Nursing Department: Answer: Rationale

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Don Mariano Marcos Memorial State University

South La Union Campus


COLLEGE OF COMMUNITY HEALTH AND ALLIED MEDICAL SCIENCES
Agoo, La Union
Tel. 072.682.0663/ichams.dmmmsu-sluc.com
Embracing World Class Standards
NURSING DEPARTMENT Care to learn, Learn to care

NAME: _______________________________________________

Direction: Read the questions carefully. Choose the best/correct answer then give the rationale of your
answer. Please indicate your reference/s: title, author, year and page number if possible.

1. A mother arrives at an emergency room with her 5-year old child and the mother states that the child
fell off a bunk bed. A head injury is suspected, and a nurse is assessing the child continuously for
signs of increased intracranial pressure (ICP). Which of the following is a late sign of increased ICP in
this child?
a. Nausea
b. Bradycardia
c. Bulging fontanel
d. Dilated scalp veins

Answer:
Rationale:

2. A nurse is performing an admission assessment on a newborn infant with a diagnosis of spina bifida
(myelomeningocele). A priority nursing assessment for this newborn is:
a. Pulse rate
b. Palpation of the abdomen
c. Specific gravity of the urine
d. Head circumference measurement

Answer:
Rationale:

3. A clinic nurse reviews the record of a 3-week old infant and notes that the physician has documented
a diagnosis of suspected Hirschsprung’s disease. The nurse reviews the assessment findings
documented in the record, knowing that which symptom most likely led to the mother to seek health
care for the infant?
a. Diarrhea
b. Projectile vomiting
c. Regurgitation of feedings
d. Foul-smelling ribbon-like stools

4. A nurse is preparing to care for a child with intussusception. The nurse reviews the child’s record and
expects to note which symptom of this disorder documented?
a. Watery diarrhea
b. Ribbon-like stools
c. Profuse projectile vomiting
d. Bright red blood and mucus in the stools.

5. A nurse provides home care instructions to the parents of a child with celiac disease. The nurse
teaches the parents to include which food item in the child’s diet?
a. Rice
b. Oatmeal
c. Rye toast
d. Wheat bread

6. A home care nurse instructs the mother about dietary measures for a 5-year old child with lactose
intolerance. The nurse tells the mother that it is necessary to provide which dietary supplement in the
child’s diet?
a. Fats
b. Zinc
c. Protein
d. Calcium

7. A nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On admission assessment,
which data would the nurse expect to obtain when asking the mother about the child’s symptoms?
a. Watery diarrhea
b. Projectile vomiting
c. Increased urine output
d. Vomiting large amounts of bile

8. A nurse provides feeding instructions to a mother of an infant diagnosed with gastroesophageal


reflux. To assist in reducing the episodes of emesis, the nurse tells the mother to:
a. Provide less frequent, larger feedings.
b. Burp the infant less frequently during feedings.
c. Thin the feedings by adding water to the formula.
d. Thicken the feedings by adding rice cereal to the formula.

9. A nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with
tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this
condition documented in the record?
a. Incessant crying
b. Coughing at nighttime
c. Choking with feedings
d. Severe projectile vomiting

10. A nurse is caring for an infant with a diagnosis of tetralogy of Fallot. The infant suddenly becomes
cyanotic and the nurse recognizes that the infant is experiencing a hypercyanotic spell (blue or Tet
spell). The nurse immediately places the infant in what position?
a. Prone position
b. Knee-chest position
c. High Fowler’s position
d. Reverse Trendelenburg position

11. The nurse is caring for a child with a diagnosis of Kawasaki disease and the mother of the child asks
the nurse about the disorder. The nurse explains to the mother that it is:
a.An acquired cell-mediated immunodeficiency disorder.
b.A chronic multisystem autoimmune disease characterized by the inflammation of connective
tissue.
c. Also called mucocutaneous lymph node syndrome and is a febrile generalaized vasculitis of
unknown origin.
d.An inflammatory autoimmune disease that affects the connective tissue of the hearts, joints and
subcutaneous tissues.

12. A nurse is caring for a child with a suspected diagnosis of rheumatic fever. The nurse reviews the
laboratory results, knowing that which laboratory study would assist in confirming the diagnosis?
a. Immunoglobulin
b. Red blood cell count
c. White blood cell count
d. Antistreptolysin O titer

13. A student nurse is caring for a 2-year old child diagnosed with croup and the clinical instructor asks
the student about the clinical manifestations associated with the illness. Which statement by the
student indicates a need for further research?
a. “The cough is harsh and brassy.”
b. “Inspiratory stridor and a low grade fever may be present.”
c. “Symptoms usually worsen at night and are better during the day.”
d. “Symptoms usually worsen during the day and are relieved during sleep.”
14. A clinic nurse reviews the record of a child just seen by a physician and diagnosed with suspected
aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically
found in this disorder?
a. Pallor
b. Hyperactivity
c. Exercise intolerance
d. Gastrointestinal disturbances

15. A lumbar puncture is performed on a child suspected of having bacterial meningitis and cerebrospinal
fluid (CSF) is obtained for analysis. A nurse reviews the results of the CSF analysis and determines
that which of the following results would verify the diagnosis?
a. Clear CSF, elevated protein and decreased glucose levels.
b. Clear CSF, decreased pressure and elevated protein level.
c. Cloudy CSF, elevated protein and decreased glucose level.
d. Cloudy CSF, decreased protein and decreased glucose levels.

16. A nurse is caring for a child recently diagnosed with cerebral palsy and the parents of the child ask
the nurse about the disorder. The nurse bases her response on the understanding that cerebral palsy
is a/an:
a. Infectious disease of the central nervous system.
b. Inflammation of the brain as a result of a viral illness.
c. Congenital condition that results in moderate to severe retardation.
d. Chronic disability characterized by impaired muscle movement and posture.

17. A nurse develops a plan of care for a child at risk for generalized tonic-clonic seizures. In the plan of
care, the nurse identifies seizure precautions and documents that which items need to be placed at
the child’s bedside?
a. Emergency cart.
b. Airway and tracheotomy set.
c. Oxygen with a tracheotomy set.
d. Suctioning equipment and an airway.

18. A child is diagnosed with Reye’s syndrome. A nurse develops a nursing care plan for the child and
includes which intervention in the plan?
a. Assessing hearing loss.
b. Monitoring urine output.
c. Changing body position every 2 hours.
d. Providing a quiet atmosphere with dimmed lighting.

19. R.A. 7160 mandates devolution of basic services from the national government to local government
units. Which of the following is the major goal of devolution?
a. To strengthen local government units.
b. To allow greater autonomy to local government units.
c. To empower the people and promote self-reliance.
d. To make basic services more accessible to the people.

20. Which h of the following is an advantage of a home visit?


a. It allows the midwife to provide nursing care to a greater number of people.
b. It provides an opportunity to do first hand appraisal of the home situation.
c. It allows sharing of experience among people with similar health problems.
d. It develops the family’s initiative in providing for health needs of its members.

21. The nurse performs Guthrie screening test by drawing blood from the heel of an infant. The screening
test is done to diagnose which of the following inborn errors of metabolism?
a. Glucose-6-phosphate dehydrogenase deficiency
b. Phenylketonuria
c. Galactosemia
d. Congenital hypothyroidism
22. Probable indications of pregnancy are objective findings that can be documented by an examiner.
Although these signs are strong indicators of pregnancy, a positive diagnosis of pregnancy cannot be
based on these findings because they may be caused by other conditions. All but one of the following
are probable signs of pregnancy?
a. Sonographic evidence of gestational sac.
b. Ballottement.
c. Fetal movement felt by the examiner.
d. Fetal outline felt by the examiner.

23. Mrs. Mayfair comes to the clinic with a chief complaint of 2 missed menstrual periods. She reports
taking a pregnancy test and tested positive. The following assessment data will alert you that Mrs.
Mayfair is probably pregnant?
a. (+) pregnancy test and missing more than one menstrual period.
b. Frequency of urination, nausea and vomiting.
c. Enlargement of uterus and (+) pregnancy test.
d. Pica and fatigue

24. Mrs. Mayfair asks you, “Am I pregnant?” Your response on whether Mrs. Mayfair is positively
pregnant will based on:
a. (+) ballottement or the upward floating of the fetus when uterus is gently tapped from the side.
b. Presence of enlargement of the abdomen with reports of fetal movement by the mother.
c. The nurse or any health care practitioner’s identification of the fetal parts and auscultation of fetal
heart sounds.
d. Presence of increased darkening of the areola of the breasts.

25. Upon assessment, it is noted that Mrs. Mayfair craves for ice chips and is opting for a vegetarian diet.
Your best response to this would be:
i. If the client wishes to adopt a vegetarian diet, the client must choose raw vegetables over cooked
ones, because raw vegetables are richer sources of phytochemicals. These phytochemicals
strengthen the immune system as well as provides nutrients which are essential for fetal growth and
development.
ii. Ice chips can never substitute for food because it is considered a non-nutritive substance.
iii. A strict vegetarian diet may provide the increase in fiber that the pregnant woman needs to
address pregnancy discomforts but it does not supply adequate amount of calories that is required by
the pregnant woman.
iv. A diet that is strictly vegetarian may lead to inadequate intake of proteins, vitamins and other
minerals.
a. i, iii, iv
b. i, ii, iii
c. i, ii, iv
d. ii, iii, iv

26. In her 8th month of pregnancy, Bree returns to the clinic and you note that she rubs her back
frequently. She asks you how she can keep her backache from getting worse. You will instruct the
patient to:
a. Stand with the neck jutting forward, shoulders straight and the pelvis tucked under and slightly
upward.
b. Stand with the neck and shoulders straight and the back flattened.
c. Stand with the shoulders slumping and the abdomen jutting forward.
d. Stand with head tilted slightly forward and pelvis straight.

27. Bree also tells you that she has been experiencing swelling of the ankles and feet at the end of each
day. You will evaluate that she has adequate knowledge if this condition if she states:
a. “I’ll wear knee high stockings to prevent fluid from accumulating in my lower extremities.”
b. “I’ll wear a girdle whenever I’m resting to facilitate circulation in my lower extremities.”
c. “I’ll dangle my legs frequently throughout the day to improve blood flow in my legs.”
d. “I’ll sit with my legs elevated for half an hour in the afternoon and in the evening.”
28. You are about to perform Leopold’s maneuver on Bree. In preparing her for this procedure, you know
the least important thing to do is:
a. Place a rolled towel under one of the client’s hips.
b. Have the client lie on her back with her knees bent.
c. Wash your hands thoroughly using warm water.
d. Ask the mother to drink plenty of water prior to the procedure.

29. Mrs. Solis is 2 months pregnant and is worried because she has some nasal congestion with
accompanying elevation in temperature. She asks whether she could take OTC medications to
prevent her sickness from worsening. Your most appropriate response would be:
a. “You shouldn’t take medications during pregnancy. You should get some rest and drink plenty of
water for your cold.”
b. “Let us talk to your doctor to see which medication would be alright for you to take.”
c. “Viral infections are self-limiting so you don’t need to take medications.”
d. “These are just effects of the hormonal changes occurring due to your pregnancy.”

30. Mrs. Perry asks you about amniocentesis. The least appropriate response is:
a. The test can provide information about genetic disorders and fetal lung maturity.
b. Real time ultrasound is used to identify fetal parts and locate pockets of amniotic fluid.
c. A small amount of clear drainage from the client’s vagina is expected.
d. The client is encouraged to engage in only light activity for 24 hours after the procedure.

31. 15cc of fluid was withdrawn from Mrs. Perry and you noted that it has a strong yellow color. This may
likely be due to:
a. Fetal distress.
b. Bladder puncture.
c. Blood incompatibility.
d. Normal fetal development.

32. Ultrasonography measures the response of sound waves against solid objects. Mrs. Young is
scheduled to undergo an ultrasound examination. How will you prepare her for the procedure?
a. Tell her to drink at least three glasses of water before the procedure.
b. Tell her that the process involves X-rays and the father should wear a lead apron if he wishes to
remain in the room.
c. Tell her that a cool gel is going to be applied to her abdomen to improve contact of the
transducer.
d. Instruct her to void prior to the procedure so that uterine contents would not be obscured by the
bladder.

33. Mrs. Williams, a 33-year old G4P3 (3003) has just been admitted because of excessive vaginal
bleeding. Her husband found her asleep, with blood pooling beneath her. Mrs. Williams was
diagnosed with placenta previa. You know that placenta previa:
a. is a degenerative anomaly of the placenta.
b. is the premature separation of a normally implanted placenta.
c. is placental implantation in the upper uterine segment covering the cervical os.
d. is the development of the placenta in the lower uterine segment.

34. Mrs. Mayer, 33 years old, was rushed to the hospital due to vaginal bleeding and claims she is 16
week pregnant. She informs you that her vaginal discharge was made up of blood and grape like
cysts. In assessing the patient, you would not expect to find:
a. Rapidly growing uterus.
b. No fetal heart sounds.
c. Abnormal fetal parts.
d. None of the above.

35. Mrs. Rowland underwent suction curettage after being diagnosed with H. mole. Extensive follow up
therapy will be done to eliminate the risk of developing choriocarcinoma. She comes to you worried
and asks, “Can I still get pregnant?” You most appropriate response would be:
a. “You should avoid sexual activity for a year since this might aggravate your condition.”
b. “You should get pregnant within a year to prevent choriocarcinoma.”
c. “You should ask your physician about it.”
d. “You should avoid getting pregnant for a year.”

Situation: Preterm premature rupture of membranes (PPROM) is rupture of fetal membranes with loss of
amniotic fluid before the 37 th week of pregnancy. Mrs. Hatcher was admitted because of PROM, stating
that she experienced a sudden gush of fluid from her vagina 12 hours ago, but because she was having
problems controlling her bladder, she just put on adult diaper and did not bother going to the clinic for
evaluation.
36. Amniotic fluid cannot be differentiated from the urine by appearance so a sterile vaginal speculum
examination is done to observe for vaginal pooling of liquid. In providing instructions regarding the
examination, you would tell Mrs. Hatcher that:
a. It would be better if you held your breath during the exam.
b. It would be easier for the examiner if your pelvic muscles are tight to facilitate the insertion of the
speculum.
c. It is a relatively painless procedure; you can expect a feeling of pressure.
d. It would aid in determining fetal defects due to your condition.

37. A nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which of the
following is noted on the external monitor tracing during a contraction?
a. Late decelerations
b. Early decelerations
c. Short-term variability

38. A maternity nurse is caring for a client with abruption placenta and is monitoring the client for
disseminated intravascular coagulopathy. Which assessment finding is least likely to be associated
with disseminated intravascular coagulopathy?
a. Prolonged clotting times.
b. Decreased platelet count.
c. Swelling of the calf of one leg.
d. Petechiae, oozing from injection sites and hematuria.

39. A nurse is assessing a pregnant client in the second trimester who was admitted to the maternity unit
with a suspected diagnosis of abruption placenta. Which of the following assessment findings would
the nurse expect to note if this condition is present?
a. A soft abdomen.
b. Uterine tenderness.
c. Absence of abdominal pain.
d. Painless, bright re vaginal bleeding.

40. A nurse is monitoring a client who is in the active stage of labor. The client has been experiencing
contractions that are short, irregular and weak. The nurse documents that the client is experiencing
which type of labor dystocia?
a. Hypotonic
b. Precipitous
c. Hypertonic
d. Preterm labor

41. A nurse in a labor room is preparing to care for a client with hypertonic uterine dysfunction. The nurse
is told that the client is experiencing uncoordinated contractions that are erratic in their frequency,
duration and intensity. The priority nursing intervention in caring for the client is to:
a. Provide pain relief measures.
b. Prepare the client for an amniotomy.
c. Promote ambulation every 30 minutes.
d. Monitor the oxytocin infusion closely.

42. A pregnant client is receiving magnesium sulfate for the management of pre-eclampsia. A nurse
determine that the client is experiencing toxicity from the medication if which of the following is noted
on assessment?
a. Proteinuria+3
b. Presence of deep tendon reflexes
c. Serum magnesium level of 6mEq/L
d. Respirations of 10breaths/min

43. A woman with pre-eclampsia is receiving magnesium sulfate. The nurse assigned to care for the
client determines that the magnesium sulfate is effective if:
a. Scotomas are present.
b. Seizures do not occur.
c. Ankle clonus is noted.
d. The blood pressure decreases.

44. A nurse is caring for a term newborn. Which assessment finding would alert the nurse to suspect the
potential for jaundice in this infant?
a. A negative direct Coomb’s test result.
b. Birth weight of 8 pounds and 6 ounces.
c. Presence of a cephalhematoma.
d. Infant blood type of O negative.

45. A senior nursing student is assigned to care for a client with severe pre-eclampsia who is receiving
an intravenous infusion of magnesium sulfate, the co-assigned nurse asks the student to describe the
actions and effects of this medication. Which of the following statements if made by the student
indicates the need for further research?
a. “It produces flushing and sweating due to deceased peripheral blood pressure.”
b. “It decreases the central nervous system activity acting as an anticonvulsant.”
c. “It decreases the frequency and duration of uterine contractions.”
d. “It increases acetylcholine, blocking neuromuscular transmission.”

46. A prenatal client with severe abdominal pain is admitted to the maternity unit. The nurse is monitoring
the client closely because concealed bleeding is suspected. Which of the following assessment
findings would indicate the presence of concealed bleeding?
a. Increase in fundal height
b. Heavy vaginal bleeding
c. Early deceleration on the fetal heart monitor
d. Back pain

47. A nurse is reviewing the record of a client in the labor room and notes that the physician has
documented that the fetus is at negative 1 (-1) station. The nurse determines that the fetal presenting
part is:
a. 1 inch below the ischial spine.
b. 1 inch below the iliac crest.
c. 1 cm above the ischial spine.
d. 1 fingerbreadth below the symphysis pubis.

48. A client is transported to the delivery room and prepared for a caesarean delivery. After the client is
transferred to the delivery room table, the nurse places her in:
a. Supine position with a wedge under the right hip.
b. Trendelenburg’s position with the legs in stirrups.
c. Prone position with the legs separated and elevated.
d. Semi-Fowler’s position with a pillow under the knees.

49. A nurse prepares to administer a vitamin K injection to a newborn and the mother asks the nurse why
her newborn infant needs the injection. The best response by the nurse would be:
a. “Your infant needs vitamin K to develop immunity”.
b. “The vitamin K will protect your infant from being jaundiced”.
c. “Newborn infants have sterile bowels and vitamin K promotes the growth of bacteria in the
bowel”.
d. “Newborn infants are deficient in vitamin K and this injection prevents your infant from abnormal
bleeding”.
50. A nurse administers erythromycin ointment (0.5%) to the eyes of a newborn infant and the mother
asks the nurse why this is performed. The nurse explains to the mother that this is routinely done to:
a. Prevent cataracts in the newborn infant born to a woman who is susceptible to rubella.
b. Protect the newborn infant’s eyes from possible infections acquired while hospitalized.
c. Minimize the spread of microorganism to the newborn infant from invasive procedures during
labor.
d. Prevent ophthalmia neonatorum from occurring after delivery in a newborn infant born to woman
with an untreated gonococcal infection.

51. A nurse is using the Nägele’s rule to calculate a pregnant woman’s estimated date of delivery and
age of gestation. The woman tells the nurse that her last period began on January 17, 2016 and
ended 6 days later. The nurse should compute the age of gestation to be:
a. 38 2/7 weeks
b. 37 4/7 weeks
c. 39 1/7 weeks
d. 40 1/7 weeks

52. A client who is 8 weeks’ pregnant calls the health care clinic and tells the nurse that she is
experiencing nausea and vomiting every morning. The nurse suggests which of the following
measures that will best promote relief of the symptoms?
a. Eating a high-carbohydrate diet.
b. Eating a high-fat diet.
c. Eating dry crackers before arising.
d. Increasing fluid with meals.

53. A clinic nurse is providing instructions to a pregnant client regarding measures that will assist in
alleviating heartburn. Which statement by the client indicates an understanding of the instructions?
a. “I should avoid between-meal snacks.”
b. “I should lie down for an hour after eating.”
c. “I should use spices for cooking rather than using salt.”
d. “I should avoid eating foods that produce gas such as beans, vegetables and fatty foods like deep
fried chicken.”

54. A nursing instructor asks a nursing student to describe the formal operations stage of Piaget’s
cognitive developmental theory. The appropriate response by the nursing student is:
a. “The child has the ability to think abstractly.”
b. “The child develops logical thought patterns.”
c. “The child begins to understand the environment.”
d. “The child has difficulty separating fantasy from reality.”

55. A maternity nurse is providing instructions to a new mother regarding the psychosocial development
of the newborn infant. Using Erikson’s psychosocial development theory, the nurse instructs the
mother to:
a. Allow the newborn infant to signal a need.
b. Anticipate all the needs of the newborn infant.
c. Attend to the newborn infant immediately when crying.
d. Avoid the newborn infant during the first 10 minutes of crying.

56. A mother of a 3-year old child tells a clinic nurse that the child is rebelling constantly and having
temper tantrums. Using Erikson’s psychosocial development theory, the nurse tells the mother to:
a. Set limits on the child’s behaviour.
b. Ignore the child when this behaviour occurs.
c. Allow the behaviour, because this is normal at this age period.
d. Punish the child every time the child says “no” to change the behaviour.

57. A nurse is evaluating the developmental level of a 2-year old child. Which of the following does the
nurse expect to observe?
a. Uses a fork to eat.
b. Uses a cup to drink.
c. Pours own milk into a cup.
d. Uses a knife for cutting food.

58. A mother of a 3-year old child asks a clinic nurse about appropriate and safe toys. The nurse tells the
mother that the most appropriate toy is which of the following?
a. A wagon
b. A golf set
c. A farm set
d. A jack set with marbles

59. A clinic nurse provides information to the mother of a toddler regarding toilet training. Which
statement by the mother indicates a need for further information regarding the toilet training?
a. “Bladder control usually is achieved before bowel control.”
b. “The child should not be forced to sit on the potty for long periods.”
c. “The ability of the child to remove clothing is a sign of physical readiness.”
d. “The child will not be ready to toilet train until the age of about 18 to 24 months.”

60. A clinic nurse assesses the communication patterns of a 5-month old infant. The nurse determines
that the infant is demonstrating the highest level of developmental achievement expected if the infant:
a. Coos when comforted.
b. Links syllable together.
c. Uses monosyllabic babbling.
d. Uses simple words such as “mama.”

61. IMCI Case Management Process is presented in sequence of steps with information on how to carry
them out. It helps and guides user. The process involves the following sequential elements:
a. Classify illness; assess child; identify treatment; counsel mother; treat child; follow up care
b. Follow up care; classify illness; counsel mother; identify treatment; assess child; treat child
c. Assess child; classify illness; identify treatment; treat child; counsel mother; follow up care
d. Assess child; counsel mother; classify illness; identify treatment; treat child; follow up care

62. Mastoiditis is classified in the presence of:


a. Tender swelling in the anterior portion of the ear.
b. Tender swelling in the posterior portion of the ear.
c. Pus draining from the ear for less than 14 days.
d. Pus draining from the ear for more than 14 days.

63. The family nursing care plan (FNCP) is the blueprint of the care that the nurse designs to
systematically minimize or eliminate the health and family nursing problems. All of the following are
features of the FNCP, except:
a. The FNCP is based upon identified health and nursing problems.
b. The FNCP relates to the future.
c. The FNCP is an end in itself.
d. The FNCP focuses on actions designed to solve a problem.

64. Presidential Decree 996 requires the compulsory immunization of all children below 8 years of age,
against the childhood immunizable diseases. All of the following statements are true with regards to
vaccinating children, except:
a. It is safe and immunologically effective to administer all EPI vaccines on the same day.
b. Use one syringe, one needle per child during vaccination.
c. Fever and systemic symptoms result as an abnormal immune response to vaccination.
d. Do not immunize a child that needs to be hospitalized.

65. Each level of health facility has cold chain equipment for use in the storage of vaccines. Temperature
monitoring of vaccines is done in all levels of health facilities. This is done how many times in a day?
a. Once, during the morning.
b. Once in the afternoon before going home.
c. Twice a day, one in the morning and in the afternoon before going home.
d. Thrice a day, one in the morning, at noon and in the afternoon before going home.

Situation: Ivory, a 19-year old tourism student had a date in Intramuros with her boyfriend. They ate
barbecue in the side walk and drink cold beverages in the side walk. After 1 week, Ivory was noted to
have high grade fever accompanied by abdominal pain and constipation. She was rushed to Castro
Hospital and was diagnosed to have typhoid fever.
66. Typhoid fever is common during the rainy season and in areas of low sanitation level. The causative
agent of typhoid fever is:
a. Salmonella typhi
b. Vibrio el tor
c. Entamoeba histolytica
d. Clostridium botulinum

67. A pathognomonic sign of typhoid fever is seen on the abdominal area called:
a. Widals
b. Rose spot
c. Somatic O
d. Typhoid psychosis

68. The nursing consideration for typhoid fever would be:


a. Drug of choice is chloramphenicol.
b. Avoid antispasmodic and laxative.
c. Educate public about control of flies.
d. All of the above.

69. Hepatic encephalopathy is the most dreaded complication of hepatitis. What manifestation would tell
you as a nurse that you client is already in hepatic encephalopathy?
a. Severe jaundice
b. Hepatosplenomegaly
c. Change in level of sensorium
d. Hematemesis

70. You expect to observe Waterhouse-Friderichen Syndrome in a client with fulminant


meningococcemia. What clinical manifestation/s will be observed?
a. Shock, tachycardia, brudzinski
b. Hypotension, enlarging rashes, adrenal insufficiency
c. Shock, hypotension, kernigs
d. Hypotension, petechiae, adrenal insufficiency

71. Red tide poisoning is a fatal form of poisoning if not treated properly. Which of the following nursing
interventions is incorrect in the management of red tide poisoning?
a. Immediately induce vomiting.
b. Use vinegar to neutralize the toxin.
c. Give the patient coconut milk.
d. Transport the patient to the hospital for respiratory support.

72. The delos Reyes couple have a 6-year old child entering school for the first time. The delos Reyes
family has a:
a. Health threat
b. Heath deficit
c. Forseeable crisis
d. Stress point

73. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of
families. The youngest child of the delos Reyes family has been diagnosed as mentally retarded. This
is classified as:
a. Health threat
b. Heath deficit
c. Forseeable crisis
d. Stress point

74. The Sentrong Sigla Movement has been launched to improve health service delivery. Which of the
following is/are true of this movement?
a. This is a project spearheaded by local government units.
b. It is a basis for increasing funding from local government units.
c. It encourages health centers to focus on disease prevention and control.
d. Its main strategy is certification of health centers able to comply with standards.

75. Freedom of choice is one of the policies of the Family Planning Program of the Philippines. Which of
the following illustrates this principle?
a. Information dissemination about the need for family planning.
b. Support of research and development in family planning methods.
c. Adequate information for couples regarding the different methods.
d. Encouragement of couples to take family planning as a joint responsibility.

76. You will not give DPT2 if the mother says that the infant had?
a. Seizures a day after DPT1.
b. Fever for 3 days after DPT1.
c. Abscess formation after DPT1.
d. Local tenderness for 3 days after DPT1.

77. A 2-month old infant was brought to the health center for immunization. During assessment, the
infant’s temperature registered at 38.1OC. Which is the best course action that you will take?
a. Go on with the infant’s imunization.
b. Give paracetamol and wait for his fever to subside.
c. Ferer the infant to the physician for further assessment.
d. Advise the infant’s mother to bring him back for immunization when he is well.

78. PCV vaccine is given during infancy to prevent which of the following diseases?
a. Severe diarrhea
b. Pneumonia, Hepatitis B and Meningitis
c. Pneumonia, Meningitis, Bacteremia, Middle Ear Infection and Sinusitis
d. Measles, Mumps and German Measles

79. The Expanded Program on Immunization (EPI) was enhanced as a response to the Universal Child
Immunization Goal of the World Health Organization. A child was brought to the health center for
BCG vaccination. Which of the following assessment results would halt you from adminstering the
vaccine?
a. Convulsions after the last immnization schedule.
b. Vomiting and diarrhea since this morning.
c. Cough for the past week; the child is taking Salbutamol.
d. Asthma for the past 4 days; the child is taking hydrocortisone.

80. In 2012, the DOH released a new classification system of hospitals and other health facilities with
specific guidelines for scope of services and functional capacity for each classification and overall
operating standards. This hospital level provides services for all kinds of diseases, injuries or
deformities and has emergency and outpatient services including isolation facilities, maternal, dental
clinics, 1st level X-ray, 2nd clinical laboeratory with consulting pathologist, blood station and
pharmacy:
a. Level 1 General hospitals
b. Level 2 General hospitals
c. Level 3 General hospitals
d. DOH hospitals

81. Which of the following aromatic herbs for body pain, rheumatism and arthritis is used by older
people?
a. Sambong
b. Yerba Buena
c. Ulasimang Bato
d. Ampalaya

82. Midwife Patricia was assigned in a remote area in Quezon province. Aling Tere is a resident in the
community and was diagnosed with gouty arthritis. Midwife Patricia is correct if she recommends:
a. Pansit-pansitan
b. Tsaang gubat
c. Bayabas
d. Akapulko

83. If an epidemic has been reported in your area of responsibility as a midwife, you will conduct an
epidemiological investigation. What should you do first?
a. Treat the clients affected by the disease.
b. Verify the existence of the disease.
c. Control the disease.
d. Confirm the diagnosis.

84. The primary purpose of conducting an epidemiological investigation is to:


a. Identify groups who are at risk for contracting the disease.
b. Delineate the etiology of the epidemic.
c. Encourage cooperation and support of those with the disease in the community.
d. Identify geographical location of cases of the disease in the community.

85. Community organizing is a social development methodology. The activities in the preparatory phase
include all but one:
a. Area selection
b. Community profiling
c. Social preparation
d. Entry in the community

86. As the organization grows, its needs will also grow. In this phase of community organizing, the nurse
is in the best position to facilitate and coordinate with other agencies. This phase is known as:
a. Phase out phase
b. Organizational phase
c. Intersectoral collaboration phase
d. Education and training phase

87. PAR is a community directed process of gathering and analyzing information. The goal of PAR is:
a. To motivate, enhance and seek wider community participation in decision-making activities.
b. To encourage consciousness of the suffering of the people and develop competence for changing
their own situation together with other people in the community.
c. To reactivate the community to bring social and behavioral change to benefit the community
alone.
d. To reach the state of complete physical, mental and social well-being of an individual and group.

88. Continuing social investigation, integration with the community and core group formation are activities
under which process of the COPAR:
a. Pre-entry
b. Entry
c. Phase out
d. Community organization and capability building

89. A cardinal principle in goal setting states that goals must be set jointly with the family. This ensures
the family’s commitment to their realization. There are several barriers as to why the nurse and the
family can’t set goals together. Which of the following will be considered the biggest barrier to
collaborate goal setting between the nurse and the family?
a. Failure of the family to perceive the existence of a problem
b. Family refuses to do something about the situation
c. Failure of the nurse to develop a working relationship with the family
d. Failure of the family to see the seriousness of a situation

90. Intensification of the Philippine Family Planning Program was made by the government to reduce the
infant and maternal mortality rates in the country. The four pillars of the Family Planning Program
include all of the following, apart from:
a. Responsible parenthood
b. Respect for life
c. Universal access to services
d. Birth spacing

91. The Rooming-in and Breastfeeding Act of 1992 states that health institutions encourage rooming-in
and facilitate breastfeeding. Other than that, which statement below is also included in the act?
a. Requiring institutions to enforce that mothers and babies should be together for 24 hours and as
long as they are both in the hospital.
b. Requiring institutions to adopt rooming-in to provide a human milk bank.
c. The creation of an environment that will foster mother and infant wellness.
d. All of the above

92. Helen, mother of Jayne and Johanna was hospitalized for Dengue Fever. She currently has high-
grade fever. Presented with the following situations, who do you think has the greater risk of acquiring
the disease?
i. Jayne getting bitten by Anopheles mosquito.
ii. Johanna using a handkerchief that has been stained by her mother’s blood to wipe her nose.
iii. Johanna getting bitten by a mosquito that has previously bitten her mother.
iv. Jayne getting bitten by a mosquito in the daytime.
a. i and ii
b. i and iii
c. ii and iv
d. iii and iv

93. Measles is an acute, contagious and exanthematous disease. Which of the following best
differentiates the Pre-eruptive stage from the Eruptive stage?
a. Maculo-papular rashes appears first in the cheeks, bridge of nose, along hairline, at the temple or
at the earlobe during Pre-eruptive stage and then progresses to include the rest of the body
during the Eruptive stage.
b. Photophobia is present in the Eruptive stage.
c. Koplik’s spots and Stimson’s line first emerge during the Pre-eruptive stage.
d. Fever may subside during the Eruptive stage.

94. The Integrated Management of Childhood Illness (IMCI) chart guides health care provider in
identifying the appropriate interventions to be done on a certain situation. The community health
nurse should be aware to consider what factor when using the case management chart?
a. Problem of the child
b. Danger signs
c. Age of the child
d. Chief complaint

95. Janjan is brought to the health center for the second time this year due to diarrhea. The first was 3
months ago due to difficulty of breathing. His latest visit will be considered as a/an:
a. Check up
b. Initial visit
c. Follow up visit
d. Final visit

96. The most common neonatal sepsis and meningitis infections seen within 24 hours after birth are
caused by which organism?
a. Candida albicans
b. Chlamydia trachomatis
c. Escherichia coli
d. Group B beta-hemolytic streptococci

97. Jaundice is said to be physiologic if, except:


a. It never appears before 24 hours.
b. Jaundice fades by the 7th day of life.
c. Total bilirubin of not more than 15mg/dl.
d. Appears 20 hours after delivery.

98. The nurse evaluates a newborn with a heart rate of less than 100 bpm, slow and irregular respiratory
rate, some flexion of muscle tone, a grimace, and a pink body but blue extremities to have a total
Apgar score of?
a. 4
b. 5
c. 6
d. 7

99. A new mother expresses concern to a nurse regarding sudden infant syndrome (SIDS). She asks the
nurse how to position her new infant for sleep. The nurse appropriately tells the mother that the infant
should be placed on the:
a. Side or prone.
b. Back or prone.
c. Stomach with face turned.
d. Back rather on the stomach.

100. The client tells the midwife she is going to begin giving a 3 month old infant rice cereal at bedtime
so the infant will sleep through the night. What will the midwife tell the client?
a. Introducing solid food before 4 to 6 months will reduce the likelihood that the infant will develop
allergies.
b. Make sure the cereal is iron fortified.
c. That is a good way to get the baby to sleep through the night.
d. The introduction of solid foods before the age of 4 to 6 months is not recommended.

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