NURSING PRACTICE PRACTICE II – Community Health Nursing and Care of the Mother and Child SITUATIONAL Situation 1 – Nurse Minette is an Independent Nurse Practitioner Practitioner following-up referred referred clients in their respective homes. Here she handles a case of POSTPARTIAL MOTHER AND FAMILY focusing on HOME CARE. 1. Nurse Minette needs to schedule a first home visit to OB client Leah. When is a first home-care visit typically made? A. B. C. D.
Withi Within n 4 days days after after disc dischar harge ge Withi Wi thin n 24 hours hours after after disc dischar harge ge Withi Within n 1 hour afte afterr discha discharg rge e Withi Within n 1 week week of disch dischar arge ge
2. Leah is developing constipation from being on bed rest. What measures measures would you suggest she take to help prevent this? A. B. C. D.
Eat more more frequent frequent small small meals meals instead instead of three three large one one daily Walk for at at least least half an hour daily daily to stimula stimulate te peristal peristalsis sis Drink more more milk, increased increased calcium calcium intake intake prevents constipation Drink eight eight full full glasses glasses of fluid fluid such as water water daily daily
3. If you were Minette, which which of the following actions would alert you that a new mother is entering a postpartal taking-hold phase? A. B. C. D.
She urges urges the baby baby to stay awak awake e so that she can can breastbreast-feed feed him him or her She tells tells you you she was in in a lot of of pain all during during labor labor She says says that that she has not selecte selected d a name for for the baby baby as yet yet She sleeps sleeps as as if exhaus exhausted ted from from the effort effort of labor labor
4. At 6-week postpartum visit what should this postpartal mother’s fundic height be? A. B. C. D.
Inverted Inverted and palpa palpable ble at the the cervi cervix x Six fingerbr fingerbreadt eadths hs below umbilicus umbilicus No longe longerr palpab palpable le on her her abdome abdomen n One centim centimeter eter above the symphys symphysis is pubis pubis
5. This postpartal mother wants to loose the weight she gained in pregnancy, so she is reluctant to increase her caloric intake for breast-feeding. By how much should a lactating mother increase her caloric intake during the first 6 months after birth? A. B. C. D.
350 kca 350 kcal/da l/day y 500 50 0 kca kcal/ l/da day y 200 20 0 kcal kcal/d /day ay 1000 10 00 kca kcal/ l/da day y
Situation 2 – As the CPE is applicable for all professional nurse, the professional growth and development of Nurses with specialties shall be addressed by a Specialty Certification Council. The following questions apply to these special groups of nurses. 6. Which of the following serves as the legal basis and statute authority for the Board of Nursing to promulgate measures measures to effect the creation of a Specialty Certification
Council and promulgate professional development development programs for this group of nurseprofessionals? A. B. C. D.
R.A. .A. 76 7610 P.D. 22 223 R.A .A.. 91 9173 R.A. .A. 716 7164 4
7. By force of law, therefore, the PRC-Board of Nursing released Resolution No. 14 Series of 1999 entitled: “Adoption of a Nursing Specialty Certification Program and Creation of Nursing Specialty Certification Council.” This rule-making power is called: A. B. C. D.
Quas Quasi-Ju i-Judi dici cial al Powe Powerr Regul egulat ator ory yP Pow ower er QuasiQua si-Le Legis gislat lative ive Powe Powerr Executiv Executive/Pr e/Promulg omulgatin ating g Power Power
8. Under the PRC-Board of Nursing Resolution promulgating the adoption of a Nursing Specialty Certification Certification Program and Council, which two (2) of the following serves as the strongest for its enforcement? enforcement? (a) Advances made in Science Science and Technology Technology have provided provided the climate for specialization specialization in almost all aspects of human endeavor; and (b) As necessary necessary consequence, there there has emerged emerged a new concept known known as globalization which seeks to remove barriers in trade, industry and services imposed by the national laws of countries all over the world; and (c) Awareness Awareness of this development development should impel the nursing nursing sector to prepare prepare our people in the services sector to meet the above challenge; and (d) Current Current trends of specialization specialization in nursing nursing practice recognized recognized by the International International Council of Nurses (ICN) of which the Philippines is a member for the benefit of the Filipino in terms of deepening and refining nursing practice and enhancing the quality of nursing care. A. B. C. D.
b & c are are stron strong g justif justifica icatio tions ns a & b are are strong strong just justifi ificat cation ions s a & c are are strong strong just justifi ifica catio tions ns a & d are are strong strong justi justifica fications tions
9. Which of the following IS NOT a correct statement as regards Specialty Certification? A. The Board Board of Nursing intended to create the Nursing Nursing Specialty Specialty Certification Certification Program as a means of perpetuating the creation of an elite force of Filipino Nurse Professionals. B. The Board Board of Nursing shall oversee oversee the administration administration of the NSCP through through the various Nursing Specialty Boards which will eventually be created C. The Board of Nursing at the the time exercised exercised their powers powers under R.A. R.A. 7164 in order to adopt the creation of the Nursing Specialty Certification Certification Council and Program D. The Board Board of Nursing Nursing consulted consulted nursing nursing leaders leaders of national national nursin nursing g associations and other concerned nursing groups which later decided to ask a special group of nurses of the program for nursing specialty Certification.
10. The NSCC was created for the purpose of implementing the Nursing Specialty policy under the direct supervision and stewardship of the Board of Nursing. Who shall comprise the NSCC? A. A Chairperson Chairperson who is is the current current President President of the APO; a member from from the Academe; and the last member coming from the Regulatory Board B. The chairperson chairperson and and members of the Regulatory Regulatory Board Board ipso ipso facto acts as the CPE Council C. A Chairperson, Chairperson, chosen chosen from among among the Regulatory Regulatory Board Board members; members; a Vice Chairperson appointed by the BON at-large; two other members also chosen at-large; and one representing the consumer group; D. A Chairperson Chairperson who is is the President President of the Association Association from from the Academe; Academe; a member from the Regulatory Board; and the last member coming from the APO No answer..maybe a bonus question… Situation 3 –Nurse Anna is a new BSN graduate and has just passed her Licensure Examination for Nurses in the Philippines. She has likewise been hired as a new Community Health Nurse in one of the Rural Rural Health Units in their City, which of the following conditions may be acceptable TRUTHS applied to Community Health Nursing Practice. 11. Which of the following is the primary focus of community health nursing practice? A. B. C. D.
Cure Cure of illn illnes esse ses s Preve Preventi ntion on of of illn illness esses es Rehabil ehabilita itatio tion n back to healt health h Prom Pr omot otio ion n of heal health th
12. In community health nursing, which of the following is our unit of service as nurses? A. B. C. D.
The The comm commun unit ity y The extend extended ed member members s of every every family family The indiv individual idual members members of of the Barangay Barangay The Th e Fam amil ily y
13. A very important part of the Community Health Nursing Assessment Process includes: A. the applicati application on of professiona professionall judgment judgment in estimating estimating importance importance of facts to family and community B. evaluati evaluation on structure structures s and qualifica qualifications tions of health health center center team C. coordina coordination tion with with other sectors sectors in relati relation on to health concer concerns ns D. carryin carrying g out nursing nursing procedur procedures es as per plan plan of action action 14. In community health nursing it is important to take into account the family health data coupled with an equally important need to perform ocular inspection of the area as activities which are powerful elements of: A. B. C. D.
eva evaluat luatio ion n ass as sess ssme ment nt impl implem emen enta tati tion on pla plannin nning g
15. The initial step in PLANNING PL ANNING process process in order to engage in any nursing project or activities at the community level involves A. B. C. D.
goal-s goal -set etti ting ng mon monitor itoriing eval evalua uati tion on of of dat data a prov provis isio ion n of data data
Situation 4 – Please continue responding as a professional nurse in these other health situations through the following questions. 16. Transmission of HIV from an infected individual to another person occurs: A. B. C. D.
Most frequen frequently tly in nurse nurses s with with needles needlestick ticks s Only if there there is is a large large viral viral load in in the blood blood Most commonl commonly y as a result result of sexua sexuall contact contact In all infants infants born born to women women with with HIV HIV infection infection
17. The medical record of a client reveals a condition in which the fetus cannot pass through the maternal pelvis. The nurse interprets this as: A. B. C. D.
Cont Contra ract cted ed pelv pelvis is Mater Materna nall disp dispro ropor portio tion n Cervic Cervical al ins insuff uffic icie iency ncy Feto etopel pelvic vic disprop disproport ortion ion
18. The nurse would anticipate a cesarean birth for a client who has which infection present at the onset of labor? A. B. C. D.
Herpes-si Herpes -simpl mplex ex vir virus us Human Human papill papilloma oma virus virus Hepa Hepati titi tis s Toxopl oxoplas asmos mosis is
19. After a vaginal examination, the nurse determines that the client’s fetus is in an occiput posterior position. The nurse would anticipate that the client will have: A. B. C. D.
A prec precip ipit itous ous birt birth h Inte In tens nse e bac back k pai pain n Freque requent nt leg leg cram cramps ps Naus Nausea ea and and vomi vomiti ting ng
20. The rationales for using a prostaglandin gel for a client prior to the induction of labor is to: A. B. C. D.
Soften and eff Soften effac ace e the the cervi cervix x Numb Numb cervic cervical al pain pain rece recepto ptors rs Preve Prevent nt cervica cervicall lacerat laceration ions s Stimulate Stimulate uterine uterine contracti contractions ons
Situation 5 – Nurse Lorena is a Family Planning and Infertility Nurse Specialist and currently attends to FAMILY PLANNING CLIENTS AND INFERTILE COUPLES. The following conditions pertain to meeting the nursing needs of this particular population group.
21. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer? A. Prostaglandins Prostaglandins released released from the the cut fallopian tubes can can kill sperm B. Sperm can can not enter the uterus because the cervical cervical entrance is blocked. blocked. C. Sper Sperm m can no longer rreach each the ova, ova, because because the fallopi fallopian an tubes are are blocked D. The ovary no longer releases releases ova as as there there is no no where for them to go. 22. The Dators are a couple undergoing testing for infertility. Infertility is said to exist when: A. B. C. D.
a a a a
wom woman an has has no ute uteru rus s woma woman n has has no childr children en couple has couple has been been trying trying to concei conceive ve for 1 year couple couple has has wanted wanted a child child for for 6 months months
23. Another client named Lilia is diagnosed as having endometriosis. This condition interferes interferes with fertility because: A. B. C. D.
endometri endom etrial al implants implants can block block the fallo fallopian pian tubes tubes the uterine uterine cervi cervix x becomes becomes inflame inflamed d and swolle swollen n the ovarie ovaries s stop produ producing cing adequa adequate te estrog estrogen en pressure pressure on the pituitary pituitary leads leads to decreased decreased FSH levels
24. Lilia is scheduled to have a hysterosalph hys terosalphingogram. ingogram. Which of the following instructions would you give her regarding this procedure? A. B. C. D.
She will will not be able to concei conceive ve for 3 months months after after the procedu procedure re The sonogram sonogram of the uteru uterus s will revea reveall any tumors tumors present present Many women women experi experience ence mild mild bleeding bleeding as an after after effect effect She may feel feel some some crampin cramping g when the the dye is is inserted inserted
25. Lilia’s cousin on the other hand, knowing nurse Lorena’s specialization specialization asks what artificial insemination insemination by donor entails. Which would be your best answer if you were Nurse Lorena? A. B. C. D.
Donor sperm sperm are are introduce introduced d vaginally vaginally into into the uterus or cervix cervix Donor sperm sperm are are injected injected intra-abd intra-abdomina ominally lly into each each ovary ovary Artifici Artificial al sperm sperm are injecte injected d vaginally vaginally to test tubal tubal patency patency The husband’s husband’s sperm sperm is administe administered red intrave intravenousl nously y weekly
Situation 6 – There are other important basic knowledge in the performance of our task as Community Health Nurse in relation to IMMUNIZATION, these include: 26. The correct temperature to store vaccines in a refrigerator is: A. B. C. D.
betwee between n betwee bet ween n betwee between n betwee between n
-4 deg C and and +8 +8 deg deg C 2 deg deg C and +8 deg deg C -8 deg C and and 0 deg C -8 deg C and and +4 +4 deg deg C
27. Which of the following vaccines is not done by intramuscular (IM) injection?
A. B. C. D.
Measle Meas les s va vacc ccin ine e DPT Hepa Hepa--B vacc vaccin ine e Tetanus etanus toxo toxoids ids
28. This vaccine content is derived from RNA recombinants. A. B. C. D.
Measles Tetanus etanus toxo toxoids ids Hepa He pati titi tis s B vacc vaccin ines es DPT
29. This is the vaccine needed before a child reaches one (1) year in order for him/her to qualify as a :fully immunized child”. A. B. C. D.
DPT Measles Hepa Hepati titi tis sB BCG
30. Which of the following dose of tetanus toxoid is given to the mother to protect her infant from neonatal tetanus and likewise provide 10 years protection for the mother? A. B. C. D.
Tetanus etanus toxo toxoid id 3 Tetanus etanus toxo toxoid id 2 Tetanus etanus toxo toxoid id 1 Teta etanus nus to toxo xoid id 4
Situation 7 – Records Records contain those comprehensive descriptions of patient’s health conditions and needs and at the same serve as evidences of every nurse’s accountability in the care giving process. Nursing records normally differ from institution to institution nonetheless they follow similar patterns of meeting needs for specific types of information. The following pertains to documentation/records documentation/records management. 31. This special form is used when the patient is admitted to the unit. The nurse completes the information in this record particularly particularly his/her basic personal data, current current illness, previous health history, health history of the family, emotional profile, environmental environmental history as well as physical assessment together with nursing diagnosis on admission. What do you call this record? A. B. C. D.
Nurs Nursin ing g Kard Kardex ex Nursing Nurs ing Health Health History History and and Assessmen Assessmentt Worksh Worksheet eet Medicine Medicine and and Trea Treatment tment Recor Record d Disc Discha harrge Summa Summary ry
32. These are sheets/forms which provide an efficient and time saving way to record information that must be obtained repeatedly repeatedly at regular and/or short intervals of time. This does not replace the progress progress notes; instead this record of information on vital signs, intake and output, treatment, postoperative care, post partum care, and diabetic regimen, etc. This is used whenever specific measurements measurements or observations are needed to be documented repeatedly. What is this? A. Nurs Nursin ing g Kard Kardex ex B. Gr Grap aphi hic c Flow Flow She Sheet ets s
C. Disc Discha harrge Sum Summa mary ry D. Medicine Medicine and and Trea Treatment tment Recor Record d 33. These records show all medications and treatment provided on a repeated basis. What do you call this record? A. B. C. D.
Nursing Nursing Health Health History History and and Assessmen Assessmentt Worksh Worksheet eet Disc Discha harrge Sum Summa mary ry Nurs Nursin ing g Kard Kardex ex Medicine Medi cine and and Trea Treatment tment Recor Record d
34. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2parts: the activity and treatment treatment section and a nursing care plan section. This carries carries information about basic demographic data, primary medical diagnosis, current orders of the physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in patient care and factors related to daily living activities. This record is used in the charge-of-shift reports or during the bedside rounds or walking rounds. What record is this? A. B. C. D.
Disc Discha harrge Sum Summa mary ry Medicine Medicine and Treatment reatment Recor Record d Nursing Nursing Health Health History History and and Assessmen Assessmentt Worksh Worksheet eet Nurs Nu rsin ing g Kar Karde dex x
35. Most nurses regard this conventional recording recording of the date, time, and mode by which the patient leaves a healthcare healthcare unit but this record includes importantly, directs of planning for discharge that starts soon after the person is admitted to a healthcare healthcare institution. It is accepted that collaboration or multidisciplinary involvement (of all members of the health team) in discharge results results in comprehensive care. What do you call this? A. B. C. D.
Discha Disc harrge Sum Summa mary ry Nurs Nursin ing g Kard Kardex ex Medicine Medicine and and Trea Treatment tment Recor Record d Nursing Nursing Health Health History History and Assessm Assessment ent Worksh Worksheet eet
Situation 8 – As Filipino Filipino Professional Nurses we must be knowledgeable about the Code of Ethics for Filipino Nurse and practice these by heart. The next questions pertain to this Code of Ethics. 36. Which of the following is TRUE about the Code of Ethics of Filipino Filipino Nurses? A. The Philippine Philippine Nurses Nurses Association Association for for being the accredited accredited professional professional organization was given the privilege to formulate a Code of Ethics for Nurses which the Board of Nursing promulgated B. Code for Nurses Nurses was first first formula formulated ted in 1982 publishe published d in the Proceedi Proceedings ngs of the Third Annual Convention of the PNA House of Delegates C. The present present code utilized the the Code of Good Governance Governance for the the Professions Professions in the Philippines D. Certificates of Registration Registration of registered registered nurses nurses may be revoked revoked or suspended for violations of any provisions of the Code of Ethics. 37. Based on the Code of Ethics for Filipino Nurses, what is regarded as the hallmark of nursing responsibility responsibility and accountability? accountability?
A. B. C. D.
Human rights rights of clien clients, ts, regar regardles dless s of creed creed and gender gender The privile privilege ge of being a regis registere tered d professio professional nal nurses nurses Health, Health, being being a fundame fundamental ntal right right of every every indiv individual idual Accurate Accu rate docume documentati ntation on of actions actions and and outcomes outcomes
38. Which of the following nurses behavior is regarded as a violation of the Code of Ethics of Filipino Nurses? A. A nurse withho withholding lding harmfu harmfull informatio information n to the family family members members of a patient B. A nurse declin declining ing commissi commission on sent by a doctor doctor for her her referra referrall C. A nurse endorsing endorsing a person person runnin running g for congre congress. ss. D. Nurse Reviewers Reviewers and/or nurse nurse review review center center managers who pays a considerable amount of cash for reviewe reviewees es who would memorize items from the licensure exams and submit these to them after the examination. 39. A nurse should be cognizant that professional programs programs for specialty certification by the Board of Nursing accredited through the: A. B. C. D.
Profess Professiona ionall Regula Regulation tion Commissio Commission n Nursing Nurs ing Speci Specialty alty Cert Certific ification ation Counc Council il Associat Association ion of Deans Deans of Philippin Philippine e Colleges Colleges of Nursin Nursing g Phili Phi lippi ppine ne Nurse Nurse Associ Associati ation on
40. Mr. Santos, R.N. works in a nursing home, and he knows that one of his duties is to be an advocate for his patients. Mr. Mr. Santos knows a primary duty of an advocate is to; A. B. C. D.
act as the patie patient’s nt’s legal legal repres representat entative ive complete complete all all nursing nursing respons responsibil ibilitie ities s on time time safeguar safeguard d the well being of every every patient patient maintain maint ain the patien patient’s t’s right right to to privacy privacy
Situation 9 – Nurse Joanna Joanna works as an OB-Gyne Nurse Nurse and attends to several HIGHHIGHRISK PREGNANCIES: Particular women with preexisting or Newly Acquired illness. The following conditions apply 41. Bernadette is a 22-year old woman. Which condition would make her more prone than others to developing a Candida infection during pregnancy? A. B. C. D.
Her husband husband plays plays golf 6 days days a week She was was over over 35 when she became became pregnant pregnant She usuall usually y drinks drinks tomato tomato juice juice for for breakf breakfast ast She has has develope developed d gestati gestational onal diab diabetes etes
42. Bernadette develops a deep vein thrombosis following an auto accident and is prescribed prescribed heparin sub-Q. What should Joanna educate her about in regard to this? A. B. C. D.
Some infants infants will will be born born with aller allergic gic symptoms symptoms to hepari heparin n Her infant infant will will be born with with scattere scattered d petechiae petechiae on his his trunk Heparin Heparin can can cause cause darkened darkened skin skin in newbor newborns ns Heparin Hepa rin does does not cross cross placenta placenta and and so does not affect affect a fetus fetus
43. The cousin of Bernadette with sickle-cell anemia alerted Joanna that she may need further instruction on prenatal care. What statement signifies this fact?
A. B. C. D.
I’ve stoppe stopped d jogging jogging so I don’t don’t risk risk becoming becoming dehydra dehydrated. ted. I take an an iron pill pill every every day to help help grow new new red blood blood cells cells I am careful careful to drink drink at least least eight eight glasses glasses of fluid fluid every day day I understand understand why folic folic acid is importan importantt for red cell cell formation formation
44. Bernadette routinely takes acetylsalicylic acid (aspirin) for arthritis. Why should she limit or discontinue this toward the end of pregnancy? A. B. C. D.
Aspirin Aspirin can lead lead to deep deep vein vein thrombosi thrombosis s followin following g birth Newborns Newborns devel develop op a red rash rash from salic salicylat ylate e toxicity toxicity Newbors Newbors develop develop withdrawa withdrawall headaches headaches from salicy salicylate lates s Salicylates can lead lead to increas increased ed maternal maternal bleeding bleeding at childbirth
45. Bernadette received received a laceration on her leg from her automobile accident. Why are lacerations of lower extremities potentially more serious in pregnant women than others? A. Lacerations can provoke provoke allergic allergic responses responses because of gonadothropic gonadothropic hormone B. Incr Increas eased ed bleeding bleeding can occur occur from uterine uterine pressu pressure re on leg veins veins C. A woman is less less able to keep keep the lacerati laceration on clean becaus because e of her fatigue fatigue D. Healing is is limited during pregnancy, pregnancy, so these will will not heal until after after birth. Situation 10 – Still in your self-managed self-managed Child Health Nursing Clinic, you encounter these cases pertaining to the CARE OF CHILDREN WITH PULMONARY AFFECTIONS. 46. Josie brought her 3 months old child to your clinic because of cough and colds. Which of the following is your primary action? A. B. C. D.
Give cotrimoxa cotrimoxazole zole tablet tablet or or syrup syrup Assess Asse ss the patient patient using the chart chart on manageme management nt of children children with cough cough Refer efer to to the the doc docto torr Teach the mother mother how to count count her child’s child’s breathi breathing ng
47. In responding to the care concerns of children with sever disease, referral to the hospital is of the essence especially if the child manifests which of the following? A. B. C. D.
Wheezing Stop Stop feed feedin ing g wel welll Fast ast br breath eathin ing g Diffic Dif ficult ulty y to to awak awaken en
48. Which of the following is the most important responsibility of a nurse in the prevention of unnecessary deaths from pneumonia and other severe diseases? diseases? A. B. C. D.
Givi Giving ng ant antib ibio ioti tics cs Taking aking of the tempera temperatur ture e of the sick sick child child Provisi Pr ovision on of Care Careful ful Asse Assessme ssment nt Weighin eighing g of the the sick sick child child
49. You were able to identify factors that lead to respiratory problems in the community where your health facility serve. Your primary role therefore in order to reduce morbidity due to pneumonia is to:
A. B. C. D.
Teach mothers mothers how to recognize early signs signs and symptoms symptoms of pneumonia pneumonia Make Make home home visits visits to sick sick childre children n Refer efer cases cases to hosp hospita itals ls Seek assista assistance nce and mobilize mobilize the BHWs BHWs to have a meeting meeting with mothers mothers
50. Which of the following is the principal focus of the CARI program of the Department of Health? A. B. C. D.
Enhanceme Enhancement nt of health health team team capabi capabiliti lities es Teach mother mothers s how to detect detect signs signs and where where to refer refer Mortality Morta lity red reductio uction n through through early early dete detection ction Teach other community health health workers workers how to assess assess patients.
Situation 11 – You are working as a Pediatric Nurse in you own Child Health Nursing Clinic. The following cases pertain to ASSESSMENT AND CARE OF THE NEWBORN AT RISK conditions. 51. Theresa, a mother with a 2 year old daughter asks, “at what age can I be able to take the blood pressure of my daughter as a routine procedure since hypertension is common in the family?” Your answer to this is: A. B. C. D.
At 2 yea years rs you you may may As ear early ly as 1 yea yearr old old When Wh en she she’s ’s 3 ye year ars s old old When When she’s she’s 6 year years s old old
52. You typically gag children to inspect the back of their throat. When is it important NOT to elicit a gag reflex? A. B. C. D.
when when a girl girl has has a geogra geographi phic c tongue tongue When a boy has a possible possible inguinal inguinal hernia hernia When a child child has has symptoms symptoms of epiglott epiglottitis itis When childre children n are are under under 5 years years of age
53. Baby John was given a drug at birth to reverse reverse the effects of a narcotic given to his mother in labor. labor. What drug is commonly used for this: A. B. C. D.
Nalox Nalo xon one e (Narc (Narcan an)) Morp Morphi hine ne Sulf Sulfat ate e Sodi Sodium um Chl Chlor orid ide e Penic enicil illi lin nG
54. Why are small-for-gestationalsmall-for-gestational-age age newborns at risks for difficulty maintaining body temperature? temperature? A. B. C. D.
They do do not have have as many fat fat store stores s as other other infant infants s They are are more more active active than usual usual so so throw throw off covers covers Their skin is is more susceptib susceptible le to conducti conduction on of cold cold They are are preterm preterm so are born relatively relatively small in size
55. Baby John develops hyperbilirubinemia. hyperbilirubinemia. What is a method used to treat hyperbilirubinemia hyperbilirubinemia in a newborn? A. Keeping Keeping infan infants ts in a warm warm and and dark envir environmen onmentt B. Administ Administrati ration on of cardi cardiovasc ovascular ular stimulant stimulant
C. Gentle Gentle exerc exercise ise to to stop muscl muscle e breakd breakdown own D. Earl Early y feeding feeding to spee speed d passage passage of of meconium meconium Situation 12 – You are the nurse in the Out-Patient Department and during your shift you encountered multiple children’s condition. The following questions apply. 56. You assessed a child with visible severe wasting, he has: A. B. C. D.
edema LBM Kwas Kwashi hior ork kor Mara Ma ras smu mus s
57. Which of the following conditions is NOT true about contraindication to immunization? A. do not give give DPT2 or DPT3 DPT3 to a child child who who has had convul convulsion sions s within within 3 days of DPT1 B. do not give give BCG BCG if the the child child has know known n hepatiti hepatitis s C. do not give DPT DPT to a child who has has recurr recurrent ent convulsi convulsion on or active active neurologic disease D. do not give give BCG BCG if the the child child has known known AIDS 58. Which of the following statements about immunization is NOT true: A. A child with with diarrhea diarrhea who who is due for OPV should receive receive the the OPV and make make extra dose on the next visit B. There There is no contraindic contraindication ation to immuniza immunization tion if the child child is well enough enough to go home C. There There is no contraindic contraindication ation to immuniza immunization tion if the child child is well enough enough to go home and a child should be immunized in the health center before referral are both correct D. A child should should be immunized immunized in the health health center before referral referral 59. A child with visible severe wasting or severe palmar pallor may be classified as: A. B. C. D.
modera moderate te malnutri malnutritio tion/a n/anem nemia ia sever sev ere e malnutr malnutriti ition/ on/ane anemia mia not very very low weigh weightt no anem anemia ia anemia anemia/ve /very ry low low weig weight ht
60. A child has some palmar pallor can be classified as: A. B. C. D.
modera moderate te anemia anemia/no /norma rmall weight weight sever severe e malnutr malnutriti ition/ on/ane anemia mia anemia ane mia/ve /very ry low wei weight ght not very very low low weigh weightt no anemi anemia a
Situation 13 – Nette, a nurse n urse palpates the abdomen of Mrs. Medina, a primigravida. She is unsure of the date of her last menstrual period. Leopold’s Maneuver Maneuver is done. The obstetrician told that she appears to be 20 weeks pregnant. 61. Nette explains this because the fundus is:
A. At the level level of the umbili umbilicus, cus, and and the fetal fetal heart can can be heard heard with a fetoscope B. 18 cm, cm, and the the baby baby is just just abou aboutt to move move C. Is just over over the symphis symphisis, is, and fetal fetal heart heart cannot cannot be heard heard D. 28 cm, and and fetal fetal heart heart can be heard heard with with a Doppler Doppler 62. In doing Leopold’s Maneuver palpation which among the following IS NOT considered a good preparation: preparation: A. The woman should should lie in a supine supine position position with her knees flexed flexed slightly slightly B. The hand hands s of the nurse nurse should be be cold so that that abdominal abdominal muscles muscles would would contract and tighten C. Be certain certain that your hands are are warm warm (by washing washing them in warm warm water first if necessary) D. The woman woman empties empties her her bladder bladder befor before e palpation palpation 63. In her pregnancy, pregnancy, she experienced fatigue and drowsiness. This probably occurs because: A. of high high bloo blood d pre pressu ssure re B. she is is expre expressi ssing ng press pressur ure e C. the fetus fetus utilizes utilizes her glucos glucose e stores stores and leaves leaves her her with a low blood blood glucose D. of the rapid rapid growt growth h of the the fetus fetus 64. The nurse assesses the woman at 20 weeks gestation and expects the woman to report: A. B. C. D.
Spotting Spotting relat related ed to to fetal fetal implantati implantation on Symptoms Symptoms of diabetes diabetes as human human placental placental lactogen lactogen is relea released sed Fee eeli ling ng feta fetall kicks kicks Nausea Nausea and vomiti vomiting ng relate related d HCG product production ion
65. Mrs. Medina comes to you for check-up on June 2, her EDC is June 11, what do you expect during assessment? A. Fundic Fundic ht. ht. 2 fingers fingers below xyphoid xyphoid proces process, s, engaged engaged B. Cervix Cervix close, close, uneffaced, uneffaced, FH-midw FH-midway ay between between the umbilicus umbilicus and symphysis symphysis pubis C. Cervix Cervix open, fundic fundic ht. 2 fingers fingers below xyphoid xyphoid proces process, s, floating floating D. Fundic height at least at the level of the xyphoid xyphoid process, process, engaged Situation 14 – Please continue responding as a professional nurse in theses varied health situations through the following questions. 66. Which of the following medications would the nurse expect the physician to order for recurrent convulsive seizures of a 10-year old child brought to your clinic? A. B. C. D.
Phenob Phen obar arbi bita tall Nife Nifedi dipi pine ne Buto Butorrpha phanol nol Dia Diazepa epam
67. RhoGAM is given to Rh-negative women to prevent maternal sensitization sensitization from occurring. The nurse is aware that in addition to pregnancy, Rh-negative women would also receive this medication after which of the following? A. B. C. D.
Unsuccess Unsuccessful ful artifici artificial al insemina insemination tion procedu procedure re Blood transfus transfusion ion after after hemor hemorrha rhage ge Therapeuti Thera peutic c or or sponta spontaneous neous abor abortion tion Head injury injury from from a car accident accident
68. Which of the following would the nurse include when describing the pathophysiology of gestational diabetes? A. B. C. D.
Glucose Glucose levels levels decrea decrease se to accommoda accommodate te fetal fetal growth growth Hypoinsul Hypoinsulinem inemia ia develops develops early early in the the first trimes trimester ter Pregna Pregnancy ncy fosters fosters the developme development nt of carbohydra carbohydrate te cravings cravings There is progressive progressive resistan resistance ce to the effects effects of insulin
69. When providing prenatal education to a pregnant woman with asthma, which of the following would be important for the nurse to do? A. B. C. D.
Demonstra Demonstrate te how to asses assess s her blood blood glucose glucose levels levels Teach correct correct administration administration of subcutaneous subcutaneous bronchodilator bronchodilators s Ensure Ensure she seeks seeks treatmen treatmentt for any acute acute exacerb exacerbation ation Explain Expla in that she should should avoid avoid steroids steroids during during her pregnan pregnancy cy
70. Which of the following conditions would cause an insulin-dependent insulin-dependent diabetic client the most difficulty during her pregnancy? A. B. C. D.
Rh inc incom ompa pati tibi bili lity ty Plac Placen enta ta Prev Previa ia Hyper Hypereme emesis sis Gravi Gravidar darum um Abrupr Abr uprtio tion n Pl Plac acent enta a
Situation 15 – One important tool a community health nurse uses in the conduct of his/her activities is the CHN Bag. Which of the following BEST DESCRIBES the use of this vital facility for our practice? 71. The community/Public Health Bag is: A. a requi require remen mentt for home home visi visits ts B. an esse essentia ntiall and indispensa indispensable ble equipme equipment nt of the community community health health nurse C. contains contains basic basic medication medications s and articles articles used used by the community community health health nurse D. a tool used used by the Community health health nurse is rendering rendering effective effective nursing nursing procedures during a home visit 72. What is the rationale in the use of bag technique during home visits? A. It helps render render effective effective nursing nursing care care to clients clients or other members of the family B. It saves saves time and effort effort of the nurse nurse in the the performa performance nce of nursing nursing procedures C. It should minimize or prevent prevent the spread of infection infection from individuals to families D. It should should not oversha overshadow dow concern concerns s for the patie patient nt
73. Which among the following is important in the use of the bag technique during home visit? A. Arrange Arrangement ment of the bag’s bag’s contents contents must must be convenie convenient nt to the nurse nurse B. The bag should should contain contain all necessa necessary ry supplies supplies and equipme equipment nt ready ready for use C. Be sure sure to thoroughly thoroughly clean clean your your bag especi especially ally when when exposed exposed to communicable disease cases D. Mini Minimize mize if not totall totally y prevent prevent the sprea spread d of infection infection 74. This is an important procedure of the nurse during home visits. A. B. C. D.
prote protecti ction on of of the the CHN CHN bag arrange arrangement ment of the contents contents of the CHN CHN bag bag clean cleaning ing of the the CHN CHN bag bag prope pr operr han hand d wa washi shing ng
75. In consideration of the steps in applying the bag technique, which side of the paper lining of the CHN bag is considered clean clean to make a non-contaminated work area? A. B. C. D.
The The The Th e The The The The
lowe lowerr lip lip outer out er su surf rfac ace e uppe upperr tip tip insi inside de sur surfa face ce
Situation 16 – As a Community Health Nurse relating relating with people in different communities, and in the implementation implementation of health programs and projects you experience experience vividly as well the varying forms of leadership and management from the Barangay Level to the Local Government/Municipal or City Level. 76. The following statements can correctly correctly be made about Organization and management: A. An organization organization (or company) is people. people. Values Values make make people persons; persons; values give vitality, meaning and direction to a company. As the people of an organization value, so the company becomes. B. Management is the process by which administration achieves its mission, mission, goals, and objectives o bjectives.. C. Manageme Management nt effectiven effectiveness ess can be measure measured d in terms of accomplishm accomplishment ent of the purpose of the organization while management management efficiency is measured measured in terms of the satisfaction of individual motives. D. Management principles are universal therefore, therefore, one need not be concerned about peoples, culture, values, traditions and human relations. A. B and C only B. A, B and D only
C. A and D only D. B, A and C only
77. Management by Filipino values advocate the consideration of the Filipino goals trilogy according to the Filipino priority-values which are: A. Family amily goals, nationa nationall goals, goals, organizat organizational ional goals goals B. Organiza Organizationa tionall goals, goals, national national goals, goals, family family goals goals C. National National goals, goals, organiz organizatio ational nal goals, goals, family family goals goals
D. Famil amily y goals, organiz organizatio ational nal goals, goals, national national goals 78. Since the advocacy for the utilization of Filipino Filipino value-system in management has been encouraged, the Nursing sector is no except, management needs to examine Filipino Filipino values and discover its positive potentials and harness harness them to achieve: A. Employ Employee ee satisf satisfact action ion B. Organiza Organizationa tionall commitments, commitments, organiza organizationa tionall objectives objectives and employee satisfaction C. Emplo Employee yee objectives objectives/sat /satisfa isfaction ction,, commi commitment tments s and organizati organizational onal objectives D. Organiza Organizationa tionall objectives objectives,, commitments commitments and employee employee objective/satisfaction/ 79. The following statements can correctly correctly be made about an effective and efficient community or even agency managerial-leader. A. Considers Considers the achiev achievemen ementt and advancement advancement of the organizat organization ion she/he she/he represents as well as his people B. Considers the recognition recognition of individual individual efforts toward the realization realization of organizational organizational goals as well as the welfare of his people C. Considers the welfare welfare of the organization above all all other consideration by higher administration D. Considers its own recognition by higher administration for purposes purposes of promotion and prestige. A. Only C and are correct B. A, C and D are correct
C. B, C and D are correct D. Only A and B are correct
80. Whether management at the community or agency level, there are 3 essential types of skills managers must have, these are: A. B. C. D.
Human relat relation ion skills, skills, technica technicall skills, skills, and cognitive cognitive skills skills Conceptual skills, human relation/behav relation/behavioral ioral skills, and technical technical skills Technical skills, budget and accounting accounting skills, skills, skills skills in fund-raising Manipulative skills, technical skill, resource resource management skills A. A and D are correct
B. B is correct
C. A is correct D. C and D are correct
Situation 17 – You are actively practicing nurse who just finished your Graduate Studies. You learned the value of Research and would like to utilize the knowledge and skills gained in the application of research to Nursing service. The following questions apply to research. 81. Which type of research inquiry investigates investigates the issues of human complexity (e.g. understanding the human expertise)? expertise)? A. B. C. D.
Logi Logica call posi positi tion on Natura Nat uralis listic tic inq inquir uiry y Posi ositivi tivism sm Quanti Quantitat tative ive Rese Resear arch ch
82. Which of the following studies is based on quantitative research? research?
A. A study examining the bereavement bereavement process in spouses of clients clients with terminal cancer B. A study exploring exploring factors factors influen influencing cing weight weight control control behavior behavior.. C. A study measur measuring ing the effect effects s of sleep depriva deprivation tion on wound wound healing healing D. A study examining examining client’s client’s feeling before, before, during and after after a bone marrow marrow aspiration 83. Which of the following studies is based on qualitative research? research? A. B. C. D.
A study examining examining clients clients reactions reactions to stress after open heart surgery surgery A study measurin measuring g nutrition nutrition and weight weight loss/gai loss/gain n in clients clients with cancer cancer A study examining examining oxyge oxygen n levels after after endotrach endotracheal eal suctionin suctioning g A study measuring measuring differences differences in blood pressure pressure before, during and after a procedure
84. An 85 year old client in a nursing home tells a nurse, “I signed the papers for that research research study because the doctor was so insistent and I want him to continue taking care of me”. Which client right is being violated? A. B. C. D.
Right of self Right self det deter ermin minati ation on Right to priva privacy cy and confidenti confidentialit ality y Right Right to to full full dis discl closu osure re Right Right nit nit to to be harmed harmed
85. “A supposition or system of ideas that is proposed to explain a given phenomenon”, best defines: A. B. C. D.
a a a a
par paradig adigm m concept theory th conce conceptu ptual al fra framew mework ork
Situation 18 – Nurse Michelle works with a Family Nursing Team in Calbayog Province specifically specifically handling a UNICEF Project Project for Children. The following conditions pertain to CARE OF THE FAMILIES WITH PRESCHOOLERS. 86. Ronnie asks constant questions. How many does a typical 3-year-old ask in a day’s time? A. B. C. D.
1,20 1,200 0 or or mor more e Less ess tha than n 50 50 100-200 300-400
87. Ronnie will need to change to a new bed because his baby sister will need Ronnie’s Ronnie’s old crib. What measure would you suggest that his parents take to help decrease sibling rivalry between Ronnie and his new sister? A. B. C. D.
Move him him to the the new bed befor before e the baby baby arri arrives ves Explain Explain that new new sisters sisters grow grow up to to become become best friend friends s Tell him him he will will have to to share share with the the new baby baby Ask him him to get get his crib crib ready ready for the the new baby
88. Ronnie’s parents parents want to know how to react to him when he begins to masturbate while watching television. What would you suggest?
A. B. C. D.
They refuse refuse to allow allow him to to watch watch televisi television on They schedul schedule e a health health check-up check-up for sex-r sex-rela elated ted disease disease They remin remind d him that that some activi activities ties are are privat private e They give give her her “timeout “timeout” ” when when this begi begins ns
89. How many words does a typical 12-month-old infant use? A. B. C. D.
Aboutt 12 Abou 12 wor words ds Twenty wenty or or more more words words Abou Ab outt 50 50 wor words ds Two, plus plus “mama “mama” ” and “pap “papa” a”
90. As a nurse. You reviewed infant safety procedures with Bryan’s mother. What are two of the most common types of accidents among infants? A. B. C. D.
Aspira Aspi rati tion on and and fal falls ls Falls alls and and auto auto acc accide idents nts Poiso oisoni ning ng and and bur burns ns Drown Drowning ing and homici homicide de
Situation 19 – Among common conditions found in children especially among poor communities are ear infections/problems. The following questions apply. 91. A child with ear problem should be assessed for the following, EXCEPT: A. B. C. D.
is the there re an any y fev fever er? ? Ear Ear dis disch char arge ge If discha discharge rge is pres present ent for for how how long? long? Ear pain
92. If the child does not have ear problem, using IMCI, what should you as the nurse do? A. B. C. D.
Check Check for ear ear disc dischar harge ge Check Check for tender tender swelli swellings ngs behind behind the ear ear Chec Check k for for ear ear pai pain n Go to the next next questi question, on, check check for malnutr malnutrition ition
93. A ear discharge that has been present for more than 14 days can be classified as: A. B. C. D.
mas mastoi toiditi ditis s chroni chr onic c ea earr inf infec ectio tion n acut acute e ear ear infe infect ctio ion n compli complica cated ted ear ear infec infectio tion n
94. An ear discharge that has been present for less than 14 days can be classified as: A. B. C. D.
chroni chronic c ear ear infec infectio tion n mas mastoi toiditi ditis s acut ac ute e ear ear infe infect ctio ion n compli complica cate te ear ear infect infection ion
95. If the child has severe classification classification because of ear problem, what would be the best thing that you as the nurse can do?
A. B. C. D.
instruct instruct mother mother when to retur return n immedia immediately tely ref efer er ur urge gent ntly ly give give an anti antibio biotic tic for 5 days days dry the ear ear by wicki wicking ng
Situation 20 – If the child with diarrhea registers registers one sign in the pink row and one in the yellow row in the IMCI Chart – 96. We can classify the patient as: A. B. C. D.
moder moderat ate e dehy dehydr drat atio ion n some some dehy dehydr drat atio ion n no deh dehyd ydra rati tion on sever sev ere e deh dehydr ydrati ation on
97. The child with no dehydration needs home treatment. treatment. Which of the following is not included in the rules for home treatment in this case: A. B. C. D.
contin continue ue feed feeding ing the child child gives giv es ore oresol sol eve every ry 4 hou hours rs know when when to to return return to the health health center center give give the chil child d extra extra flui fluids ds
98. A child who has had diarrhea for 14 days but has no sign of dehydration is classified as: A. B. C. D.
sever severe e persi persiste stent nt diarr diarrhea hea dys dysente enterry seve severe re dyse dysent nter ery y persi per siste stent nt dia diarr rrhea hea
99. If the child has sunken eyes, drinking drinking eagerly, thirsty and skin pinch goes back slowly, the classification would be: A. B. C. D.
no deh dehyd ydra rati tion on moder moderat ate e dehy dehydr drat atio ion n some so me de dehy hydr drat atio ion n sever severe e dehydr dehydrati ation on
100. Carlo has had diarrhea for 5 days. There is no blood in the stool, he is irritable. His eyes are sunken, the nurse offers fluid to Carlo and he drinks eagerly. When the nurse pinched the abdomen, it goes back slowly. How will you classify Carlo’s illness? A. B. C. D.
seve severe re deh dehyd ydra rati tion on no deh dehyd ydra rati tion on some so me de dehy hydr drat atio ion n modera moderate te dehydr dehydrati ation on
