificial active immunity
D. Artificial passive immunity
Rationale:TT1 ti TT2 are considered the primary dose, while TT3 to TT5 are the booster dose. A woman with completed immunization of DPT need not receive TT1 and TT2. Tetanus toxoid is the actual toxin produce by clostridium tetani but on its WEAK and INACTIVATED form. It is Artificial because it did not occur in the course of actual illness or infection, it is Active because what has been passed is an actual toxin and not a ready made immunoglobulin.
50. Agatha, was hacked and slashed by a psychotic man while she was crossing the railway. She suffered multiple injuries and was injected Tetanus toxoid Immunoglobulin. Agatha asked you, What immunity does TTIg provides? You best answered her by saying TTIg provides
A. Natural active immunity
B. Natural passive immunity
C. Artificial active immunity
D. Artificial passive immunity
Rationale:In this scenario, Agatha was already wounded and has injuries. Giving the toxin [TT Vaccine] itself would not help Agatha because it will take time before the immune system produce antitoxin. What agatha needs now is a ready made anti toxin in the form of ATS or TTIg. This is artificial, because the body of agatha did not produce it. It is passive because her immune system is not stimulated but rather, a ready made Immune globulin is given to immediately supress the invasion.
51. This is the single most important procedure that prevents cross contamination and infection
A. Cleaning
B. Disinfecting
C. Sterilizing
D. Handwashing
Rationale:When you see the word HANDWASHING as one of the options, 90% Chance it is the correct answer in the local board. Or should I say, 100% because I have yet to see question from 1988 to 2005 board questions that has option HANDWASHING on it but is not the correct answer.
52. This is considered as the most important aspect of handwashing
A. Time
B. Friction
C. Water
D. Soap
Rationale:The most important aspect of handwashing is FRICTION. The rest, will just enhance friction. The use of soap lowers the surface tension thereby increasing the effectiveness of friction. Water helps remove transient bacteria by working with soap to create the lather that reduces surface tension. Time is of essence but friction is the most essential aspect of handwashing.
53. In handwashing by medical asepsis, Hands are held ….
A. Above the elbow, The hands must always be above the waist
B. Above the elbow, The hands are cleaner than the elbow
C. Below the elbow, Medical asepsis do not require hands to be above the waist
D. Below the elbow, Hands are dirtier than the lower arms
Rationale:Hands are held BELOW the elbow in medical asepsis in contrast with surgical asepsis, wherein, nurses are required to keep the hands above the waist. The rationale is because in medical asepsis, Hands are considered dirtier than the elbow and therefore, to limit contamination of the lower arm, The hands should always be below the elbow.
54. The suggested time per hand on handwashing using the time method is
A. 5 to 10 seconds each hand
B. 10 to 15 seconds each hand
C. 15 to 30 seconds each hand
D. 30 to 60 seconds each hand
Rationale:Each hands requires atleast 15 to 30 seconds of handwashing to effectively remove transient microorganisms.
55. The minimum time in washing each hand should never be below
A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 30 seconds
Rationale:According to Kozier, The minimum time required for watching each hands is 10 seconds and should not be lower than that. The recommended time, again, is 15 to 30 seconds.
56. How many ml of liquid soap is recommended for handwashing procedure?
A. 1-2 ml
B. 2-3 ml
C. 2-4 ml
D. 5-10 ml
Rationale:If a liquid soap is to be used, 1 tsp [ 5ml ] of liquid soap is recommended for handwashing procedure.
57. Which of the following is not true about sterilization, cleaning and disinfection?
A. Equipment with small lumen are easier to clean
B. Sterilization is the complete destruction of all viable microorganism including spores
C. Some organism are easily destroyed, while other, with coagulated protein requires longer time
D. The number of organism is directly proportional to the length of time required for sterilization
Rationale:Equipments with LARGE LUMEN are easier to clean than those with small lumen. B C and D are all correct.
58. Karlita asked you, How long should she boil her glass baby bottle in water? You correctly answered her by saying
A. The minimum time for boiling articles is 5 minutes
B. Boil the glass baby bottler and other articles for atleast 10 minutes
C. For boiling to be effective, a minimum of 15 minutes is required
D. It doesn’t matter how long you boil the articles, as long as the water reached 100 degree Celsius
Rationale:Boiling is the most common and least expensive method of sterilization used in home. For it to be effective, you should boil articles for atleast 15 minutes.
59. This type of disinfection is best done in sterilizing drugs, foods and other things that are required to be sterilized before taken in by the human body
A. Boiling Water
B. Gas sterilization
C. Steam under pressure
D. Radiation
Rationale:Imagine foods and drugs that are being sterilized by a boiling water, ethylene oxide gas and autoclave or steam under pressure, They will be inactivated by these methods. Ethylene oxide gas used in gas sterlization is TOXIC to humans. Boiling the food will alter its consistency and nutrients. Autoclaving the food is never performed. Radiation using microwave oven or Ionizing radiation penetrates to foods and drugs thus, sterilizing them.
60. A TB patient was discharged in the hospital. A UV Lamp was placed in the room where he stayed for a week. What type of disinfection is this?
A. Concurrent disinfection
B. Terminal disinfection
C. Regular disinfection
D. Routine disinfection
Rationale:Terminal disinfection refers to practices to remove pathogens that stayed in the belongings or immediate environemnt of an infected client who has been discharged. An example would be Killing airborne TB Bacilli using UV Light. Concurrent disinfection refers to ongoing efforts implented during the client’s stay to remove or limit pathogens in his supplies, belongings, immediate environment in order to control the spread of the disease. An example is cleaning the bedside commode of a client with radium implant on her cervix with a bleach disinfectant after each voiding.
61. Which of the following is not true in implementing medical asepsis
A. Wash hand before and after patient contact
B. Keep soiled linens from touching the clothings
C. Shake the linens to remove dust
D. Practice good hygiene
Rationale:NEVER shake the linens. Once soiled, fold it inwards clean surface out. Shaking the linen will further spread pathogens that has been harbored by the fabric.
62. Which of the following is true about autoclaving or steam under pressure?
A. All kinds of microorganism and their spores are destroyed by autoclave machine
B. The autoclaved instruments can be used for 1 month considering the bags are still intact
C. The instruments are put into unlocked position, on their hinge, during the autoclave
D. Autoclaving different kinds of metals at one time is advisable
Rationale:Only C is correct. Metals with locks, like clamps and scissors should be UNLOCKED in order to minimize stiffening caused by autoclave to the hinges of these metals. NOT ALL microorganism are destroyed by autoclaving. There are recently discovered microorganism that is invulnarable to extreme heat. Autoclaved instruments are to be used within 2 weeks. Only the same type of metals should be autoclaved as this will alteration in plating of these metals.
63. Which of the following is true about masks?
A. Mask should only cover the nose
B. Mask functions better if they are wet with alcohol
C. Masks can provide durable protection even when worn for a long time and after each and every patient care
D. N95 Mask or particulate masks can filter organism as mall as 1 micromillimeter
Rationale:only D is correct. Mask should cover both nose and mouth. Masks will not function optimally when wet. Masks should be worn not greater than 4 hours, as it will lose effectiveness after 4 hours. N95 mask or particulate mask can filter organism as small as 1 micromillimeter.
64. Where should you put a wet adult diaper?
A. Green trashcan
B. Black trashcan
C. Orange trashcan
D. Yellow trashcan
Rationale:Infectious waste like blood and blood products, wet diapers and dressings are thrown in yellow trashcans.
65. Needles, scalpels, broken glass and lancets are considered as injurious wastes. As a nurse, it is correct to put them at disposal via a/an
A. Puncture proof container
B. Reused PET Bottles
C. Black trashcan
D. Yellow trashcan with a tag “INJURIOUS WASTES”
Rationale:Needles, scalpels and other sharps are to be disposed in a puncture proof container.
66. Miranda Priestly, An executive of RAMP magazine, was diagnosed with cancer of the cervix. You noticed that the radioactive internal implant protrudes to her vagina where supposedly, it should be in her cervix. What should be your initial action?
A. Using a long forceps, Push it back towards the cervix then call the physician
B. Wear gloves, remove it gently and place it on a lead container
C. Using a long forceps, Remove it and place it on a lead container
D. Call the physician, You are not allowed to touch, re insert or remove it
Rationale:A dislodged radioactive cervical implant in brachytherapy are to be picked by a LONG FORCEP and stored in a LEAD CONTAINER in order to prevent damage on the client’s normal tissue. Calling the physician is the second most appropriate action among the choices. A nurse should never attempt to put it back nor, touch it with her bare hands.
67. After leech therapy, Where should you put the leeches?
A. In specially marked BIO HAZARD Containers
B. Yellow trashcan
C. Black trashcan
D. Leeches are brought back to the culture room, they are not thrown away for they are reusable
Rationale:Leeches, in leech therapy or LEECH PHLEBOTOMY are to be disposed on a BIO HAZARD container. They are never re used as this could cause transfer of infection. These leeches are hospital grown and not the usual leeches found in swamps.
68. Which of the following should the nurse AVOID doing in preventing spread of infection?
A. Recapping the needle before disposal to prevent injuries
B. Never pointing a needle towards a body part
C. Using only Standard precaution to AIDS Patients
D. Do not give fresh and uncooked fruits and vegetables to Mr. Gatchie, with Neutropenia
Rationale:Never recap needles. They are directly disposed in a puncture proof container after used. Recapping the needles could cause injury to the nurse and spread of infection. B C and D are all appropriate. Standard precaution is sufficient for an HIV patient. A client with neutropenia are not given fresh and uncooked fruits and vegetables for even the non infective organisms found in these foods could cause severe infection on an immunocompromised patients.
69. Where should you put Mr. Alejar, with Category II TB?
A. In a room with positive air pressure and atleast 3 air exchanges an hour
B. In a room with positive air pressure and atleast 6 air exchanges an hour
C. In a room with negative air pressure and atleast 3 air exchanges an hour
D. In a room with negative air pressure and atleast 6 air exchanges an hour
Rationale:TB patients should have a private room with negative air pressure and atleast 6 to 12 air exhanges per hour. Negative pressure room will prevent air inside the room from escaping. Air exchanges are necessary since the client’s room do not allow air to get out of the room.
70. A client has been diagnosed with RUBELLA. What precaution is used for this patient?
A. Standard precaution
B. Airborne precaution
C. Droplet precaution
D. Contact precaution
Rationale:Droplet precaution is sufficient on client’s with RUBELLA or german measles.
71. A client has been diagnosed with MEASLES. What precaution is used for this patient?
A. Standard precaution
B. Airborne precaution
C. Droplet precaution
D. Contact precaution
Rationale:Measles is highly communicable and more contagious than Rubella, It requires airborne precaution as it is spread by small particle droplets that remains suspended in air and disperesed by air movements.
72. A client has been diagnosed with IMPETIGO. What precaution is used for this patient?
A. Standard precaution
B. Airborne precaution
C. Droplet precaution
D. Contact precaution
Rationale:Impetigo causes blisters or sores in the skin. It is generally caused by GABS or Staph Aureaus. It is spread by skin to skin contact or by scratching the lesions and touching another person’s skin.
73. The nurse is to insert an NG Tube when suddenly, she accidentally dip the end of the tube in the client’s glass containing distilled drinking water which is definitely not sterile. As a nurse, what should you do?
A. Don’t mind the incident, continue to insert the NG Tube
B. Obtain a new NG Tube for the client
C. Disinfect the NG Tube before reinserting it again
D. Ask your senior nurse what to do
Rationale:The digestive tract is not sterile, and therefore, simple errors like this would not cause harm to the patient. NGT tube need not be sterile, and so is colostomy and rectal tubes. Clean technique is sufficient during NGT and colostomy care.
74. All of the following are principle of SURGICAL ASEPSIS except
A. Microorganism travels to moist surfaces faster than with dry surfaces
B. When in doubt about the sterility of an object, consider it not sterile
C. Once the skin has been sterilized, considered it sterile
D. If you can reach the object by overreaching, just move around the sterile field to pick it rather than reaching for it
Rationale:Human skin is impossible to be sterilized. It contains normal flora of microorganism. A B and D are all correct.
75. Which of the following is true in SURGICAL ASEPSIS?
A. Autoclaved linens and gowns are considered sterile for about 4 months as long as the bagging is intact
B. Surgical technique is a sole effort of each nurse
C. Sterile conscience, is the best method to enhance sterile technique
D. If a scrubbed person leaves the area of the sterile field, He/she must do handwashing and gloving again, but the gown need not be changed.
Rationale:Sterile conscience, or the moral imperative of a nurse to be honest in practicing sterile technique, is the best method to enhance sterile technique. Autoclaved linens are considered sterile only within 2 weeks even if the bagging is intact. Surgical technique is a team effort of each nurse. If a scrubbed person leave the sterile field and area, he must do the process all over again.
76. In putting sterile gloves, Which should be gloved first?
A. The dominant hand
B. The non dominant hand
C. The left hand
D. No specific order, Its up to the nurse for her own convenience
Rationale:Gloves are put on the non dominant hands first and then, the dominant hand. The rationale is simply because humans tend to use the dominant hand first before the non dominant hand. Out of 10 humans that will put on their sterile gloves, 8 of them will put the gloves on their non dominant hands first.
77. As the scrubbed nurse, when should you apply the goggles, shoe cap and mask prior to the operation?
A. Immediately after entering the sterile field
B. After surgical hand scrub
C. Before surgical hand scrub
D. Before entering the sterile field
Rationale:The nurse should put his goggles, cap and mask prior to washing the hands. If he wash his hands prior to putting all these equipments, he must wash his hands again as these equipments are said to be UNSTERILE.
78. Which of the following should the nurse do when applying gloves prior to a surgical procedure?
A. Slipping gloved hand with all fingers when picking up the second glove
B. Grasping the first glove by inserting four fingers, with thumbs up underneath the cuff
C. Putting the gloves into the dominant hand first
D. Adjust only the fitting of the gloves after both gloves are on
Rationale:The nurse should only adjust fitting of the gloves when they are both on the hands. Not doing so will break the sterile technique. Only 4 gingers are slipped when picking up the second gloves. You cannot slip all of your fingers as the cuff is limited and the thumb would not be able to enter the cuff. The first glove is grasp by simply picking it up with the first 2 fingers and a thumb in a pinching motion. Gloves are put on the non dominant hands first.
79. Which gloves should you remove first?
A. The glove of the non dominant hand
B. The glove of the dominant hand
C. The glove of the left hand
D. Order in removing the gloves Is unnecessary
Rationale:Gloves are worn in the non dominant hand first, and is removed also from the non dominant hand first. Rationale is simply because in 10 people removing gloves, 8 of them will use the dominant hand first and remove the gloves of the non dominant hand.
80. Before a surgical procedure, Give the sequence on applying the protective items listed below
1. Eye wear or goggles
2. Cap
3. Mask
4. Gloves
5. Gown
A. 3,2,1,5,4
B. 3,2,1,4,5
C. 2,3,1,5,4
D. 2,3,1,4,5
Rationale:The nurse should use CaMEy Hand and Body Lotion in moisturizing his hand before surgical procedure and after handwashing. Ca stands for CAP, M stands for MASK, Ey stands for eye goggles. The nurse will do handwashing and then [HAND], Don the gloves first and wear the Gown [BODY]. I created this mnemonic and I advise you use it because you can never forget Camey hand and body lotion. [ Yes, I know it is spelled as CAMAY ]]
81. In removing protective devices, which should be the exact sequence?
1. Eye wear or goggles
2. Cap
3. Mask
4. Gloves
5. Gown
A. 4,3,5,1,2
B. 2,3,1,5,4
C. 5,4,3,2,1
D. 1,2,3,4,5
Rationale:When the nurse is about to remove his protective devices, The nurse will remove the GLOVES first followed by the MASK and GOWN then, other devices like cap, shoe cover, etc. This is to prevent contamination of hair, neck and face area.
82. In pouring a plain NSS into a receptacle located in a sterile field, how high should the nurse hold the bottle above the receptacle?
A. 1 inch
B. 3 inches
C. 6 inches
D. 10 inches
Rationale:Even if you do not know the answer to this question, you can answer it correctly by imagining. If you pour the NSS into a receptacle 1 to 3 inch above it, Chances are, The mouth of the NSS bottle would dip into the receptacle as you fill it, making it contaminated. If you pour the NSS bottle into a receptacle 10 inches above it, that is too high, chances are, as you pour the NSS, most will spill out because the force will be too much for the buoyant force to handle. It will also be difficult to pour something precisely into a receptacle as the height increases between the receptacle and the bottle. 6 inches is the correct answer. It is not to low nor too high.
83. The tip of the sterile forceps is considered sterile. It is used to manipulate the objects in the sterile field using the non sterile hands. How should the nurse hold a sterile forceps?
A. The tip should always be lower than the handle
B. The tip should always be above the handle
C. The handle and the tip should be at the same level
D. The handle should point downward and the tip, always upward
Rationale:A sterile forcep is usually dipped into a disinfectant or germicidal solution. Imagine, if the tip is HIGHER than the handle, the solution will go into the handle and into your hands and as you use the forcep, you will eventually lower its tip making the solution in your hand go BACK into the tip thus contaminating the sterile area of the forcep. To prevent this, the tip should always be lower than the handle. In situation questions like this, IMAGINATION is very important.
84. The nurse enters the room of the client on airborne precaution due to tuberculosis. Which of the following are appropriate actions by the nurse?
1. She wears mask, covering the nose and mouth
2. She washes her hands before and after removing gloves, after suctioning the client’s secretion
3. She removes gloves and hands before leaving the client’s room
4. She discards contaminated suction catheter tip in trashcan found in the clients room
A. 1,2
B. 1,2,3
C. 1,2,3,4
D. 1,3
Rationale:All soiled equipments use in an infectious client are disposed INSIDE the client’s room to prevent contamination outside the client’s room. The nurse is correct in using Mask the covers both nose and mouth. Hands are washed before and after removing the gloves and before and after you enter the client’s room. Gloves and contaminated suction tip are thrown in trashcan found in the clients room.
85. When performing surgical hand scrub, which of the following nursing action is required to prevent contamination?
1. Keep fingernail short, clean and with nail polish
2. Open faucet with knee or foot control
3. Keep hands above the elbow when washing and rinsing
4. Wear cap, mask, shoe cover after you scrubbed
A. 1,2
B. 2,3
C. 1,2,3
D. 2,3,4
Rationale:Cap, mask and shoe cover are worn BEFORE scrubbing.
86. When removing gloves, which of the following is an inappropriate nursing action?
A. Wash gloved hand first
B. Peel off gloves inside out
C. Use glove to glove skin to skin technique
D. Remove mask and gown before removing gloves
Rationale:Gloves are the dirtiest protective item nurses are wearing and therefore, the first to be removed to prevent spread of microorganism as you remove the mask and gown.
87. Which of the following is TRUE in the concept of stress?
A. Stress is not always present in diseases and illnesses
B. Stress are only psychological and manifests psychological symptoms
C. All stressors evoke common adaptive response
D. Hemostasis refers to the dynamic state of equilibrium
Rationale:All stressors evoke common adaptive response. A psychologic fear like nightmare and a real fear or real perceive threat evokes common manifestation like tachycardia, tachypnea, sweating, increase muscle tension etc. ALL diseases and illness causes stress. Stress can be both REAL or IMAGINARY. Hemostasis refers to the ARREST of blood flowing abnormally through a damage vessel. Homeostasis is the one that refers to dynamic state of equilibrium according to Walter Cannon.
88. According to this theorist, in his modern stress theory, Stress is the non specific response of the body to any demand made upon it.
A. Hans Selye
B. Walter Cannon
C. Claude Bernard
D. Martha Rogers
Rationale:Hans Selye is the only theorist who proposed an intriguing theory about stress that has been widely used and accepted by professionals today. He conceptualized two types of human response to stress, The GAS or general adaptation syndrome which is characterized by stages of ALARM, RESISTANCE and EXHAUSTION. The Local adaptation syndrome controls stress through a particular body part. Example is when you have been wounded in your finger, it will produce PAIN to let you know that you should protect that particular damaged area, it will also produce inflammation to limit and control the spread of injury and facilitate healing process. Another example is when you are frequently lifting heavy objects, eventually, you arm, back and leg muscles hypertorphies to adapt to the stress of heavy lifting.
89. Which of the following is NOT TRUE with regards to the concept of Modern Stress Theory?
A. Stress is not a nervous energy
B. Man, whenever he encounters stresses, always adapts to it
C. Stress is not always something to be avoided
D. Stress does not always lead to distress
Rationale:Man, do not always adapt to stress. Sometimes, stress can lead to exhaustion and eventually, death. A,C and D are all correct.
90. Which of the following is TRUE with regards to the concept of Modern Stress Theory?
A. Stress is essential
B. Man does not encounter stress if he is asleep
C. A single stress can cause a disease
D. Stress always leads to distress
Rationale:Stress is ESSENTIAL. No man can live normally without stress. It is essential because it is evoked by the body’s normal pattern of response and leads to a favorable adaptive mechanism that are utilized in the future when more stressors are encountered by the body. Man can encounter stress even while asleep, example is nightmare. Disease are multifactorial, No diseases are caused by a single stressors. Stress are sometimes favorable and are not always a cause for distress. An example of favorable stress is when a carpenter meets the demand and stress of everyday work. He then develops calluses on the hand to lessen the pressure of the hammer against the tissues of his hand. He also develop larger muscle and more dense bones in the arm, thus, a stress will lead to adaptations to decrease that particular stress.
91. Which of the following is TRUE in the stage of alarm of general adaptation syndrome?
A. Results from the prolonged exposure to stress
B. Levels or resistance is increased
C. Characterized by adaptation
D. Death can ensue
Rationale:Death can ensue as early as the stage of alarm. Exhaustion results to a prolonged exposure to stress. Resistance is when the levels of resistance increases and characterized by being able to adapt.
92. The stage of GAS where the adaptation mechanism begins
A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion
Rationale:Adaptation mechanisms begin in the stage of alarm. This is when the adaptive mechanism are mobilized. When someone shouts SUNOG!!! your heart will begin to beat faster, you vessels constricted and bp increased.
93. Stage of GAS Characterized by adaptation
A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion
94. Stage of GAS wherein, the Level of resistance are decreased
A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion
Rationale:Resistance are decreased in the stage of alarm. Resistance is absent in the stage of exhaustion. Resistance is increased in the stage of resistance.
95. Where in stages of GAS does a person moves back into HOMEOSTASIS?
A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion
96. Stage of GAS that results from prolonged exposure to stress. Here, death will ensue unless extra adaptive mechanisms are utilized
A. Stage of Alarm
B. Stage of Resistance
C. Stage of Homeostasis
D. Stage of Exhaustion
97. All but one is a characteristic of adaptive response
A. This is an attempt to maintain homeostasis
B. There is a totality of response
C. Adaptive response is immediately mobilized, doesn’t require time
D. Response varies from person to person
Rationale:Aside from having limits that leads to exhaustion. Adaptive response requires time for it to act. It requires energy, physical and psychological taxes that needs time for our body to mobilize and utilize.
98. Andy, a newly hired nurse, starts to learn the new technology and electronic devices at the hospital. Which of the following mode of adaptation is Andy experiencing?
A. Biologic/Physiologic adaptive mode
B. Psychologic adaptive mode
C. Sociocultural adaptive mode
D. Technological adaptive mode
99. Andy is not yet fluent in French, but he works in Quebec where majority speaks French. He is starting to learn the language of the people. What type of adaptation is Andy experiencing?
A. Biologic/Physiologic adaptive mode
B. Psychologic adaptive mode
C. Sociocultural adaptive mode
D. Technological adaptive mode
Rationale:Sociocultural adaptive modes include language, communication, dressing, acting and socializing in line with the social and cultural standard of the people around the adapting individual.
100. Andy made an error and his senior nurse issued a written warning. Andy arrived in his house mad and kicked the door hard to shut it off. What adaptation mode is this?
A. Biologic/Physiologic adaptive mode
B. Psychologic adaptive mode
C. Sociocultural adaptive mode
D. Technological adaptive mode
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