RAILWAY RECRUTMENT BOARD STAFF NURSE QUESTIONS

1. In performing a bacterial wound swab, why is it necessary to cover the wound with appropriate dressing?
a. It reduces the transmission of microorganisms.
b. Promotes patient’s comfort.
c. Facilitates wound healing, absorbs exudate, and reduces risk of bacterial colonization.
d. It decreases trauma to the tissue.

2. Which of the following types of burn injury is more frequent?
a. Thermal burns
b. Chemical burns
c. Electrical burns
d. Radiation related burns

3. What kind of technique used for assessing the extent of burn that gives reproducible accuracy especially age-related cases?
a. Wallace’s “rule of nines” tool
b. Lund and Browder chart
c. Fitzpatrick’s Scale
d. Both A and B

4. Which of the following classification of burn injury that involves the muscle, bone, tendon and interstitial tissue?
a. Full thickness burn
b. Superficial partial thickness burn
c. Superficial burn
d. Subdermal burn

5. Which of the following clearly describes a stage 3 pressure injury?
a. It includes a full thickness tissue loss with exposed bone, tendon, and muscle.
b. It includes a partial thickness loss of dermis and shallow open ulcers.
c. It includes a full thickness skin loss; subcutaneous fat may be visible.
d. It is present on areas of persistent, non-blanchable redness when compared with the surrounding skin.

6. Which of the following is considered as a major factor in determining pressure injuries to patients?
a. Redness
b. Abscess
c. Edema
d. Pain

7. Which of the following strategy is not essential in preventing pressure injuries?
a. Promote rubbing and massaging the bony prominences.
b. Monitor patient’s nutrition and hydration.
c. Maintain good skin hygiene.
d. Prevent shear and friction.

8. Which of the following types of leg ulcer which is often painless?
a. Venous Ulcer
b. Arterial leg ulcer
c. Diabetic leg ulcer
d. Both A and B

9. All of the following describes the importance of using critical thinking except:
a. Nurses do not involve themselves in making important decisions.
b. Nurses use knowledge in a various field of study and subjects.
c. Nurses deal with change in a very demanding and stressful environment.
d. Nurses should use it to solve client problems and make a reasonable solution.

10. Nurses use the nursing process systematically in order to plan and provide the appropriate nursing care. Which of the following step in the nursing process where a nurse will continue, modify, or terminate the client’s plan based on the outcomes gathered?
a. Diagnosing
b. Evaluating
c. Assessing
d. Implementing

11. There are various types of assessment use by a nurse which depends on the situation. Which of the following is performed during any physiologic or psychological crisis of the patient?
a. Time-Lapsed Reassessment
b. Initial Assessment
c. Problem-Focused Assessment
d. Emergency Assessment

12. Obtaining data is a very crucial part in planning patient’s care. Which of the following types of data is also referred as the overt data?
a. Subjective data
b. Constant data
c. Objective data
d. Inherent data

13. There are different types of nursing diagnosis that a nurse can choose from. Which of the following types is considered as a client problem which is present at the time of assessing the patient?
a. Actual diagnosis
b. Wellness diagnosis
c. Risk nursing diagnosis
d. Syndrome diagnosis

14. Maslow’s hierarchy of needs clearly depicts the human needs as it is ranked based on how essential it is for our survival. Which of the following is not a characteristic of Maslow’s hierarchy of needs?
a. It is realistic, sees life clearly, and is subjective about his or her observations.
b. Has superior perception, is more decisive.
c. It is self-centered rather than problem centered.
d. It is highly effective, flexible, spontaneous, courageous, willing to make mistakes.

15. Aside from Maslow, Kalish also presented a hierarchy of needs. Which of the following needs he incorporated or added to the five levels of needs by Maslow?
a. Affection needs
b. Stimulation needs
c. Independence needs
d. Recognition needs

16. Which of the following describes a secondary level of prevention?
a. Family planning services
b. Referring a client to a support group
c. Hepatitis B Immunization
d. Denver Developmental Screening Test

17. Health behavior change is a cyclical process where a patient progress in a series number of steps. Which of the following correctly describes the contemplation stage?
a. It is the stage where the patient acknowledges that he has a problem and considers changing that behavior for the future.
b. It is the stage where the patient plans to make actions in the immediate future (e.g. within next two weeks)
c. It is the stage where the person actively participates in the course of program designed for him.
d. It is the stage where the person strives to prevent relapse by integrating actions into his life.

18. The definition of health is very complex and may consider a lot of factors. Which of the following models of health and wellness describes that a person is considered healthy as long as they can perform their roles in the society?
a. Adaptive Model
b. Role Consistency Model
c. Role Status Model
d. Role Performance model

19. Agent-host-environment model by Leavell and Clark is one of the theories which is widely use in determining illness rather than promoting wellness. It is based on the interaction of three factors: agent, host and environment. Which of the following deals with the agent factor?
a. Climate
b. Economic level
c. Lack of body nutrients
d. Family history

20. Sociologists use the term illness behavior to describe how an individual deals with his signs, symptoms, and medical regimen at the time of his illness or disease. Which of the following is not included in the four aspects of the sick role provided by Parsons?
a. Clients are held responsible for their condition
b. Clients are obliged to try to get well as quickly as possible
c. Clients are excused from certain social roles and tasks
d. Clients or their families are obliged to seek competent help

21. Growth is the physical change and increase in size. Development on the other hand is an increase in the function and skill progression. Which of the following correctly describe the principle about growth and development?
a. The pace of growth and development is even.
b. Certain stages of growth and development are more critical than the others.
c. Development becomes increasingly undifferentiated.
d. Development proceeds from simple to complex or from integrated acts to single acts.

22. One of the significant characteristics during the toddlerhood stage is the increase in psychosocial skills and motor development. Which of the following nursing implications is very important during this stage?
a. The nurse should assist in developing coping behaviors
b. The nurse should assist the parents to identify and meet the unmet needs
c. The nurse should provide opportunities for play and social activity
d. The nurse should balance between safety and risk-taking strategies to permit growth

23. Freud identified five stages of development. Which of the following correctly happens during the anal stage?
a. 6 years to puberty
b. 1 ½ to 3 years old
c. 1 to 3 years old
d. 4 to 6 years old

24. Erikson identified eight stages of development. He pointed out that during the early childhood, the central task should be autonomy versus shame and doubt. Which of the following is an indicator of negative resolution to this stage?
a. Compulsive self-restraint
b. Mistrust
c. Estrangement
d. Lack of self-confidence

25. Cognitive development deals on ways in which a person learn to think, reason out, and use language. The cognitive theory by Piaget pointed out three primary abilities which are present in each phase. Which of the following deals with the process where an individual encounters and reacts towards new situation and using the mechanisms that they already have?
a. Accommodation
b. Adaptation
c. Assimilation
d. Coping behavior

26. Which of the following maternal factors does not contribute to the higher risk of low birth weight babies?
a. Low stress levels, including physical or emotional abuse
b. Use of addictive drugs or alcohol during pregnancy
c. Complications during pregnancy, poor health status, exposure to infections
d. Poor nutrition during pregnancy

27. Reflexes are normal to newborn; they are unconscious and involuntary responses. Which of the following infant reflexes is also known as the fencing reflex?
a. Babinski reflex
b. Stepping reflex
c. Tonic neck reflex
d. Palmar reflex

28. Which of the following psychosocial development stages is considered as the crucial crisis according to Erikson?
a. Autonomy versus shame and doubt
b. Initiative versus guilt
c. Identity versus role confusion
d. Trust versus mistrust

29. Nurses use different types of therapeutic communication techniques in order to build an effective relationship towards their patients. Which of the following techniques illustrates acknowledging the patient?
a. “You trimmed your nails today and washed your hands.”
b. “Your book is here in the drawer. It is not stolen.”
c. “I’ll stay with you until your mother arrives.”
d. “Tell me about…”

30. Learning is represented by a change of behavior. Which of the following learning theories where a nurse is seen applying a humanistic theory?
a. The nurse will provide an enough time for his patient to solve problems through trial and error.
b. The nurse will acknowledge the patient for correct behavior.
c. The nurse will encourage active learning by being the facilitator and/or mentor
d. The nurse will assess a person’s developmental and individual readiness

31. Andragogy is defined as the art and science use in teaching adults. Which of the following concepts can be used as a guide for client teaching?
a. An adult’s previous experiences can be used as a resource for learning.
b. As people mature, they move from independence to dependence.
c. An adult’s readiness to learn is often not related to a developmental task or social role.
d. An adult is more oriented in learning when material is use sometime in the future.

32. Nurses as part of the health care team can contribute largely on the health literacy of patients. Which of the following client behaviors will a nurse suspects that a patient has a problem in terms of health literacy?
a. No presence of pattern of excuses for not reading the instruction materials.
b. The patient will read the instructions instead of family members.
c. Pattern of compliance
d. Patient will insist that they already understand the information given to them.

33. A leader is someone who can influence others to accomplish a specific goal. Which of the following leadership styles that has a minimal leader activity level?
a. Authoritarian Leadership Style
b. Democratic Leadership Style
c. Laissez-Faire Leadership Style
d. A and B

34. Delegation is the transfer of responsibility and authority to a competent person. It is a tool that a nurse can use in order to improve productivity. Which of the following tasks that should not be delegated to unlicensed assistive personnel?
a. Taking vital signs
b. Evaluation of care effectiveness
c. Postmortem care
d. Suctioning of chronic tracheostomies

35. Which of the following interventions that a nurse should not perform in patients suffering from hypothermia?
a. Cover the client’s scalp with a cap or turban.
b. Apply warm blankets.
c. Provide a warm environment.
d. Keep limbs far from the body.

1. Rationale: C is the correct answer because it provides a moist environment for the wound thus promotes healing as it reduces bacterial colonization. The other choices though correct but they cannot explain clearly the importance of wound dressing. A is wrong because it talks about avoiding to touch the wound. B is wrong because it is more on assisting patient’s comfortable position. D is wrong because it is more on the removal of the dressing and checking the condition of wound.

2. Rationale: A is the correct answer because the cause of thermal burns happens usually in the house (e.g. kitchen) which makes a person more prone to hot liquids or flames. B, C, and D are not considered as more frequent types though they may happen at workplace.

3. Rationale: B is the correct answer because it uses age-dependent graphs which are most preferred for children and neonates. A is incorrect because it is more applicable to adults. Children have different body proportions compared to children. C is incorrect because this scale is use to determine the color of the skin to determine the response to the UV light.

4. Rationale: D is the correct answer because it correctly defines the type of burn classification. Subdermal burn appears as white, brown, or deep red with no blisters. Grafting is required and scarring will occur. A is wrong because it only involves epidermis, dermis, and subcutaneous tissue; it appears as with or without blisters. B is wrong because it only involves epidermis and extends into the papillary or superficial layer of the dermis; there are small blisters. C is wrong because it involves only the epidermis and no blisters.

5. Rationale: C is the correct answer because it correctly defines a stage 3 pressure injury. A is wrong because it is a stage 4 pressure injury. B is wrong because it is a stage 2 pressure injury. D is wrong because it is a stage 1 pressure injury. This stage may be difficult to assess especially to individuals who have dark skin tones.

6. Rationale: D is the correct answer because it signifies that pain over the site is a precursor to tissue breakdown. A, B, C, are wrong because they are secondarily check during assessment of the skin and their presence may mean other skin condition.

7. Rationale: A is correct answer because massaging or rubbing any bony prominences will only increase the chance of developing a pressure injury leading to tissue damage. Pillows can be used to avoid pressure injury especially if the patient is positioned properly. B is essential because it allows the body to repair itself. C is essential because good skin hygiene preserves skin integrity. D explains the importance of proper positioning in order to prevent shear and friction.

8. Rationale: C is correct answer because it is associated with a loss of protective sensation (neuropathy) and/or the presence of ischemia with patients having diabetes. A is wrong because it ranges from no pain to severe, constant pain. It is often worse after standing for long periods. B is wrong because it is often accompanied by severe cramping pain in the foot or calf muscle at rest when the legs are elevated.

9. Rationale: A is the correct answer because it is not true that nurses don’t make important decisions, rather they are. These decisions often include the total well-being of their patients. B, C, and D are all options which clearly describe the importance of using critical thinking by the nurses in the work field.

10. Rationale: B is the correct answer because it is in the evaluating stage where a nurse collects the data in order to determine the outcomes. From the outcomes gathered, a nurse compares and relates it to the goals set or the patient. If changes need to be done, it is here where the nurse will continue, modify or terminate the client’s plan. A is wrong because it is the step where the nurse will analyze the data and formulate diagnostic statements. C is wrong because it is a step where a nurse collects, organize and validate the data. D is wrong because it is a step where a nurse implements the interventions planned for the patient.

11. Rationale: D is the correct answer because it is the type of assessment use in order to identify any life threatening problems and/or new or overlooked problems. A is wrong because it is done during several months after initial assessment. B is wrong because it is performed within specified time after admission to a health care facility. C is wrong because it is performed during the ongoing process of nursing care.

12. Rationale: C is the correct answer because an objective data are the ones which can be detected by someone else (observer) and can be measured using accepted standard procedures; this is the reason why it is also termed as signs or overt data. A is wrong because a subjective data is also referred as symptoms or covert data; these type of data is the one that the patient feels.  B is wrong because a constant data are information which doesn’t change over a period of time (e.g. blood type). D is completely wrong because it is not included in the types of data that a nurse acquires.

13. Rationale: A is the correct answer because an actual diagnosis is made based on the signs and symptoms present. B is wrong because it “describes human responses to levels of wellness in an individual, family, or community that have a readiness for enhancement: (NANDA International, 2005, p.277). C is wrong because it is made based on the presence of risk factors that suggest that a problem will likely occur if it is left untreated and/or left unseen by the healthcare team. D is wrong because it is a type of diagnosis which is related to a number of other diagnoses.

14. Rationale: C is the correct answer because Maslow’s hierarchy of needs is not self-centered rather it is problem centered. A, B, and D are all characteristics of Maslow’s hierarchy of needs.

15. Rationale: B is the correct answer because it is one of the needs that Kalish added between the physiologic and safety and security needs of Maslow. A is wrong because affection needs is under the love and belongingness needs of Maslow. C and D are wrong because independence needs and recognition are under the self-esteem needs of Maslow.

16. Rationale: D is correct because a Denver Developmental Screening Test is an example of screening survey and/or procedures. A and C are wrong because they are both primary level of prevention. B is wrong because it is an example of a tertiary level of prevention.

17. Rationale: A is correct because it correctly defines the contemplation stage. B is wrong because it is the preparation stage. C is wrong because it is the action stage. D is wrong because it is the maintenance stage.

18. Rationale: D is correct because this model considers that sickness is the inability to fulfill one’s role. A is wrong because this model deals about how an individual adapts with his environment towards to good health. Both B and C are wrong because they are not included in the accepted models of health and illness.

19. Rationale: C is the correct answer because lack of body nutrients predisposes a certain individual in acquiring a disease; other example include environmental factor or stress factor. A and B are both wrong because climate and economic level are all example of environment factor. D is wrong because family history is an example of host factor; other example includes age and lifestyle habits.

20. Rationale: A is correct because it is not included in the four aspects; it is not true that clients are held responsible for their condition. B, C, and D are all included in the four aspects of sick role.

21. Rationale: B correctly describe the about growth and development. A is wrong because the pace of growth and development is uneven; as such, growth is greater during infancy compared to childhood. C is wrong because development becomes increasingly differentiated, i.e. it starts in a generalized response to a skilled specific response. D is wrong because development proceeds from single acts to integrated acts.

22. Rationale: D is correct because this nursing intervention is very important in toddlerhood stage. A is wrong because it is important during adolescence stage. B is wrong because it is important during neonatal stage. C is wrong because it is important in the preschool stage.

23. Rationale: B is correct because during this age that anal stage happens. A is wrong because it happens during latency stage. C is wrong because it is just a diversion to the choices. D is wrong because it happens during the phallic stage.

24. Rationale: A is correct because it is the right negative resolution during early childhood; others include compulsive compliance and defiance.  B and C are both wrong because they happen during infancy stage. D is wrong because it happens during late childhood stage.

25. Rationale: C is the correct term for the definition given above. A is wrong because accommodation is defined as the process of change where cognitive processes mature sufficiently to allow an individual to solve problems that were unsolvable before. Both B and D are wrong because they mean the same thing; it is the ability to deal with the demands in the environment.

26. Rationale: A is correct because a low stress level will result to a less risk of low birth weight baby. B, C, and D are all maternal factors that contribute to the higher risk of low birth weight babies.

27. Rationale: C is correct because tonic neck reflex is the other term for fencing reflex; it is defined as the postural reflex which disappears after 4-6 months. A is wrong because Babinski reflex is characterized as rising of the big toe and fanning out of other toes when the sole of the foot is being stroked. B is wrong because it is also known as the walking or dancing reflex which disappears at about 2 months. D is wrong because a palmar reflex happens when a small object is placed against the palm of the hand causing the fingers to curl on it.

28. Rationale: D is correct because according to Erikson the resolution of this stage will determine how a person will handle to resolve the next stages to come. A, B, and C are all diversion to the question.

29. Rationale: A is correct because the statement acknowledges the patient in a nonjudgmental way. B is wrong because it uses a presenting reality technique. C is wrong because it uses an offering self technique. D is wrong because it uses an open-ended questions technique.

30. Rationale: C is correct because it describes how a nurse clearly applies the humanistic theory towards his patient. D is wrong because the nurse applies the cognitive theory. A and B are both wrong because they describe a nurse who uses the behavioristic theory.

31. Rationale: A is correct because an adult will response to either new or same situations based on the previous experiences that they encountered. B is wrong because people will mature from dependence to independence. C is wrong because an adult’s readiness is related to developmental task or social role. D is wrong because adult is more oriented in learning when the materials are presented immediately and not in the future.

32. Rationale: D is correct because it indicates that a patient may have a problem with his health literacy level. A, B, and C are not client behaviors that will indicate a health literacy problem to a patient.

33. Rationale: C is correct because a minimal leader activity level depicts a laissez-faire style which is why it is considered as inefficient. A and B are both wrong because they are both high in terms of leader activity level.

34. Rationale: B is correct because evaluation of care effectiveness should be done by nurses; unlicensed assistive personnel are not required to create a nursing care plan. A, C, and D are tasks which can be delegated to unlicensed assistive personnel.

35. Rationale: D is the answer because the limbs should not be far from the body but rather close to it. A, B, and C are all nursing interventions that can be done to patients with hypothermia.