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Tuesday, June 30, 2009

DEADLINE IN FILING OF APPLICATIONS FOR THE NOV. 29-30, 2009 NURSES LICENSURE EXAM.

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The PROFESSIONAL REGULATION COMMISSION announces that the filing of applications for the November 29-30, 2009 (Sunday-Monday) NLE Nurses Licensure Examinations is now on-going in the Central Office and in the Regional Offices of PRC.

The following are the deadlines of filing of applications:

1. NEW / FIRST TIMERS - SEPTEMBER 16, 2009

2. REPEATERS - OCTOBER 16, 2009

Applications shall no longer be accepted after these deadlines.


(orig. signed)
NICOLAS P. LAPEÑA, JR.
Chairman

SOURCE: http://www.prc.gov.ph/articles.asp?sid=4&aid=3153




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Friday, June 26, 2009

CGFNS phone lines are busy

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CGFNS International places a high priority on ensuring that applicants have a thorough understanding of the application process in order to make well-informed decisions. However, due to the high volume of calls we receive, our phone lines have been extremely busy. The CGFNS Call Center is open Monday through Friday, 8am to noon U.S. Eastern Time.

When you telephone us, typically your call will be answered by an operator who will ask how to direct your call. The operator will direct your call to the appropriate service people to answer your questions.

Please understand that the operator may not know the answers to your questions, they are just directing your call. Please tell the operator which service you are inquiring about, the Credentials Evaluation Service, the Credentials Verification Service for New York State, VisaScreen® or the Certification Program (with the CGFNS Qualifiying ExamSM). If you are calling about the International Consultants of Delaware, please call between 12:30pm and 3:30pm U.S. Eastern Time.

If you haven’t applied for a service and are calling to find out which service you need to apply for, please be advised that it will depend on the U.S. state where you are going to practice. Contact the state board of that particular state to find out which of our services they require.

Once the operator transfers you to the extension for your particular service, you will be placed in a queue and there may be calls ahead of you. There will be a recording of tips to find information other than phoning, but know that your call will be answered by a human being, so we kindly ask for your patience.

We want your application process to be pleasant. Here are some hints that may help you obtain the service you need: Make use of our 24-hour automated phone service, +1 (215) 599 6200, to verify receipt of documentation and examination scores, confirm application status and access other information. Have your CGFNS ID number and birth date ready.

Make use of the many resources on our Web site, including applications, forms and using the online application system CERPASS. In addition, check out our FAQ section under Tools for answers to questions on specific subjects.

Plan your calls. We experience peak call volumes on Mondays and on the first two business days of each month. Call on another day or at another time, if possible. Phone lines for CGFNS are open 8am to noon Monday through Friday, U.S. Eastern Time.

Make an appointment. You may call +1 (215) 222 8454 to schedule a 30-minute appointment, on Wednesdays between 10am and 2pm, U.S. Eastern Time, in our office in Philadelphia.

Keep us informed of any address changes.

Send us a message! Use the Contact Us form on the Web site. Please do not use the Online store, we cannot answer application questions through the store.



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Thursday, June 25, 2009

Nursing Skills: Medication Through Saline Lock (Videos)

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Wednesday, June 24, 2009

Current and projected nurse shortage indicators

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On March 6, 2009, the U.S. Bureau of Labor Statistics reported that the health care sector of the American economy is continuing to grow, despite steep job losses in nearly all major industries. Hospitals, long-term care facilities and other ambulatory care settings added 27,000 new jobs in February 2009, a month when 681,000 jobs were eliminated nationwide. As the largest segment of the health care workforce, nurses will likely be recruited fill a large portion of these new positions.







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VisaScreen Renewal

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VisaScreen® certificate holders who have not changed their status or obtained a permanent U.S. visa are required to renew their certificates within five years of the issue date. VisaScreen® renewal certificate applicants should begin the process six months before their current certificate expires. The renewal fee is $250 USD.

The renewal application is available for download at http://www.cgfns.org/files/pdf/apps/VisaScreenReApp.pdf or applicants may apply online.



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Tuesday, June 23, 2009

CGFNS Qualifying Exam Schedule

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The CGFNS Qualifying ExamSM tests your nursing knowledge/understanding as it is taught and practiced in the United States. The exam uses objective, multiple-choice and alternate item type questions designed by testing experts to help predict your
likelihood of passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) examination.

AMA Computer University
Maximina St. Villa Arca Subdivision, Project 8
Quezon City
Philippines 1100
Test Taker Instructions
--------------------------------------------------------------------------------

MISNET EDUCATION Inc._Cebu City
#65 General Maxilom Avenue
5/F Ongtiak Business Center
Cebu City
Philippines 6000
Test Taker Instructions
--------------------------------------------------------------------------------

MISNET EDUCATION Inc._Makati City
121 Valero Street
24/F Antel 2000 Bldg, Salcedo Village Unit 2201
Makati City
Philippines 1227
Test Taker Instructions

http://www.kryteriononline.com/host_locations/index.asp

For more information visit http://www.cgfns.org/sections/programs/cp/cp-qe.shtml



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Monday, June 22, 2009

Immigration debate continues in the United States

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Although several bills have been circulated, the U.S. Congress has thus far failed to enact new immigration legislation. This leaves nurses and health care workers with little or no opportunity
to enter the United States on occupational visas.

According to the proposed Nursing Relief Act of 2009, which cites a Department of Labour report, the current nursing shortage in the United States exceeds 126,000.

Meanwhile, Russel Ford, posting on the Global Immigration Counsel Web site, reports that Representatives John Shadegg (R-AZ), Jeff Flake (R-AZ) and Ed Pastor (D-AZ) have sponsored legislation to create a new nonimmigrant visa category for professional nurses called the “W” visa. The proposed legislation reflects the view that current immigration laws do not adequately address the need for qualified nurses in that country and do not provide an adequate visa category and/or quota to help alleviate this need.

Ford reports that “The Nursing Relief Act of 2009 seeks to… provide the health care industry with the ability to overcome this shortage by recruiting, hiring, employing and retaining qualified nurses regardless of their country of citizenship.”

The Web site also reports that in a separate bill, Senators Dick Durbin (D-IL) and Chuck Grassley (R-IA) plan to reintroduce legislation that would require employers to make a good faith effort to hire U.S. citizens over H-1B visa holders.

Computerworld.com reports the two senators introduced a similar bill in March 2007, but that bill died after being folded into a comprehensive immigration reform bill that did not go up for a vote.

The 2007 bill would have required employers to advertise job openings for 30 days before submitting H-1B applications for those positions. The bill also sought to prevent employers from hiring H-1B workers and then outsourcing them to other companies. The widespread layoffs being caused by the economic downturn may increase the chances of success for a new bill.

Earlier in 2009, Grassley and Sen. Bernie Sanders (I-VT) succeeded at getting H-1B hiring restrictions on financial services firms receiving federal bailout money into the economic stimulus
package.

Sources: Ford R, “Proposed Nonimmigrant Visa Category for
Professional Nurses Would Fix the Shortage of Qualified Nurses” Global
Immigration Counsel Web site, accessed 21 April 2009 http://www.
globalimmigrationcounsel.com/articles/us-immigration/reform-1/



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List of Hospitals Conducting Basic IVT Training

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List of Hospitals Conducting Basic IVT Training



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Sunday, June 21, 2009

What you need to know about H-1B

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Taken from: U.S. Citizenship and Immigration Services http://www.uscis.gov/h-1b_count

What is a ‘Cap’?
The word ‘cap’ used in this update refers to annual numerical limitations set by Congress on
certain nonimmigrant visa classifications, eg, H-1B and H-2B. Caps control the number of workers
that can be issued a visa in a given fiscal year to enter the United States, pursuant to a particular
nonimmigrant classification. Caps also control the number of aliens already in the United States
that may be authorized to change status to a cap-subject classification.

H-1B
The H-1B visa program is used by some U.S. employers to employ foreign workers in specialty
occupations that require theoretical or technical expertise in a specialized field and a bachelor’s
degree or its equivalent. Typical H-1B occupations include architects, engineers, computer
programmers, accountants, doctors and college professors. The H-1B visa program also includes
certain fashion models of distinguished merit and ability and up to 100 persons who will performing services of an exceptional nature in connection with Department of Defense (DOD) research and development projects or coproduction projects. The current annual cap on the H-1B category is 65,000. Not all H-1B nonimmigrants are subject to this annual cap. Please note that up to 6,800 visas may be set aside from the cap of 65,000 during each fiscal year for the H-1B1 program under the terms of the legislation implementing the U.S.-Chile and U.S.-Singapore Free Trade Agreements. Unused numbers in this pool are made available for H-1B use for the next fiscal year.

H-1B Employer Exemptions
H-1B nonimmigrants who are employed, or who have received an offer of employment, by
institutions of higher education or a related or affiliated nonprofit entity, as well as those employed, or who will be employed, by a nonprofit research organization or a governmental research organization are exempt from the cap.

H-1B Advanced Degree Exemption
The H-1B Visa Reform Act of 2004 makes available 20,000 new H-1B visas for foreign workers
with a Master’s or higher level degree from a U.S. academic institution. For each fiscal year, 20,000 beneficiaries of H-1B petitions on behalf of persons who hold such credentials are statutorily exempted from the cap.



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H-1B applications are below cap for 2010

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For the first time in several years, the cap on H-1B visas was not reached during open enrollment, which started 1 April 2009. By 29 May 2009, the United States Citizenship and Immigration Services (USCIS) announced that it had received 45,800 H-1B petitions counting toward the congressionally mandated 65,000 cap. Enrollment will remain open until that figure is reached. The H-1B is a working visa that allows a U.S. company to employ a non-U.S. citizen
for up to six years. Because applying for a work visa is generally quicker than applying for a U.S. Green Card, staff required on long-term assignments in the United States are often initially brought in using visas such as the H-1B. Health professionals, such as physical therapists, occupational therapists and medical technologists often enter under the H-1B visa. A few baccalaureateprepared nurses who have been recruited for positions that require a degree may be eligible to enter the United States under this category. The USCIS will continue to accept regular cap-subject H-1B petitions until a sufficient number has been received to reach the statutory limits. The H-1B advanced degree exemption (see sidebar) has received the full cap of 20,000 petitions. USCIS continues to accept Masters petitions because not all accepted cases are approvable. The USCIS will continue to accept both cap-subject petitions and advanced
degree petitions. When the USCIS declares that the H-1B visa cap is met, all petitions received on the last day will be subject to a random lottery. Until the USCIS declares that the H-1B visa cap has been met, capsubject H-1B petitions may continue to be filed.

SOURCE: Hammond Law Group, LLC, April 8 2009, Workpermit.com http://www.workpermit.com/us/us_h1b.htm





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Friday, June 19, 2009

Another Filipino nurse in KSA found with A(H1N1)

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MANILA, Philippines — A Filipino nurse in Saudi Arabia was reported to be among the new A(H1N1) cases there, an online news site reported Wednesday.

Khaleej Times reported the Filipino nurse, whose name was withheld, is working at the King Fahd National Guard Hospital in Riyadh.

It said the nurse was among three new cases of A(H1N1) in Riyadh, Dhahran and Madinah.

She had come to the King Khaled International Airport in Riyadh on June 10 on board Cathay Pacific flight 330200 from the Philippines via Bahrain, the report said.

The new cases brought the number of A(H1N1) cases in Saudi Arabia to 14 in the last two weeks.

The kingdom’s first swine flu case was another Filipino nurse who works at the Riyadh’s King Faisal Specialist Hospital and Research Center. Authorities said she has recovered but that she and her family will remain under observation.

The nurse was the latest swine flu case involving passengers originating from the Philippines. On Tuesday, Hong Kong health authorities announced that four Filipinos who returned to Hong Kong from Manila last week have tested positive for the virus.

The Philippine Consulate in Hong Kong also confirmed that the infected Filipinos include a 15-year-old girl and her 8-year-old sister, a 28-year-old domestic helper and a 33-year-old contractual worker, the Philippine Consulate said.

The first case was in May involving Filipino-Japanese siblings who returned to Tokyo and the other one was a Filipina nurse who became Saudi Arabia’s first swine flu case.

In China, four other Filipinos have been placed under quarantine on suspicion that they were carrying the new flu virus after getting into close contact with an infected person.

As of Tuesday, the Philippines leads in Southeast Asia with the highest confirmed cases of A(H1N1). The Department of Health said 247 Filipino nationals have been infected with mild swine flu.

In Saudi Arabia, the new swine flu cases prompted the Cabinet to call for greater international coordination and cooperation among countries and organizations to combat the pandemic.

The Khaleej Times report said the second case was a 13-year-old boy, the brother of a patient already admitted to Saudi Aramco Hospital.

The third case was an eight-month-old girl whose father was diagnosed with the infection and is currently being treated at King Fahd Hospital in Madinah.

Health Ministry spokesman Dr. Khaled Mirghalani said the patients who are already receiving treatment are fast recovering and are in sound health.

“We never thought that our specialists would cure this problem so easily," the health ministry spokesman said, describing the flu’s attack as mild.

He added those who had traveled with the infected passengers should get in touch with the ministry if they develop any symptoms of the disease.

The ministry also sent out a circular on Monday describing measures being taken to combat the virus and reiterated advice to the public on how to prevent its spread, including washing hands with soap for a minimum of 20 seconds after coughing or sneezing, using disinfectant gel, covering one’s mouth when coughing, and avoiding contact with the eyes unless hands are clean.

It denied that any information concerning the spread of swine flu was being withheld, and repeated its free-of-charge hotline number — 8002494444 — for further inquiries concerning the virus. - GMANews.TV

SOURCE: http://www.gmanews.tv/story/165108/Another-Filipino-nurse-in-KSA-found-with-A(H1N1)



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Five more swine flu cases detected in Kingdom

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RIYADH/JEDDAH: The Ministry of Health announced five more cases of swine flu yesterday raising the total number of confirmed cases to 22.

The five new cases involve two Filipino nurses who were treating one of the patients infected with the H1N1 virus at Riyadh’s King Abdul Aziz Medical City; a two-year-old boy of unreported nationality who had close contact with swine flu patients at Saudi Aramco Hospital in Dhahran; a nine-year-old Malaysian boy who arrived recently at King Abdul Aziz International Airport in Jeddah on Malaysian Airlines Flight 150 and who is being treated in Makkah; and yet another Filipino nurse who arrived on June 13 at Riyadh’s King Khaled International Airport via Cathay Pacific Flight 733 on June 13 and who is being treated at King Fahd Medical City National Guard Hospital.

Announcing the new swine flu cases, the Ministry of Health also notified the public that taking flu medication as a preventative treatment against H1N1 is ineffective. Flu medication is only effective after a person contracts the virus. The ministry made its announcement after reports that customers are rushing to stock up on Tamiflu and similar medications.

“Tamiflu is not a preventive medicine, it is a curative tablet that is given when the patient shows symptoms of the disease,” Health Ministry spokesman Dr. Khalid Al-Mirghalani told Arab news yesterday.

According to pharmacists in Jeddah, Tamiflu is flying off the shelves.

“Demand has gone up dramatically,” said pharmacist Mohammed Farooq, the manager of Family Pharmacy in Jeddah. “More and more people are asking for the drug by name. I don’t remember anyone asking for Tamiflu by name before the H1N1 first appeared.”

Farooq said the sale of the medicine that is often mentioned in the media, when it comes to H1N1-related cases, has risen in his store by about 700 percent.

Farooq said even though he can currently obtain only older packages of Tamiflu that will expire in four months, he is confidently stocking his shelves with the medication, “something I usually would not do in normal cases.”

“(Tamiflu) was a slow moving product,” said Mohammed Sayed, a pharmacist for Oxygen Super Pharmacy. “We made a new order last week, double the previous order.”

Sayed said he thinks consumers have been influenced by references to the drug in relation to the H1N1 virus.

“Most of consumers’ awareness of the product has come from watching swine flu news reports on television,” he said

Omar, a 29-year-old businessman seen stocking up on the drug at a local pharmacy, said he’s buying enough of the medication for his entire family now out of concern that the price will go up later, “and there is the fear it will soon be out of stock in the market.”

Al-Nahdi Pharmacy’s Mohammed Hamdi said yesterday he has only a few boxes of Tamiflu remaining and that the pharmacy is ordering more. He says his suppliers have not indicated that they would run out of the product.

The Ministry of Health said the Kingdom is not at risk of running out of flu medicines.

Dr. Sami Abudawood of the Department of Health in Jeddah pointed out that the Ministry of Health would provide flu medication for free at public hospitals to anyone diagnosed with the flu as part of its measures to combat the H1N1 virus.

Meanwhile, Oman’s Health Ministry yesterday reported the Gulf nation’s first three cases of swine flu.

Ministry adviser Jaafar bin Ali said yesterday the cases were diagnosed in three students who had been studying in the United States.

He said their symptoms appeared after arriving in Oman on June 13. All have been sent home after treatment.

SOURCE: http://www.arabnews.com/?page=1§ion=0&article=123788&d=18&m=6&y=2009



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Thursday, June 18, 2009

Nursing Skills:Male Catheter Insertion (Videos)

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UK still needs more Filipina nurses and carers

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By Danny Buenafe, ABS-CBN Europe News Bureau Chief | 06/17/2009 11:38 PM

Printer-friendly versionPrinter-friendly version | Send to friendSend to friend | Post commentPost Comment

Despite the global crisis, Filipina nurses and caregivers are still in demand in the United Kingdom.

Even nurses who have not taken the board exams can qualify to work in a UK-based caring home.

The good part is that the British Embassy in Manila has shortened the processing of UK work and student visas. What used to be a three- to four-month processing can now be over in just four to six weeks.

Consul General Teresa de Vega and British Ambassador Designate Stephen Lillie were exclusively interviewed by the ABS-CBN Europe News Bureau.

“Meron naman po demand para sa mga nurses, para sa ibang skilled professionals,” said de Vega.

“I think it’s obviously an area of opportunity. How many people will be recruited obviously has to be determined by the health service here in accordance with points-based system,” added Ambassador Designate Lillie.

The Caring Career Training (CCT) Company is one of the four legitimate recruiters of Filipina nurses and carers into the UK through a student visa. It requires a minimum two-year school training.

The nurses and carers receive a monthly modest pay, which progresses depending on their performance at the assigned caring home.

Almost 200 nurses had already been recruited by CCT, and they appear to be happy with the training facilities and accommodation.

“May mga paperworks talaga. May mga workbooks, mga sasagutan,,, related naman sa work,” commented Joanne Timbol.

“Naghahanap din sila ng mga work plans namin pero hindi naman kami pinapabayaan,” said Sheila Gonzaga.

But CCT clarified that there is an initial corresponding free of 3,500 pounds (P300,000) to cover training, food and accommodation expenses including the visa.

This does not yet cover the plane fare which the applicant has to pay.



Jay Mariano, CCT overseas director, said, “In the Philippines, we do not receive the money. What happens is that they do the transactions straight to the UK. Para po may receipt sila .”

Based on statistics, there is an annual increase of 10 percent in the manpower requirements of UK caring homes. Unlike in the Philippines, the population of adults is much higher in the UK.

Apart from nurses, the Philippine Embassy said there is also a demand for plumbers and electricians.

SOURCE: http://www.abs-cbnnews.com/pinoy-migration/06/17/09/uk-still-needs-more-filipina-nurses-and-carers



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Wednesday, June 17, 2009

IV Insertion by Rachel: Student Practicing IV therapy

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DFA Red Ribbon (DFA Authentication of Phil documents required abroad

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DFA Authentication (Red Ribbon) Requirements:

NOTE: Document to be red ribbon must NOT be more than 3months old

1)Pre requisites of document to be authenticated:

a.If College T O R & Diploma:

Certified true copy by school registrar & then by CHED (or only claim stub from CHED)

b.If H.S./Elem Form 137-A & Diploma:

Certified true copy by school registrar & then by DECS/DepEd

c.If Diploma on Technical Skills & Development course &T O R:

Certified true copy by school & then by TESDA

d.If NSO (Birth, Death, Marriage, CENOMAR):

Original copy with OR + original (old or new)Local Civil Registrar copy of document

e.If Report Rating / Cert of Registration / Cert of good standing / Professional License:

Certified true copy from PRC

f.If Certificates like parental consent / medical / employment:

Affidavit(thru lawyer) & authenticated by RTC Executive Judge

**Pls ask staff for the pre-requisites of other documents to be authenticated**

2)Authorization letter in the following format (scanned & emailed or fax copy is ok,use [Name Here] always):

This is to authorize [Name] to have my (name of document/s) authenticated by DFA (& UAE / Qatar Embassy, if applicable)

Signature + date

-----------------------

Printed name of document owner

3)Photocopy of genuine ID with picture & signature or passport (1st & last page) of document owner

Leadtime Charge (per owner)

Red Ribbon 1-3 weeks (fastest s 7working days)

P 175 for succeeding docs of same owner as 1st

UAE Embassy 4-7 working days
Qatar Embassy 10-12working days

We can also have your documents further authenticated by embassy (if needed).
*Document for authentication by UAE / Qatar Embassy should have been red ribbon not more than 1yr ago. Authorization letter is optional for embassy*

Our other services / products:

1) Passporting (new or renew)
2) NSO (security paper Birth Cert, Marriage Cert, Death Cert or Singleness /
CENOMAR
3) International Driver's License
4) Embassy Authentication (for UAE countries, qatar)
5) Visa Assistance ( US, UK, Canada, Australia, China, etc)
6) Plane tickets for Domestic & International Destination
7) Tours (Domestic & International Destinations)
8) Boat tickets (SuperCat, Cebu Ferries, SuperFerry)
9) 2GO courier (domestic & international destinations)



You need to go to your nearest travel agency because they will help you do this.



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Tuesday, June 16, 2009

Nursing IV Therapy Training Video

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Central IV Therapy Part 1




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Monday, June 15, 2009

Starting Intravenous Therapy: IV Therapy Video Tuitorial

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Sunday, June 14, 2009

Nursing Skills: Female Catheter Insertion (Videos)

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Saturday, June 13, 2009

Nursing Skills: Sterile Gloving (Videos)

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Friday, June 12, 2009

H1C Visa define by Homeland Security -Immigration section :

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The Nursing Relief for Disadvantaged Areas Reauthorization Act of 2005, Pub. L. 109-423, took effect December 20, 2006. The Act reauthorized the H-1C nonimmigrant nurses program, a program originally created by the Nursing Relief for Disadvantaged Areas Act of 1999. Under this program, eligible hospitals file attestations with the Department of Labor, Office of Foreign Labor Certification National Processing Center which, if approved, will support nonimmigrant worker petitions filed with the Department of Homeland Security, U.S. Citizenship and Immigration Services.

The Department of Health and Human Services has informed the Office of Foreign Labor Certification that the same hospitals eligible for the original program continue to be eligible. These were listed in the Department of Labor's Interim Final Rule implementing its portion of the H-1C program published on August 22, 2000 (65 Fed. Reg. 51138).

The Employment and Training Administration, under the authority of the new public law, is reinstating the H-1C labor attestation program and is accepting applications by qualified hospitals. READ MORE ABOUT H1C





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Thursday, June 11, 2009

Nursing Skills: Drawing Up From a Vial (Videos)

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Wednesday, June 10, 2009

Nursing Skills: Intramuscular Z-track Injection (Videos)

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POEA: Filipino nurse with A(H1N1) now well

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By Dennis Carcamo Updated June 08, 2009 01:41 PM


MANILA, Philippines – The Filipino nurse treated for Influenza A(H1N1) at a hospital in the Kingdom of Saudi Arabia has already been discharged after her health condition normalized, the Philippine Overseas Employment Administration (POEA) announced today.

In a press conference early this morning, POEA administrator Jennifer Manalili said the overseas worker is now well and has gone back to her residence in Saudi Arabia with her husband and three children.

"Magaling na siya at nakabalik na sa kanila kasama ang kanyanga asawa at anak," Manalili said.

As this developed, Manalili reiterated her appeal to OFWs to heed the Department of Health’s call for them to observe a 10-day quarantine when they arrive in the country to avoid transmission of the virus.

She also advised returning OFWs who will be transacting at the POEA office to wear surgical masks.

There are an estimated 3,000 OFWs who troop to the POEA office in Mandaluyong City, Manalili said.

POEA employees have also started wearing surgical masks since the DOH has issued the A(H1N1) advisory.

SOURCE



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Tuesday, June 9, 2009

November 2008 NLE Practice V - CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS – PART B

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NURSING PRACTICE V – CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS – PART B

Situation 1: Understanding different models of care is a necessary part of the nurse patient relationship.

1. The focus of this therapy is to have a positive environmental manipulation, physical and social to effect a positive change.
a. Milieu
b. Psychotherapy
c. Behavior
d. Group

2. The client asks the nurse about Milieu therapy. The nurse responds knowing that the primary focus of milieu therapy can be best described by which of the following?
a. A form of behavior modification therapy
b. A cognitive approach of changing the behavior
c. A living learning or working environment
d. A behavioral approach to changing behavior

3. A nurse is caring to a client with phobia who is being treated for the condition. The client is introduced to short periods of exposure to the phobic object while in a relaxed state. The nurse understands that this form of behavior modification can be best described as:
a. Systemic desensitization
b. Aversion therapy
c. Self control therapy
d. Operant conditioning

4. A client with major depression is considering cognitive therapy. The client said to the nurse, “how does this treatment work?” The nurse responds by telling the client that:
a. “This type of treatment helps you examine how your thoughts and feelings contribute to your difficulties.”
b. “This type of treatment helps you examine how your past life has contributed to your problems.”
c. “This type of treatment helps you confront your fears by exposing you to the feared object abruptly.”
d. “This type of treatment will help you relax and develop new coping skills.”

5. A client stated, “I get down on myself when I make mistakes.” Using cognitive theory approach, the nurse should
a. Teach the client relaxation exercise to diminish stress
b. Provide the client with mastery experience to boost self-esteem
c. Explore the client’s past experiences that causes the illness
d. Help client modify the belief that anything less than perfect is horrible

6. The most advantageous therapy for a preschool age child with a history of physical and sexual abuse would be
a. Play
b. Psychoanalysis
c. Group
d. Family

7. An 18 year old client is admitted with the diagnosis of anorexia nervosa. A cognitive behavioral approach is used as part of her treatment plan. The nurse understands that the purpose of this approach is to
a. Help the client identify and examine dysfunctional thoughts and beliefs
b. Emphasize social interaction with client who withdraw
c. Provide a supportive environment and a therapeutic community
d. Examine intra-psychic conflicts and past events in life

8. The nurse is preparing to provide reminiscence therapy for a group of clients. Which of the following clients will the nurse select for this group?
a. A client who experiences profound depression with moderate cognitive impairment
b. A catatonic, immobile client with moderate cognitive impairment
c. An undifferentiated schizophrenic client with moderate cognitive impairment
d. A client with mild depression who exhibits and demonstrates normal cognition

9. Which intervention would be typical of a nurse using cognitive behavioral approach to a client experiencing low self-esteem?
a. Use of unconditional positive regard
b. Classical conditioning
c. Analysis of free association
d. Examination of negative though patters

10. Which of the following therapies has been strongly advocated for the treatment of post traumatic stress disorders?
a. ECT
b. Group therapy
c. Hypnotherapy
d. Psychoanalysis

11. The nurse knows that in group therapy, the maximum number of members to include is
a. 4
b. 8
c. 10
d. 16

12. The nurse is providing information to a client with the use of disulfiram (antabuse) for the treatment of alcohol abuse. The nurse understands that this form of therapy works on what principle?
a. Negative reinforcement
b. Aversion therapy
c. Operant conditioning
d. Gestalt therapy
13. A biological or medical approach in treating psychiatric patient is:
a. Million therapy
b. Somatic therapy
c. Behavior therapy
d. Psychotherapy

14. Which of these nursing actions belong to the secondary level of preventive intervention?
a. Providing mental health consultation to health care providers
b. Providing emergency psychiatric services
c. Being politically active in relation to mental health issues
d. Providing mental health education to members of the community

15. When the nurse identifies a client who has attempted to commit suicide, the nurse should:
a. Call a priest
b. Counsel the client
c. Refer the client to the psychiatrist
d. Refer one matter to the police

Situation 2: Rose seeks psychiatric consultation because of intense fear of flying in an airplane which has greatly affected her chances of success in her job.

16. The most common defense mechanism used by phobic client is:
a. Suppression
b. Rationalization
c. Denial
d. Displacement

17. The goal of the therapy in phobia is
a. Change her lifestyle
b. Ignore tension producing situation
c. Change her reaction towards anxiety
d. Eliminate fear producing situations

18. The therapy most effective for clients with phobia is
a. Hypnotherapy
b. Group therapy
c. Cognitive therapy
d. Behavior therapy

19. The fear and anxiety related to phobia is said to be abruptly decreased when the patient is exposed to what is feared through:
a. Guided imagery
b. Systematic desensitization
c. Flooding
d. Hypotherapy

20. Based on the presence of symptom, the appropriate nursing diagnosis is
a. Self esteem disturbance
b. Activity intolerance
c. Impaired adjustment
d. Ineffective individual coping

Situation 3: Mang Jose, 39 year old farmer, unmarried, had been confined in the National Center for Mental Health for three years with a diagnosis of schizophrenia.

21. The most common defense mechanism used by a paranoid client is
a. Displacement
b. Suppression
c. Rationalization
d. Projection

22. When Mang Jose says to you: “The voices are telling me bad things again!” The best response is:
a. “Whose voices are those?”
b. “I doubt what the voices are telling you.”
c. “I do not hear the voice you say you hear.”
d. “Are you sure you hear these voices?”

23. A relevant nursing diagnosis for clients with auditory hallucination is:
a. Sensory perceptual alteration
b. Altered thought process
c. Impaired social interaction
d. Impaired verbal communication

24. During mealtime, Jose refused to eat telling that the food was poisoned. The nurse should
a. Ignore his remark
b. Offer him food in his own container
c. Show him how irrational his thinking is
d. Respect his refusal to eat

25. When communicating with Jose, the nurse considers the following except
a. Be warm and enthusiastic
b. Refrain from touching Jose
c. Do not argue regarding his hallucination and delusion
d. Use simple, clear language

Situation 4: Gringo seeks psychiatric counseling for his ritualistic behavior of counting his money as many as 10 times before leaving home.

26. An initial appropriate nursing diagnosis is
a. Impaired social interaction
b. Ineffective individual coping
c. Impaired adjustment
d. Anxiety moderate
27. Obsessive compulsive disorder is BEST described by
a. Uncontrollable impulse to perform an act or ritual repeatedly
b. Persistent thoughts
c. Recurring unwanted and disturbing thought alternating with a behavior
d. Pathological persistence of unwilled thought, feeling or impulse

28. The defense mechanism used by persons with obsessive compulsive disorder is undoing and it is best described in one of the following statements
a. Unacceptable feelings or behavior are kept out of awareness by developing the opposite behavior or emotion
b. Consciously unacceptable instinctual drives are diverted into personally and socially acceptable channels
c. Something unacceptable already done is symbolically acted out in reverse
d. Transfer of emotions associated with a particular person, object or situation to another less threatening person, object or situation

29. To be more effective, the nurse who cares for persons with obsessive compulsive disorder must possess one of the following qualities
a. Compassion
b. Consistency
c. Patience
d. Friendliness

30. Persons with OCD usually manifest
a. Fear
b. Apathy
c. Suspiciousness
d. Anxiety

Situation 5: The patient who is depressed will undergo electroconvulsive therapy.

31. Studies on biological depression support electroconvulsive therapy as a mode of treatment. The rationale is
a. ECT produces massive brain damage which destroys the specific area containing memories related to the events surrounding the development of psychotic condition
b. The treatment serves as a symbolic punishment for the client who feels guilty and worthless
c. ECT relieves depression psychologically by increasing the norepinephrine level
d. ECT is seen as a life-threatening experience and depressed patients mobilize at bodily defenses to deal with this attack

32. The preparation of a patient for ECT ideally is MOST similar to preparation for a patient
a. Electroencophalogram
b. X-ray
c. General anesthesia
d. Electrocardiogram

33. Which of the following is a possible side effect which you will discuss with the patient?
a. hemorrhage within the brain
b. encephalitis
c. robot-like body stiffness
d. confusion, disorientation and short term memory loss

34. Informed consent is necessary for the treatment for involuntary clients. When this cannot be obtained, permission bay be taken from the
a. Social worker
b. Doctor
c. Next of kin or guardian
d. Chief nurse

35. After ECT, the nurse should do this action before giving the client fluids, food or medication
a. Assess the gag reflex
b. Assess the sensorium
c. Next of kin or guardian
d. Check O2 stat with a pulse oximeter

Situation 6: Mts. Ethel Agustin, 50 y/o, teacher, is affected with myasthenia gravis

36. Looking at Mrs. Agustin, your assessment would include the following except
a. Nystagmus
b. Difficulty of hearing
c. Weakness of the levator palpebrae
d. Weakness of the ocular muscle

37. In an effort to combat complications which might occur relatives should he taught
a. Checking cardiac rate
b. Taking blood pressure reading
c. Techniques of oxygen inhalation
d. Administration of oxygen inhalation

38. The drug of choice for her condition is
a. Prostigmine
b. Morphine
c. Codeine
d. Prednisone

39. As her nurse, you have to be cautious about administration of medication, if she is under medicated, this can cause
a. Emotional crisis
b. Cholinergic crisis
c. Menopausal crisis
d. Myasthenia crisis

40. If you are not extra careful and by chance you give over medication, this would lead to
a. Cholinergic crisis
b. Menopausal crisis
c. Emotional crisis
d. Myasthenia crisis

Situation 7: Rosanna, 20 y/o, unmarried patient believes that the toilet for the female patient is contaminated with AIDS virus and refuses to use it unless she flushes it three times and wipes the seat same number of times with antiseptic solution.

41. The fear of using “contaminated” toilet seat can be attributed to Rosanna’s inability to
a. Adjust to a strange environment
b. Express her anxiety
c. Develop the sense of trust in other person
d. Control unacceptable impulses or feeling

42. Assessment data upon admission helps the nurse to identify this appropriate nursing diagnosis
a. Ineffective denial
b. Impaired adjustment
c. Ineffective individual coping
d. Impaired social interaction

43. An effective nursing intervention to help Rosanna is
a. Convincing her to use the toilet after the nurse has used it first
b. Explaining to her that AIDS cannot be transmitted by using the toilet
c. Allowing her to flush and clear the toilet seat until she can manage her anxiety
d. Explaining to her how AIDS is transmitted

44. The goal for treatment for Rosanna must be directed toward helping her to
a. Walk freely about the past experience
b. Develop trusting relationship with others
c. Gain insight that her behavior is due to feeling of anxiety
d. Accept the environment unconditionally

45. Psychotherapy which is prescribed for Rosanna is described as
a. Establishing an environment adapted to an individual patient needs
b. Sustained interaction between the therapist and client to help her develop more functional behavior
c. Using dramatic techniques to portray interpersonal conflicts
d. Biologic treatment for mental disorder

Situation 8: Dennis 40 y/o, married man, an electrical engineer was admitted with the diagnosis of paranoid disorders. He has become suspicious and distrustful 2 months before admission. Upon admission, he kept on saying, “my wife has been planning to kill me.”

46. A paranoid individual who cannot accept the guilt demonstrate one of the following defense mechanism
a. Denial
b. Projection
c. Rationalization
d. Displacement

47. One morning, Dennis was seen tilting his head as if he was listening to someone. An appropriate nursing intervention would be
a. Tell him to socialize with other patient to divert his attention
b. Involve him in group activities
c. Address him by name to ask if he is hearing voices again
d. Request for an order of antipsychotic medicine

48. When he says, “these voices are telling me my wife is going to kill me.” A therapeutic communication of the nurse is which one of the following?
a. “I do not hear the voices you say you hear.”
b. “Are you really sure you heard those voices?”
c. “I do not think you heard those voices.”
d. “Whose voices are those?”

49. The nurse confirms that Dennis is manifesting auditory hallucination. The appropriate nursing diagnosis she identifies:
a. Sensory perceptual alteration
b. Self-esteem disturbance
c. Ineffective individual coping
d. Defensive coping

50. Most appropriate nursing intervention for a client with suspicious behavior is one of the following:
a. Talk to the client constantly to reinforce reality
b. Involve him in competitive activities
c. Use non-judgmental and consistent approach
d. Project cheerfulness in interacting with the patient

Situation 9: Clients with bipolar disorder receives a very high nursing attention due to the increasing rate of suicide related to the illness.

51. The nurse is assigned to care for a recently admitted client who has attempted suicide. What should the nurse do?
a. Search the client’s belongings and room carefully for items that could be used to attempt suicide
b. Express trust that the client won’t cause self-harm while in the facility.
c. Respect the client’s privacy by not searching any belongings.
d. Remind all staff members to check on the client frequently.

52. In planning activities for the depressed client, especially during the early stages of hospitalization, which of the following plan is best?
a. Provide an activity that is quiet and solitary to avoid increased fatigue such as working on a puzzle and reading a book
b. Plan nothing until the client asks to participate in the milieu
c. Offer the client a menu of daily activities and ask the client to participate in all of them
d. Provide a structured daily program of activities and encourage the client to participate

53. A client with a diagnosis of major depression, recurrent with psychotic features is admitted to the mental health unit. To create a safe environment for the client, the nurse most importantly devises a plan of care that deals specifically with the clients:
a. Disturbed though process
b. Self-care deficit
c. Imbalanced nutrition
d. Deficient knowledge

54. The client is taking a tricyclic anti-depressant, which of the following is an example of TCA?
a. Paxil
b. Zoloft
c. Nardil
d. Pamelor

55. A client visits the physician’s office to seek treatment for depression, feelings of hopelessness, poor appetite, insomnia, fatigue, low self-esteem, poor concentration, and difficulty making decisions.
a. Cyclothymic disorder
b. Major depression
c. Bipolar disorder
d. Dysthymic disorder

56. The nurse is planning activities for a client who has bipolar disorder who has an aggressive social behavior. Which of the following activities would be most appropriate for this client?
a. Ping pong
b. Linen delivery
c. Chess
d. Basketball

57. The nurse assesses a client with admitted diagnosis of bipolar affective disorder, mania. The symptom presented by the client that requires the nurse’s immediate intervention is the client’s
a. Outlandish behavior and inappropriate dress
b. Grandiose delusion of being a royal descendant of King Arthur
c. Non-stop physical activity and poor nutritional intake
d. Constant incessant talking that includes sexual topics and teasing the self

58. A nurse is conducting a group therapy session and during the session. A client with mania consistently talks and dominates the group. The behavior is disrupting the group interaction. The nurse would initially:
a. Ask the client to leave the group session
b. Tell the client that she will not be allowed to attend any more group sessions
c. Tell the client that she needs to allow other client in a group time to talk
d. Ask another nurse to escort the client out of the group session

59. A professional artist is admitted to the psychiatric unit for treatment of bipolar disorder. During the last 2 weeks, the client has created 154 paintings, slept only 2 to 3 hours every 2 days, and lost 18 lbs (8.2 kg). Based on Maslow’s hierarchy of needs, what should the nurse provide this client with first?
a. The opportunity to explore family dynamics
b. Help with reestablishing a normal sleep pattern
c. Experiences that build self-esteem
d. Art materials and equipment

60. The physician orders lithium carbonate (lithonate) for a client who’s in the manic phase of bipolar disorder. During lithium therapy, the nurse should watch for which adverse reactions?
a. Anxiety, restlessness, and sleep disturbance
b. Help with reestablishing a normal sleep pattern
c. Experiences that build self-esteem
d. Art materials and equipment

Situation 10: Annie has a morbid fear of heights. She asks the nurse what desensitization therapy is.

61. The accurate information of the nurse of the goal of desensitization is:
a. To help the clients relax and progressively work up a list of anxiety provoking situations through imagery
b. To provide corrective emotional experiences through a one-to-one intensive relationship
c. To help clients in a group therapy setting to take on specific roles and reenact in front of an audience situations in which interpersonal conflict is involved
d. To help clients cope with their problems by learning behaviors that are more functional and be better equipped to face reality and make decisions

62. It is essential in desensitization for the patient to
a. Have rapport with the therapist
b. Use deep breathing or another relaxation technique
c. Assess one’s self for the need of an anxiolytic drug
d. Work through unresolved unconscious conflict

63. In this level of anxiety, cognitive capacity diminishes. Focus becomes limited and client experiences tunnel vision. Physical signs of anxiety became more pronounced.
a. Severe anxiety
b. Panic
c. Mild anxiety
d. Moderate anxiety

64. Anti-anxiety medications should be used with extreme caution because long term use can lead to
a. Parkinsonian-like syndrome
b. Hypertensive crisis
c. Hepatic failure
d. Risk for addiction

65. The nursing management of anxiety related with post-traumatic stress disorder includes all of the following except:
a. Encourage participation in recreation or sports activities
b. Reassure client’s safety while touching client
c. Speak in a calm soothing voice
d. Remain with the client when fear level is high

Situation 11: You are fortunate to be chosen as part of the research team in the hospital. A review of the following IMPORTANT nursing concepts was made.

66. A professional, a nurse can do research for varied reason except:
a. Professional advancement through research participation
b. To validate results of new nursing modalities
c. For financial gains
d. To improve nursing care

67. Each nurse participants was asked to identify a problem. After the identification of the research problem, which of the following should be done?
a. Methodology
b. Review of related literature
c. Acknowledgement
d. Formulate hypothesis

68. Which of the following communicate the results of the research to the readers they facilitate the description of the data.
a. Hypothesis
b. Statistics
c. Research problem
d. Tables and graphs

69. In quantitative data, which of the following is described as the distance in the scoring unites of the variable from the highest to the lower?
a. Frequency
b. Mean
c. Median
d. Range
70. This expresses the variability of the data in reference to the mean. It provides us with a numerical estimate of how far, on the average the separate observation are from the mean.
a. Mode
b. Standard deviation
c. Median
d. Frequency

Situation 12: Survey and Statistics are important part of research that is necessary to explain the characteristics of the population.

71. According to the WHO statistics on the Homeless population around the world, which of the following groups of people in the world disproportionately represents the homeless population?
a. Hispanics
b. Asians
c. African Asians
d. Caucasians

72. All but one of the following is not a measure of Central Tendencies
a. Mode
b. Variance
c. Standard deviation
d. Range

73. In the value: 87, 85, 88, 92, 90, what is the mean?
a. 88.2
b. 88.4
c. 87
d. 90

74. In the value: 80, 80, 80, 82, 82, 90, 90, 100, what is the mode?
a. 80
b. 82
c. 90
d. 85.5

75. In the value 80, 80, 10, 10, 25, 65, 100, 200, what is the median
a. 71.25
b. 22.5
c. 10 and 25
d. 72.5

76. Draw Lots, lottery, table of random numbers or a sampling that ensures that each element of the population has an equal and independent chance of being chosen is called
a. Cluster
b. Simple
c. Stratified
d. Systematic

77. An investigator wants to determine some of the problems that are experienced by diabetic clients when using an insulin pump. The investigator went into a clinic where he personally knows several diabetic clients having problem with insulin pump. The type of sampling done by the investigator is called
a. Probability
b. Purposive
c. Snowball
d. Incidental

78. If the researcher implemented a new structured counseling program with a randomized group of subject and a routine counseling program with another randomized group of subject, the research is utilizing which design?
a. Quasi-experimental
b. Experimental
c. Comparative
d. Methodological

79. Which of the following is not true about a Pure Experimental research?
a. There is a control group
b. There is an experimental group
c. Selection of subjects in the control group is randomized
d. There is a careful selection of subjects in the experimental group

80. The researcher implemented a medication regimen using a new type of combination drugs to manic patients while another group of manic patient receives the routine drugs. The researcher however handpicked the experimental group for they are the clients with multiple episodes of bipolar disorder. The researcher utilized which research design?
a. Quasi-experimental
b. Pure experimental
c. Phenomenological
d. Longitudinal

Situation 13: As a nurse, you are expected to participate in initiating or participating in the conduct of research studies to improve nursing practice. You, to be updated on the latest trends and issues affected the profession and the best practices arrived at by the profession.

81. You are interested to study the effects of meditation and relaxation on the pain experienced by cancer patients. What type of variable is pain
a. Depend
b. Correlational
c. Independent
d. Demographic

82. You would like to compare the support system of patient with chronic illness to those with acute illness. How will you best state your problem?
a. A descriptive study to compare the support system of patients with chronic illness and those with acute illness in terms of demographic data and knowledge about interventions
b. The effects of the types of support system of patients with chronic illness and those with acute illness
c. A comparative analysis of the support system of patients with chronic illness and those with acute illness
d. A study to compare the support system of patients with chronic illness and those with acute illness

83. You would like to compare the support system of patients with chronic illness to those with acute illness. Considering that the hypothesis was “Clients with chronic illness have lesser support system than clients with acute illness.” What type of research is this?
a. Descriptive
b. Experimental
c. Correlational, non-experimental
d. Quasi experimental

84. In any research study where individual persons are involved, it is important that an informed consent of the study is obtained. The following are essential information about the consent that you should disclose to the prospective subjects except
a. Consent to incomplete disclosure
b. Description of benefits, risks and discomforts
c. Explanation of procedure
d. Assurance of anonymity and confidentiality

85. In the hypothesis “The utilization of technology in teaching improves the retention and attention of the nursing students.” Which is the dependent variable?
a. Utilization of technology
b. Improvement in the retention and attention
c. Nursing students
d. Teaching

Situation 14: You are actively practicing nurse who has just finished your graduate studies. You learned the value of research and would like to utilize the knowledge and skills gained in the application of research to the nursing service. The following questions apply to research.

86. Which type of research inquiry investigates the issues of human complexity (e.g. understanding the human expertise)?
a. Logical position
b. Naturalistic inquiry
c. Positivism
d. Quantitative research

87. Which of the following studies is based on quantitative research?
a. A study examining the bereavement process in spouse of clients with terminal cancer
b. A study exploring the factors influencing weight control behavior
c. A study measuring the effects of sleep deprivation on wound healing
d. A study examining client’s feelings before, during and after bone marrow aspiration

88. Which of the following studies is based on the qualitative research?
a. a study examining client’s reaction to stress after open heart surgery
b. a study measuring nutrition and weight loss/gain in clients with cancer
c. a study examining oxygen levels after endotracheal suctioning
d. a study measuring differences in blood pressure before, during and after procedure

89. An 85 year old client in a nursing home tells a nurse, “I signed the papers of the research study because the doctor was so insistent and I want him to continue taking care for me.” Which client’s right is being violated?
a. Right of self determination
b. Right to privacy and confidentiality
c. Right to full disclosure
d. Right not to be harmed

90. A supposition or system of ideas that is proposed to explain a given phenomenon best defines:
a. A paradigm
b. A concept
c. A theory
d. A conceptual framework

Situation 15: Mastery of research design determination is essential in passing the NLE.

91. Ana wants to know if the length of time she will study for the board examination is proportional to her board rating. During the June 2008 board examination, she studied for 6 months and gained 69%. On the next board exam, she studied for 6 months again for a total of 1 year and gained 74%. On the third exam, she studied for 6 months again for a total of 1and ½ years and gained 82%. The research design she used is
a. Comparative
b. Correlational
c. Experimental
d. Qualitative

92. Anton was always eating high fat diet. You want to determine if what will be the effect of high cholesterol food to Anton in the next 10 years. You will use
a. Comparative
b. Correlational
c. Historical
d. Longitudinal

93. Community A was selected randomly as well as community B. Nurse Edna conducted teaching to community A and assessed if community A will have a better status than community B. This is an example of
a. Comparative
b. Correlational
c. Experimental
d. Qualitative

94. Ana researched on the development of a new way to measure intelligence by creating a 100 item questionnaire that will assess the cognitive skills of an individual. The design best suited for his study is
a. Historical
b. Methodological
c. Survey
d. Case study

95. Gen is conducting a research study on how Mark, an AIDS client lives his life. A design suited for this is
a. Historical
b. Case study
c. Phenomenological
d. Ethnographic

96. Marco is to perform a study about how nurses perform surgical asepsis during World War II. A design best for this study is
a. Historical
b. Case study
c. Phenomenological
d. Ethnographic

97. Tonyo conducts sampling at Barangay 412. He collected 100 random individuals and determined who their favorite comedian actor is. 50% said Dolphy, 20% said Vic Sotto, while some answered Joey de Leon, Allan K, Michael V. Tonyo conducted what type of research study?
a. Phenomenological
b. Case study
c. Non-experimental
d. Survey

98. Jane visited a tribe located somewhere in china, it is called the Shin Jea Tribe. She studied the way of life, tradition and the societal structure of these people. Jane will best use which research design?
a. Historical
b. Case study
c. Phenomenological
d. Ethnographic

99. Anjoe researched on TB. It’s transmission, causative agent and factors, treatment sign and symptoms as well as medication and all other in depth information about tuberculosis. This study is best suited for which research design?
a. Historical
b. Case study
c. Phenomenological
d. Ethnographic

100. Diana is to conduct a study about the relationship of the number of family members in the household and the electricity bill. Which of the following is the best research design suited for this study?
1. Descriptive
2. Exploratory
3. Explanatory
4. Correlational
5. Comparative
6. Experimental
a. 1,4
b. 2,5
c. 3.6
d. 1,5


ANSWER KEY:


1. A
2. C
3. A
4. A
5. D
6. A
7. A
8. D
9. D
10. B
11. C
12. B
13. B
14. B
15. C
16. D
17. C
18. D
19. D
20. D
21. D
22. C
23. A
24. B
25. A
26. B
27. C
28. C
29. B
30. D
31. C
32. C
33. D
34. C
35. A
36. B
37. D
38. A
39. D
40. A
41. D
42. C
43. C
44. C
45. B
46. B
47. C
48. A
49. A
50. C
51. A
52. D
53. A
54. D
55. D
56. B
57. C
58. C
59. B
60. B
61. D
62. A
63. B
64. D
65. B
66. C
67. B
68. D
69. D
70. B
71. B
72. A
73. B
74. B
75. A
76. D
77. B
78. B
79. D
80. A
81. A
82. E
83. A
84. A
85. B
86. B
87. C
88. A
89. A
90. C
91. C
92 A
93. C
94. B
95. C
96. A
97. D
98. D
99. B
100. A








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Monday, June 8, 2009

Nurses decry lower salaries in new law

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INQUIRER.net

MANILA, Philippines— Public health workers on Wednesday staged a rally outside the office of the health secretary slamming the Department of Health’s silence on the approval of the Salary Standardization Law (SSL) in Congress earlier this week.

Emma Manuel, national president of the Alliance of Health Workers Inc., said members of her organization are disappointed with the passage of the salary standardization scheme which disregards the Nursing Act of 2002 and threatens their benefits under the Magna Carta of Public Health Workers.

The new law is “worse than the A/H1N1 virus, instantly killing the Nursing Act provision on Salary Grade 15 for nurses and putting the benefits of public health workers in jeopardy,” Manuel said.

Under the new law, new nurses are at Salary Grade 11 getting a monthly salary of P12,000. The law provides for P6,000 worth of increases spread over four years.

But under another law, the Nursing Act or Republic Act 9173, which was enacted seven years ago but still not implemented until now, new nurses should be at Salary Grade 15, getting a monthly salary of P25,000.

“In the last seven years, the government deprived the Filipino nurses of their right to Salary Grade 15,” said Manuel.

Teresita Barcelo, national president of the Philippine Nurses Association Inc., said the signing of SSL into law killed the Nursing Law and “denied Filipino nurses of their right to humane salaries.”

“We help take care of life but we are deprived of our rights. We are fighting for our legitimate right—the implementation of RA 9173,” she said in Filipino.

Barcelo said nurses in the Philippines are overworked, with a nurse to patient ratio of one is to 50. She said this situation makes it hard for nurses here to perform their health duties and to sustain their families’ financial needs.

Manuel also lamented the silence of the Department of Health in the issue. She said it smacks of “utmost insensitivity to the plight of nurses and health workers. While health workers tirelessly lobbied in the House and Senate, the DoH washed its hands, literally and figuratively.”

Ernie Espinosa, president of National Center for Mental Health Workers Association, agreed. “Neither the DoH secretary nor any director from the department joined us in our fight for our salaries and rights. We are health workers who serve the people and the government,” he said.

Health Assistant Secretary Luna Fernandez told the group that the DoH will be open for dialog with the health workers.



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How Filipino nurses can work in Japan

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INQUIRER.net
First Posted 16:07:00 06/04/2009

Filed Under: Foreign affairs & international relations, Migration, Overseas Employment, Nursing matters, Diplomacy, Asia Australia - North Asia


MANILA, Philippines—The details of how Filipino nurses and caregivers who graduated from Philippine schools can work in Japan will be the subject of a memorandum of understanding (MOU) that the Philippines and Japan are scheduled to sign tomorrow, June 5.

In a statement, the Japanese embassy here said the MOU is on school courses under the Japan-Philippines Economic Partnership Agreement (JPEPA) on the Movement of Natural Persons.

The MOU clarifies the provisions and processes of deployment and acceptance of Filipino candidates for nurses and caregivers. The main processes are: publicity and the recruitment of Filipino candidates and institutions; matching of Filipino candidates with corresponding institutions; finalization of employment contracts; and the entry of Filipino candidates into Japan.

The MOU focuses on a two- to four-year school course for caregiver candidates. All candidates will enroll in a caregiver school in Japan and will be qualified as certified care workers upon completion of the course.

After the signing, both the Japan International Corporation of Welfare Services (Jicwels) and the Commission on Higher Education (CHEd) will start preparations for sending and receiving Filipino candidates. JPEPA itself has been effective since December 11, 2008.

Takashi Tsunoda, managing director of Jicwels, a public organization related to the Ministry of Health, Labour and Welfare, and Chairman Emmanuel Angeles of the CHEd are the signatories for the MOU.

Ambassador Makoto Katsura of Japan will witness the signing ceremony at the HEDC Building in the University of the Philippines-Diliman.

SOURCE



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Nursing Skills: Subcutaneous Injection (Videos)

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Sunday, June 7, 2009

November 2008 NLE Practice IV - CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS – PART B

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NURSING PRACTICE IV – CARE OF THE CLIENT WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS – PART B

Situation 1: After an abdominal surgery, the circulating and scrub nurses have critical responsibility about sponges and instrument count.

1. Counting is performed thrice: during the pre-incision phase, the operative phase and closing phase. Who counts the sponges, needle and instruments?
a. The scrub nurse only
b. The circulating nurse only
c. The surgeon and the assistant surgeon
d. The scrub nurse and the circulating nurse

2. The layer of the abdomen is divided into 5. Arrange the following from the first layer going to the deepest layer.
1. Fascia
2. Muscle
3. Peritoneum
4. Subcutaneous/fat
5. Skin
a. 5,4,3,2,1
b. 5,4,2,1,3
c. 5,4,1,3,2
d. 5,4,1,2,3

3. When is the first sponge instrument count reported?
a. Before closing the subcutaneous layer
b. Before peritoneum is closed
c. Before closing the skin
d. Before the fascia is sutured

4. Like any nursing interventions, counts should be documented. To whom does the scrub nurse report any discrepancy of counts so that immediate and appropriate action is instituted?
a. Anesthesiologist
b. Surgeon
c. OR nurse supervisor
d. Circulating nurse

5. Which of the following are 2 interventions of the surgical team when an instrument was confirmed missing?
a. MRI and incidence report
b. CT Scan, MRI, Incidence report
c. XRAY and incidence report
d. CT Scan and incidence report


Situation 2: An entry level nurse should be able to apply theoretical knowledge in the performance of the basic nursing skills.

6. A client has an indwelling urinary catheter and she is suspected of having urinary infection. How should you collect a urine specimen for culture and sensitivity?
a. Clamp tubing for 60 minutes and insert a sterile needle into the tubing above the clamp to aspirate urine
b. Drain urine from the drainage bag into the sterile container
c. Disconnect the tubing from the urinary catheter and let urine flow into a sterile container
d. Wipe the self sealing aspiration port with antiseptic solution and insert a sterile needle into the self sealing port

7. To obtain specimen for sputum culture and sensitivity, which of the following instruction is best?
a. Upon waking up, cough deeply and expectorate into container
b. Cough after pursed lip breathing
c. Save sputum for two days in covered container
d. After respiratory treatment, expectorate into a container

8. The best time for collecting the sputum specimen for culture is
a. Before retiring at night
b. Upon waking up in the morning
c. Anytime of the day
d. Before meals

9. When suctioning the endotracheal tube, the nurse should
a. Explain procedure to patient. Insert catheter gently applying suction. Withdraw using twisting motion
b. Insert catheter until resistance is met then withdraw slightly, applying suction
c. Hyperoxygenate client. Insert catheter using back and forth motion
d. Insert suction catheter four inches into the tube. Suction 30 seconds using twisting motion as catheter is withdrawn.

10. The purpose of NGT IMMEDIATELY after an operation is:
a. For feeding or gavage
b. For gastric decompression
c. For lavage, or the cleansing of stomach content
d. For the rapid return of peristalsis

Situation 3: Mr. Santos, 50, is to undergo cystoscopy due to multiple problems liles scantly urination, hematuria and dysuria.

11. You are the nurse in charge of Mr. Santos. When asked what are the organs to be examined during cystoscopy, you will enumerate as follows:
a. Urethra, kidney, bladder, urethra
b. Urethra, bladder wall, trigone, ureteral opening
c. Bladder wall, uterine wall, and urethral opening
d. Urethral opening, ureteral opening bladder

12. In the OR, you will position Mr. Santos who is undergoing cystoscopy in:
a. Supine
b. Lithotomy
c. Semi-fowler
d. Trendelenburg

13. After cystoscopy, Mr. Santos asked you to explain why there is no incision of any kind. What do you tell him?
a. “Cystoscopy is direct visualization and examination by urologist.”
b. “cystoscopy is done by x-ray visualization of the urinary tract.”
c. “Cystoscopy is done by using lasers on the urinary tract.”
d. “Cystoscopy is an endoscopic procedure of the urinary tract.”

14. Withing 24-48 hours post cystoscopy, it is normal to observe one of the following:
a. Pink-tinged urine
b. Distended bladder
c. Signs of infection
d. Prolonged hematuria

15. Leg cramps are NOT uncommon post-cystoscopy. Nursing intervention includes:
a. Bed rest
b. Warm moist soak
c. Early ambulation
d. Hot sitz bath

Situation 4: Mang Felix, a 79 year old man who is brought to the surgical unit form PACU after a transurethral resection. You are assigned to receive him. You noted that he has a 3 way indwelling urinary catheter for continuous fast drip bladder irritation which is connected to a straight drainage.

16. Immediately after surgery, what would you expect his urine to be?
a. Light yellow
b. Amber
c. Bright red
d. Pinkish to red

17. The purpose of the continuous bladder irrigation is to:
a. Allow continuous monitoring of the fluid output status
b. Provide continuous flushing of clots and debris from the bladder
c. Allow for proper exchange of electrolytes and fluid
d. Ensure accurate monitoring of intake and output

18. Mang Felix informs you that he feels some discomfort on the hypogastric area and he has to void. What will be your most appropriate action?
a. Remove his catheter then allow him to void on his own
b. Irrigate his catheter
c. Tell him to “go ahead and void. You have an indwelling catheter.”
d. Assess color and rate of outflow if there is a change, refer to urologist for possible irrigation

19. You decided to check on Mang Felix’s IV fluid infusion. You noticed a change in flow rae, pallor and coldness around the insertion site. What is your assessment finding?
a. Phlebitis
b. Infiltration to subcutaneous tissue
c. Pyrogenic rection
d. Air embolism

20. Knowing that proper documentation of assessment findings and interventions are important responsibilities of the nurse during first post operative day, which of the following is the LEAST relevant to document in the case of Mang Felix?
a. Chest pain and vital signs
b. Intravenous infusion rate
c. Amount, color, and consistency of bladder irrigation drainage
d. Activities of daily living started

Situation 5: Melamine contamination in milk has brought worldwide crisis both in the milk production sector as well as the health and economy. Being aware of the current events is one quality that a nurse should possess to prove that nursing is a dynamic profession that will adapt depending on the patient’s needs.

21. Melamine is a synthetic resin used for whiteboards, hard plastics and jewelry box covers due to its fire retardant properties. Milk and food manufacturers add melamine in order to:
a. It has a bacteriostatic property leading to increase food and milk life as a way of preserving the foods
b. Gives a glazy and more edible look on foods
c. Make milks tasty and creamy
d. Create an illusion of a high protein content on their product

22. Most of the milks contaminated by Melamine came from which country?
a. India
b. China
c. Philippines
d. Korea

23. Which government agency is responsible for testing the melamine content of foods and food products?
a. DOH
b. MMDA
c. NBI
d. BFAD

24. Infants are the most vulnerable to melamine poisoning. Which of the following is NOT a sign of melamine poisoning?
a. Irritability, back ache, urolithiasis
b. High blood pressure, fever
c. Anuria, oliguria or hematuria
d. Fever, irritability and large output of diluted urine

25. What kind of renal failure does melanin poising cause?
a. Chronic, pre-renal
b. Acute, post-renal
c. Chronic, intrarenal
d. Actue, pre-renal

Situation 6: Leukemia is the most common type of childhood cancer. Acute Lymphoid Leukemia is the cause of almost 1/3 of all cancer that occurs in children under age 15.

26. The survival rate for Acute Lymphoid Leukemia is approximately
a. 25%
b. 40%
c. 75%
d. 95%

27. Whereas acute non-lymphoid leukemia has a survival rate of
a. 25%
b. 40%
c. 75%
d. 95%

28. The three main consequence of leukemia that causes the most danger is:
a. Neutropenia causing infection, anemia causing impaired oxygenation, and thrombocytopenia leading to bleeding tendencies
b. Central nervous system infiltration, anemia causing impaired oxygenation and thrombocytopenia leading to bleeding tendencies
c. Splenomegaly, hepatomegaly, fractures
d. Invasion by the leukemia cells to the bone causing severe bone pain

29. Gold standard in the diagnosis of leukemia is by which of the following?
a. Blood culture and sensitivity
b. Bone marrow biopsy
c. Blood biopsy

30. Adriamycin, Vincristine, Prednisone and L asparaginase are given to the client for long term therapy. One common side effect, especially of adriamycin is alopecia. The child asks: “Will I get my hair back once again?” The nurse best response is by saying:
a. “Don’t be silly, of course you will get your hair back.”
b. “We are not sure, let’s hope it’ll grow.”
c. “This side effect is usually permanent, but I will get the doctor to discuss it for you.”
d. “Your hair will regrow in 3 to 6 months but of different color, usually darker and of different texture.”

Situation 7: Breast cancer is the 2nd most common type of cancer after lung cancer and 99% of which, occurs in woman. Survival rate is 98% if this is detected early and treated promptly. Carmen is a 53 year old patient in the high risk group for breast cancer was recently diagnosed with Breast Cancer.

31. All of the following are factors that said to contribute to the development of breast cancer except:
a. Prolonged exposure to estrogen such as an early menarche or late menopause, nulliparity, and childbirth after age 30.
b. Genetics
c. Increasing age
d. Prolonged intake of tamoxifen (Nolvadex)

32. Protective factors for the development of breast cancer includes which of the following except:
a. Exercise
b. Prophylactic tamoxifen
c. Breast feeding
d. Alcohol intake

33. A patient diagnosed with breast cancer has been offered the treatment choices of breast conservation surgery with radiation or a modified radical mastectomy. When questioned by the patient about these options, the nurse informs the patient that the lumpectomy with radiation
a. Reduces the fear and anxiety that accompanies the diagnosis and treatment of cancer
b. Has about the same 10-year survival rate as the modified radical mastectomy
c. Provides a shorter treatment period with a fewer long term complications
d. Preserves the normal appearance and sensitivity of the breast

34. Carmen, who is asking the nurse the most appropriate time of the month to do her self-examination of the breast. The MOST appropriate reply by the nurse would be:
a. The 26th days of the menstrual cycle
b. 7 to 8 days after conclusion of the menstrual period
c. During her menstruation
d. The same day each month

35. Carmen being treated with radiation therapy. What should be included in the plan of care to minimize skin damage from the radiation therapy?
a. Cover the areas with thick clothing materials
b. Apply a heating pad to the site
c. Wash skin with water after the therapy
d. Avoid applying creams and powders to the area

36. Based on DOH and World Health Organization (WHO) guidelines, the mainstay for early protection method for breast cancer that is recommended for developing countries is
a. a monthly breast self examination (BSE) and an annual health worker breast examination (HWBE)
b. an annual hormone receptor assay
c. an annual mammogram
d. a physician conduct a breast clinical examination every 2 years

37. the purpose of performing the breast self examination (BSE) regularly is to discover
a. fibrocystic masses
b. cancerous lungs
c. areas of thickness or fullness
d. changes from previous BSE

38. If you are to instruct a post-menopausal woman about BSE, when would you tell her to do BSE?
a. On the same day of each month
b. Right after the menstrual period
c. On the first day of her menstruation
d. On the last day of her menstruation

39. During breast self-examination, the purpose of standing in front of the mirror is to observe the breast for
a. Thickening of the tissue
b. Axillary lymphnodes
c. Lumps in the breast tissue
d. Change in size and contour

40. When preparing to examine the left breast in a reclining position, the purpose of placing a small folded towel under the client’s left shoulder is to
a. Bring the breast closer to the examiner’s right hand
b. Tense the pectoral muscle
c. Balance the breast tissue more evenly on the chest wall
d. Facilitate lateral positioning of the breast

Situation 8: Radiation therapy is another modality of cancer management. With emphasis on multidisciplinary management, you have important responsibilities as nurse.

41. Albert is receiving external radiation therapy and he complains of fatigue and malaise. Which of the following nursing interventions would be most helpful for Albert?
a. Tell him that sometimes these feelings can be psychogenic
b. Refer him to the physician
c. Reassure him that these feelings are normal
d. Help him plan his activities

42. Immediately following the radiation teletherapy, Albert is
a. Considered radioactive for 24 hours
b. Given an complete bath
c. Placed on isolation for 6 hours
d. Free from radiation

43. Albert is admitted with a radiation induced thrombocytopenia. As a nurse, you should observe the following symptoms:
a. Petechiae, ecchymosis, epistaxis
b. Weakness, easy fatigability, pallor
c. Headache, dizziness, blurred vision
d. Severe sore throat, bacteremia, hepatomegaly

44. What nursing diagnosis should be of highest priority?
a. Knowledge deficit regarding thrombocytopenia precautions
b. Activity intolerance
c. Impaired tissue integrity
d. Ineffective tissue perfusion, peripheral, cerebral, cardiovascular, gastrointestinal, renal

45. What intervention should you include in your care plan?
a. Inspect his skin for petechiae, bruising, GI bleeding regularly
b. Place Albert on strict isolation precautions
c. Provide rest in between activities
d. Administer antipyretics if his temperature exceeds 38C

Situation 9: Burns are caused by transfer of heat source to the body. It can be thermal, electrical, radiation or chemical.

46. A burn characterized by pale white appearance, charred or with fat exposed and painlessness is
a. Superficial partial thickness burn
b. Deep partial thickness burn
c. Full thickness burn
d. Deep full thickness burn

47. Which of the following BEST describes superficial partial thickness burn or first degree burn?
a. Structures beneath the skin are damaged
b. Dermis is partially damaged
c. Epidermis and dermis are both damaged
d. Epidermis is damaged

48. A burn that is said to be “WEEPING” is classified as
a. Superficial partial thickness burn
b. Deep partial thickness burn
c. Full thickness burn
d. Deep full thickness burn

49. During the acute phase of the burn injury, which of the following is a priority?
a. Wound healing
b. Reconstructive surgery
c. Emotional support
d. Fluid resuscitation

50. While in the emergent phase, the nurse knows that the priority is to:
a. prevent infection
b. control pain
c. prevent deformities and contractures
d. return the hemodynamic stability via fluid resuscitation

51. The MOST effective method of delivering pain medication during the emergent phase is
a. Intramuscularly
b. Subcutaneously
c. Orally
d. Intravenously

52. When a client accidentally splashes chemicals to his eyes, the initial priority care following the chemical burn is to
a. Irrigate with normal saline for 1 to 15 minutes
b. Transport a physician immediately
c. Irrigate with water for 15 minutes or longer
d. Cover the eyes with a sterile gauze

53. Which of the following can be a fatal complication of upper airway burns?
a. Stress ulcers
b. Hemorrhage
c. Shock
d. Laryngeal spasms and swelling

54. When a client will rush towards you and he has burning clothes on, it is your priority to do which of the following first?
a. Log roll on the grass/ground
b. Slap the flames with his hands
c. Try to remove the burning clothes
d. Splash the client with 1 bucket of cool water

55. Once the flames are extinguished, it is most important to
a. Cover client with a warm blanket
b. Give him sips of water
c. Calculate the extent of his burns
d. Assess Sergio’s breathing

56. During the first 24 hours after the thermal injury, you should assess Sergio for
a. Hypokalemia and hypernatremia
b. Hypokalemia and hyponatremia
c. Hyperkalemia and hyponatremia
d. Hyperkalemia and hypernatremia

57. A client who sustained deep partial thickness and full thickness burns of the face, whole anterior chest and both upper extremities two days ago begins to exhibit extreme restlessness. You recognize that this most likely indicates that the client is developing
a. Cerebral hypoxia
b. Hypervolemia
c. Metabolic acidosis
d. Renal failure

58. A 165 lbs trauma client was rushed to the emergency room with full thickness burns on the whole face, right and left arm, and at the anterior part of chest sparing the abdominal area. He also has superficial partial thickness burn at the posterior trunk and at the half upper portion of the left leg. He is in the emergent phase of burn. Using the parkland’s formula, you know that during the first 8 hours of burn, the amount of fluid will be given is:
a. 5,400 ml
b. 10,600 ml
c. 9,450 ml
d. 6,750 ml

59. The doctor incorporated insulin on the client’s fluid during the emergent phase. The nurse knows that insulin is given because
a. Clients with burn also develops metabolic acidosis
b. Clients with burn also develops hyperglycemia
c. Insulin is needed for additional energy and glucose burning after the stressful incident to hasten wound healing, regain of consciousness and rapid return of hemodynamic stability
d. For hyperkalemia

60. The IV fluid of choice for burn as well as dehydration is:
a. 0.45% Na CL
b. NSS
c. Sterile water
d. D5LR

SITUATION 10: Enterostomal Therapy is now considered a specialty in nursing. You are participating in the OSTOMY CARE CLASS.

61. You plan to teach Fermin how to irrigate the colostomy when
a. The perineal wound heals and Fermin can sit comfortable on the commode
b. Fermin can lie on the side comfortable, about the 3rd post-operative day
c. The abdominal incision is closed and contamination is no longer a danger
d. The stools starts to become formed around the 7th post-operative day
62. When preparing to teach Fermin how to irrigate colostomy, you should plan to do the procedure:
a. When Fermin would have normal bowel movement
b. At least 2 hours before visiting hours
c. Prior to breakfast and morning care
d. After Fermin accepts alteration in body image

63. When observing a return demonstration of a colostomy irrigation, you know that more teaching is required if Fermin
a. Lubricates the tip of the catheter prior to inserting into the stoma
b. Hangs the irrigating bag on the bathroom door cloth hook during fluid insertion
c. Discontinues the insertion of fluid after 500 ml of fluid has been instilled
d. Clamps off the flow of fluid when feeling uncomfortable

64. You are aware that teaching about colostomy care is understood when Fermin states, “I will contact my physician and report:
a. If I have any difficulty inserting the irrigating tube into the stoma.”
b. If I noticed a loss of sensation to touch in the stoma tissue.”
c. The expulsion of flatus while the irrigating fluid is running out.”
d. When mucus is passed from the stoma between the irrigation.”

65. You would know after teaching Fermin that dietary instruction for him is effective when he states, “it is important that I eat:
a. Soft food that is easily digested and absorbed by the large intestines.”
b. Bland food so that my intestines do not become irritated.”
c. Food low in fiber so that there are fewer stools.”
d. Everything that I ate before the operation, while avoiding foods that cause gas.”

Situation 11: Based on studies of nurses working in special units like the intensive care unit and coronary care unit, it is important for nurses to gather as much information to be able to address their needs for nursing care.

66. Critically ill patients frequently complain about which of the following when hospitalized?
a. Hospital food
b. Lack of blankets
c. Lack of privacy
d. Inadequate nursing staff

67. Who of the following is at greatest risk of developing sensory problem?
a. Female patient
b. Adolescent
c. Transplant patient
d. Unresponsive patient

68. Which of the following factors may inhibit learning in critically ill patients?
a. Gender
b. Medication
c. Educational level
d. Previous knowledge of illness

69. Which of the following statements does not apply to critically ill patients?
a. Majority need extensive rehabilitation
b. All have been hospitalized previously
c. Are physically unstable
d. Most have chronic illness

70. Families of critically ill patients desire which of the following needs to be met first by the nurse?
a. Provision of comfortable space
b. Emotional support
c. Updated information on client’s status
d. Spiritual counseling

Situation 12: Johnny sough consultation to the hospital because of irritability, jittery and he has been experiencing these signs and symptoms for several months.

71. His diagnosis was hyperthyroidism. The following are expected symptoms except
a. Anorexia
b. Palpitation
c. Fine tremors of the hands
d. Hyperalertness

72. She has to take drugs to treat her hyperthyroidism. Which of the following will you NOT expect that the doctor will prescribe?
a. Colace (Docusate)
b. Cytomel (llothyronine)
c. Tapazole


73. The nurse knows that Tapazole has which of the following side effects that will warrant immediate withholding of the medication?
a. Death
b. Sore throat
c. Hyperthermia
d. Thrombocytosis

74. You asked questions as soon as she regained consciousness from thyroidectomy primarily to assess the evidence of
a. Thyroid storm
b. Mediastinal shift
c. Damage to the laryngeal nerve
d. Hypocalcemia tetany

75. Should you check for hemorrhage, you will
a. Slip you hand under the nape of the neck
b. Check for hypotension
c. Apply neck collar to prevent hemorrhage
d. Observe the dressing if it is soaked with blood

76. Basal metabolic rate is assessed on Johnny to determine his metabolic rate. In assessing the BMR using the standard procedure, you need to tell Johnny that:
a. Obstructing his vision
b. Restraining his upper and lower extremities
c. Obstructing his hearing
d. Obstructing his nostrils with a clamp

77. The BMR is based on the measurement that:
a. Rate of respiration under different condition of activities and rest
b. Amount of oxygen consumption under resting condition over a measured period of time
c. Amount of oxygen consumption under stressed condition over a measured period of time
d. Ration of respiration to pulse rate over a measured period of time

78. Her physician ordered lugol’s solution in order to
a. decrease the vascularity and size of the thyroid gland
b. decrease the size of the thyroid gland only
c. increase the vascularity and size of the thyroid gland
d. increase the size of the thyroid gland only

79. Which of the following is a side effect of Lugol’s solution?
a. Hypokalemia
b. Nystagmus
c. Enlargement of the thyroid gland
d. Excessive salivation

80. In administering Lugol’s solution, the precautionary measure should include:
a. Administer with glass only
b. Dilute with juice and administer with a straw
c. Administer it with milk and drink it
d. Follow it with milk of magnesia

Situation 13: Pharmacological treatment was not effective for Johnny’s hyperthyroidism and now, he is scheduled for thyroidectomy.

81. Instruments in the surgical suite for surgery are classified as either CRITICAL, SEMI-CRITICAL and NON-CRITICAL. If the instrument is introduced directly into the blood stream or into any normally sterile cavity or area of the body, it is classified as:
a. Critical
b. Semi critical
c. Non-critical
d. Ultra critical

82. Instruments that do not touch the paitnet or have contact only to intact skin is classified as:
a. Critical
b. Semi critical
c. Non critical
d. Ultra critical

83. If an instrument is classified as semi critical, an acceptable method of making the instrument ready for surgery is through
a. Sterilization
b. Decontamination
c. Disinfection
d. Cleaning

84. While critical items should be
a. Clean
b. Decontaminated
c. Sterilized
d. Disinfected

85. As a nurse, you know that intact skin acts as an effective barrier to most microorganisms. Therefore, items that come in contact with the intact skin or mucus membranes should be
a. Disinfected
b. Sterile
c. Clean
d. Alcoholized

86. You are caring for Johnny who is scheduled to undergo total thyroidectomy because of diagnosis of thyroid cancer. Prior to total thyroidectomy, you should instruct Johnny to
a. Perform range and motion exercise on the head and neck
b. Apply gentle pressure against the incision when swallowing
c. Cough and deep breath every 2 hours
d. Support head with the hands when changing position

87. As Johnny’s nurse, you plan to set up an emergency equipment at the bedside following thyroidectiomy. You should include
a. An airway and rebreathing tube
b. A tracheostomy set and oxygen
c. A crush chart with bed board
d. Two ampoules of sodium bicarbonate

88. Which of the following nursing interventions is appropriate after a total thyroidectomy?
a. Place pillows under your patient’s shoulders
b. Raise the knee gatch to 30 degrees
c. Keep your patient in a high-fowler’s position
d. Support the patient’s head and neck with pillows and sandbags

89. If there is an accidental injury to the parathyroid gland during a thyroidectomy, which of the following might Leda develop post-operatively?
a. Cardiac arrest
b. Dyspnea
c. Respiratory failure
d. Tetany

90. After surgery, Johnny develops peripheral numbness, tingling and muscle twitching, and spasm. What would you anticipate to administer?
a. Magnesium sulfate
b. Calcium gluconate
c. Potassium iodides
d. Potassium chloride

Situation 14: Budgeting is an important part of a nurse managerial activity. The correct allocation and distribution of resources is vital in the harmonious operation of the financial balance of the agency.

91. Which of the following best defines budget?
a. Plan for the allocation of resources for future use
b. The process of allocating resources for future use
c. Estimate cost and expense
d. Continuous process in seeing that the goals and objectives of the agency is met

92. Which of the following best defines Capital Budget?
a. Budgeting estimates the cost of direct labor, number of staff to be hired, and necessary number of workers to meet the general patient’s needs
b. Includes the monthly and daily expenses and expected revenue and expenses
c. These are related to long term planning and includes major replacement of expenses of the plant, major equipments and inventories
d. These are expenses that are not dependent of the level of production or sales. These tend to be time-related, such as salaries or rents being paid per month

93. Which of the following best describes Operational Budget?
a. Budget to estimate the cost of direct labor, number of staff to be hired and necessary number of workers to meet the general patient needs
b. Includes the monthly and daily expenses and expected revenue and expenses
c. These are related long term planning and includes major replacement or expenses of the plant, major equipments and inventories
d. These are expenses that are not dependent on the level of production or sales. These tend to be time related, such as salaries or rents being paid per month

94. Which of the following accurately describes Fixed Cost in budgeting?
a. These are usually the raw materials and labor salaries that depend on the production or sales
b. These are expenses that change in proportion to the activity of a business
c. These are expenses that are not dependent on the level of production or sales. They tend to be time-related, such as rent
d. This is the summation of the Variable Cost and the fixed cost

95. Which of the following accurately describes Variable cost in budgeting?
a. These are related to long term planning and include major replacement or expansion of the plant, major equipment and inventories
b. These are expenses that change in proportion to the activity of a business
c. These are expenses that are not dependent on the level of production or sales. They tend to be time related such as rent
d. This is the summation of variable cost and the fixed cost.

Situation 15: Andrea is admitted to the ER following an assault where she was hit in the face and head. She was brought to the ER by a policewoman. Emergency measures were started.

96. Andrea’s respiration is described as waxing and waning. You know that this rhythm of respiration is defined as
a. Biot’s
b. Kussmaul’s
c. Cheyne stokes
d. Eupnea

97. What do you call the triad of sign and symptoms seen in a client with increasing ICP?
a. Virchow’s triad
b. The Chinese triad
c. Cushing’s triad
d. Charcot’s triad

98. Which of the following is true with the Triad seed in the head injuries?
a. Narrowing of pulse pressure, cheyne stokes respiration, tachycardia
b. Widening pulse pressure, irregular respiration, bradycardia
c. Hypertension, kussmaul’s respiration, tachycardia
d. Hypotension, irregular respiration, bradycardia

99. In a client with a Cheyne stokes respiration, which of the following is the most appropriate nursing diagnosis?
a. Ineffective airway clearance
b. Ineffective breathing pattern
c. Impaired gas exchange
d. Activity intolerance

100. You know that apnea is seen in client with Cheyne Stokes respiration, APNEA is defined as:
a. Inability to breath in a supine position so the patient sits up in bed to breathe
b. The patient is dead, the breathing stops
c. There is an absence of breathing for a period of time, usually 15 seconds or more
d. A period of hypercapnea and hypoxia due to the cessation of respiratory effort in spite of normal respiratory functioning



ANSWER KEY:

1. D
2. D
3. B
4. B
5. C
6. D
7. A
8. B
9. B
10. B
11. B
12. B
13. D
14. A
15. B
16. D
17. B
18. D
19. B
20. D
21. D
22. B
23. D
24. D
25. B
26. C
27. B
28. A
29. B
30. D
31. D
32. D
33. D
34. B
35. D
36. A
37.B
38. A
39. A
40. C
41. D
42. D
43. A
44. C
45. A
46. C
47. B
48. B
49. A
50. D
51. D
52. C
53. D
54. A
55. D
56. C
57. A
58. A
59. D
60. D
61. D
62. A
63. B
64. A
65. D
66. C
67. D
68. B
69. B
70. B
71. A
72. A
73. B
74. C
75. A
76. D
77. B
78. A
79. D
80. B
81. A
82. C
83. C
84. C
85. A
86. D
87. B
88. D
89. D
90. B
91. A
92. C
93. B
94. C
95. B
96. C
97. C
98. B
99. B
100. C









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