NARSOFFDUTY

You Know You Are a NURSE

2009-04-18T16:19:00.000+08:00

Did you hear about the nurse who died and went straight to hell??
It took her two weeks to realize she wasn't at work!
You know you're a nurse if.....

• You believe that every patient needs tlc, diazepam,temazepam and haloperidol.

• You would like to meet the inventor of the Nurse call buzzer some night in a dark alley.

• You believe not all patients are annoying, some are unconscious.

• Your sense of humour gets more warped each year.

• You can only tell time by the 24 hr clock.

• Almost everything can seem humorous....eventually.

• When asked what colour that patients diarrheic was, you show them your
Shoes.

• You know the smell of different diarrhoea to identify it.

• Every time you walk you make a jingling noise because of all the
Scissors and clamps in your pocket.

• You can tell the pharmacist more about the medication they are dispensing than they know.

• You carry more "spare" meds in your pocket rather than waiting for pharmacy to deliver them.

• You refuse to watch ER because it is too much like the real thing and it triggers flashbacks.

• You check the caller id on your day off to see if anyone from the hospital is trying to call and ask you to work.

• You've been telling stories in a restaurant and made someone at another table throw up.

• notice that you are using more 4 letter words than you did before you started nursing.

• Everytime someone asks you for a pen you can find at least 4 of them on you.

• You can intubate your friends at parties.

• You don't get excited about blood unless it's your own.

• You live by the motto "to be right is only half the battle, to convince the doctor is more difficult"

• You've basted your thanksgiving turkey with a nasogastric syringe.

• You've told a confused patient that your name was that of your co-worker and to holler if they need help.

• Eating microwave popcorn out of a clean bedpan is perfectly normal.

• Your bladder can expand to the size of a Mack Truck's Radiator Sump.

• When checking the level of a patient’s orientation you aren't sure of the answer.

• You find yourself checking out other customers veins in grocery waiting lines.

• You can sleep soundly at the hospital cafeteria table on your dinner break and not be embarrassed when you wake up.

• You avoid unhealthy looking shoppers in the mall for fear that they will drop near you and you'll have to do cpr on your day off.

• You have ever referred to someone's death as a transfer to the "Eternal Care Unit".

• You have ever wanted to hold a seminar entitled "Suicide ... Doing It Right".

• You have ever had a patient look you straight in the eye and say "I have no idea how that got stuck in there".

• You have ever had to leave a patient's room before you begin to laugh uncontrollably.

• You throw a party for a co-worker and use a urinal (clean of course) as a lemon-aid pitcher and use a bed sheet for a tablecloth

• You believe that the government should require a permit to reproduce.

• You hate to get dressed in "real clothes" because scrubs are what you live in and why can't they make jeans that comfortable.
• You have ever restrained someone and it was not a sexual experience.
• Your most common assessment question is "what changed tonight to make it an emergency after 6 hours / days / weeks / months / years)?".

• You often stay awake for 24+ hrs at a time when you work nights realize you don't need alcohol or drugs to hallucinate just lack of
sleep...

• You pull over in some parking lot after working nights because you are too tired to drive home and wake up to someone knocking on your window thinking you have had a stroke because you are passed out in your car and drooling.

• Your finger has gone places you never thought possible.

• You have seen more penises than any prostitute
• You disbelieve 90% of what you are told and 75% of what you see.
• You've sworn to have "Not For Resuss" tattooed on your chest.
• You threaten to strangle anyone who even starts to say the "q" word when it is even remotely calm.

Its just to help you understand our mindset and questionable mental status/sanity.
Most of the time we function in spite of this sick sense of humour, fairly normally and very responsibly.

Believe me, this is how we think, ALL THE TIME, Scary huh??

It must be added to the list that you hate flying just incase the air stewards announce "if there is a Doctor or Nurse on board... please make yourself known to the cabin crew" At which point you cringe and hide!

US demand for Filipino nurses declining - educator

2008-10-14T14:59:00.003+08:00

Some 40 percent of Filipino nurses in the United States have undesirable work habits, which could likely be the cause for the slump in the demand for Pinoy nurses, an educator said Friday.

An article in Sun-Star Cebu quoted Henry Seno, president of the American Dream Review Institute Inc. (Amdream) as saying that the decline in the demand for Filipino nurses abroad is caused more by a change in work attitude of the latest batch of nursing professionals rather than the June 2006 nursing board exam cheating controversy.

Amdream's website said it is an affiliate of a Los Angeles-based company with operations in the Philippines that serves as a springboard for Asian operations. It was conceptualized for the purpose of assisting nurses to pass the different US immigration requirements. The Philippines is a haven for medical professionals. However, the dilemma is, only a handful passes the test required for migration to the US.

“Nurses in the Philippines now are no longer of the same quality as the nurses five to 10 years back," Seno said.

He said 40 percent of Filipino nurses in the United States, despite receiving an average salary of $8,000 to $10,000 a month, “do not show up for work (and) literally do not report to the hospitals, especially those with immigrant status (while) those who report act as if they are not there because they’re busy doing other things."

Seno also hits the growing number of nursing schools in the country, churning out nursing graduates who are lacking in hands-on experience and a good grasp of educational background.

“There are more nursing schools now and so many nursing graduates. These schools have become mere diploma mills," Seno said.

This negative scenario, he said, has caused hospitals and clinics in the United States to recruit more nurses from India, Korea and China compared to those they hire from Philippines as these institutions have become apprehensive in their choice of nursing imports.

Seno also blames local recruitment agencies for taking advantage of the need for nurses in the US by “duping" hospitals and health institutions to hire Pinoy nurses who are not qualified for nursing jobs.

Source

NLE RESULT

2008-07-24T22:00:00.004+08:00

DOWNLOAD

CONGRATULATIONS TO ALL THE PASSERS OF JUNE 2008!!!

Filipino nurses still in demand

2008-07-22T23:58:00.002+08:00

MANILA – Contrary to the claims of a group of Filipino nurses, the Philippines’ Department of Labor and Employment (DOLE) maintained that the global demand for locally-trained medical practitioners remains high especially in Western countries with an aging population.

Labor Secretary Marianito Roque said the global demand for Filipino nurses is high but the lack of adequate and necessary experience prevents many of them from finding overseas employment.

“(The only question) is how acceptable they would be given their experience,” Roque was quoted by GMAnews.tv as saying.

The Labor chief rebuked the claims of the Philippine Nursing Association (PNA) earlier this month that an oversupply of Filipino nurses has resulted from the declining demand for nurses in the United States and United Kingdom.

Roque asserted that Saudi Arabia alone is “in need of 10,000 nurses for their public hospitals” and they are looking for Filipino nurses to fill in these vacancies.
He said there is also a growing demand for Filipino nurses in Canada as well as Australia.

While he admitted that the US is putting a cap on the entry of Filipino nurses, Roque said this should not prevent Filipinos from looking at other possible market for capable nurses.

“We are preventing the demand because we don’t want them to leave in fear that the supply will run out. But there are (other) markets for them,” Roque said.

Earlier, Dr. Leah Samaco-Paquiz, president of the PNA, said the demand for Filipino nurses had “plateaued” in the US since 2006 because of the “visa retrogression” there.
“In the US, the quota for visas has been filled up resulting in delayed processing of visas with current efforts focused on 2006 accepted applicants,” Paquiz said.

She added that “many licensed nurses are now underemployed or unemployed as a result of changes of policy in destination countries, the current situation of oversupply and quality problems, among others.”

Despite this situation, Dean Leonora Reyes, vice president of Association of Deans of Philippine Colleges of Nursing, said they could not discourage people from taking up nursing.

“We cannot tell people not to enroll but they should choose the reputable program (nursing schools) that can deliver. They must go to reputable institution, (the ones that are) accredited because priority is given to those coming to these schools,” Reyes said.

Meanwhile, Dr. Marilyn Lorenzo, director of University of the Philippines’ Institute of Health Policy and Development Studies, recalled that the demand for Filipino nurses begun to rise in 1999 but slowed down in 2006.
The demand for nurses abroad had led to the rise in nursing schools and graduates in the Philippines.

In 1999, the number of nursing graduates was only 5,672 while in 2004 and 2005, the number of graduates increased to 14,383 and 34,589, respectively.
But experts believed that the boom in nursing would again happen after 10 years.

Source

CONGRATULATIONS JOW!

2008-07-15T15:19:00.000+08:00

TOP 10 AMERICAN HOSPITALS

2008-07-14T02:44:00.000+08:00

Hospital Name & Link	Job Opportunity Bulletin	Employment Office
1. Johns Hopkins Hospital, Baltimore	Click	Human Resources Divisional Offices Homewood Shriver Terrace Suite 5 3400 North Charles Street Baltimore, MD 21218-2688 Phone: 410-516-8048
2. Mayo Clinic, Rochester, Minn.	Click	200 First St. S.W. Rochester, MN 55905, Tel: 507-284-2511
3. Cleveland Clinic	Click	9500 Euclid Avenue , Cleveland, OH 44195 , Tel: 216.444.2200 or 800.223.2273 ext. 48950
4. Massachusetts General Hospital, Boston	Click	Central Employment Resources, 101 Merrimac St., 5th Floor, Boston, MA 02114, Email careers@partners.org, or Call 617-726-2210.
5. UCLA Medical Center, Los Angeles	Click	CHS 17-253, Los Angeles, CA 90095-1731, Human Resource call (310) 794-0500
6. New York-Presbyterian Univ. Hosp. of Columbia and Cornell	Click	Main Campus 622 West 168th Street New York, NY 10032 Tel: (212) 305-2500
7. Duke University Medical Center, Durham, N.C.	Click	Personal Assistance Service, 2200 West Main Street, 7th Floor, Suite 700, Wachovia Plaza, Durham, NC 27708, Tel: 416-1727
8. Barnes-Jewish Hospital/Washington University, St. Louis	Click	One Barnes-Jewish Hospital Plaza Saint Louis, MO 63110, Phone: 314-747-3000
9. University of California, San Francisco Medical Center	Click	HUMAN RESOURCES 3333 California Street, Suite 305 San Francisco, CA 94143-1202 Phone: 415/476-1645 · Fax: 415/476-4672
10. University of Washington Medical Center, Seattle	Click	1959 NE Pacific, Seattle, WA 98195, Tel : 206-598-3300

Source: US News and World Report

Oversupply of Nurses?

2008-07-12T23:03:00.003+08:00

Jul 10, 2008

Could it be that the Philippines got too excited about the demand for nurses worldwide that today, there are too many nurses than the healthcare institutions can handle.

A report from the University of the Philippines Dean of the College of Nursing revealed that indeed our country has so many nurses that new nursing graduates are finding it hard to find jobs. The competition among nursing grduates is so stiff that local hospitals can now afford to hire nurses for free.

Another proof that we have too many nurses is a report from the President of the Philippine Nurses Association (PNA), Leah Paquiz, that the quota requirement for migrant workers in America for this year had been reached.

This is not the first time that the Philippines had experienced an oversupply of professionals of a particular field. There was a time when demand for Physical Therapists (PT) abroad made the course very popular among Filipino students only to find out later that the supply becomes greater than the demand and many PT graduates found themselves jobless or if employed, in a job that offer very little or no monetary pay.

The cliché that history repeats itself seems to be true in this case as it seems to be happening again with the nurses. In spite of the obvious oversupply of nurses, nursing schools continues to proliferate and offer nursing courses to hopeful students; almost all of them wishing to land a job overseas.

What’s worse is that many of these new nursing schools are mere diploma mills adding more number of nurses every year. The government program that “ladderizes” nursing education allowing students to be practical nurses also adds to the oversupply problem.

The impending future of too many nurses posed a serious problem for the country that should not be ignored. Paquiz of PNA said, “There is no local demand or positions for practical nurses within the Philippine Health Care Delivery system particularly in the light of the oversupply of nurses and subsequent unemployment of graduate nurses.”

The PNA are calling the attention of the Commission on Higher Education (CHED) to monitor and be strict against new nursing schools and even on courses that offer two-year practical nursing program. Paquiz said that foreign employers still prefer the four-year college-degree nurses who passed the Licensure Board Exams.

A PNA statement said, The PNA “strongly objects to the institution of the Practical Nursing program and vehemently rejects the proposed ladderization of the nursing curriculum,” a PNA statement said.

The PNA also want to emphasize that more than the quantity, the

Philippines

should focus more on producing quality nurses and not to view nursing as a surefire way out of poverty

source

PNA Seminars 2008

2008-06-29T23:52:00.001+08:00

PHILIPPINE NURSES ASSOCIATION

Committee on Continuing Education

Venue: PNA Auditorium 1663 F.T. Benitez Street, Malate, Manila

July 4 Lung Disease: Focus on Asthma 8:00 am – 12:00 nn
On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

July 11-12 Nursing Skills Fair 8:00 am - 5:00 pm

Pre-Registration Registration Fee:
Php 1,500.00 Member Php 1,700.00 Non-Member

July 18 Rheumatic Heart Disease 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

July 25 Looking Beyond the Vital Signs: Comprehensive Assessment 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

August 1 Care of Patient with Acute Coronary Syndrome 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

August 8 Basic Infection Control Course 8:00 am – 5:00 pm

On-Site Registration

Registration Fee: Php 600.00 Member Php 650.00 Non-Member

August 15 Oncology Nursing: What’s the Buzz? 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

August 22 Nursing Care of the Critically Ill Patient 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

August 29-30 Nursing Skills Fair 8:00 am - 5:00 pm

Pre-Registration Registration Fee:
Php 1,500.00 Member Php 1,700.00 Non-Member

September 5 Understanding the Stroke Patient: What do they need? 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

September 12 Basic Infection Control Course 8:00 am – 5:00 pm

On-Site Registration

Registration Fee: Php 600.00 Member Php 650.00 Non-Member

September 19 Practical Tips in Handling Instruments in the Operating Room 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

September 26 Pain Assessment and Management in Pediatrics 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

October 3 Taking A Closer Look at Renal Nursing 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

October 10-11 Nursing Skills Fair 8:00 am - 5:00 pm

Pre-Registration Registration Fee:
Php 1,500.00 Member Php 1,700.00 Non-Member

October 17 Triage Nursing 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

November 7 Organ Transplantation: Issues and Concerns

On-Site Registration 8:00 am – 12:00 nn

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

November 14 Basic Infection Control Course 8:00 am – 5:00 pm

On-Site Registration

Registration Fee: Php 600.00 Member Php 650.00 Non-Member

November 21 Nursing Opportunities Here and Abroad 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

November 28 Cardiac Rehabilitation 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

December 5 Scaring Facts About Rabies 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

December 12 Implementing “Time-out” in Surgical Procedure 8:00 am – 12:00 nn

On-Site Registration

Registration Fee: Php 300.00 Member Php 350.00 Non-Member

Hapi Bday Andi

2008-06-27T04:20:00.003+08:00

Instead of counting candles,
Or tallying the years,
Contemplate your blessings,
As your birthday nears.
Consider special people
Who love you, and who care,
And others who’ve enriched your life
Just by being there.
Think about the memories
Passing years can never mar,
Experiences great and small
That have made you who you are.
Another year is a happy gift,
So cut your cake,
and make a wish!

You deserve a big CAKE...
So Celebrate and Enjoy this Moment

For it Comes Once a Year!

HAPPY HAPPY BIRTHDAY ANDI!
Stay sweet as a cake!

happy birthday hottie golds!

2008-06-06T00:01:00.003+08:00

On your birthday, we're thinking how much light and sparkle you freely dispense wherever you go, how your sunny smile lights up any gathering... ♥
contagious happiness that infects all who come in contact with you...
we wish you all the success, happiness, & joy in life.
we love you!
(matouch ka matouch ka! hehe) =p
ps: burger! burger! burger!

From: Your NOD Family ♥

Group opposes implementation of new nursing curriculum

2008-05-23T00:13:00.000+08:00

The Coordinating Council of Private Educational Associations (Cocopea) voiced strong opposition against the new nursing curriculum that the Commission on Higher Education (CHED) wants to implement this June.

The group said, under the new curriculum, it would take a student five years to finish the course from the current four years because of additional subjects.

Additional subjects mean parents would have to shell out more money for tuition, lab fees and books.

"Do not overburden the students. Wala na nga silang oras sa sarili. What kind of graduates would we be producing?" said Fr. Antonio Samson, president of Ateneo de Zamboanga.

School officials expressed concern that pending tuition increase would affect the number of students interested to take up nursing.

"Kung dati 1,000 baba yun kasi hindi sila handa sa dagdag gastos," said Dr. Amelou Reyes, president Philippine Women's University.

Under the new curriculum, students would have to spend an additional 561 hours in their required learning experience or hospital hours.

Cocopea said under the old curriculum, students are already having difficulty finding suitable hospitals. It added that the additional hours would only exacerbate the logistical problem of schools.

The group warned it will ask for a temporary restraining order with the Supreme Court if CHED continues to turn a blind eye on the repercussions of the new curriculum.

CHED, meanwhile, defended the proposed curriculum. It said that it already compromised with school officials that they would be given a year to implement the new curriculum.

"The commission en banc has decided that nursing schools that are ready to adopt and implement the new curriculum can, those who cannot they are given one year," said Dr. William Medrano, CHED Chief Operating Officer.

The commission asserted that changing the curriculum is their way of further improving the quality of nursing education in the country.

"The technical committee only wants to enhance the skills of our nurses and to improve further the quality of nursing education," said Medrano.

Surgery Video Scandal in Youtube

2008-04-17T02:02:00.000+08:00

A doctor gingerly pulls out the 6-inch long canister from the male patient's rectum... someone shouts, "Baby out!" amid loud cheers.

A 3 minute unauthorized video of a rectal surgery was uploaded in youtube. But was removed last Wednesday due to controversial issues regarding client's safety , privacy and confidentiality.

The patient who is a 39 year old florist of Basak-Pardo, Cebu City was horrified to find out that he was the one in the video circulating in the internet. He claimed he was drunk during the incident and realized only the following morning that a foreign object had been left in his rectum after having sexual contact with a stranger on New Year's Eve.

He went to the government-run VSMMC, the largest government hospital in Central Visayas, and underwent a rectal surgery on Jan. 3. He said he was sedated and did not know that the procedure was being recorded with a cellular phone camera.

Ehical, Legal and Moral Issues : Right to Privacy and Confidentiality

*The posting of the video in the Internet violated several provisions of the Patients Bill of Rights, including the right to be free from unwarranted publicity, right to confidentiality and to good quality health care and professional standards.

*Capturing still images or videos is an invasion of patient's rights to privacy unless of course, the patient has signed a consent that will allow it to happen.

2008-03-30T02:05:00.000+08:00

Face it, foreign talent's much needed
By Neville Stack
March 29, 2008

IT'S OFTEN hard to live with them. But even harder to live without them.

They are called expats or migrants, guest workers.

Whatever the name, many countries have come to rely on them. Heavily.

In my time, I was one: An expat expert, head-hunted by this newspaper group to train journalists, to advise on writing and ultimately to be a prolific correspondent for their newspapers.

But I was struck then, as now, by the reliance Singapore places on workers from other countries.

I am certainly not complaining, for I was treated extremely well and made many local friends, whom I still treasure.

Increasingly, skilled foreigners are being recruited in Singapore to keep the country moving ahead.

Minister Mentor Lee Kuan Yew has pointed out the need in stark terms. Earlier this month, he said that Singapore has no choice but to attract foreign talent if it wants to progress.

But this is not just a Singaporean phenomenon. Where I live now, in Europe, the foreign worker is an accepted - though sometimes controversial - part of our lives.

The waitress, the plumber, the computer guy, all from elsewhere in Europe. In the local hospitals, Filipino nurses and Indian doctors are the norm.

In general they are all educated, English-speaking, smart. And courageous enough to leave home and work in a faraway country of which they knew little.

What would we do without them? What indeed...

Yet some of the richer countries, who naturally attract the largest numbers, are quite scared of what is happening. 'Flooding in' is how the migrants are described.

No matter that the hosts caused the problem in the first place.

Current estimates on the total number of international foreign workers stand at about 25 million, with a comparable number of dependants accompanying them.

Sometimes, a host country sets up a programme in order to invite guest workers in time of need.

SECOND THOUGHTS

Now the hosts are having second thoughts about their capacity to absorb so many newcomers.

The 'anti' movements are quite passionate. Dangerously so, in some cases. Where foreigners - even tourists - are physically attacked.

No one can do anything about workers from other European countries because the European Union has abolished controls and guarantees free movement of labour within the member states.

In the American election campaign, what to do about 'the undocumented' is a major issue.

In Germany and France, especially, strict standards of language and civic-awareness are currently being imposed, especially on would-be workers from Africa.

Most other European countries are doing the same.

In Britain, belatedly, curbs on arranged brides from other countries as well as language skills are being introduced.

That is all very well - except for the harm that is being done to the countries of origin. And that can be very serious indeed.

The brain drain is sucking badly-needed doctors and nurses from the very parts of the world where they are desperately needed.

TECHNOLOGY TRANSFER

Only last week I met with a black doctor from Sudan. He is studying to be a consultant physician and doing very responsible work in an Irish hospital.

Then he plans to go back home, to Darfur 'where I am desperately needed'.

Good for him, say I.

That is what is called 'technology transfer', where the rich countries get help in return for training. And then he - and others like him - will then go to where he is needed most.

I do hope they stick to what they plan because that would be a mutually beneficial arrangment - the best of both worlds, in fact.

Nothing but good can come from the host country's acquisition of the skilled workers who come from other countries in search of a better, fuller life.

This encourages countries like the Philippines to develop 'brain factories', whereby professionals in fields such as medicine and music are exported and money sent back home to help their families.

In this age of global commerce and communication, the more people gain the know-how of other cultures and varied skills the better. In that way, dangerous misunderstanding, uninformed criticism, inadvertent offence can be averted.

If, as in the case of certain fanatics, this leads to envy, hatred and resentment, then that is a risk that must be accepted.

The good far outweighs the bad in a worldwide interchange.

http://newpaper.asia1.com.sg/news/story/0,4136,160484,00.html

Feature Story: Nursing to the Ends of the Earth

2008-03-12T06:17:00.001+08:00

After completing her degree in Australia, Theresa returned home to practice her profession in Zamboanga’s needy areas, only to find that her Australian nursing degree was not recognized in the Philippines. “I was appalled! I had studied for four years in a first world country and yet what I learned was not good enough for the Philippines!

NOD Summer Shindig

2008-03-11T16:30:00.001+08:00

Yes!!! You are not hallucinating! So kick-off your white shoes and rip off your uniforms because,

YOU ARE INVITED!!!

Tentative Date: April 5 - 6, 2008 (Saturday - Sunday)
Tentative Place: Subic, Zambales

Macon Hits II

2008-03-08T03:17:00.001+08:00

Happy Birthday Gwen and Kitin

2008-03-07T05:23:00.000+08:00

Warm wishes on your birthday...

oh i mean hot wishes on your birthday.

May you have more blessings your way. ;-)

Happy birthday!!

2008-03-01T14:39:00.002+08:00

Age is not counted by years,
but by friends...
the more you have friends,
the more you get younger...
so don't worry bout your age.. lols

Rock on Nodian!!

*death note character.. kira hhehehe

from:

*NOD family!

PS:

ay yab yu!!! uuhhhmmmwwwaaaahhhhh!!!

ti dendenti jijie
(our twins..lols)

Sample NCLEX Questions VI

2008-02-29T16:46:00.003+08:00

1. A client sustained a fracture 3 days ago. When the following blood studies are returned, they are all elevated. Which elevation is considered a normal finding following a fracture?

A) Alkaline phosphatase.

B) Uric acid.

C) Amylase.

D) Calcium.

Answer: A

A) Bone is rich in alkaline phosphatase and blood levels normally increase following a fracture and during fracture healing. Elevation of the other blood studies should alert the nurse to the need for further assessment of the client, because of the probable presence of an illness.

Topic: Physiological Integrity

2. A nursing care plan will include observations for possible complications associated with duodenal ulcer disease. An indication of a serious complication would be

A) Constipation of several days duration.

B) Bright-red bloody stools.

C) Tarry stools.

D) Severe diarrhea.

Answer: C

C) Bleeding is a more severe complication than either constipation or diarrhea. Bright-red stools indicate a bleeding problem low in the gastrointestinal tract. A bleeding duodenal ulcer would have tarry stools, as the blood has been digested by the action of the intestinal juices.

Topic: Physiological Integrity

3. A component of the discharge plan for a client discharged on Warfarin will be to instruct him to avoid which of the following over-the-counter products unless his doctor instructs otherwise?

A) Antihistamine.

B) Vitamin C.

C) Advil

D) Aspirin.

Answer: D

D) Aspirin or any medication that contains aspirin (such as certain cold medications) combined with the anticoagulant Warfarin could cause serious bleeding. Vitamin K should be avoided because it makes Warfarin less effective.

Topic: Physiological Integrity

4. The laboratory result that should be monitored regularly in a client who is receiving gentamycin (Garamycin) is

A) Serum calcium.

B) White blood cell count (WBC).

C) Serum creatinine.

D) Platelets.

Answer: C

C) Gentamycin, a potent aminoglycoside antibiotic, has the potential for causing nephrotoxicity. Renal function studies such as the serum creatinine and BUN should be monitored regularly to detect impaired renal function.

Topic: Physiological Integrity

5. A client, 5 months pregnant, comes to the clinic for a check-up. The nurse instructs her to immediately report any visual disturbances. The best rationale for this instruction is that visual problems

A) Mean the client needs more protein in her diet.

B) Indicate increased intracranial pressure.

C) Indicate a deficiency in iron.

D) Are a symptom of pre-eclampsia.

Answer: D

D) Visual disturbance is a symptom of pre-eclampsia and the client must immediately be put under a physician's care to prevent further development of eclampsia.

Topic: Physiological Integrity

6. The RN in the emergency room admits a 20-year-old woman who has been raped and suffered severe lacerations. Initially, the assessment should focus on the client's

A) Degree of crisis.

B) Ability to recount the incident.

C) Physical injuries.

D) Mental status.

Answer: C

C) Initially, physical injuries will take precedence over other aspects of care. They need to be assessed, treated and documented for possible legal action. Crisis treatment will be the next goal of care.

Topic: Psychosocial Integrity

7. A client fell from a horse and sustained a head injury. The nurse will consider all of the following goals; the one to receive first priority is to

A) Maintain an open airway.

B) Maintain fluid-electrolyte balance.

C) Control pain and restlessness.

D) Monitor neurological status, including vital signs.

Answer: A

A) A patent airway is always a priority need, particularly in a client with a head injury, because hypoxia and hypercapnia cause cerebral edema with increasing intracranial pressure.

Topic: Physiological Integrity

8. Following several radiation treatments, the nurse observes that a client's skin appears wet and weeping. According to protocol, the intervention is to

A) Give the treatment and instruct the client to use antibiotic lotion on the lesions.

B) Not give the treatment and explain to the client not to bathe the skin until the weeping stops.

C) Give the treatment and make a note on the record concerning the skin condition.

D) Not give the treatment and notify the physician.

Answer: D

D) During the time the reaction occurs, the protocol states that clients are taken off radiation therapy and instructed to use antibiotic lotion and steroid cream to prevent infection.

Topic: Safe, Effective Care Environment

9. A client, age 68, has an external shunt placed in preparation for hemodialysis. The nursing care plan will include

A) Observing for dark spots in the shunt that may represent clot formation.

B) Testing the shunt to determine if it is cool to the touch, like that of the forearm, which signifies patency.

C) Listening for a bruit over the shunt area; if bruit is heard, the shunt may be clotted.

D) Observing for blood going through the shunt to identify possible clotting that may occur immediately following the dialysis run.

Answer: A

A) Shunts should be inspected several times each day for presence of possible clotting. Dark spots will quickly be followed by separation of the sera and cells if clotting becomes complete. When dark spots appear, clients should be instructed to immediately seek treatment for declotting.

Topic: Physiological Integrity

10. The nurse is assigned to a male client who was admitted with flu symptoms of nausea and vomiting. He is receiving IV therapy. The lab has sent his early morning blood results which are: BUN 32, Creatinine 1.1, Hematocrit 50. The initial nursing intervention is to

A) Notify the physician immediately.

B) Decrease the IV rate and notify the physician, as lab results indicate overhydration.

C) Evaluate the urine output for amount and specific gravity.

D) Do nothing because the results are within normal limits.

Answer: C

C) These lab results indicate that the client is dehydrated. Specific gravity and urine output are indicators used to support the laboratory findings. The higher the specific gravity, the more dehydrated the client.

Topic: Physiological Integrity

11. A client who has just been admitted to the unit is in the dayroom. The nurse observes that she appears anxious and ill at ease. The nurse's most therapeutic response is to

A) Tell her that everyone feels strange at first.

B) Ask her why she is uncomfortable.

C) Offer to stay with her for a short while.

D) Leave her in the company of another client.

Answer: C

C) Remaining with a client who is anxious will assist in decreasing anxiety. Telling her everyone feels this way is false reassurance (A), and asking questions when the client is very anxious (B) is nontherapeutic. At this point, leaving the client with another person is also not therapeutic (D).

Topic: Psychosocial Integrity

12. A pregnant client arrives in the emergency room. An initial assessment indicates that she is ready to deliver and crowning is occurring. The first nursing action is to

A) Ask the client to push according to your instructions.

B) Instruct the client to take short shallow breaths to improve fetal oxygenation.

C) Apply gentle perineal pressure to prevent rapid expulsion of the head.

D) Notify the physician.

Answer: C

C) The first action is to support the perineum to prevent tears and rapid delivery. The nurse will ask the client to take short breaths (following instructions) but to prevent pushing; the nurse will also send someone for the physician.

Topic: Health Promotion and Maintenance

13. Assessing a client for hypovolemic shock, the sign that the nurse would expect to observe is

A) Oliguria.

B) Hypertension.

C) Cyanosis.

D) Tachypnea.

Answer: A

A) In shock, there is decreased blood volume through the kidneys. This is evidenced by a decrease in the amount of urine excreted. The body has numerous compensatory mechanisms that assist in keeping the blood pressure normal for a short time.

Topic: Physiological Integrity

14. Important baseline information that must be collected prior to the physician prescribing oral contraceptives for an 18-year-old female is

A) A history of thrombophlebitis or migraine headaches.

B) A complete sexual history.

C) Parental approval and written consent.

D) A report on the AIDS antibody test.

Answer: A

A) Because one of the suspected effects of the pill is thrombophlebitis, it is important to know the client's history. If the client's history indicates a predisposition, the pill would not be the contraceptive method of choice. The AIDS test is not required for contraceptive counseling; neither is parental permission.

Topic: Physiological Integrity

15. The milliliters of drug that should be used to give 0.5 gm if the label on the bottle reads 5 gm in 10 mL is

A) 5.0 mL.

B) 1.0 mL.

C) 0.5 mL.

D) 2.0 mL.

Answer: B

B) Dose on hand is in 10 mL, so to calculate the amount to give, divide the dose desired by the dose on hand and multiply by 10 mL. Example: 0.5 gm divided by 5 gm equals 0.1, then multiplying by 10 equals 1 mL.

Topic: Physiological Integrity

16. A client with congestive heart failure is placed on a mildly restricted sodium diet of 2,000 mg/day. The nurse will know this client requires more teaching if he says that he can eat

A) Instant coffee.

B) Fresh fruits.

C) Boiled eggs.

D) Canned soup.

Answer: D

D) Canned soups are high in sodium and if the client thinks that he can eat these soups, he would require further teaching. The remaining foods would be acceptable. Instant coffee is high in potassium.

Topic: Physiological Integrity

17. Following delivery, a 32-week, 5 lb. female infant demonstrates nasal flaring, intercostal retraction, expiratory grunt, and slight cyanosis. Blood gases and electrolyte studies of the baby are ordered immediately to assess the infant's

A) Antibody titer for RH.

B) Oxygen, carbon dioxide, and pH levels.

C) Leukocyte count.

D) Blood glucose level.

Answer: B

B) Blood gases are drawn to determine if the oxygen, carbon dioxide, and pH levels are within normal range. The treatment given to the infant depends to a great extent on these results. For example, if the blood PO2 level is down and the PCO2 is elevated, the concentration of oxygen the infant is receiving will be increased and the infant may be placed on CPAP or PEEP to increase residual capacity and improve oxygenation. Drugs such as sodium bicarbonate may be given to correct acidosis or a low pH. Normal values: pH 7.35-7.45; PO2 40-60; PCO2 35-45.

Topic: Health Promotion and Maintenance

18. The nurse responsible for planning an elderly, senile client's schedule knows that it is most important that the daily activities

A) Are changed each day to meet the need for variety.

B) Provide many opportunities for making choices to stimulate involvement and interest.

C) Involve physically limited activity, as the client tires easily.

D) Are highly structured to reduce anxiety.

Answer: D

D) Elderly senile clients are often anxious, especially in an unfamiliar environment. Struc-ture decreases anxiety. Making choices and constantly changing activities will increase anxiety. Their activity should not necessarily be limited.

Topic: Psychosocial Integrity

19. The nurse would assess for a cardinal sign of eclampsia during pregnancy which is

A) Hypertension.

B) Concentrated urine.

C) Weight gain of 1 to 2 pounds a week.

D) Lassitude and fatigue.

Answer: A

A) High blood pressure is one of the cardinal signs of eclampsia, along with excessive weight gain, edema and albumin in the urine.

Topic: Health Promotion and Maintenance

20. The nursing diagnosis most important for a client with a spinal cord injury at the level of cervical 3-4 (C 3-4) is

A) Altered pattern of urinary elimination.

B) High risk for disuse syndrome.

C) Ineffective breathing pattern.

D) High risk for impaired skin integrity.

Answer: C

C) Innervation to the diaphragm and intercostal muscles can be disrupted by a cervical injury; therefore, the priority nursing diagnosis is ineffective breathing pattern. The other diagnoses would be of lesser priority.

Topic: Physiological Integrity

21. A 4-year-old African-American girl lives in San Francisco with her mother and father. An initial diagnosis of sickle cell anemia was made after she experienced her first thrombic crisis. Based on knowledge of this disease, the nurse knows that a thrombic crisis is the result of

A) Occlusion of small blood vessels.

B) Injury to the joints.

C) Hemarthrosis.

D) Pooling of the blood in the spleen.

Answer: A

A) Thrombic crises are the result of occlusion of small blood vessels. Sequestration crises are the result of pooling of blood in the spleen. Hemarthrosis occurs in hemophilia.

Topic: Physiological Integrity

22. Caring for a child with a basilar skull fracture, the nurse understands that the child is at risk for developing meningitis because

A) Any open fracture may become infected.

B) The blood supply is disrupted and the white blood cells cannot work against invading bacteria.

C) The fracture causes a direct tear in the meninges.

D) Of the proximity to sinuses and oronasal pharynx which may contaminate the cerebral spinal fluid.

Answer: D

D) While the fracture is not open to the environment, the upper respiratory tract harbors many organisms that could colonize in the central nervous system via the tear in the dura. Normally, the blood supply is not disrupted.

Topic: Physiological Integrity

23. Amniocentesis would not be performed on a woman if the nurse assesses that she

A) Has a family history of genetic disorders.

B) Will not consider an elective abortion.

C) Is an Ashkenazic Jew.

D) Is carrying twins.

Answer: B

B) The test is done primarily to determine fetal trisomy 21 (Down's syndrome) in pregnant women over 35 years of age. If the fetus is defective and the woman or couple do not wish to have an elective abortion, the procedure would probably not be performed due to its potential risk (though small) to the woman. Answer (C) is not correct as Ashkenazic Jews have a high incidence of Tay-Sachs disease. Although more difficult, amniocentesis may be performed on women carrying twins.

Topic: Health Promotion and Maintenance

24. A client is hospitalized following a myocardial infarction. He is receiving Digoxin and Lasix. After discharge teaching, the client should be able to tell the nurse that side effects of the drugs would include

A) Hypercalcemia.

B) Hypocalcemia.

C) Hypernatremia.

D) Hypokalemia.

Answer: D

D) Lasix is a loop diuretic which inhibits the reabsorption of sodium and chloride in the ascending loop of Henle. Potassium loss is a direct result of a large volume of urine output. The client should be taught the symptoms of hypokalemia. The client will not be hyper- or hypocalcemic or necessarily have a high sodium level because of the Lasix.

Topic: Physiological Integrity

25. An elderly female client with the diagnosis of congestive heart failure has just been admitted to the nursing unit. She is experiencing dyspnea and becomes very agitated. The priority intervention is to

A) Administer oxygen at 3 l/minute via nasal prongs per standing orders.

B) Place the client in Fowler's position.

C) Reassure the client that the nurse will stay with her.

D) Evaluate the client's breath sounds.

Answer: B

B) All four of the interventions will be carried out; however, placing her in Fowler's position is the first intervention. This position will provide better mechanics for breathing because it increases lung expansion.

Topic: Physiological Integrity

26. Which of the following statements indicates that a client with gout understands his discharge instructions?

A) "I will restrict meats and fish in my diet."

B) "I will restrict foods high in sodium."

C) "I will report any side effects of aspirin."

D) "I will increase my intake of fluids."

Answer: D

D) Clients should understand it is important to increase their fluid intake to at least 2000 ml each day. The increased fluid will assist in urate excretion and minimize urate precipitation in the urinary tract. Certain meats, such as organ meats and shellfish, are high in purine and should be restricted.

Topic: Physiological Integrity

27. The client, age 86, has a fractured hip and his physician has applied Buck's traction preoperatively. The nursing assessment is to ensure that there is adequate countertraction and will include

A) Weights hanging freely off the floor and bed.

B) Checking that the client is pulled down on the bed, using the end board as a foot rest.

C) Ropes knotted to prevent them from moving through the pulleys.

D) Checking that the foot of the bed is elevated to provide countertraction.

Answer: A

A) Weights must hang freely off floor and bed to ensure countertraction. Ropes should be securely knotted, but they must move freely through pulleys. The client should not be pulled down in bed, because this position will negate the traction. Topic: Physiological Integrity

28. The nurse is assigned to a 32-year-old male client who has just returned from surgery following above the knee amputation of his left leg. The nursing strategy that will be most helpful in assisting the client to adjust to his handicap is to

A) Ask him how he feels about the amputation.

B) Collect more information about his feelings before formulating specific goals.

C) Establish trust by anticipating all of his needs before he has to ask the nurse to do something for him.

D) Suggest that he join a group of clients who have experienced similar problems.

Answer: A

A) Assisting the client to adjust to his handicap would involve helping him express his feelings about the surgery. The more directly the nurse can assist the client to discuss and deal with these feelings, the more quickly he will be able to adjust. The more client-oriented the approach, the more it is therapeutic.

Topic: Physiological Integrity

29. Following a cardiac catheterization procedure in a child, the nurse will test the specific gravity of urine. The rationale for this test is to

A) Evaluate the child's hydration status.

B) Determine if the kidneys are functioning.

C) Identify possible complications.

D) Determine if the dye is being excreted.

Answer: A

A) Specific gravity results indicate the hydration status of the child. Children are NPO prior to the test so it is important that adequate hydration be accomplished following the procedure. Specific gravity does indicate the ability of the kidneys to concentrate or dilute urine, but in this case, the nurse would be looking for hydration status.

Topic: Physiological Integrity

30. A young client, age 14, will receive a Milwaukee Brace to correct for scoliosis, 24 degree curve. Reviewing her discharge instructions, the nurse will know she does not require more teaching when she says she will

A) Wear the brace all day and remove it only to bathe.

B) Put the brace on a minimum of 1 hour 3 times per day.

C) Wear the brace after school and at night.

D) Take off the brace if her skin gets sore or starts to break down.

Answer: A

A) It is important that the brace remain on at all times except for bathing. It will also be important to teach her to use good skin care in the area where the brace touches her skin.

Topic: Physiological Integrity

31. The physician orders a nasogastric tube to be inserted. During the insertion of the NG tube, the nurse will position the client in

A) High-Fowler's with neck hyperextended.

B) High-Fowler's with head bent forward.

C) Right side-lying with head straight up.

D) Low-Fowler's with head tilted back.

Answer: B

B) The preferred position is Fowler's with the head flexed forward to assist the tube to move into the esophagus. The nurse would never ask the client to hyperextend the neck, as this might open the airway and cause the tube to enter the trachea.

Topic: Physiological Integrity

32. The nurse is assigned to work with a client diagnosed as having pernicious anemia. The nurse will know the client requires more teaching if the client says that she should include in her diet more

A) Meat, milk, cheese.

B) Whole grains, cereals.

C) Organ meats, yellow vegetables.

D) Fruits, green leafy vegetables.

Answer: D

D) Fruits and vegetables contain vitamin C and B. Vitamin B12 comes from animal products. Clients with pernicious anemia have a B12 deficiency. Clients either need frequent B12 injections or they must drastically increase the foods (such as meat, milk and cheese) that provide B12 in sufficient quantity.

Topic: Physiological Integrity

33. A client on the psychiatric unit with the diagnosis of anorexia nervosa has lost 20 pounds and is beginning to show signs of dehydration. Which of the following nursing approaches indicates the best understanding of the situation?

A) "If you like, you can eat alone in your room."

B) "The staff wants you to eat and drink on your own; but if you won't, we'll have to tube feed you."

C) "You can't expect to get better if you don't eat and drink."

D) "Why do you want to hurt yourself like this?"

Answer: B

B) With anorexia nervosa, the danger is of starvation and death; therefore, the client should be informed of the consequences of not eating. She should not be allowed to eat alone, because there is no assurance she will actually eat the food.

Topic: Psychosocial Integrity

34. For a client with a suspected peptic ulcer, which of the following questions in an assessment history is the most relevant?

A) "Are there any changes in your bowel or bladder habits?"

B) "Have you had any changes in your stool?"

C) "Are you frequently constipated?"

D) "Do you have frequent diarrhea?"

Answer: B

B) The client is complaining of abdominal pain; therefore, the question seeking to determine gastrointestinal bleeding (tarry stools) is the most relevant.

Topic: Physiological Integrity

35. A client has otosclerosis and is scheduled for a stapedectomy. This condition chiefly involves the

A) Ossicle.

B) Auditory canal.

C) Tympanic membrane.

D) Auditory nerve.

Answer: A

A) The stapes and ossicle in the middle ear become fixed and immovable.

Topic: Physiological Integrity

36. Several chronic schizophrenic clients are assigned to a group therapy session. The best rationale for this form of treatment is that it

A) Enables clients to become aware that others have problems and that they are not alone in their suffering.

B) Is not psychoanalytically based, but deals with unconscious material.

C) Provides a social milieu similar to society in general, where the client can relate to others.

D) Is the most economicalÑone staff member can treat many clients.

Answer: C

C) Because many people's problems occur in an interpersonal framework, the group setting is a way to correct faulty perceptions as well as work on effective ways of relating to others. The remaining answers are all accurate, but they do not fit the requirement of best rationale.

Topic: Psychosocial Integrity

37. A 50-year-old client with a chronic respiratory problem comes into the emergency room with the following symptoms: fever, cough, chest pain, and tachycardia. An arterial blood gas is obtained on admission with a repeat test 1 hour later; oxygen via nasal prongs at 6 l/min. is started. Following are the ABG results:

FIO2 pH PCO2 HCO3 PO2

ABG 1: 21% 7.35 50 27 48

ABG 2: 6 liters 7.20 75 29 140

Assessing these symptoms would lead the nurse to identify the nursing diagnosis of

A) Impaired Gas Exchange.

B) Ineffective Breathing Pattern.

C) Decreased Cardiac Output.

D) Ineffective Airway Clearance.

Answer: A

A) The client's drive to breathe is hypoxia. When she was given an FIO2 to return her arterial PO2 level to above normal, the peripheral chemoreceptors no longer could respond to hypoxia.

Topic: Physiological Integrity

38. Which laboratory test result would be most important to evaluate before administering a chemotherapeutic agent?

A) Serum electrolytes.

B) Prothrombin time and APTT.

C) Complete blood count (CBC).

D) Liver function studies.

Answer: C

C) Chemotherapy commonly results in bone marrow depression. The CBC is evaluated to determine the adequacy of bone marrow function. Low WBC or platelet counts can be indicators of life-threatening toxicity.

Topic: Physiological Integrity

39. A major nursing goal in the care of a client with diabetes insipidus is

A) Watching for signs of hypokalemia.

B) Maintaining adequate fluid balance.

C) Insuring that the diabetic diet is followed.

D) Accurate administration of insulin.

Answer: B

B) Diabetes insipidus is an antidiuretic hormone deficiency condition related to posterior lobe pituitary hypofunction. Large volumes of fluids are lost through renal excretion; therefore, maintaining fluid balance is a broad, critical goal. Hyperkalemia can result from dehydration.

Topic: Physiological Integrity

40. A client on the oncology unit is in a great deal of pain but it is controlled with PCAÑpatient-controlled IV analgesia. The rationale for using this method is that it

A) Results in less pain medication used by client.

B) Programs medication to remain within acceptable limits.

C) Enables clients to administer medication when pain is experienced.

D) Allows nurses to care for more clients.

Answer: C

C) PCA works more effectively to control pain for the client with no significant difference in the amount of medication used. It is less time consuming for the nurse, but this is not the essential rationale.

Topic: Physiological Integrity

41. An infant born of a heroin addicted mother appears normal at birth. In assessing the infant, the nurse knows that withdrawal will occur

A) Within 2 days to a week.

B) At an unpredicted time because it varies with each infant.

C) Within minutes to one hour after birth.

D) Within 12-24 hours.

Answer: D

D) When the infant's mother is heroin addicted, withdrawal occurs from 12-24 hours after birth. If the mother were on methadone, answer (A) would be correct.

Topic: Health Promotion and Maintenance

42. Following a car accident, a client develops a tension pneumothorax and is admitted to the hospital. The nurse should be prepared to

A) Establish an IV.

B) Assist the physician with chest tube insertion.

C) Draw arterial blood gases for evaluation.

D) Assist the physician to perform chest decompression with a large-bore needle.

Answer: D

D) This is a medical emergency and releasing the pressure with a large-bore needle must be done immediately to preserve function of the remaining lung.

Topic: Physiological Integrity

43. A client on a psychiatric unit does not respond when the nurse stands by her bed and calls her name. The nurse's initial action would be to

A) Obtain vital signs immediately.

B) Phone the physician and bring a gastric lavage set to the bedside.

C) Shake the client and ask, "Are you all right?"

D) Attempt to sit client up and gently shake her.

Answer: C

C) When a client is unresponsive, utilize CPR principles. This action can give immediate data as to the degree of conscious awareness of the client and would be the first appropriate nursing action.

Topic: Physiological Integrity

44. A client with advanced cirrhosis of the liver will most likely be ordered a diet of

A) Fat controlled, low potassium and sodium.

B) Low protein and sodium.

C) No protein, low potassium.

D) Low protein and fat, low carbohydrate.

Answer: B

B) This diet will control the end products of protein metabolism and prevent ammonia buildup, as well as decrease fluid accumulation. A small amount of protein is needed for tissue repair.

Topic: Physiological Integrity

45. An obese man of 54 came into the emergency clinic complaining of a painful, tender big toe. The admitting diagnosis was gout. The client was put on colchicine medication. The nurse explains to the client that the primary action of this medication is to

A) Decrease uric acid level.

B) Alleviate pain.

C) Alkalinize urine.

D) Reduce inflammation.

Answer: D

D) Colchicine is an anti-inflammatory drug that is taken at the first sign of joint pain. Pain will be alleviated as a secondary factor. The drug Allopurinol decreases uric acid level, and sodium bicarbonate alkalinizes urine.

Topic: Physiological Integrity

46. A 40-year-old client is to be discharged and she wishes to walk outside. The nurse explains that the reason clients are discharged in a wheelchair is for

A) Comfort.

B) Rehabilitation.

C) Convenience.

D) Safety.

Answer: D

D) Transportation by wheelchair can prevent falls and injury; therefore, safety is the important issue.

Topic: Safe, Effective Care Environment

47. To perform the skill, "turning to the side-lying position," the nurse would lower the head of the bed, elevate the bed to working height, move the client to your side of the bed, and flex client's knees. The next intervention would be to

A) Roll the client on his side.

B) Place one hand on client's hip and other on shoulder.

C) Reposition client.

D) Reposition client's arms so they are not under his body.

Answer: B

B) Before rolling a client on his side, the nurse's hands must be in the correct position to turn. Answer (D) would be the final intervention.

Topic: Physiological Integrity

48. A client with the diagnosis of cirrhosis is being prepared for a liver biopsy. Before the procedure, it is most important that the nurse evaluate his

A) Informed consent.

B) Vital signs.

C) Psychological preparation.

D) Coagulation studies.

Answer: D

D) Because the cirrhotic client frequently has associated coagulopathy, it is essential that the coagulation profile be evaluated before performing a needle biopsy of an internal organ. A high prothrombin time may indicate a deficiency in prothrombin, fibrinogen or factors V, VII or X. The other options are also important, but not as vital.

Topic: Physiological Integrity

49. A female client with the diagnosis of acute depressive episode sits in a corner for long periods of time. She looks at the floor and does not speak. The nursing action indicated for the client is to

A) Ambulate the client every hour.

B) Allow the client to nap morning and afternoon.

C) Seat the client near a window so that she can look out.

D) Send the client to group activities.

Answer: A

A) The client needs to be mobilized and active, so interacting by walking with her is the best nursing intervention. It is too soon to send her to group activities, and she should not sleep during the day.

50. The nurse is assigned to a client who is receiving a mydriatic eye drop. Which of the following assessments indicates a systemic anticholinergic effect?

A) Respirations becoming more shallow.

B) Sweating and blurred vision.

C) Complaints of light headedness and headache.

D) Decreased pulse and blood pressure.

Answer: B

B) Sweating and blurred vision are signs of a systemic anticholinergic effect. In addition to these symptoms the client may experience loss of sight, difficulty breathing, flushing, or eye pain. If these symptoms occur, the medication must be discontinued.

Topic: Physiological Integrity

51. A client with cardiac failure and pulmonary edema has been placed on telemetry (a cardiac monitor). The purpose of this monitoring is to

A) Assess atrial ectopic beats as a result of hypoxia.

B) Identify ventricular arrhythmias resulting from hypoxia.

C) Assess ectopic beats as a result of hyperkalemia.

D) Treat ventricular arrhythmias as a result of hyperkalemia.

Answer: B

B) When the lungs are filled with fluid, oxygenation is not as efficient as it should be. Hypoxia can cause ventricular arrhythmias. These are identified easily by the use of telemetry.

Topic: Physiological Integrity

52. A client with cardiac failure and pulmonary edema has been placed on telemetry (a cardiac monitor). The purpose of this monitoring is to

A) Assess atrial ectopic beats as a result of hypoxia.

B) Identify ventricular arrhythmias resulting from hypoxia.

C) Assess ectopic beats as a result of hyperkalemia.

D) Treat ventricular arrhythmias as a result of hyperkalemia.

Answer: B

B) When the lungs are filled with fluid, oxygenation is not as efficient as it should be. Hypoxia can cause ventricular arrhythmias. These are identified easily by the use of telemetry.

Topic: Physiological Integrity

53. The signs and symptoms most often observed in clients with mitral valve stenosis are

A) Vertigo, orthopnea.

B) Palpitations, dyspnea, chest pain.

C) Angina, syncope.

D) Exertional dyspnea, fatigue.

Answer: D

D) Exertional dyspnea and fatigue are directly related to diminished cardiac output.

Topic: Physiological Integrity

54. The signs and symptoms most often observed in clients with mitral valve stenosis are

A) Vertigo, orthopnea.

B) Palpitations, dyspnea, chest pain.

C) Angina, syncope.

D) Exertional dyspnea, fatigue.

Answer: D

D) Exertional dyspnea and fatigue are directly related to diminished cardiac output.

Topic: Physiological Integrity

55. A physician orders prednisone for her client with lupus erythematosus. An important client teaching principle that the nurse would reinforce is to

A) Take medication away from food.

B) Weigh daily.

C) Limit activity.

D) Increase salt intake.

Answer: B

B) It is important to weigh daily because corticosteroid therapy may result in sudden weight gain from sodium retention. The client should reduce salt intake and take the medication with food to reduce GI irritation.

Topic: Physiological Integrity

56. A client is admitted for induction of labor. Physician's orders are to start oxytocin (Pitocin), 10 units in 100 mL D5W. After monitoring contractions, the nurse observes a contraction that lasts almost 2 minutes. The nursing intervention is to

A) Stop the infusion of oxytocin.

B) Notify the physician.

C) Continue to monitor the client.

D) Slow down the infusion of oxytocin.

Answer: A

A) If the contraction lasts over 90 seconds, the safety intervention is to stop the oxytocin and then notify the physician. Slowing down the infusion or continuing to monitor the client are not safe nursing actions.

Topic: Health Promotion and Maintenance

57. A 4-year-old child is brought to the emergency room after two days of vomiting, diarrhea and a temperature of 102 degrees F to 104 degrees F. The nurse knows that the care plan will be based on the priority nursing diagnosis of

A) Diarrhea.

B) Fluid Volume Deficit.

C) Altered Nutrition: Less than Body Requirements

D) Hyperthermia.

Answer: B

B) While all of the nursing diagnoses may be included in the care plan, the critical one is Fluid Volume Deficit, another way of saying dehydration. Because a young child has less body surface than an adult, dehydration can occur rapidly and lead to acidosis and death.

Topic: Physiological Integrity

58. A client who has a history of two abortions comes to the clinic for prenatal care. She is 8 weeks pregnant and has Rh negative blood. For a complete assessment of her status, the nurse would expect the physician to order a test for

A) Rho Gam.

B) Hemolytic disease.

C) Rh incompatibility.

D) Direct Coomb's.

Answer: C

C) If the mother is Rh negative and has had two abortions, Rh incompatibility may be present caused by antibodies in the mother's blood. The physician would perform an indirect Coomb's test (a direct Coomb's is done on cord blood). The mother should have received Rho Gam after the abortions to prevent hemolytic disease in the newborn.

Topic: Health Promotion and Maintenance

59. A client has just returned from a bronchoscopy procedure to diagnose possible bronchogenic carcinoma. The critical nursing assessment immediately following the test is to

A) Evaluate the client's ability to deep breathe and cough.

B) Assess vital signs and compare with baseline signs.

C) Evaluate for signs of dyspnea or wheezing.

D) Assess the client's face and neck for edema.

Answer: C

C) Dyspnea and wheezing are signs of laryngeal edema or bronchospasm which may result in respiratory distress and must be reported to the physician immediately. Clients are instructed to refrain from coughing which could result in hemorrhaging. The face and neck should be assessed for subcutaneous crepitus, not just edema. Vital signs are always important to monitor, but at this time the most crucial assessment is to monitor for respiratory problems.

Topic: Physiological Integrity

60. Following surgery, a 1-day-old infant returns with a gastrostomy tube in place. On the second postoperative day, the nursing intervention would be to

A) Plug the tube.

B) Secure the tube above the level of the stomach.

C) Do nothing, leaving the tube in place.

D) Return the tube to gravity drainage.

Answer: D

D) The gastrostomy tube is returned to gravity drainage until the infant can tolerate feedings. After the second or third day, the gastrostomy tube is pinned to the infant's shirt so it is above the level of the stomach to prevent draining of stomach contents out through the tube.

61. The rationale for using transtracheal oxygen delivery is that this method will

A) Provide high levels of oxygen for clients with acute respiratory failure.

B) Provide for independent functioning for clients requiring continuous oxygen delivery.

C) Work effectively in children requiring long term oxygen therapy.

D) Promote long term oxygen delivery without frequent catheter care.

Answer: B

B) Clients can easily maintain their independence when using transtracheal oxygen catheters. This method of oxygen delivery is contraindicated in clients with acute respiratory failure. Catheter care must be provided at least twice daily with both the Heimlich Micro-Trach catheter and the SCOOP Catheter.

Topic: Physiological Integrity

62. A client has burns on the front and back of both his legs and arms. The approximate percentage of his body that has been involved is

A) 54 percent.

B) 36 percent.

C) 45 percent.

D) 27 percent.

Answer: A

A) The client's burns cover approximately 54 percent of his body surface. Each arm is 9 percent (18 percent) and each leg is 18 percent (36 percent).

Topic: Physiological Integrity

63. A client has been admitted to the hospital the day before she is scheduled for an abdominal hysterectomy. Nursing responsibilities for the preoperative period would include notifying the physician if the

A) Erythrocyte count is 6 million/cu mm.

B) Urine report indicates ketonuria.

C) Temperature is 99.6 degrees F orally.

D) Hemoglobin is 14 gm/100 ml.

Answer: B

B) All the other reports are within normal range. The ketonuria indicates a probable diabetic complication or other metabolic condition.

64. Following retinal detachment surgery, the client asks to go to the bathroom. The most appropriate response to his request is to tell him that he

A) May get up with assistance.

B) Must remain on strict bedrest.

C) May briefly get up, but he should keep the affected area dependent.

D) May get up as long as he does not bend his head down.

Answer: B

B) The client must remain on strict bedrest to prevent further damage and to keep the retina attached to the choroid until surgery. Both (C) and (D) are incorrect, because if he gets up, it would be impossible to keep the retina approximated to the choroid.

Topic: Physiological Integrity

65. If a client has an injury to the seventh cranial nerve, the nursing assessment will identify an abnormality in

A) Tongue control.

B) Hearing.

C) Trapezius muscle movement.

D) Closing the eyelid.

Answer: D

D) The seventh cranial nerve supplies both motor and sensory function. The eyelid closure is a result of the motor function.

Topic: Physiological Integrity

66. A 75-year-old client has the diagnosis of organic brain syndrome. In planning the daily schedule, it is important for the nurse to understand that the client

A) Is more likely to be able to remember current experiences than past ones.

B) May have moderate-to-severe memory impairment and short periods of concentration.

C) Can usually be trusted to be responsible for her daily care needs.

D) Will be more comfortable with a rigid daily schedule.

Answer: B

B) It is important to remember that OBS clients usually have some memory and concentration impairment. The degree depends upon the individual and is influenced by the basic personality structure and the cause of the problem.

Topic: Health Promotion and Maintenance

67. When caring for an unconscious child, the nurse's primary concern must always be

A) Maintaining range of motion and muscle tone.

B) Airway protection and adequate respiratory status.

C) Decreasing intracranial pressure.

D) Fluid balance and cardiac stability.

Answer: B

B) As neuro status deteriorates, the airway must be assured to avoid compromising oxygenation or aspiration. Hypoxia will exacerbate the brain injury. The other answers are appropriate goals after airway patency is assured.

Topic: Physiological Integrity

68. Heart rates vary according to age. In assessing the heart rate of a one year old, the nurse would expect to find a normal rate of

A) 120-130 beats per minute.

B) 110 beats per minute.

C) 140-190 beats per minute.

D) 100 beats per minute.

Answer: A

A) 120-130 beats would be the average or normal range of heart rate for the child under one year of age.

Topic: Physiological Integrity

69. A 42-year-old client is diagnosed as a chronic schizophrenic. Assessing the client, the nurse keeps in mind that a diagnosis of schizophrenia involves

A) Inability to concentrate.

B) Loss of contact with reality.

C) Feelings of worthlessness.

D) Guilt feelings.

Answer: B

B) Loss of contact with reality is a symptom of schizophrenia. All of the other symptoms are indicative of depression. While schizophrenia may be accompanied by depression, these symptoms will not usually be observed.

Topic: Psychosocial Integrity

70. As part of preoperative teaching, the nurse informs the client of postoperative measures to prevent atelectasis. The intervention that will best accomplish this goal is to

A) Apply a scultetus binder as soon as the client is fully awake to assist with deep breathing.

B) Closely observe the client's intake of fluids to liquefy secretions.

C) Have the client turn, cough and deep breathe every 2 hours.

D) Put pillows under the client's knees to decrease pressure on the incision, thereby increasing willingness to take deep breaths.

Answer: C

C) Atelectasis is the collapse of alveoli caused by mucus plugs in the small bronchioles due to inadequate ventilation. Turning, coughing and deep breathing improve ventilation and help prevent the collapse. Liquefying secretions is important but answer (1) is more critical.

Topic: Physiological Integrity

71. A female client is brought to the maternity unit by her husband. She went into labor at home and the contractions are 4 minutes apart and regular. Her membranes have ruptured spontaneously. All of the following actions are appropriate; the first nursing intervention is to

A) Notify the physician.

B) Check the fetal heart rate (FHR).

C) Assess the quantity of fluid.

D) Check the color of fluid.

Answer: B

B) The FHR needs to be checked first to determine whether the cord is prolapsed. The cord has an increased possibility of prolapsing when the membranes rupture.

Topic: Health Promotion and Maintenance

72. Observing a nursing assistant wash her hands, the nurse knows that the NA needs more instruction in handwashing technique when she observes the NA

A) Drying her hands with a paper towel.

B) Not rubbing her hands together to cause friction.

C) Not holding her hands under running water for one minute.

D) Using too much soap.

Answer: B

B) One of the most important steps in handwashing (medical asepsis) is to create friction by rubbing the two hands together. Hands should be washed for 30 seconds and paper towels are appropriate for drying.

Topic: Safe, Effective Care Environment

73. Which of the following nursing actions should appear on a client's postoperative nursing care plan following a pneumonectomy?

A) Strip chest tubes every hour.

B) Force fluids to 3500 ml/day.

C) Monitor IPPB therapy.

D) Provide range-of-motion exercises to affected arm.

Answer: D

D) Range-of-motion exercises should be initiated within four hours of surgery to prevent adhesion formation. IPPB therapy will not be used because the pressure could interrupt the suture line. Most physicians do not insert chest tubes in these clients, because the fluid is allowed to accumulate and eventually consolidate in the space. An increased fluid load of 3500 ml/day could lead to respiratory compromise.

happy birthday ferrari gurl!!!!

2008-02-22T23:50:00.003+08:00

Happy Birthday Ate Jovie aka Ferrari Gurl

Make your every trip worth the ride!

We wish you all the best and success in life.

More blessings come your way.

Always take care and God bless!

Congratulations to our NOD Friends

2008-02-22T10:42:00.004+08:00

To the following:

Critical
Gelaine
Irra
Jerodomingo
Karen-grace
Keyk
Madchip
Marisse
Smoosh

When you're a nurse you know that every day you will touch a life or a life will touch yours. ;-)
-anonymous

Downloadable December 2007 NLE Result

2008-02-21T15:26:00.005+08:00

Finally, the result is out!

NurseOffDuty would like to Congratulate our NEW REGISTERED NURSES!

if you can not open the link from the previous post, you can now download the pdf file of the December 2007 NLE Result below.

Thanx to paker_pasaway ;-)

DOWNLOADABLE DECEMBER 2007 NLE RESULT PDF

DECEMBER 2007 NURSE LICENSURE RESULT

2008-02-21T13:30:00.000+08:00

http://newsinfo.inquirer.net/examresults/NURSE/20080221/

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

please check your names in the link above

December 2007 Nurse Licensure Examination (UPDATE) 43% of 67,000 pass nursing board

2008-02-21T11:28:00.001+08:00

By Veronica Uy
INQUIRER.net
First Posted 10:19:00 02/21/2008

MANILA, Philippines -- At least 43 percent of the 67,000 examinees who took the nursing board in December 2007 have passed, Leonor Rosero-Tripon, chairman of the Professional Regulation Commission told INQUIRER.net Thursday.

Tripon said the 43.42 percent passing mark was “within the usual range.”

She said among the nursing graduates who took the exam were those who were required by the Court of Appeals and the United States' Commission on Graduates of Foreign Nursing Schools after the June 2006 leakage of some test questions.

The controversial exam resulted in new procedures for testing and checking of tests.

A radio report said graduates from the St. Louie University, Xavier University, Siliman University, Trinity, Mindanao State University, and Palawan State University were among the top 10.

source

What To Do About Nursing's Reputation?

2008-02-18T17:04:00.000+08:00

What To Do About Nursing's Reputation?

An endless stream of negative press is harming the image of nursing, warns an article in this week’s Nursing Standard.

Media stories about "killer infections, starving patients, and overstretched wards" suggest the profession has lost its way. But in a new series of articles on The State of Nursing, Alison Whyte calls on nursing staff to insist on the best for patients, and for nurses.

She writes: "Nursing’s image has taken a bit of a battering. We have seen appalling care exposed by secret filming, shocking reports of undernourished patients and nurses depicted as feckless, boozy bed-hoppers in a TV sitcom.

"The angels have been thrown from their pedestal and given a pair of horns."

She asks whether patient care has really deteriorated, or whether nurses are simply overstretched and understaffed due to changes in the NHS.

"After a decade that saw nurses’ roles expanding and their status rising, a number of factors began to chip away at their image," Ms Whyte believes. Now, nursing is no longer seen as an attractive career option.

Yvette Wells of the Royal College of nursing says: "Lots of nurses are providing excellent and innovative care in specialist areas. However, we need to become more politically astute. In my view, nurses still have no power."

But she adds: "Some people are not well suited to nursing and I think we need to review the selection process."

The article concludes: "The challenge for nursing leaders is to get across to the public that nurses are neither angels nor devils. Most are highly skilled professionals who want the best possible care for their patients, and need support at all levels when they strive to overcome the barriers to this."

Date: February 14th 2008

source

Work as an RN in Bermuda

2008-02-16T14:45:00.001+08:00

Hi guys!

I just received this ads thru e-mail from my nursing alumni group. Hope this will help nurses who are willing to work in Bermuda!

Goodluck!

A DREAM OPPORTUNITY IN A DREAM LOCATION!

WORK AS AN RN IN BERMUDA

If you have ever dreamt of working in tropical paradise, earning tax-free U.S. dollars and developing your clinical skills in a large modern hospital, than your dream could soon become a reality.

CGFNS / NCLEX NOT Required

Applicants must have a minimum of three years current nursing experience in either Operating Room, Post Anesthesia Recovery Unit, ER, ICU, nursing care of the elderly and mental health.

CGFNS and NCLEX are not required.However, applicants must have passed IELTS with a score of 7.0 in all sections. TOEFL scores are also acceptable as follows: written 560, TOEFL-CBT 250, TOEFL-ibt Total 83, Speaking 26. All English test results must have been obtained within the past two years. Canada / US educated applicants are exempt from this requirement.

All positions come with a starting annual salary of almost $59,000 US, plus a relocation bonus of $3,000US. These are 3 year contract positions and all RNs will be employed directly by the Bermuda Hospitals Board.

Fast Processing. “ No Agency Fees Charged"

If you have passed one of the required English language exams, the time to process your Bermuda work visa and nursing license is only 2-3 months. Beat the US Visa retrogression, apply for Bermuda today.

Contact Ed Lucena today for more information and to submit your resume.

E-Mail: edlucena@hrpc.com.ph

Horizon Recruitment Pacific Corporation

POEA-213-LB-092407-R

3/F Reliance House, 205 EDSA, Greenhills, Mandaluyong City

Tel:727-2157,726-3605, 724-8601- 06

Mobile: 0917-8226315, 0917-5233427

Website: http://www.hrpc.com.ph/

To know more about Bermuda, please visit: www.aboutbermuda.com

Note: Only qualified candidates will be interviewed.

Happy Birthday Tisoy and Enigma!!!

2008-02-14T18:46:00.004+08:00

We wish you...
a great year filled with good health, happiness,
prosperity and success!

Hope you share and receive lots of blessings for days to come....

Happy Happy Birthday!!!

"TisoyRN and Enigma"!

♥ NOD Family ♥

happy valentines nodians!

2008-02-14T00:27:00.001+08:00

glitter-graphics.com

"Valentines day is not just about telling your partner you love them, its about reminding everyone you loved that you love them.."

Happy Hearts Nodians!!!!

Happy Birthday Bert!!!

2008-02-12T11:59:00.000+08:00

Smiles and laughter, joy and cheer
New happiness that stays throughout the year
Hope your birthday brings all these and more
Filling life with surprise and joys galore!

Happy BERTday...

"BERT"ing...!!!

US Immigration Visa Legislation for Nurses Awaited

2008-02-11T14:14:00.000+08:00

by Bong Reblando

GENERAL SANTOS CITY — The US Congress would likely pass immigration visa legislation for foreign nurses, including Filipinos, only after the US presidential election in Nov. 4 this year, a New Jersey executive nurse said.

"A law on immigration visa may be passed next year since US Congress is too busy now in the presidential campaign, a sagging economy, and the war in Iraq," Darlene Dilangalen Borromeo, associate director of Nursing at Bergen Medical Center in New Jersey, said.

She explained that the absence of immigration visas has stalled processing of applications of Filipino nurses, particularly those who have already passed the Nursing Council Licensure Exam (NCLEX).

Borromeo disclosed since the quota for Filipino nurses has already been consummed and only the US Congress is empowered by law to allocate new quotas for foreign workers including Filipinos wanting to work in the US, the US embassy in Manila has no visa to issue.

But the Philippine-born American nurse emphasized that the US Congress would prioritize the law on immigration visas since healthcare is one of the primary issues in the US presidential campaign.

"Certainly, a law on granting immigrant visas for foreign nurses and health workers is an immediate concern of the US Congress, the same way with economy and the war in Iraq," Borromeo said.

She said the US needs 1.2 million nurses in the next 10 years to cope with the country’s healthcare program as most nurses now are retiring, with their average age ranging between 45 to 65 years old.

On top of this, Borromeo also disclosed the need for more nurses in the US as many existing hospitals in the US are expanding and several others having been newly constructed.

A native of Barangay Lagao here, Borromeo made the remarks during the recent "Nursing Leaders Night" hosted by the Beta Nu Delta Nursing Society headed by Prof. Jerome Babate at the city’s downtown Family Country Hotel Convention Center.

The immediate president of the Philippine Nurses’ Association (PNA) in New Jersey, Borromeo attended the three-day International Nursing Conference in historic Manila Hotel last Jan. 31 to Feb. 1, along with her three nursing student scholars.

Borromeo is an honorary member of the Beta Nu Delta Nursing Society, which was founded by nurses and nursing students of Notre Dame Marbel University and Notre Dame of Dadiangas University in 1973. The Beta Nu Delta Nursing Society, which now accepts nursing students from Brokenshire Nursing College in the city, has conferred Borromeo as an honorary member, wherein she opened the Darlene Dilangalen Borromeo Nursing Leadership Program.

Read full article here

I ♥ NOD...

2008-02-10T21:53:00.001+08:00

A Merry-Happy Valentine's Day to everyone... especially the NODians, who are always busy, maybe looking for their Valentine dates. Uhmmm.. anyways, because it is the season of LOVE, HEARTS, ROSES and CARDS, woinot an "I ♥ NOD" pin. Yes... it is like the "I ♥ NY" logo. This is one big crazy idea, a pin with a "heart!" But I bet, you like it! So hurry up, it is up for grabs! Happy Valentine's everyone.

♥♥♥

*For orders, comments and suggestions, click COMMENTS and leave a message there.

♥♥♥

SMooooooSh and Rockh the Phil! (The Homecoming)

2008-02-04T21:38:00.000+08:00

Meet some of our balikbayans who just came home last January 29, 2007:

Smoosh had a short trip in L.A, California
while Roch from UAE is having a short trip in the Phil.
Unfortunately, Ferarigirl couldnt make it home but she sent some Lindt chocolates to share...

The meeting last January 31, 2007 was sudden and short planned.
Few NODian came to meet up with these two who are having their first eyeball.

Like the other NODians, I missed this EB.
But, they intentionally left a space for me in the picture so there i am..
heheheheh.. nakainsert na.. hanapin nyo nalang :-p

Thanx FERARIGURL AND ROCH for sharing some of your blessings...

Kung gusto nyo ng chocolates, ask from those who went there... lol..

Noel said, he is saving his pieces of chocolates for his valentina..
so anyone?!

Guidelines for Guestbook

2008-02-04T01:11:00.000+08:00

Guidelines:

* put a photo of your self that provides a recognizable image of you

* upload your REAL PICTURE and not some manipulated/ distorted/ vague/ stolen image

* no lewd or vulgar photos

* you can add brief captions

* please report abuse

* no SPAMMING

* entries need approval so please follow the guidelines accordingly

Sample Test Questions V

2008-02-03T16:06:00.000+08:00

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Question Number 1 of 20

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A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type of isolation is most appropriate for this client?

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	A)	Reverse
	B)	Airbourne
	C)	Standard precautions
	D)	Contact

The correct answer is D: Contact

Contact precautions or Body Substance Isolation (BSI) involves the use of barrier protection (e.g. gloves, mask, gown, or protective eyewear as appropriate) whenever direct contact with any body fluid is expected. When determining the type of isolation to use, one must consider the mode of transmission. The hands of personnel continue to be the principal mode of transmission for methicillin resistant staphylococcus aureus (MRSA). Because the organism is limited to the sputum in this example, precautions are taken if contact with the patient''s sputum is expected. A private room and contact precautions , along with good hand washing techniques, are the best defenses against the spread of MRSA pneumonia.

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Question Number 2 of 20

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The school nurse is teaching the faculty the most effective methods to prevent the spread of lice in the school. The information that would be most important to include would be which of these statements?

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	A)	"The treatment requires reapplication in 8 to 10 days."
	B)	"Bedding and clothing can be boiled or steamed."
	C)	Children are not to share hats, scarves and combs.
	D)	Nit combs are necessary to comb out nits.

The correct answer is C: “Children are not to share hats, scarves and combs.”

Head lice live only on human beings and can be spread easily by sharing hats, combs, scarves, coats and other items of clothing that touch the hair. All of the options are correct statements. However they do not best answer the question of how to prevent the spread of lice in a school setting.

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Question Number 3 of 20

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Several clients are admitted to an adult medical unit. The nurse would ensure airborne precautions for a client with which medical condition?

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	A)	Autoimmune deficiency syndrome (AIDS) with cytomegalovirus (CMV)
	B)	A positive purified protein derivative with an abnormal chest x-ray
	C)	A tentative diagnosis of viral pneumonia with productive brown sputum
	D)	Advanced carcinoma of the lung with hemoptasis

The correct answer is B: A positive purified protein derivative with an abnormal chest x-ray

The client who must be placed in airborne precautions is the client with a positive PPD (purified protein derivative) who has a positive x-ray for a suspicious tuberculin lesion. A sputum smear for acid fast bacillus would be done next. CMV usually causes no signs or symptoms in children and adults with healthy immune systems. When signs and symptoms do occur, they''re often similar to those of mononucleosis, including: sore throat, fever, muscle aches, fatigue. Good handwashing is recommended for CMV.

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Question Number 4 of 20

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The nurse is to administer a new medication to a client. Which actions are in the best interest of the client?

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	A)	Verify the order for the medication. Prior to giving the medication the nurse should say "Please state your name?"
	B)	Upon entering the room the nurse should ask: "What is your name? What allergies do you have?" then check the client's name band and allergy band
	C)	As the room is entered say "What is your name?" then check the client's name band
	D)	Verify the client's allergies on the admission sheet and order. Verify the client's name on the name plate outside the room then as the nurse enters the room ask the client "What is your first, middle and last name?"

The correct answer is B: Upon entering the room the nurse should ask: "What is your name? What allergies do you have?" then check the client''s name band and allergy band

A dual check is consistently done for a client''s name. This would involve verbal and visual checks. Since this is a new medication an allergy check is appropriate.

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Question Number 5 of 20

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A mother calls the hospital hot line and is connected to the triage nurse. The mother proclaims: “I found my child with odd stuff coming from the mouth and an unmarked bottle nearby.” Which of these comments would be the best for the nurse to ask the mother to determine if the child has swallowed a corrosive substance?

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	A)	Ask the child if the mouth is burning or throat pain is present
	B)	Take the child’s pulse at the wrist and see if the child is has trouble breathing lying flat.
	C)	What color is the child’s lips and nails and has the child voided today?
	D)	Has the child had vomiting or diarrhea or stomach cramps yet?

The correct answer is A: “Ask the child if the mouth is burning or throat pain is present”

Local irritation of tissues indicates a corrosive poisoning. The other comments may be helpful for the overall child’s condition. However, the question is about the concern for a caustic substance

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Question Number 6 of 20

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A 10 year-old child has a history of epilepsy with tonic-clonic seizures. The school nurse should instruct the classroom teacher that if the child experiences a seizure in the classroom, the most important action during the seizure would be to

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	A)	Move any chairs or desks at least 3 feet away from the child
	B)	Note the sequence of movements with the time lapse of the event
	C)	Provide privacy as much as possible to minimize fightening the other children
	D)	Place the hands or a folded blanket under the head of the child

The correct answer is D: Place the hands or a folded blanket under the head of the child

The priority during seizure activity is to protect the person from physical injury. Place a pillow, folded blanket or your hands under the child''s head to prevent harm to the head. The other body parts are of less risk of injury. The sequence of actions above would be options d, a, b, and c in order of priority.

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Question Number 7 of 20

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A newly admitted adult client has a diagnosis of hepatitis A. The charge nurse should reinforce to the staff members that the most significant routine infection control strategy, in addition to handwashing, to be implemented is which of these?

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	A)	Apply appropriate signs outside and inside the room
	B)	Apply a mask with a shield if there is a risk of fluid splash
	C)	Wear a gown to change soiled linens from incontinence
	D)	Have gloves on while handling bedpans with feces

The correct answer is D: Have gloves on while handling bedpans with feces

The specific measure to prevent the spread of hepatitis A is careful handling and protection while handling fecal material. All of the other actions are correct but not the most significant

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Question Number 8 of 20

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Which of these nursing diagnoses of 4 elderly clients would place 1 client at the greatest risk for falls?

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	A)	Sensory perceptual alterations related to decreased vision
	B)	Alteration in mobility related to fatigue
	C)	Impaired gas exchange related to retained secretions
	D)	Altered patterns of urinary elimination related to nocturia

The correct answer is D: Altered patterns of urinary elimination related to nocturia

Nocturia is especially problematic because many elders fall when they rush to reach the bathroom at night. They may be confused or not fully alert. Inadequate lighting can increase their chances of stumbling and they may fall over furniture or carpets.

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Question Number 9 of 20

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The nurse is assigned to a client newly diagnosed with active tuberculosis. Which of these protocols would be a priority for the nurse to implement?

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	A)	Have the client cough into a tissue and dispose in a separate bag
	B)	Instruct the client to cover the mouth with a tissue when coughing
	C)	Reinforce for all to wash their hands before and after entering the room
	D)	Place client in a negative pressure private room and have all who enter the room use masks with shields

The correct answer is D: Place client in a negative pressure private room and have all who enter the room use masks with shields

A client with active tuberculosis should be hospitalized in a negative pressure room to prevent respiratory droplets from leaving the room when the door is opened. Tuberculosis (TB) is caused by spore-forming mycobacteria, more often Mycobacterium tuberculosis. In developed countries the infection is airborne and is spread by inhalation of infected droplets. In underdeveloped countries (Africa, Asia, South America), transmission also occurs by ingestion or by skin invasion, particularly when bovine TB is poorly controlled.

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Question Number 10 of 20

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The mother of a toddler who is being treated for pesticide poisoning asks: “Why is activated charcoal used? What does it do?” What is the nurse's best response?

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	A)	"Activated charcoal decreases the systemic absorption of the poison from the stomach."
	B)	"The charcoal absorbs the poison and forms a compound that doesn't hurt your child."
	C)	"This substance helps to get the poison out of the body by the gastrointestinal system."
	D)	"The action may bind or inactivate the toxins or irritants that are ingested by children or adults."

The correct answer is B: "The charcoal absorbs the poison and forms a compound that doesn''t hurt your child."

All of the options are correct responses. However, option b is most accurate information to answer the mother’s question and about the effectiveness of activated charcoal. The language is appropriate for a parent''s understanding.

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Question Number 11 of 20

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A 20 year-old client has an infected leg wound from a motorcycle accident, and the client has returned home from the hospital. The client is to keep the affected leg elevated and is on contact precautions. The client wants to know if visitors can come. The appropriate response from the home health nurse is that:

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	A)	Visitors must wear a mask and a gown
	B)	There are no special requirements for visitors of clients on contact precautions
	C)	Visitors should wash their hands before and after touching the client
	D)	Visitors should wear gloves if they touch the client

Your response was "A".

The correct answer is C: Visitors should wash their hands before and after touching the client

Gown and gloves are worn by persons coming in contact with the wounds or infected equipment. Visitors should wash their hands before and after touching the client.

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Question Number 12 of 20

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A client is scheduled to receive an oral solution of radioactive iodine (¹³¹I). In order to reduce hazards, the priority information for the nurse to include during the instructions to the client is which of these statements?

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	A)	In the initial 48 hours avoid contact with children and pregnant women, and after urination or defecation flush the commode twice.
	B)	Use disposable utensils for 2 days and if vomiting occurs within 10 hours of the dose, do so in the toilet and flush it twice.
	C)	Your family can use the same bathroom that you use without any special precautions.
	D)	Drink plenty of water and empty your bladder often during the initial 3 days of therapy.

The correct answer is A: “In the initial 48 hours avoid contact with children and pregnant women, and after urination or defecation flush the commode twice.”

The client''s urine and saliva are radioactive for 24 hours after ingestion, and vomitus is radioactive for 6 to 8 hours. The client should drink 3 to 4 liters a day for the initial 48 hours to help remove the agent from the body. Staff should limit contact with hospitalized clients to 30 minutes per day per person.

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Question Number 13 of 20

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Which approach is the best way to prevent infections when providing care to clients in the home setting?

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	A)	Handwashing before and after examination of clients
	B)	Wearing nonpowdered latex free gloves to examine the client
	C)	Using a barrier between the client's furniture and the nurse's bag
	D)	Wearing a mask with a shield during any eye/mouth/nose examination

The correct answer is A: Handwashing

Handwashing remains the most effective way to avoid spreading infection. However, too often nurses do not practice good handwashing techniques and do not teach families to do so. Nurses need to wash their hands before and after touching the client and before entering the nursing bag. All of the options are correct. The sequence for priority actions would be options a, c, b, and d.

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Question Number 14 of 20

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During the care of a client with a salmonella infection, the primary nursing intervention to limit transmission is which of these approaches?

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	A)	Wash hands thoroughly before and after client contact
	B)	Wear gloves when in contact with body secretions
	C)	Double glove when in contact with feces or vomitus
	D)	Wear gloves when disposing of contaminated linens

The correct answer is A: Wash hands thoroughly before and after client contact

Gram-negative bacilli cause Salmonella infection. Two million new cases appear each year. Lack of sanitation is the primary means of contamination. Thorough handwashing can prevent the spread of salmonella. Note that all of the options are correct actions. However, the primary action is to wash the hands.

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Question Number 15 of 20

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A nurse who is reassigned to the emergency department needs to understand that gastric lavage is a priority in which situation?

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	A)	An infant who has been identified to have botulism
	B)	A toddler who ate a number of ibuprofen tablets
	C)	A preschooler who swallowed powdered plant food
	D)	A school aged child who took a handful of vitamins

The correct answer is A: An infant who has been identified to have botulism

C. botulinum forms a toxin in improperly processed foods in anaerobic conditions. It is a neurotoxin that impairs autonomic and voluntary neurotransmission and causes muscular paralysis. Findings appear within 36 hours of ingestion. Be aware that all of the options may be candidates for gastric lavage or for activated charcoal administration

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Question Number 16 of 20

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After an explosion at a factory one of the workers approaches the nurse and says “I am an unlicensed assistive personnel (UAP) at the local hospital.” Which of these tasks should the nurse assign to this worker who wants to help during the care of the wounded workers?

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	A)	Get temperatures
	B)	Take blood pressure
	C)	Palpate pulses
	D)	Check alertness

The correct answer is C: Palpate pulses

The heart rates would indicate if the client is in shock or has potential for shock. If the pulses could not be palpated, those clients would need to be seen first.

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Question Number 17 of 20

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Which of these clients with associated lab reports is a priority for the nurse to report to the public health department within the next 24 hours?

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	A)	An infant with a postive culture of stool for Shigella
	B)	An elderly factory worker with a lab report that is positive for acid-fast bacillus smear
	C)	A young adult commercial pilot with a positive histopathological examination from an induced sputum for Pneumocystis carinii
	D)	A middle-aged nurse with a history of varicella-zoster virus and with crops of vesicles on an erythematous base that appear on the skin

The correct answer is B: An elderly factory worker with a lab report that is positive for acid-fast bacillus smear

Tuberculosis is a reportable disease because persons who had contact with the client must be traced and often must be treated with chemoprophylaxis for a designated time. Options a and d may need contact isolation precautions. Option c findings may indicate the initial stage of the autoimmune deficency syndrome (AIDS

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Question Number 18 of 20

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A nurse is reinforcing teaching with a client about compromised host precautions. The client is receiving filgrastim (Neupogen) for neutropenia. The selection of which lunch suggests the client has learned about necessary dietary changes?

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	A)	grilled chicken sandwich and skim milk
	B)	roast beef, mashed potatoes, and green beans
	C)	peanut butter sandwich, banana, and iced tea
	D)	barbeque beef, baked beans, and cole slaw

The correct answer is B: roast beef, mashed potatoes, and green beans

The client has correctly selected an appropriate lunch and appears to have knowledge of restrictions. Low granulocyte counts and susceptibility to infection are expected. Compromised host precautions require that foods are either cooked or canned. Options 1, 3 and 4 do not demonstrate learning, as raw fruits, vegetables, and milk are to be avoided

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Question Number 19 of 20

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Which of these clients would the nurse recommend to keep in the hospital during an internal disaster at the agency?

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	A)	An adolescent diagnosed with sepsis 7 days ago with vital signs maintained within low normal
	B)	A middle-aged woman documented to have had an uncomplicated myocardial infarction 4 days ago
	C)	An elderly man admitted 2 days ago with an acute exacerbation of ulcerative colitis
	D)	A young adult in the second day of treatment for an overdose of acetometaphen

The correct answer is D: A young adult in the second day of treatment for an overdose of acetometaphen

zthe correct answer is D. An overdose of Tylenol requires close observation for 3 to 4 days as well as Mucomyst oral treatement for as long. A risk of liver failure exists within this time period.

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Question Number 20 of 20

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A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal meningitis. Which admission orders should the nurse do first?

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	A)	Institute seizure precautions
	B)	Monitor neurologic status every hour
	C)	Place in respiratory/secretion precautions
	D)	Cefotaxime IV 50 mg/kg/day divided q6h

The correct answer is C: Place in respiratory/secretion precautions

Meningococcal meningitis has the risk of being a bacterial infection. The initial therapeutic management of acute bacterial meningitis includes respiratory/secretions precautions, initiation of antimicrobial therapy, monitor neurological status along with vital signs, institute seizure precautions and lastly maintenance of optimum hydration. The first action is for nurses to take any necessary precautions to protect themselves and others from possible infection. Viral meningitis usually does not require protective measures of isolation.

Happy Birthday Glitz!!!

2008-02-02T01:17:00.000+08:00

Send this eCard !

♥♥♥

Happy Happy Birthday Glitz! May you have a lot of surprises on your birthday! We wish you all the BEST. WE LOVE YOU!

From: Your NOD Family...<^_^
♥♥♥

Happy Birthday Glitz!!!!!

2008-02-02T00:28:00.000+08:00

glitter-graphics.com

PEARSON NCLEX PRACTICE TEST, REFESHER COURSE

2008-01-30T13:33:00.000+08:00

THE NCLEX PRACTICE TEST AND refresher Course are now available at Pearson Vue Testing Center based at the international Academy of Mangement and Economics (IAME, 4th Floor, Noli Santos International Tower, Ayala Avenue Extension, 1061 Metropolitan Avenue, San Antonio Village Makati City. The NClex Practice Test may be taken from one hour to four hours depending on the BSN and review preparation of the nurse. The refresher course consisting of 12 modules comes from Pearson Education, the largest British publishing company and parent Company of Pearson Test Centers. The Noli Santos Foundation subsidizes 50 percent of the fees for Nclex practice test and the refresher course as assistance to and recognitionn of the future "unsung heroes of the Philippines".

The Pearson Vue Testign Center may be called at 896-2355, 757-2608 local 25, 09165142070, or e-mail testing@iame.edu.ph.

>SOURCE: Philippine Daily Inquirer: Wednesday, January 30, 2008 G3(People, Events, & Products) section.

> Bert ;P

NOD Invades Abu Dhabi: Summer Meets Roch

2008-01-29T02:23:00.000+08:00

We’ve seen Andi from her humble abode in Quezon Province down to her adventures in Batangas and Manila. After her farewell get together with some of our fellow Nodians last January 12 and 18, she took off to UAE without much sleep on January 19.

Bringing with her good memories of some Nodian friends, this time she walks in the streets of United Arab Emerates with one of our pioneers in NurseOffDuty- ROCH aka SleepingBeauty. The two, tirelessly roamed around the historically rich city of Abu Dhabi while at the same time featuring the country’s gigantic modern structures.

Btw, Thanx to Jay for the photo shoots, ur a pro! Great shots ;-)

So ill end with ellipses….

To Andi, it is farewell Philippines and hellow UAE!...

To Roch, it is farewell UAE and now, hellow Philippines…

So watch out for Roch’s Hellow Philippines Adventures….

To be continued……

♥ glitz ♥

So you want to be a Nurse in the US

2008-01-29T02:22:00.000+08:00

SAN FRANCISCO, CA - A Filipino nurse quit his job and sold all his belongings, all for the promise of a lucrative job at an American hospital. Little did he know that the recruiter wouldn’t show up and would run away with his money. This nurse had settle for another job in Saudi Arabia, a far cry from his American dream.

A fellow nurse had better luck and was even promoted supervisor in another hospital. But his salary was much lower than that received by American nurses under him, a difference of almost $10 in a workplace where every penny counts.

Several other Pinoy nurses hired under recruitment agencies were treated as second-class citizens. “They assume that Filipinos don’t have lives,” one of them complained, citing instances when they would be plucked out of precious “off” days for another round of hard labor. To think that they were chronically paid less than other agency nurses.

So, do you still want to be a nurse in the United States?

Groundbreaking report, “a crucial first step”

These sad stories and more of the same are revealed in a groundbreaking report by a US-based policy research group on the “burgeoning”—but largely uncharted—American nursing industry.

The study by AcademyHealth zeroes in on unethical practices of recruitment of foreign educated nurses (FENs), particularly Filipinos.

The 41-page report released last November identified at least 25 problems reported by FENs interviewed for the study. Many of these abuses allegedly came at the hands of “staffing” agencies for which many FENs end up working at a much lower salary besides finding themselves in substandard living conditions.

Many of the nurses interviewed were Filipinos, who, according to a 2007 survey of the American Hospitals Association, were working in 84 percent of US hospitals hiring FENs.

Former Health Secretary Jaime Galvez Tan, who furnished the Inquirer a copy of the study, said the report was a crucial first step in addressing unethical recruitment practices in the US.

He said all eyes were on the Philippines because it was the biggest supplier of nurses worldwide. AcademyHealth said it “remains the most important source-country for the United States,” which, according to its study, would have a demand for around 800,000 nurses by 2010.

RP is test case

“The US is finally taking notice,” Galvez Tan told the Inquirer in an interview ...

Read full story HERE

NURSEOFFDUTY ROCKS GRILL GLORIETTA AND GILIGANS MALATE

2008-01-28T01:56:00.000+08:00

January 26,2008

Saturday night is party night!
And what better way to spend it with...
than with the NODIANS <(^^,)

The group started out at the Grill in Glorietta at around 2 pm
and headed towards Giligans Malate later that night.
Then, they left the place at around 4 am the following day.
And surprisingly as i checked on the site late that morning,
some just couldn't help but login to www.nurseoffduty.blogspot.com
since they came home from the partee..
( walang tulugan... mga adict!!!!) hehe..

Here is a candid shot of NODIANS who knows how to partee...
All the way from her hometown, partee gurl GoldieOro
is making up after missing the Grand EB last January 12, 2008.
(tnx for the photos 24k)

________________________________

NOEL aka Ngitz is the MAN OF THE NIGHT!
The man from CDO sure knows how to partee...
(Ngitz, its time to hit the books...)

________________________________

NURSEOFFDUTY ROCKS!

♥ glitzy ♥

Dont forget to checkout the gallery at
www.nurseoffduty.multiply.com