Midterm Exam With Tos NCM 112
Midterm Exam With Tos NCM 112
VISION
A globally competitive university recognized for excellence in sciences and emerging technologies.
MISSION
TSU shall develop highly competitive and empowered human resources fostering responsive global education, future-
proof research culture, inclusive and relevant extension programs, and sustainable production projects.
Core Values
T-ruth in words, action and character
S-ervice with excellence and compassion
U-nity in diversity.
OBJECTIVES
To prepare graduates for the practice of nursing in various settings by providing the broadest basic education, skills, andcompetencies for future
leadership positions in nursing.
To develop among the students the spirit of compassionate caring, quality of service, social insight, and commitment inhealth
care of the nation.
To continue to strengthen and facilitate health research initiatives and maintain active outreach programs with the community
through coordination and collaboration of undertakings.
Name: Score:
Year and Section: Date:
1. Write your Name, year and section on the provided space given above.
2. Read each question, and choices carefully, choose and ENCIRCLE the letter of the correct answer.
3. Use only black or blue inked ball pen, and NO ERASURES ALLOWED.
1. The physician prescribes a combination of rifampin (Rifadin) and isoniazid (INH) to treat this
client’s tuberculosis. When the client asks the nurse about why the physician has prescribed two
drugs, which response is most accurate?
A. One medication diminishes the side effects of the other.
B. One medication kills the live organism; the other, its spores.
C. Using combined medications can reduce the dosages of both drugs.
D. Using two or more drugs lowers the potential for bacterial resistance.
2. If the client complains of GI side effects associated with rifampin (Rifadin), which nursing action
is best?
A. Administering the drug at night.
B. Providing the client with an antacid.
C. Giving the drug with food or at mealtimes.
D. Encouraging the client to drink plenty of water.
3. The nurse is preparing to review transmission-based precautions with other nurses on the unit.
Which statement regarding transmission-based precautions would the nurse include in her
teaching?
A. “Measles and adenovirus require airborne precautions.”
B. “Barrier protection requires a private room for the client.”
C. “Droplet precautions are used for clients with meningitis.”
D. “Contact precautions are used for clients with disseminated varicella zoster.”
4. The charge nurse is teaching unit nurses about droplet precautions. Which statement by one of
the nurses indicates further teaching is needed by the charge nurse?
A. “Mumps is a viral infection that requires droplet precautions.”
B. “Pharyngeal diphtheria is a viral infection that requires droplet precautions.”
C. “Pertussis is a bacterial respiratory infection that requires droplet precautions.”
D. “Mycoplasma pneumonia is a bacterial respiratory infection that requires droplet
precautions.”
5. A client with bacterial pneumonia is to be started on IV antibiotics. The nurse should verify
which diagnostic test has been completed before administering the antibiotic?
A. urinalysis C. sputum culture
B. chest radiograph D. red blood cell count
6. After administering the annual Mantoux tuberculin skin test to employees, the nurse instructs the
staff to return within how many hours after administration to have the results determined?
A. 12 to 24 hours C. 48 to 72 hours
B. 24 to 48 hours D. 72 to 84 hours
7. The nurse is preparing to discharge a client who was treated for tuberculosis. Which
guidelines for home management should the nurse include in his discharge teaching? Select
all that apply.
i. The client may resume his normal activities.
ii. The family should maintain respiratory isolation at home.
iii. The medication regimen should be followed diligently as prescribed.
iv. The client may return to work when three sputum cultures are negative.
v. The nurse should educate the client about the medication and possible side
effects and their management.
A. I,ii,ii B. ii,iii,iv C. iii,iv,v D. i,iv,v
8. The nurse is caring for a group of clients in an infectious disease unit. The nurse understands
that which of the conditions listed are required to be reported by the CDC? Select all that apply.
A. tetanus D. chlamydia
B. scarlet fever E. group B streptococcal infection
C. Lyme disease
9. The nurse is caring for a client diagnosed with tuberculosis. The physician plans to treat the
client with a first-line medication. Which medication should the nurse prepare to administer?
A. rifampin C. levofloxacin
B. ciprofloxacin D. streptomycin
10. The nurse on a pediatric unit has just admitted a 3-year-old diagnosed with measles. Which
precautions should the nurse initiate? Select all that apply.
i. droplet precautions iv. hazmat precautions
ii. contact precautions v. airborne precautions.
iii. universal precautions
A. i,ii, B. iii,v C. iv,v D. ii,iii
13. A nurse is preparing to administer a MMR vaccine to a 35- year-old male. The nurse should
A. prepare a 25-gauge, 1 1/2-inch needle.
B. inject the needle at a 90-degree angle.
C. pinch and hold the skin while injecting the needle.
D. swab and clean an area of skin over the dorsolateral muscle.
14. The nurse is caring for a client with suspected meningitis who will be having a lumbar
puncture. Which statement regarding aftercare is correct?
A. Specimen jars should be labeled and numbered and taken to the laboratory
immediately and refrigerated.
B. The nurse should position the client with the head of the bed up 20 degrees so the
client can drink fluids to replace CSF removed during the procedure.
C. The nurse should put the client in the low semi-Fowler’s position with a pillow
under her abdomen to increase intraabdominal pressure.
D. The nurse should assess for numbness, tingling, pain at injection site, movement of the
extremities, any drainage at the site, and the ability to void.
15. A client who has been diagnosed with tuberculosis has been placed on drug therapy. The
medication regimen includes rifampin. Which instruction should the nurse give the client
about potential adverse effects of rifampin? Select all that apply.
i. Avoid alcohol intake.
ii. Decrease protein intake in the diet.
iii. The urine may have an orange color.
iv. Have eye examinations every 6 months.
v. Maintain follow-up monitoring of liver enzymes.
A. I,iii,v C. ii,iii,iv
B. iii,iv,v D. ii,iv.v
16. The nurse is instructing a sexually active female who is taking isoniazid (INH). What
should the nurse tell the client? Isoniazid:
A. inhibits ovulation.
B. has mutagenic effects on ova.
C. increases the risk of vaginal infection.
D. decreases the effectiveness of hormonal contraceptives.
17. A client with tuberculosis is taking isoniazid (INH). What should the nurse instruct the client
to do to help prevent development of peripheral neuropathies?
A. Get extra rest.
B. Avoid excessive sun exposure.
C. Adhere to a low-cholesterol diet.
D. Supplement the diet with pyridoxine (vitamin B6).
18. The nurse recognizes which of the following as a Category A biological agent that may be
used in terroristic acts?
A. typhoid C. smallpox
B. C. malaria D. Ebola
19. When a disease infects a host a portal of entry is needed for an organism to gain access.
What has been identified as the portal of entry for tuberculosis?
A. Integumentary system C. Urinary system
B. Respiratory system D. Gastrointestinal system
20. When teaching the parents of an infant about adverse effects associated with the
inactivated polio vaccine (IPV), which of the following statements made by the
healthcare provider is correct?
A. “Your child may develop a red rash on the chest, but this is a normal reaction.”
B. “It’s likely that your child will develop a sore throat and runny nose for a few
days.”
C. “There may be some redness, swelling, and pain where the vaccination was given.”
D. “A fever of 101 degrees F (38 degrees C) or more is a common reaction to the
vaccine.”
21. What airborne precautions should the nurse anticipate when a client with SARS is
admitted to the hospital? Select all that apply.
A. wear a surgical face mask upon entering client’s room.
B. require client to be placed in a negative pressure airflow room.
C. wear a fit-tested N-95 respirator at all times when in client’s room.
D. require client to wear a face mask in the hallway during transport.
E. have the client enter through the facility’s dedicated isolation entrance.
22. A client comes into the emergency room after a blood splashed into her eye at work. The priority
nursing intervention is to
A. test vision in the affected eye.
B. cover the eye with a sterile cloth.
C. irrigate the eye with normal saline solution.
D. determine what chemical splashed into the eye.
23. A patient has a concentration of S. aureus located on his skin. The patient is not showing signs of
increased temperature, redness, or pain at the site. The nurse is aware that this is a sign of a
microorganism at which of the following stages?
A. Infection C. Colonization
B. Disease D. Bacteremia
24– 27 A student nurse is reviewing the types of precautions. She is correct when she classifies
the following Communicable diseases into the transmission-based precautions.
A. Contact precaution C. Airborne precaution
B. Droplet precaution D. Blood and blood product precaution
24. measles
25. tuberculosis
26. diphtheria
27. influenza
28. A nurse is teaching several student nurses about immunity. It is correct when she says
Monocytes move from the systemic circulatory system into general connective tissues, where
they differentiate into what phagocytic cell type?
A. Macrophage C. T cell
B. B cell D. B cell
29. A 12-year-old girl received some deep cuts falling on the playground, and her parents took her to
the hospital. She hadn't been immunized against tetanus. To provide her with protection against
the possibility of tetanus now, and in the future, how do you think the hospital staff should treat
her?
A. Give injections of tetanus toxoid
B. Give injections of tetanus antitoxin.
C. Give her an injection of antibiotic and clean her wound.
D. Give separate injections of tetanus toxoid and tetanus antitoxin, one in each arm.
30. An infectious outbreak of unknown origin has occurred in a long-term care facility. The nurse
who oversees care at the facility should report the outbreak to what organization?
A. American Nurses Association (ANA)
B. American Medical Association (AMA)
C. Environmental Protection Agency (EPA)
D. Centers for Disease Control and Prevention (CDC)
31. An educator is discussing phagocytosis. She asks a student nurse which cell types of the
innate immune system do not perform phagocytosis?
A. Neutrophils C. Basophils
B. Macrophages D. Eosinophils
32. Nurse May is a new Public Health Nurse. As part of the Department of Health Program
communicable diseases are to be reported once identified on their clients. It is her
responsibility to have a knowledge of the common Communicable diseases. She is correct
when she says Polio is a disease caused by a?
A. Toxin B. Bacterium C. Virus D. Fungus
33. The nurse places a patient in isolation. Isolation techniques have the potential to break the
chain of infection by interfering with what component of the chain of infection?
A. Mode of transmission C. Agent
B. Susceptible host D. Portal of entry
34. The nurse is caring for a patient who is colonized with methicillin-resistant Staphylococcus
aureus (MRSA). What infection control measure has the greatest potential to reduce
transmission of MRSA and other nosocomial pathogens in a health care setting?
A. Conducting culture surveys on a regularly scheduled basis
B. Using antibacterial soap when bathing patients with MRSA
C. Using aseptic housekeeping practices for environmental cleaning
D. Performing hand hygiene before and after contact with every patient
35. What is the best rationale for health care providers receiving the influenza vaccination on a
yearly basis?
A. To decrease risk of transmission to vulnerable patients
B. To eventually eradicate the influenza virus in the United States
C. To prevent the emergence of drug-resistant strains of the influenza virus
D. To decrease nurses’ susceptibility to health care-associated infections.
36. The nurse is caring for a group of clients in an infectious disease unit. The nurse understands
that which of the conditions listed are required to be reported by the CDC? Select all that apply.
A. tetanus B. scarlet fever C. chlamydia D. Lyme disease
37. In the developing fetus, prenatal hematopoiesis (the differentiation and development of
immune cells) is not generally known to occur in which of the following organs?
A. Liver C. Spleen
B. Lymph nodes D. Appendix
38. Which of the following would be considered tertiary prevention? Select all that apply.
A. The nurse administers a PPD test for a travel visa clearance.
B. The nurse administers an influenza vaccine to a 60-year-old male.
C. The nurse administers vancomycin to a client with a bacterial infection.
D. The nurse presents information about smoking cessation at a health fair.
E. The nurse works with a stroke patient to implement assistive devices in activities of
daily living.
39. A doctor is seeing a patient who seems to have a weakened immune system. Which of the
following is correct regarding where B and T cells mature, just prior to traveling to lymph
nodes?
A. B cells mature in the thymus; T cells mature in the thyroid gland.
B. B cells mature in the bone marrow; T cells mature in the thymus.
C. B cells mature in the thyroid gland; T cells mature in the pancreas.
D. B cells mature in the pancreas; T cells mature in the bone marrow.
40. The school nurse recognizes that meningitis can be caused by which of the following? Select
all that apply.
i. fungal infections iv. noninfectious causes
ii. parasites v. bacterial infections
iii. Viral Infections
A. I,ii,iii,v B. i,ii,iii,iv,v C. I,iii,iv,v D. ii,iii,iv,v
41. Nurse Eva is assigned to a patient whose immune system is weakened. She knows that one of the
following is not true regarding neutrophils.
A. Neutrophils are phagocytes.
B. Neutrophils circulate in the blood.
C. Neutrophils help activate B cells and T cells.
D. Neutrophils are the most common cells of the immune system.
42. A patient with possible bacterial meningitis is admitted to the ICU. What assessment finding
would the nurse expect for a patient with this diagnosis?
A. Pain upon ankle dorsiflexion of the foot
B. Neck flexion produces flexion of knees and hips.
C. Numbness and tingling in the lower extremities.
D. Inability to stand with eyes closed and arms extended without swaying.
43. A male patient presents to the clinic complaining of a headache. The nurse notes that the patient
is guarding his neck and tells the nurse that he has stiffness in the neck area. The nurse suspects
the patient may have meningitis. What is another well-recognized sign of this infection?
A. Negative Brudzinski’s sign C. Positive Kernig’s sign
B. Hyper patellar reflex D. Sluggish pupil reaction
44. A student nurse is helping a PHN in giving vaccination to certain clients in the RHU. What
teaching would the nurse provide to a client receiving tetanus toxoid?
A. "You will have lifetime immunity from this injection."
B. "Soreness at the injection site is a common reaction."
C. "This medication must be repeated weekly for 4 weeks."
D. "Increase fluid and fiber in your diet to prevent constipation."
45. Which vaccination is marketed and recommended in the prevention of a virus that is known
to cause cervical cancer?
A. Herpes zoster vaccine (Zostavax)
B. Papillomavirus vaccine (Gardasil)
C. Pneumococcal vaccine (Prevnar 13)
D. Hepatitis B virus vaccine (Recombivax HB)
46. A 23-year-old is brought to the hospital after efforts to relieve a fever are unsuccessful. The
tentative diagnosis is meningitis. If the diagnosis is accurate, which assessment findings should
the nurse document? Select all that apply.
i. Photophobia iv. A stiff neck
ii. Diarrhea v. Vertigo
iii. Fever vi. Muscle weakness
A. i,iii,iv B. ii,iv,v C. iii,iv,v D. iv,v,vi
47. A nurse understands that recognition of self vs. non-self by the adaptive immune system in
humans is accomplished in which of the following ways?
A. Exposure of B cells to the body’s own antigens in the thymus
B. Exposure of T cells to the body’s own antigens in the thymus
C. Exposure of B cells to the body’s own antigens in the bursa of Fabricius
D. Exposure of T cells to the body’s own antigens in the bursa of Fabricius
48. Which of the following are typical signs and symptoms of pneumonia? Select-all-that- apply:
i. Stridor v. Coarse crackles
ii. Oxygen saturation less than 90% vi. Non-productive, nagging cough
iii. Elevated white blood cells vii. Low PCO2 of less than 35
iv. Tachypnea
A. I,ii,ii,iv B. ii,ii,v,vii C. iv,v,vi,vii D. ii,iii,iv,v
49. During a routine checkup a 72-year-old patient is advised to receive a influenza vaccine
injection. He questions this saying "I had one last year. Why do I need another one?" What is
the nurses best response?
A. "The effectiveness of the vaccine wears off after 6 months."
B. "When you reach 65 years old, you need booster shots on an annual basis."
C. "Each year a new vaccine is developed based on the flu strains that are likely to be in
circulation."
D. "Taking the flu vaccine each year allows you to build your immunity to a higher level
each time."
50. Paralytic poliomyelitis may be suspected in nonimmunized children or young adults who have
asymmetric flaccid limb paralysis or bulbar palsies without sensory loss during an acute febrile
illness. However, certain disorders may produce similar findings. Which of the following can
usually be distinguished based on clinical criteria and test results at the initial evaluation?
A. Guillain-Barré syndrome C. West Nile virus infection
B. Coxsackievirus infections D. Echovirus infections
51. The physician plans to perform a lumbar puncture (spinal tap) to confirm the diagnosis of
meningitis. Which nursing intervention is most appropriate after the lumbar puncture has been
performed?
A. Withhold food and fluids for 1 hour.
B. Keep the client flat for several hours.
C. Assist the client into a sitting position.
D. Keep the client in a side-lying position.
52. During a visit to the physician’s office, a client complains to the nurse that the physician would
not prescribe an antibiotic for a head cold. Which explanation to the client by the nurse
regarding the use of antibiotics is best?
A. Antibiotics are ineffective in treating viral infections.
B. Antibiotics only prevent the spread of colds to others.
C. Antibiotics are ineffective after cold symptoms develop.
D. Antibiotics are used only for immunosuppressed individuals.
53. A 23-year-old who experienced a generalized seizure while at work is admitted to the hospital
and is undergoing diagnostic tests. The nurse enters seizure precautions into the client’s care
plan. Which environmental modifications should the nurse implement? Select all that apply.
i. Provide soft, soothing music. iv. Keep the side rails up and padded.
ii. Ensure a warm, well-lit room. v. Lower the bed to the lowest position.
iii. Keep the room dark and quiet. vi. Make sure suction equipment is available.
A. I,ii,iii,v B. ii,iv,v,vi C. iii,iv,v,vi D. I,iv,v,vi
54. Nurse Jen is explaining to a group of mothers about humoral immunity. She is correct when she
says it is a type of adaptive immunity that results in the circulation of which of the following
throughout the blood?
A. Antigens C. Macrophages
B. Natural killer cells D. Antibodies
55. Aseptic meningitis without paralysis (nonparalytic poliomyelitis) resembles other viral
meningitides. When it is suspected, which of the following diagnostic tests is usually done?
A. Blood culture C. Lumbar puncture
B. Serial antibody titers D. Throat culture
56. An infant whose mother has immunity to measles receives antibodies transplacentally; these
antibodies are protective for a period of time. At what age should infants be vaccinated?
A. Birth to 2 mo. C. 4 mo.
B. C. 12 to 15 mo. D. 18 to 24 mo.
57. Which symptom reported by the client to the nurse is the best indicator that
complications are developing from this cold?
A. Nasal stuffiness B. Dry cough C. High fever D. Scratchy throat
58. To prevent the client with a head cold from developing a secondary ear infection, which
recommendation is most appropriate?
A. Blowing the nose very gently
B. Inserting cotton into the ears
C. Sleeping with the head elevated
D. Massaging the area behind ears
59. An animal control officer was bitten by a stray dog that showed signs of rabies. Which
statement by the nurse is correct regarding the treatment for rabies prophylaxis?
A. "You will receive treatment if you begin to show symptoms of rabies."
B. "You will need to receive 3 subcutaneous injections over the next week."
C. "You will need to receive 5 intramuscular injections over the next 28 days."
D. "You will receive one oral dose of medication today, and one more in 1 week."
60. A parent brings her child into the clinic to receive the diphtheria-tetanus-pertussis (DTaP)
vaccine and asks the healthcare provider how the vaccine protects her child against
pertussis. Which of the following is the best response?
A. “The vaccine contains pre-made antibodies that your child’s body will use to ward off the
disease.”
B. “The vaccine will give your child a mild case of pertussis which will cause the body
will produce antibodies.”
C. “The vaccine contains non-infectious pertussis proteins that will stimulate the body
make antibodies to the disease.”
D. ” The vaccine will cause the body to produce a large number of white blood cells which
will eat the pertussis bacteria.”
61. You are caring for a patient who has been bitten by dog who is suspected to have rabies.
What medication do you suspect the physician will order for this patient?
A. Tetanus vaccine C. Rabies vaccine
B. Antibiotics D. Antivenom
62. A nurse assigned in the Rural Health Unit is explaining immunity she understands that the
portion of an antibody provides antigen-binding sites?
A. Light chain C. Constant portion
B. Heavy chain D. Variable portion
63. A patient was admitted to the intensive care unit 48 hours ago for treatment of a gunshot wound.
The patient has recently developed a productive cough and a fever of 104.3 'F. The patient is
breathing on their own and doesn't require mechanical ventilation. On assessment, you note
coarse crackles in the right lower lobe. A chest x-ray shows infiltrates with consolidation in the
right lower lobe. Based on this specific patient scenario, this is known as what type of
pneumonia?
A. Aspiration pneumonia C. Hospital-acquired pneumonia
B. Ventilator acquired pneumonia D. Community-acquired Pneumonia
64. The mother of a 2-year-old who has been bitten by the family dog asks the nurse what to do about
the bite. What should the nurse tell the mother?
A. “You need to take the child to the local urgent care center immediately.”
B. “Wash the bite area with lots of running water, and then check the injury.”
C. “Determine when the child’s latest tetanus vaccine was administered.”
D. “Make an appointment to see the child’s physician now to start rabies shots.”
65. The healthcare provider is caring for a child with a diagnosis of pertussis. Which of the
following best describes the characteristics of the child’s cough?
A. Dry, nocturnal cough.
B. Hacking and non-productive.
C. Brassy, with a “seal-like” barking sound.
D. Staccato, followed by an inspiratory whooping sound.
66. The nurse is providing teaching after an adult receives a booster immunization for COVID-19.
Which adverse reaction will the nurse immediately report to the health care provider? (select
all that apply)
i. Joint pain iv. Fever of 100f
ii. swelling and redness at injection site v. Heat over injection site
iii. Rash over the arms, back and chest vi. Shortness of breath
A. i,iii,vi B. ii,iv,v C. iv,v,vi D. iii,v,vi
67. If B cells did not require help from T cells in order to activate, what would be one
possible negative result?
A. Antibodies would not bind as tightly to specific antigens.
B. B cells would be over-reactive and attack cells of the body.
C. B cells would not be able to attack cancerous cells in the body.
D. B cells would not know where to migrate in order to fight infection.
68. A child who has a pertussis infection is admitted to the pediatric unit. Which of these infection
control measures will the healthcare provider use when caring for the patient? Choose all
answers that apply:
i. HEPA filter iii. Gown v. Mask vii. Gloves
ii. N95 iv, respirator vi. Hand hygiene
A. iii,v,vi,vii B. I,ii,iii,iv C. iv,v,vi,vii D. ii,iii,v,vii
69. A child with a diagnosis of pertussis is admitted to the pediatric unit. Which of these will be
included when planning care? Choose all answers that apply:
A. Monitoring nutritional status
B. Providing adequate hydration
C. Monitoring of respiratory status.
D. Administering antitussive medications
~ 0 ~ GOOD LUCK ~ 0 ~
Prepared by:
FLORA M. TEL-EQUEN, RN
Clinical Instructor
Name of Faculty Member: FLORA M. TEL-EQUEN Subject & Year Level: NCM 112 (COMMUNICABLE DISEASES (BSN3)
Testing Period: MID TERM EXAM
Flora M. Tel-equen Prof. Regie S. Jimenez, Rn, Msn Prof. Mary Jane N. Rigor
RLE Chairperson Chairperson, Nursing Department Dean, College of Science