NURSING SEMINAR 1
SAS 1
1. Florence Nightingale’s theory focused on environment. Which of the following did she
define and describe in her theory?
a. Food, air, water, elimination, and shelter
b. Ventilation, warmth, light, diet, cleanliness, and noise
c. Physical, emotional, mental and spiritual
d. Physiologic, safety, love & belongingness, self-esteem, and self-actualization
RATIO: Florence Nightingale’s Environmental Theory defined Nursing as “the act of utilizing the
patient’s environment to assist him in his recovery.” It involves the nurse’s initiative to configure
environmental settings appropriate for the gradual restoration of the patient’s health and that
external factors associated with the patient’s surroundings affect the life or biologic and
physiologic processes and his development. The ten major concepts of the Environment Theory,
also identified as Nightingale’s Canons, are: Ventilation and warming; Light and noise;
Cleanliness of the area; Health of houses; Bed and bedding; Personal cleanliness; Variety;
Offering hope and advice; Food and Observation.
2. In Jean Watson’s Theory of Human Caring, she has stated that nursing is concerned with the
following EXCEPT
a. Promoting health
b. Preventing illness
c. Caring for the sick
d. Identifying the basic needs
RATIO: Jean Watson’s Theory of Human Caring states that “nursing is concerned with
promoting health, preventing illness, caring for the sick, and restoring health.”
3. According to Jean Watson, which one is central to nursing practice and promotes health
better than a simple medical cure?
a. Caring
b. Compassion
c. Dedication
d. Empathy
RATIO: According to Watson, caring is central to nursing practice and promotes health better
than a simple medical cure. She believes that a holistic approach to health care is central to the
practice of caring in
nursing.
4. In Jean Watson’s theory she has stated to focus on which of the following?
a. Treatment of diseases
b. Rehabilitation
c. Health promotion
d. Control of environment
RATIO: Jean Watson’s theory focuses on health promotion, as well as the treatment of diseases.
5. In Patricia Benner’s nursing theory she has described the advanced beginner nurse as
a. They are taught general rules to help perform tasks, and their rule governed behavior is
limited and inflexible.
b. Shows acceptable performance, and has gained prior experience in actual nursing
situations.
c. Generally, has two or three years’ experience on the job in the same field.
d. Perceives and understands situations as whole parts.
RATIO: The advanced beginner shows acceptable performance, and has gained prior
experience in actual nursing situations. This helps the nurse recognize recurring meaningful
components so that principles, based on those experiences, begin to formulate in order to
guide actions.
6. How many levels of nursing experience did Patricia Benner identify?
a. 3
b. 4
c. 5
d. 7
RATIO: The theory identifies five levels of nursing experience: novice,
competent, proficient, and expert.
advanced beginner,
7. According to Katie Eriksson’s nursing theory, she said to take which of the following into use
when caring for the human being in health and suffering?
a. Charity
b. Chastity
c. Comfort
d. Caritas
RATIO: According to Katie Eriksson’s nursing theory , Caritative caring means that we take
“caritas” into use when caring for the human being in health and suffering
8. Which of the following is NOT a part of Dorothea Orem’s nursing theory?
a. The theory of self-care
b. The self-care deficit theory
c. The 21 nursing problems
d. The theory of nursing systems
RATIO: Orem’s general theory of nursing in three related parts: Theory of self-care; Theory of
self-care deficit and Theory of nursing system.
9. This theory from Dorothea Orem focuses on the performance or practice of activities that
individuals initiate and perform on their own behalf to maintain life, health and well-being.
a. Theory of self-care
b. The self-care deficit theory
c. The theory of nursing systems
d. All of the above
RATIO The theory of self-care, focuses on the performance or practice of activities that
individuals perform on their own behalf. Those might be actions to maintain one’s life and life
functioning, develop oneself or correct a health deviation or condition.
10. How many methods of helping did Dorothea Orem
identify?
a. 3
b. 5
c. 7
d. 9
RATIO: Orem identified 5 methods of helping: Acting for and doing for others; Guiding others;
Supporting another; Providing an environment promoting personal development about meet
future demands; and Teaching another
11. In Martha E. Roger’s Theory of Human Beings she defined nursing as
a. “The act of assisting others in the provision and management of selfcare to maintain
or improve human functioning at home level of effectiveness.”
b. “Unique profession in that is concerned with all of the variables affecting an individual’s
response to stress.”
c. “An art and science that is humanistic and humanitarian.”
D. “Health care profession that focuses on human life processes and patterns and
emphasizes promotion of health for individuals, families, groups, and society as a whole.”
RATIO: Rogers’ theory defined Nursing as “an art and science that is
humanistic and
humanitarian. It is directed toward the unitary human and is concerned with the nature and
direction of human development. The goal of nurses is to participate in the process of change.”
12. Which of the following sentences is NOT a concept related to Florence Nightingale’s theory?
a. "Poor or difficult environments led to poor health and disease"
b. "Environment could be altered to improve conditions so that the natural laws would allow
healing to occur"
c. The goal of nursing is “to put the patient in the best condition for nature to act upon him”
d. "Human beings are open systems in constant interaction with the environment"
RATIO: Letter D is from Imogene King’s Goal Attainment theory. The rest of the choices are
related concepts to Florence Nightingale’s Theory
13. In Martha E. Roger’s the Science of Unitary Human Beings contains two dimensions: the
science of nursing, which is the knowledge specific to the field of nursing that comes from
scientific research; and
a. Art of nursing
b. Adaptation Model
c. Behavioral Systems Model
d. Carative caring
RATIO: SUHB contains two dimensions: the science of nursing, which is the knowledge specific
to the field of nursing that comes from scientific research; and the art of nursing, which involves
using the science of nursing creatively to help better the lives of the patient.
14. What are the five variables identified in Betty Neuman’s System model?
a. Oral, Anal, Phallic, Latent, and Genital
b.Physiologic, safety and security, love and belongingness, self-esteem, and selfactualization
c. Ventilation, warmth, light, diet, cleanliness, and noise
d. Physiological, psychological, sociocultural, developmental, and spiritual
RATIO: The client system identified by Betty Neuman is a composite of five variables
(physiological, psychological, sociocultural, developmental, and spiritual
15. In Betty Neuman’s model, the focus is on the client as a system (which may be an individual,
family, group, or community) and on the client’s responses to
a. Illness
b. Stressors
c. Needs
d. Health promotion
RATIO: Neuman (1982) believes that nursing is concerned with the whole person. She views
nursing as a “unique profession in that it is concerned with all of the variables affecting an
individual’s response to stress”
16. In Imogene King’s nursing theory, her model focuses on the attainment on which
of the following?
a. Goal
b. Well-being
c. Balanced nutrition
d. Basic needs
RATIO: The model focuses on the attainment of certain life goals. It explains that the nurse and
patient go hand-in-hand in communicating information, set goals together, and then take actions
to achieve those goals.
17. Which of the following is the theory associated with Sister Callista Roy?
a. Behavioral System Model
b. Theory of Carative Caring
c. Adaptation Model of Nursing
d. Theory of Bureaucratic Nursing
RATIO: The Adaptation Model of Nursing is a prominent nursing theory aiming to explain or
define the provision of nursing science. In her theory, Sister Callista Roy’s model sees the
individual as a set of interrelated systems that maintain a balance between various stimuli.
18. In Dorothy Johnson’s Behavioral System Model, she defined which of the following
statements?
a. “Nursing is a science and the performing art of nursing is practiced in relationships with
persons (individuals, groups, and communities) in their processes of becoming.” - Parse
b. “participation in care, core and cure aspects of patient care, where CARE is the sole
function of nurses, whereas the CORE and CURE are shared with other members of the
health team.” Lydia Hall
c. “People may differ in their concept of nursing, but few would disagree that nursing is
nurturing or caring for someone in a motherly fashion.”
Ernestine Wiedenbach
d. “an external regulatory force which acts to preserve the organization and
integration of the patients’ behaviors at an optimum level under those conditions
in which the behavior constitutes a threat to the physical or social health, or in
which illness is found.”
RATIO: Letter A is from Rosemarie Rizzo Parse’s Theory of Human Becoming, Letter B is from
LydiaHall’s Core, Care and Cure Theory, while Letter C is from Ernestine Wiedenbach’s The
Helping Art of Clinical Nursing.
19. According to Myra Levine’s theory, she states that nursing is
a. An art
b. Human interaction
c. Concerned with promoting health, preventing illness, caring for the sick, and restoring
health.
d. Science and the performing art of nursing is practiced in relationships with persons
(individuals, groups, and communities) in their processes of becoming.”
RATIO: Nursing is the human interaction relying on communication, rooted in the individual
human being’s organic dependency in his relationships with other human beings.
20. In Hildegard Peplau’s Theory of Interpersonal Relations, she has identified four components
which are
a. Digestion, respiration, elimination, and sleep
b. Person, environment, health, and nursing
c. Orientation, identification, exploitation, and resolution
d. Air, food, water, and shelter
RATIO: Peplau theorized that nurse-patient relationships must pass through three phases in order
to be successful: (a) orientation, (b) working, and (c) termination.
21. Which phase of interpersonal relations in Peplau’s Theory of
Relations should the nurse establish rapport with the client?
a. Orientation
b. Identification
c. Exploitation
d. Resolution
Interpersonal
RATIO: During the brief orientation phase, hospitalized patients realize they need help and attempt
to adjust to their current (and often new) experiences.
22. The nursing theorist who identified the 5 stages of the nursing process is
Lydia Hall
B.
Madeleine Leininger
C.
Ida Jean Orlando
D.
Imogene King
RATIO: The nursing process functions as a systematic guide to client centered care with 5
sequential steps. These are assessment, diagnosis, planning, implementation, and evaluation.
A.
23. According to Joyce Travelbee’s theory, nursing is accomplished through
A. Human-to-human relationships
B. Nurse-patient relationship
C. Manipulation of the environment
D. Promoting health
RATIO: Travelbee's grand theory of Human-to-Human Relationships provides nurses with a
foundation necessary to connect therapeutically with other human beings. The assumptions
involve humans, who are nurses, relating to humans who are suffering, are in distress, or have
the potential to suffer.
24. In Lydia Hall’s Core, Care, Cure model, she has identified the core as which of the following?
a. Primary role of a professional nurse such as providing bodily care for the patient
b. The patient receiving nursing care
c. The aspect of nursing which involves the administration of medications and treatments
d. the purpose of nursing was to help and support an individual, family, or community
RATIO: The core, according to Hall's theory, is the patient receiving nursing care. The core has
goals set by him or herself rather than by any other person and behaves according to their
feelings and values.
25. Faye Glenn Abdellah’s 21 nursing problems were categorized into which of the following?
a. Physical, sociological, and emotional needs
b. Prevention, treatment, and rehabilitation
c. Physiological, psychological, and spiritual
d. Food, air, and water
RATIO: The 21 nursing problems fall into three categories: physical, sociological, and emotional
needs of patients; types of interpersonal relationships between the patient and nurse; and
common elements of patient care.
SAS 2
1. Nurse Edberg is about to perform physical assessment of the abdomen.
assessment must Nurse Edberg do?
A. Inspection, palpation, percussion, and auscultation
B. Auscultation, percussion, palpation, and inspection
C. Inspection, auscultation, percussion, and palpation
D. Any order that the nurse desires
Which order of
ANSWER: C
RATIO: With abdominal assessment, you inspect first, then auscultate, percuss, and
palpate. This order is different from the rest of the body systems, for which you inspect,
then percuss, palpate, and auscultate.
2. Nurse Ann is going to assess a newly admitted client who is suspected to
Hemorrhagic Fever.
Which of the following should she record as subjective data?
a. Body temperature of 38.8 degrees Celsius
b. Complete blood count result
c. Patient’s complaint about abdominal pain
d. Client’s blood pressure of 110/78
have Dengue
ANSWER: C
RATIO: Subjective data are information from the client's point of view
(“symptoms”), including feelings, perceptions, and concerns obtained through interviews.
3. Which of the following is the purpose of physical examination?
a. To obtain subjective data from the patient
b. To know about the patient’s chief complaint
c. To determine changes in a patient’s health status and how to respond to a problem
as well as promote healthy lifestyles and wellbeing
d. To evaluate the outcome of the nursing interventions
ANSWER: C
RATIO: The purpose of physical examination is to determine changes in a patient’s health
status and how to respond to a problem as well as promote healthy lifestyles and wellbeing.
4. A student nurse is instructed to perform an intramuscular injection by using the Z-track
method. The student nurse must know that the purpose of doing the Z-track method is
A. To enhance blood flow to the injection site
B. To allow faster absorption of the drug into the muscle
C. To prevent drug leakage into the subcutaneous tissue, helps seal the drug in the
muscle, and minimizes skin irritation.
D. To allow faster drug clearance.
ANSWER: C
RATIO: By leaving a zigzag path that seals the needle track, this technique prevents drug
leakage into the subcutaneous tissue, helps seal the drug in the muscle, and minimizes skin
irritation.
5. Nurse Aladdin Abdulrahman is reviewing the patient’s blood pressure after administering an
oral antihypertensive 30 minutes before. The nurse is employing which stage of the nursing
process?
a. Nursing diagnosis
b. Planning
c. Implementation
d. Evaluation
ANSWER: D
RATIO: The last phase of the process is the evaluation phase. This is where the medical
professionals assess and evaluate the success of the planning and implementation processes.
This phase ensures that the individual is making progress towards his/her goals and is
achieving the desired outcome.
6. A patient named Jasmine Allamudin is in the bathroom when Nurse Belle enters to give a
prescribed medication.
What should the nurse in charge do?
a. Wait for the patient to return to her bed then leave the medication at her bedside.
b. Return shortly to the patient’s room and remain there until the patient takes her
medication.
c. Tell the patient to be sure to take the medication and then leave it at her bedside.
d. Leave the medication at her patient’s bedside.
ANSWER: B
RATIO: Option B is the proper action that the nurse should impose upon giving
medications.
7. Dr. Rodrigo Robredo orders heparin, 7500 units, to be administered subcutaneously every 6
hours. The vial reads 10000 units per milliliter. Nurse Leni should anticipate giving how much
heparin for each dose?
a. 0.25 ml
b. 0.5 ml
c. 0.75 ml
d. 1.25 ml
ANSWER: C
RATIO: 0.75 ml is anticipated to be administered to the patient as per doctor’s order.
8. A patient named Panfilo dela Rosa is suffering from hypoxia. The physician is most
likely to order which of the following tests?
a. Arterial blood gas analysis
b. Total hemoglobin and hematocrit
c. Chest X-ray
d. Complete blood count
ANSWER: A
RATIO: One of the principal utilities of arterial blood gas (ABG) analysis is to help assess
blood oxygenation status. The two ABG parameters used for this assessment are pO2(a)
(partial pressure of oxygen in arterial blood) and sO2(a) (% of total hemoglobin that is
saturated with oxygen).
9. Nurse Ishbelle uses a stethoscope to auscultate a female patient’s chest. Which statement
about the stethoscope with the bell and the diaphragm is true?
a. The bell detects thrills best
b. The bell detects high-pitched sounds best
c. The diaphragm detects high-pitched sounds best
d. The diaphragm detects low-pitched sounds best
ANSWER: C
RATIO: The stethoscope has two different heads to receive sound, the bell and the
diaphragm. The bell is used to detect low-frequency sounds; the diaphragm, high frequency
sounds.
10. Nurse Vincent is teaching the community about the importance of exercise to prevent
the occurrence of type II diabetes mellitus.
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Passive prevention
ANSWER: A
RATIO: Primary prevention aims to prevent disease or injury before it ever occurs. This is
done by preventing exposures to hazards that cause disease or injury, altering unhealthy or
unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or
injury should exposure occur.
11. When observing universal precaution, the nurse must always practice
following to prevent the transmission of infection?
a. Having a proper diet
b. Maintain adequate exercise
c. Taking supplemental vitamins and minerals
d. Practice hand hygiene at all times
which of the
ANSWER: D
RATIO: Universal precautions are intended to prevent parenteral, mucous membrane, and
nonintact skin exposures of health-care workers to bloodborne pathogens.
12. Nurse Jason is going to feed the patient via the nasogastric tube. Which nursing action is
essential in performing enteral feeding?
a. Elevating the head of the bed
b. Positioning the patient to the left side
c. Warming the formula before administering it
d. Hanging a full day’s worth of formula at one time
ANSWER: A
RATIO: Position patient sitting up at 45 to 90 degrees (unless contraindicated by the patient's
condition), with a pillow under the head and shoulders. This allows the NG tube to pass more
easily through the nasopharynx and into the stomach.
13. Nurse Joy is going to administer a tablet via the sublingual route. She should instruct her
patient to place the tablet on the:
a. Inside of the cheek
b. Floor of the mouth
c. Roof of the mouth
d. Top of the tongue
ANSWER: B
RATIO: Sublingual administration involves placing a drug under your tongue to dissolve and
absorb into your blood through the tissue there
14. Which of the following best describes Kussmaul respirations?
a. Increased rate and depth of breathing over a prolonged period of time. In response
to metabolic acidosis, the body's attempt to blow off CO2 to buffer a fixed acid such
as ketones.
b.
Gradual increase in volume and frequency, followed by a gradual decrease in volume and
frequency, with apnea periods of 10 - 30 seconds between cycle.
c.
Short episodes of rapid, deep inspirations followed by 10 - 30 second apneic period.
d.
Only able to breathe comfortable in upright position (such as sitting in chair), unable to
breath laying
down.
ANSWER: A
RATIO: Your body maintains a steady pH level of 7.35 to 7.45. When this pH level
becomes higher or lower, your body has to find ways to try make up for the pH changes.
This is where Kussmaul breathing comes in.
15. Doctor Rodrigo Robredo has ordered dextrose 5% in water, 1000 ml to be infused over 8
hours. The I.V. tubing is delivering 15 drops per milliliter. Nurse Bong should run the infusion rate
at:
a. 15 drops per minute
b. 21 drops per minute
c. 31 drops per minute
d. 125 drops per minute
ANSWER: C
RATIO: Infusion rate is 31 drops per minute.
16. Which of the following is true about the working phase of the nurse patient relationship?
a. Obtain subjective data
b. Make the patient comfortable
c. Greet the patient
d. Establish rapport
ANSWER: B
RATIO: Option B is true about the working phase of the nurse-patient relationship.
17. Which of the following interventions is considered as a primary level of prevention?
a. Using physical therapy to help the patient cope with above-the-knee amputation.
b. Obtaining a breast biopsy to detect breast cancer
c. Administering an anti-Hepatitis B immunization to an infant
d. Administering Ceftriaxone (Rocephin) to a patient who has gonorrhea
ANSWER: C
RATIO: Option C is is considered as a primary level of prevention
18. Nurse JM is tasked to do a nursing care plan in the ward. The identification of actual
or potential health problems is done during which step of the nursing process?
a. Assessment
b. Nursing diagnosis
c. Planning
d. Implementation
ANSWER: A
RATIO: The identification of actual or potential health problems is done during the
Assessment Phase.
19. A female patient named Mikasa Ackerman has been found to be suffering from deep-vein
thrombosis. Which
nursing diagnosis should Nurse Eren prioritize at this time?
a. Altered peripheral tissue perfusion related to venous congestion
b. Risk for injury related to edema
c. Fluid volume excess related to peripheral vascular disease d. Impaired gas
exchange related to decreased blood flow
ANSWER: A
RATIO: Altered peripheral tissue perfusion related to venous
congestion is the priority of Nurse Eren.
20. Nurse Erina has found out that after giving proper interventions to Soma who has fever
brought about by
meningitis, the patient’s fever has not subsided yet. She is revising patient Soma’s nursing care
plan. During
which step of the nursing process does revision take place?
a. Nursing diagnosis
b. Planning
c. Evaluation
d. Assessment
ANSWER: C
RATIO: During the evaluation step of the nursing process the nurse determines whether the
goals established have been achieved, and evaluates the success of the plan.
21. A client named Kakashi has been prescribed with diphenhydramine (Benadryl) for his
allergies. He then contacts
the nurse and complains of drowsiness after taking the medication making it almost impossible
for him to do his work. This is an example of
a. Drug synergism
b. Side effect
c. First-pass effect
ANSWER: B
RATIO: A side effect is an unwanted symptom caused by medical treatment. All
medicines can cause side effects, including prescription, over-the counter and
complementary medicines.
22. Doctor Eren has ordered Nurse Misaka to administer cefuroxime (Ceftin) 500 mg via IV bolus
t.i.d to a patient with acute glumerulonephritis. The nurse would expect to give the drug to be
given
a. Twice a day
b. Thrice a day
c. Once a day
d. Four times a day
ANSWER: B
RATIO: TID means thrice a day.
23. A physician orders 250 mg of an antibiotic suspension, the label on the suspension read
“500 mg/5 ml” how much would the nurse administer?
a. 2.5 ml
b. 5 ml
c. 7.5 ml
d. 10 ml
ANSWER: A RATIO: Option A is valid.
24. A nurse is to administer 500 mg of a drug intramuscularly. The label on the multidose vial
reads 250 mg/ml. how much of the medication would the nurse prepare on the syringe?
a. 0.5 ml
b. 1 ml
c. 1.5 ml
d. 2 ml
ANSWER: D
RATIO: Option D is correct.
25. When assessing for the liver functioning of a patient who is receiving hepatotoxic drugs
the nurse must check which of the following?
a. Blood urea nitrogen (BUN)
b. Creatinine clearance (CLcr)
c. Complete blood count
d. Alanine aminotransferase and aspartame aminotransferase
ANSWER: D
RATIO: ALT and AST are liver enzymes.
SAS 3
1. Which of the following statements by Nurse Stella is a great example of the therapeutic
communication technique known as giving recognition?
a.
“I’m glad that you are already taking your medication. They will help you a lot.”
b.
“I can see that you have a new dress today and it seems that you have washed
your hair.”
c.
“I will sit beside you until it is time for your group session.”
d.
“I’ve noticed that you did not attend the group session today. Are you willing to talk about
that?”
RATIO: Option B is an example of a therapeutic communication technique of giving recognition.
2. A client named Rodrigo De Lima tells the nurse, “Whenever I am furious, I always get into a
fistfight with my spouse, sometimes I punch my children as well.” The nurse states, “I have
observed you smiling while you talk about domestic violence.” The therapeutic communication
technique employed by the nurse is
a. Making observations
b. Formulating a plan of action
c. Providing general leads
d. Exploring
RATIO: As the nurse stated that she have observed the patient smiling.
3. A client named Agot tells Nurse Jinky, mo “I feel awful because my mom does not allow me to
go back home after I am discharged from the hospital.” Which response from Nurse Jinky is
therapeutic?
a.
b.
“Your mom sounds like she is an empathic person. I’ll help you talkto her.”
“You feel that your mom will not allow you to return to your home?”
c.
“Why will you not speak this out with your mom? You may probably learn that she really
does not feel that way?”
d.
“It’s somehow common for patients to have feelings like this after long periods of being
in the hospital.”
RATIO: This is an example of the therapeutic communication technique of restatement.
Restatement is the repeating of the main idea that the client has verbalized. This lets the client
know whether or not an expressed statement has been understood and gives him or her the
chance to continue, or clarify if necessary.
4. Nurse Ronald is conducting an interview to a depressed patient. Which statement from
Nurse Ronald is a great example of giving general leads?
a.
“I can see that and then?”
b.
“Why are you feeling so depressed right now?”
c.
“Can you give me the date and time we are currently in today?”
d. “You seem so tense right now.”
RATIO: It is a therapeutic communication which the nurse gives general leads to the patient by
letting it share all of her thoughts
d.
5. Nurse Roque has told to his patient who will undergo an major surgery, “Don’t worry, we’ve
got some great doctors here at the hospital. You’ll be in good shape once the operation is
done.” The type of non-therapeutic technique applied in the statement is
a. Interrogation
b. Giving advice
c. False reassurance
d. Defending
RATIO: The nurse’s statements in the situation portrays false reassurance. Giving false
reassurance indicates to the patient that there is no cause for anxiety therefore devaluing the
patient’s feelings.
6. A patient named Panfilo has had a left above-the-knee amputation after a motor vehicular
accident. Upon regaining consciousness, the patient states, “What happened? I can’t recall
anything.” What is the nurse’s initial response?
a. “I think you will recall more about the incident as you get better.”
b. “It was necessary to amputate your leg after the accident.”
c. “You were in a motor-vehicular accident last night.”
d. “Tell me what you think happened?”
RATIO: This is truthful and gives the patient information that may initiate recollection about
the accident.
7. After giving anxiolytics, the patient says to Nurse Tina, “It seems that you are too busy to stay
with me.” How should nurse Tina respond?
a. “You’ll feel better after I’ve given you the medication.”
b. “You will be able to sleep after the drug starts to take effect.”
c. “I have to attend to other patients, however, I will be back after 10 minutes.”
d. “I apologize but I need to attend to other patients in the ward.”
RATIO: The nurse should tell the patient that she has other thing to do and assure that will still
take care of her.
8. A patient named Historia seems tense and anxious during a nurse-client interaction, which
nursing statement belittles the patient’s feelings and concerns?
a. “You seem to be assuming a lot of things.”
b. “I have observed that you are biting your nails again.”
c. “You seem anxious today.”
d. “Come on, I know you can do better than that.”
RATIO: This nursing statement is an example of a non-therapeutic communication known as
belittling feelings. This occurs if the nurse misjudges the degree of the client’s discomfort showing
a lack of empathy.
9. Which of the following statements from Nurse Katrina shows a good example of focusing?
a. “You mentioned about growing up with your mother. Let’s discuss that further.”
b. “Your time with me today is for an hour. I’ll stay with you until then.”
c. “I’m finding it hard to understand what you mean.”
d. “Tell me one of the wonderful things that has occurred to you this week.”
RATIO: Focusing is a therapeutic communication that takes notice of a single though or word and
works with the client who is experiencing flight of ideas or looseness of association.
10. A patient named Mocha tells the nurse, “You will not believe what my father said to me
during visiting hours. How dare he talk to me that way. I don’t deserve any of that.” Which
would be the best response by the nurse?
a. “Describe to me what has occurred during your time with your father.”
b. “Why do you think your father has behaved that way?”
c. “What do you think is your role in this relationship with your father?” d. “Does your father
often treat you in that manner?” RATIO: The nurse should make sure what was the situation
and why does the father talks to the patient in that way
11. A patient named Bong is experiencing hallucinations and tells the nurse, “I can hear
voices telling me to eat a lot of soap.” Which of the following therapeutic communication
skills must the nurse employ?
a. Focusing
b. Seeking clarification
c. Present reality
d. Provide general leads
RATIO: The nurse must employ the therapeutic communication technique known as present
reality whenever a patient is experiencing either a hallucination, illusion, or delusion.
12. When Nurse Martha visits a patient at home the patient tells her, “I haven’t slept during the
last couple of nights.”
Which of the following statements from the nurse is therapeutic for the patient?
a. “I too have trouble sleeping sometimes.”
b. “I see that you have difficulty of sleeping.”
c. “Is that so?”
d. “I see.”
RATIO: : The nurse is employing restatement as a therapeutic communication skill in this
situation. This type of skill assists the nurse in obtaining a more specific perception of the
problem of the patients.
13. Nurse Mona is assigned 4 patients in the infectious disease ward. Which of the following
patients must Nurse Mona attend to first?
a.
A 54-year old male patient who is recently diagnosed to have pulmonary tuberculosis
b.
A 66-year old female patient who has community acquired pneumonia
c.
A 37-year old male patient who is diagnosed to have Acquired Immunodeficiency
Syndrome (AIDS)
d.
A 24-year old female patient who is suspected to have a streptococcus infection
RATIO: Aids is an infectious disease
14. A 7-year old child recently had German measles or rubella. Being immune to
rubella after having the disease would be
a. Natural active acquired immunity
b. Artificial active acquired immunity
c. Natural passive acquired immunity
d. Artificial passive acquired immunity
RATIO: Natural active acquired immunity is immunity that is acquired gained through illness and
recovery.
15. Nurse Susan is currently assigned to the medical ward. She is tasked to properly practice
the proper isolation techniques. Which of the following patients should Nurse Susan place in
reverse isolation?
a. A 45-year old patient who is suffering from pneumonia
b. A 28-year old patient who is diagnosed with acute myelogenous leukemia
c. A 33-year old patient who has a diabetic foot
d. A 55-year old patient who is suffering from pulmonary tuberculosis
RATIO: patients who have leukemia are immunocompromised. The nurse must practice
reverse isolation techniques bin order to prevent the patient from having infection.
16. A patient named Bato who has an infected would of the head is positive for methicillinresistant staphylococcus aureus. Nurse Chel must practice which of the following?
a. Standard precautions
b. Respiratory isolation
c. Reverse isolation
d. Contact Isolation
RATIO: Contact or Body Substance Isolation (BSI) involves the use of barrier protection (e.g.
gloves,mask, gown, or protective eyewear as appropriate) whenever direct contact with any bodily
fluid is expected. When determining the type of isolation to use, one must consider the mode of
transmission. The hands of personnel continues to be the principal mode of transmission for
methicillin resistant staphylococcus aureus (MRSA).
17. Nurse Joyce is teaching the community the best way to prevent the transmission of infection.
This is best done by teaching which of the following to the community?
a. Proper wearing and using face masks
b. Hand hygiene
c. Cleaning the surroundings
d. Eating nutritious food
RATIO: The best way to avoid the transmission of infection is to do hand hygiene.
18. Nurse Jessie is currently adhering to the principles of medical asepsis when performing
patient care in the hospital setting. Which nursing action performed by the nurse follows these
recommended guidelines?
a. The nurse carries the patient’s soiled bed linens close to the body to prevent spreading
microorganisms into the air.
b.
The nurse places soiled bed linens and hospital gowns on the floor when making
the bed.
c.
The nurse moves the patient table away from the nurse’s body when wiping it off after a
meal.
The nurse cleans the most soiled items in the patient’s bathroom first and follows with the
cleaner items.
d.
RATIO: This prevents the transmission of infection if objects are held away from the nurse’s
body.
19. A 44-year old female is recently diagnosed to have pulmonary tuberculosis. She is currently
undergoing treatment at the DOTS center. The nurse assigned to her must know that the tubercle
bacilli is transmitted in which of the following?
a. Airborne
b. Contact
c. Droplet
d. All of the above
RATIO: Infectious droplet nuclei are generated when persons who have pulmonary or laryngeal
TB disease cough, sneeze, shout, or sing. TB is spread from person to person through the air.
The dots in the air represent droplet nuclei containing tubercle bacilli.
20. Nurse Naya is teaching the community about the importance of hand hygiene. Which
component of hand washing should the nurse include that is most important for removing
microorganisms?
a. Friction
b. Water
c. Time
d. Soap
RATIO: Lathering and scrubbing hands creates friction, which helps lift dirt, grease, and microbes
from skin.
SAS 4
SITUATION: Aling Nena, a 32year old fish vendor from Barangay Carael came to see you at the
prenatal clinic. She brought with her all her three children. Feliza, 1 year 6 months; Loreta, 3
and Voltaire, 7 years old. She mentioned that she stopped taking oral contraceptives several
months ago and now suspects she is pregnant. She cannot remember her LMP.
1. Which hormone is necessary for a positive pregnancy test?
a. Progesterone
b. Human chorionic gonadotropin
c. Estrogen
d. Lactogen
RATIO: A pregnancy test can tell whether you are pregnant by checking for a particular hormone
in your urine or blood. The hormone is called human chorionic gonadotropin (HCG). HCG is made
in a woman's placenta after a fertilized egg implants in the uterus.
2. With this pregnancy, Aling Nena is a
a. P3 G3
b. Primigravida
c. P3 G4
d. P0 G3
RATIO: Gravidity is defined as the number of times that a woman has been pregnant. Parity is
defined as the number of times that she has given birth to a fetus with a gestational age of 24
weeks or more, regardless of whether the child was born alive or was stillborn.
3. In explaining the development of her baby, you identified in chronological order of growth of
the fetus as it occurs in pregnancy as
a. Ovum, embryo, zygote, fetus, infant
b. Zygote, ovum, embryo, fetus, infant
c. Ovum, zygote, embryo, fetus, infant
d. Zygote, ovum, fetus, embryo, infant
RATIO: The process of prenatal development occurs in three main stages. The first two weeks
after conception are known as the germinal stage, the third through the eighth week is known
as the embryonic period, and the time from the ninth week until birth is known as the fetal
period.
4. When teaching Aling Nena about her pregnancy, you should include personal common
discomforts. Which of the following is an indication for prompt professional supervision?
a. Constipation and hemorrhoids
b. Backache
c. Facial edema
d. Frequency of urination
RATIO: Some swelling during pregnancy is normal. Sudden swelling in your face and hands or
around the eyes could be a red flag for a serious condition called preeclampsia. Preeclampsia is
excessive swelling and accompanied by other symptoms such as high blood pressure and high
levels of protein in your urine.
5. Which of the following statements would be appropriate for you to include in Aling Nena’s
prenatal teaching plan?
a. Exercise is very stressful, it is not recommended
b. Limit your food intake to vegetables only
c. Alcohol has no harmful effects on the fetus
d. Avoid unnecessary fatigue, rest periods should be included in your schedule
RATIO: Is it normal to feel tired in pregnancy? It's common to feel tired, or even exhausted,
during pregnancy, especially in the first 12 weeks. Hormonal changes at this time can make you
feel tired, nauseous and emotional. The only answer is to rest as much as possible.
SITUATION: Nurse Dina is assigned at the City Health Office to teach contraception to Mang
Jess and Aling Sion who are respectively 35 and 34 years old. The couple has had 4 children
and has decided to use contraceptives. The couple seems interested in both the artificial
methods and surgical methods of contraception.
6. Aling Sion asks Nurse Dina about the details of bilateral tube ligation. Which of the following
information is NOT true with regard to bilateral tube ligation?
a. It is a surgical procedure that can be done through laparoscopy.
b. It is a surgical procedure that creates a temporary contraception or sterilization that
can be easily reversed in the future.
c. There is a risk of ectopic pregnancy albeit a rare occurrence
d. No other contraceptive methods will be used once the female undergoes the minor surgery.
RATIO: Risks associated with tubal ligation include: Damage to the bowel, bladder or major blood
vessels. Reaction to anesthesia. Improper wound healing or infection.
7. Mang Jess on the other hand wants information about vasectomy. Which of the following is
NOT true regarding vasectomy?
a.
A vasectomy can be done in an ambulatory setting, such as in a primary health care clinic.
b.
The man may experience a small amount of local pain afterward, which can be managed
by taking a mild analgesic and applying ice to the site.
c.
The male can have unprotected sex with his spouse immediately after the surgery has been
d.
The surgical procedure is about 99.5% effective.
done.
RATIO: Vasectomy offers many advantages as a method of birth control. The main benefit is
effectiveness. A vasectomy is over 99.99% effective in preventing pregnancies. Like female tubal
ligation, vasectomy is a one-time procedure that provides permanent contraception.
8. During the discussion about oral contraceptive pills Aling Sion asked Nurse Dina, “What
do I do if I forget to take an oral contraceptive pill?” Nurse Dina must reply which of the
following?
“If the pill omitted was one of the placebo ones, ignore it and just take the next pill on time
the next day.”
a.
“If you forgot to take one of the active pills, take it as soon as you remember. Continue
the following day with your usual pill schedule.
Missing one pill this way should not initiate ovulation.”
b.
“If you miss two consecutive active pills, take two pills as soon as you remember. Then,
continue the following day with your usual schedule. You may experience some vaginal spotting
with two forgotten pills.”
c.
d.
d. All of the above
RATIO: If you just missed one, take it as soon as you remember. If you don't remember until
the next day, go ahead and take 2 pills that day. If you forget to take your pills for 2 days, take
2 pills the day you remember and 2 pills the next day.
9. The couple has finally chosen the intrauterine device as a method of contraception. Nurse
Dina must inform Aling Sion of which of the following?
a. Breast tenderness after insertion of the IUD
b. Vaginal discoloration 1 week after insertion of the IUD
c. Amenorrhea for 6 months after the insertion of the IUD
d. Vaginal spotting and uterine cramping during the first 2 or 3 weeks after IUD
insertion.
RATIO: However, it's perfectly normal to have discomfort and spotting that lasts for several
hours afterward. These cramps may gradually decrease in severity but continue on and off for
the first few weeks after insertion. They should subside entirely within the first three to six
months.
10. Aling Sion asks Nurse Dina, “How long should I be having the intrauterine device?”
Nurse Dina must tell Aling Sion that the effectiveness of the Copper T380 IUD is at
around
a. 10 years
b. 5 years
c. 3 years
d. 6 months
RATIO: Copper T 380 A, the intrauterine device (IUD), has now been clinically approved by the
US Food and Drug Administration (FDA) to have a longer lifespan. According to a population
council news release, the device, which originally had a 4-year term duration, has been found
out to be effective for 6 years.
SITUATION: Rodrigo a 35-year-old male and Leni a 33-year-old female is visiting a fertility
clinic. The couple has mentioned that they have been married for 7 years and have been trying
since then to conceive a child. They have always been unsuccessful. It was found out that the
female has obstructed fallopian tubes. The physician has recommended the couple to undergo
in vitro fertilization (IVF).
11. The nurse must know that the process of in vitro fertilization involves which of the following
procedures? a. Oophorectomy
b. Laparoscopy
c. Salpingectomy
d. Drug therapy
RATIO: Typically, transvaginal ultrasound aspiration is used to retrieve eggs. During this
procedure, an ultrasound probe is inserted into your vagina to identify follicles, and a needle is
guided through the vagina and into the follicles.
12. How many hours after fertilization will the laboratory-grown zygotes be inserted into the
woman’s uterus? a. 12 hours
b. 24 hours
c. 48 hours
d. 40 hours
RATIO: For patients with at least one normal fallopian tube, GIFT may be an option. Zygote
intrafallopian transfer (ZIFT), another variation of IVF, involves transferring pre-embryos into the
fallopian tubes just 24 hours after in vitro fertilization. At this stage, the fertilized eggs are called
zygotes.
13. Based from the information above, how many fertilized eggs will be
woman’s uterus?
inserted in the
a. 1 only
b. 1-2 fertilized ova
c. 3-4 fertilized ova
d. Up to 5 fertilized ova may be transferred
RATIO: During IVF, mature eggs are collected (retrieved) from ovaries and fertilized by sperm in
a lab. Then the fertilized egg (embryo) or eggs (embryos) are transferred to a uterus. One full
cycle of IVF takes about three weeks. Sometimes these steps are split into different parts and
the process can take longer.
14. Why is progesterone or luteinizing hormone prescribed a woman after undergoing IVF?
a.
Due to the blockage of the fallopian tubes
Hormonal imbalances brought about by the procedure
c. The corpus luteum can be injured by the aspiration of the follicle
d. Due to cysts growing on the mother’s ovaries
RATIO: Progesterone production is the domain of the ovary until the placenta takes over
progesterone production at around 8-10 weeks gestational age. Because of the estimated
b.
c.
d.
timing and the desire to be conservative, most IVF clinics in the US recommend
progesterone supplementation for 8-10 weeks after egg retrieval/FET.
15. Prior to aspiration of ova from the female which of the following hormones will be given
to the woman 1 month prior to the procedure?
a. Follicle-stimulating hormone
b. Luteinizing hormone
c. Estrogen
d. Human chorionic gonadotropin hormone
RATIO: Before beginning IVF, women will first undergo ovarian reserve testing. This involves
taking a blood sample and testing it for the level of follicle stimulating hormone (FSH). The
results of this test will give your doctor information about the size and quality of your eggs.
Your doctor will also examine your uterus.
SITUATION: Aling Leni, a 33-year-old mother came to the health center for her prenatal checkup. She is currently in her second trimester of her pregnancy, at about 22 age of gestation with
a score of P2G4.
16. Upon interview, Aling Leni told Nurse Kristine that she can feel fetal movements. Nurse
Kristine that the fetal movements can be felt by the mother as early as
a. 12-15 weeks AOG
b. 16-20 weeks AOG
c. 21-25 weeks AOG
d. 8-11 weeks AOG
RATIO: When will I feel my baby moving? You might start to feel your baby moving, often called
'quickening', around 18 weeks into your pregnancy. If this is your first pregnancy, it might not
happen until about 20 weeks. However, by the second pregnancy, you might notice the tell-tale
signs as early as 16 weeks.
17. Nurse Kristine began assessing Aling Leni’s pregnancy. Which of the following findings
would indicate for a positive pregnancy?
a. Linea nigra that has formed on the mother’s abdomen
b. Goodell’s sign
c. Fetal movements felt by the mother
d. Fetal heart tone heard by the nurse through the stethoscope
RATIO: Positive signs of pregnancy are those signs that are definitely confirmed as a
pregnancy. They include fetal heart sounds, ultrasound scanning of the fetus, palpation of
the entire fetus, palpation of fetal movements, x-ray, and actual delivery of an infant.
18. Nurse Kristine has told Aling Leni about the importance of taking folic acid supplements.
Aling Leni asks the significance of taking these supplements. Nurse Kristine must state that
a. Folic acid prevents the occurrence of mental retardation in the fetus
b. Folic acid prevents iron deficiency anemia in the pregnant mother
c. Folic acid prevents neural tube defects from developing in the fetus
d. Folic acid prevents gestational diabetes in the mother
RATIO: When the baby is developing early during pregnancy, folic acid helps form the neural
tube. Folic acid is very important because it can help prevent some major birth defects of the
baby's brain (anencephaly) and spine (spina bifida).
19. Aling Leni has observed that there was a change in the color of her vagina which went from
pink to violet. Which of the following statements by Nurse Kristine is correct with this finding?
a.
“It is a normal occurrence during pregnancy known as Chadwick’s sign.”
“It is a normal occurrence during pregnancy known as Goodell’s sign.” c. “It is a normal
occurrence during pregnancy known as Hegar’s sign.”
d. “It is a normal occurrence during pregnancy known as Braxton-Hicks’ sign.”
RATIO: Chadwick sign is a bluish discoloration of the cervix, vagina, and labia resulting from
increased blood flow. It can be observed as early as 6 to 8 weeks after conception, and its
presence is an early sign of pregnancy.
b.
20. Which of the following is TRUE with regard to Aling Nena’s psychological change during her
second trimester of her pregnancy?
a.
The woman and her partner both spend time recovering from the surprise of learning that
they are pregnant and concentrate on what it feels like to be pregnant.
b.
The woman and her partner move through emotions such as narcissism and introversion
as they concentrate on what it feels like to be a parent.
The woman and her partner prepare clothing and sleeping arrangements for the baby but
also grow impatient as they ready themselves for birth.
c.
The woman has a common reaction of ambivalence, or feeling both pleased and
not pleased about the pregnancy.
d.
RATIO: Fatigue, morning sickness, and moodiness usually improve or go away. You may feel
more forgetful and disorganized than before. You may feel lots of emotions about things like
the way you look or feeling the baby move.
SAS 5
SITUATION: Baby James, an 8-hour old newborn is admitted to the NICU because of low
APGAR Score. His mother had a prolonged second stage of labor.
1. Which of the following is the most important concept associated with all high-risk newborn?
A.
Support the high-risk newborn's cardiopulmonary adaptation by maintaining adequate
airway
B.
Identify complications with early intervention in the high risk newborn to reduce
morbidity and mortality
C.
Assess the high risk newborn for any physical complications that will assist the parent with
bonding
D.
Support mother and significant others in their request toward adaptation to the high risk
newborn
RATIO: A high-risk infant is an infant that appears well but has a much greater chance than
most infants of developing a clinical problem, such as hypothermia, hypoglycemia, apnea,
infection, etc. in the newborn period. High-risk infants appear clinically well on examination.
2. Which of the following would the nurse expect to find in a newborn with birth asphyxia?
A. Hyperoxemia
B. Acidosis
C. Hypocapnia
D. Ketosis
RATIO: Hypocapnia (from the Greek words υπό meaning below normal and καπνός kapnós
meaning smoke), also known as hypocarbia, sometimes incorrectly called acapnia, is a state of
reduced carbon dioxide in the blood. Hypocapnia usually results from deep or rapid breathing,
known as hyperventilation.
3. When planning and implementing care for the newborn that has been
resuscitated, which of the following would be important to assess?
successfully
A. Muscle flaccidity
B. Hypoglycemia
C. Decreased intracranial pressure
D. Spontaneous respiration
RATIO: Assessment of Oxygen Need and Administration of Oxygen - Optimal management of
oxygen during neonatal resuscitation becomes particularly important because of the evidence
that either insufficient or excessive oxygenation can be harmful to the newborn infant.
4. When assessing the head of the newborn’s head, the nurse has observed for swelling and the
appearance of the head is as though it appears like a cone. Which of the following terms must
the nurse note on her chart? a. Caput succedaneum
b. Molding
c. Cephalhematoma
d. Craniosynostosis
RATIO: “Caput succedaneum” refers to swelling, or edema, of an infant's scalp that appears as
a lump or bump on their head shortly after delivery. This condition is harmless and is due to
pressure put on the infant's head during delivery. It doesn't indicate damage to the brain or
the bones of the cranium.
5. For this newborn who is experiencing birth asphyxia, which of the following would be
the most appropriate nursing diagnosis?
a. Imbalanced nutrition: less than body requirements
b. Risk for hypothermia
c. Ineffective breathing pattern
d. Impaired gas exchange
RATIO: An ineffective breathing pattern is a condition of inadequate ventilation due to an
impairment in the mechanism of inspiration and expiration. Prolonged inadequate ventilation
may lead to compromised respiratory function performance, such as providing oxygen for the
tissues, and removing waste products.
SITUATION: Rhea, a 32-year-old primigravida at 39-40 weeks AOG was admitted to the labor
room due to hypogastric and lumbo-sacral pains. Internal examination revealed a fully dilated,
fully effaced cervix. Station 0.
6. She is immediately transferred to the DR table. Which of the following conditions signify
that delivery is near?
a. A desire to defecate
b. Begins to bear down with uterine contraction
c. Perineum bulges
d. All of the above
RATIO: When delivery is near, baby drops, cervix dilates, cramps and increased back pain and
Loose-feeling joints.
7. Artificial rupture of the membrane is done. Which of the following nursing diagnoses is the
priority?
a. High risk for infection related to membrane rupture
b. Risk for injury related to prolapsed cord
c. Alteration in comfort related to increasing strength of uterine contraction
d. Anxiety related to unfamiliar procedure
RATIO: Amniotomy does not hurt or cause pain to the mother or the baby. The mother may
experience a little discomfort when the amniotic hook
(the instrument to perform amniotomy) is passed through the birth canal.
typically followed by increased contractions to facilitate labor.
Amniotomy is
8. Rhea complains of severe abdominal pain and back pain during contraction. Which two of
the following measures will be MOST effective in reducing pain?
a. Rubbing the back with a tennis ball and effleurage
b. Guided imagery
c. Proper breathing techniques
d. Offer warm compresses
RATIO: The conscious relaxation and controlled breathing of the Lamaze method can be a
useful and effective comfort strategy during childbirth.
9. Lumbar epidural anesthesia is administered. Which of the following nursing responsibilities
should be done immediately following procedure?
a. Reposition from side to side
b. Administer oxygen
c. Increase IV fluids as indicated
d. Assess for maternal hypotension
RATIO: Clinical observations are to continue until the epidural has ceased including hourly
sedation, heart rate, respiratory rate, pain score (while
awake). Blood pressure and
temperature are to be assessed 4 hourly until the epidural has ceased.
10. Which is NOT the drug of choice for epidural anesthesia?
a. Sensorcaine
b. Xylocaine
c. Ephedrine
d. Marcaine
RATIO: Xylocaine (lidocaine HCl) Injections are sterile, nonpyrogenic, aqueous solutions
that contain a local anesthetic agent with or without
epinephrine and are administered parenterally by injection. See INDICATIONS for specific uses.
SITUATION: Mocha, a 27-year-old mother is at G4P3 at full term gestation is brought to the ER
after a gush of fluid passes through her vagina while shopping at the supermarket.
11. Mocha is brought to the emergency room. The fetal heart tone (FHT) is noted to be 116
beats per minute. Which of the following actions should the nurse do first?
a. Monitor FHT every 15 minutes
b. Administer oxygen inhalation
c. Ask the charge nurse to notify the obstetrician
d. Place her on the left lateral position
RATIO: A normal fetal heart rate (FHR) usually ranges from 120 to 160 beats per minute (bpm)
in the in utero period. It is measurable sonographically from around 6 weeks and the normal
range varies during gestation, increasing to around 170 bpm at 10 weeks and decreasing from
then to around 130 bpm at term.
12. Nurse Jhunela checks the perineum of Mocha. Which of the following characteristic of the
amniotic fluid would cause an alarm to the nurse?
a. Greenish
b. Scanty
c. Colorless
d. Blood tinged
RATIO: All the other choices are normal signs of the amniotic fluid, or as to what it should look
like. Fluid that looks green or brown usually means that the baby has passed the first bowel
movement (meconium) while in the womb. (Usually, the baby has the first bowel movement
after birth.) If the baby passes meconium in the womb, it can get into the lungs through the
amniotic fluid.
13. Mocha asks nurse Jhunela, "Why do I have to be on complete bed rest? I am not comfortable
in this position." Which of the following response of the nurse is most appropriate?
a. Keeping you on bed rest will prevent the possibility of cord prolapse b. Completed bed
rest will prevent more amniotic fluid to escape
c. You need to conserve your energy so you will be strong enough to push later during
the delivery
d. Let us ask your obstetrician when she returns to check on you
RATIO: In most cases, bed rest is used to give the body it's best chance to normalize. Bed rest
will be used with women who have conditions related to high blood pressure in order to decrease
stress and lower blood pressure.
14. Mocha wants to know how many fetal movements per hour is normal, the correct response
of nurse Jhunela would be
a. Twice
b. Thrice
c. Four times
d. 10-12 times
RATIO: A common way to do a kick count is to see how much time it takes to feel 10 movements.
Ten movements (such as kicks, flutters, or rolls) in 1 hour or less are considered normal. But do
not panic if you do not feel 10 movements. Less activity may simply mean the baby is sleeping.
15. Upon examination by the obstetrician, he charted that Mocha is in the early stage of labor.
Which of the following is true in this state?
a. Self-focused
b. Effacement is 100%
c. Lasts for 2 hours
d. Cervical dilatation of 1-3 cm
RATIO: Your cervix starts out three to four centimeters long. When it is 50 percent effaced, it is
about two centimeters long. When it is 100 percent effaced, it is "paper-thin." Effacement can
happen over days before labor starts.
SITUATION: Baby boy Berlin was delivered spontaneously following a term pregnancy. Apgar
scores are 8 and 9 respectively. Routine procedures are carried out.
16. When is the APGAR Score taken?
a. Immediately after birth and at 30 minutes after birth
b. At 5 minutes after birth and at 30 minutes after birth
c. At 1 minute after birth and at 5 minutes afterbirth
d. d. Immediately after birth and at 5 minutes after birth
RATIO: The Apgar score describes the condition of the newborn infant immediately after birth
and, when properly applied, is a tool for standardized assessment 18. It also provides a
mechanism to record fetalto-neonatal transition. Apgar scores do not predict individual mortality
or adverse neurologic outcome.
17. The best way to position a newborn during the first week of life is to lay him
a. Prone with head slightly elevated
b. On his back, flat
c. On his side with his head flat on bed
d. On his back with head slightly elevated
RATIO: In addition to avoiding inclined surfaces, the commission is reminding parents that
babies can suffocate if they sleep with blankets, pillows, or other items. The safest way for a
baby to sleep is flat on their back, in a bare crib, and on a flat, firm surface.
18. Baby boy Berlin has large sebaceous glands on his nose, chin, and forehead. These are
known as
a. Milia
b. Lanugo
c. Hemangiomas
d. Mongolian spots
RATIO: A sebaceous gland is a microscopic exocrine gland in the skin that opens into a hair follicle
to secrete an oily or waxy matter, called sebum, which lubricates the hair and skin of mammals.
19. Baby boy Berlin must be carefully observed for the first 24 hours for?
a. Respiratory distress
b. Duration of cry
c. Frequency of voiding
d. Range in body temperature
RATIO: Preterm birth, intrapartum-related complications (birth asphyxia or lack of breathing at
birth), infections and birth defects cause most neonatal deaths.
20. According to the WHO, when should the mother starts breastfeeding the infant?
a. Within 30 minutes after birth
b. Withing 12 hours after birth
c. Within a day after birth
d. After infant’s condition establishes
RATIO: WHO and UNICEF recommend that children initiate breastfeeding within the first hour
of birth and be exclusively breastfed for the first 6 months of life – meaning no other foods or
liquids are provided, including water. Infants should be breastfed on demand – that is as often
as the child wants, day and night.
SAS 6
1.A client, 12 weeks’ gestation, comes to the prenatal clinic complaining of severe nausea and
frequent vomiting. The nurse suspects that this client has hyperemesis gravidarum and knows
that this is frequently associated with
a. Excessive amniotic fluid
b. A GI history of cholecystitis
c. High levels of chorionic gonadotropin hormone
d. Slowed secretion of free
hydrochloric acid
RATIONALE: The usual findings for a woman suffering from hyperemesis gravidarum is having
high levels of serum HCG. Normal level at around 12 weeks gestation should be at 25,700–
288,000 mIU/mL.
2.A client in the thirty-third week of pregnancy begins to experience contractions. She is to be
treated at home with bed rest. The teaching plan for this client should include the information
that the client
a. Needs to have the foot of the bed raised on blocks
b. Needs to sit in bed with several large pillows
supporting her back
c. Should be placed on her side with her head raised on a small pillow
d. Should assume the knee-chest position every 2 hours for 10 minutes while awake
RATIONALE: The best lying or sleeping position might vary. No matter in what position you lie,
place a pillow under your head, but not your shoulders. The pillow should be a thickness that
allows your head to be in a normal position to avoid training your back. You might also want to
put a pillow between your legs for support.
3.In the fifth month of pregnancy, ultrasonography is performed on a client. The results indicate
that the fetus is small for gestational age and there is evidence of a low-lying placenta. The
nurse would use this information in the last trimester of pregnancy by assessing the client for
signs of possible
a. Placenta previa
b.
Premature labor
c.
Abruptio placenta
d.
Precipitate delivery
RATIONALE: Neonates from pregnancies with placenta previa have a mild increase in the risk
of intra-uterine growth restriction (IUGR)/small for gestational age (SGA).
4.A client experiences an episode of painless vaginal bleeding during the last trimester. The nurse
realizes that this may be caused by
a. Placenta previa
b. Abruptio placenta
c. Frequent intercourse
d. Excessive alcohol ingestion
RATIONALE: Symptomatic placenta previa usually manifests as vaginal bleeding in the late
second or third trimester, often after sexual intercourse. The bleeding typically is painless unless
labor or placental abruption occurs.
5.The care of a client with placenta previa includes
a. Vital signs at least once per shift
b. A tap-water enema before delivery
c. Observation and recording of the bleeding
d. Limited ambulation until bleeding stops
RATIONALE: Continued bleeding can put the fetus in jeopardy. The client should be restricted
to complete bed rest until bleeding stops. Vital signs should be recorded every 4 hours until
bleeding stops.
6.A client is admitted with the diagnosis of possible placenta previa. Following the physician’s
orders, the nurse starts IV fluids, administers oxygen, and draws blood for laboratory tests. The
client’s apprehension is increasing and she asks the nurse what is happening. The nurse tells her
not to worry, that she is going to be all right, and everything is under control. The nurse’s
statements are
a. Adequate, since all preparations are routine and need no explanation
b. Proper, since the client’s anxieties would be increased if she knows the dangers
c. c. Correct, since only the physician should explain why treatments are being done
d. Questionable, since the client has the right to know what treatment is
being given and why
RATIONALE: The client’s rights have been violated. All clients have the right to a complete and
accurate explanation of treatment based on cognitive ability
7.A client comes to the clinic for a sonography at 36 weeks’ gestation.
Before the test begins, the client complains of severe abdominal pain. Heavy vaginal bleeding
is noted and the client’s BP drops while her pulse rate increases. The nurse should suspect
that the client has
a. Hydatidiform mole
b. Endometriosis
c. Marginal placenta previa
d. Complete abruptio placenta
RATIONALE: The signs and symptoms are associated with abruptio placenta. Signs and
symptoms of placenta previa include, bright red painless bleeding, and placenta is situated at
the lower aspect of the uterus. A hydatidiform mole is growth of an abnormal fertilized egg or
an overgrowth of tissue from the placenta. Women appear to be pregnant, but the uterus
enlarges much more rapidly than in a normal pregnancy.
8.Which of the following would be the initial action of a nurse to a mother who is suffering
from abruptio placenta?
a. Monitor for contractions
b. Obtain baseline vital signs and measure the abdominal girth
c. Monitor fetal heart tone
d. Measure the urine output of the mother
RATIONALE: The initial nursing action should always be assessment which should be Letter B.
obtaining baseline information and measuring the abdominal girth is important in order to
compare later results and changes. The nurse should always follow the steps in the nursing
process.
9.Abruptio placenta is most likely to occur in a woman with
a. Cardiac disease
b. Hyperthyroidism
c. Cephalopelvic disproportion
d. Pregnancy-induced hypertension
RATIONALE: High blood pressure during pregnancy can affect the development of the placenta,
causing the nutrient and oxygen supply to the baby to be limited. This can lead to an early
delivery, low birth weight, placental separation (abruption) and other complications for the baby.
10. The nurse must anticipate for which of the following complications of the blood that may
occur after abruptio placenta?
a. Thrombosis
b. Disseminated intravascular coagulation
c. Cerebrovascular accident
d. Deep vein thrombosis
RATIONALE: Disseminated intravascular coagulation due to placental
abruption with
intrauterine fetal death is not uncommon. It can result in increased maternal mortality rates and
the need for hysterectomy or greater transfusion volumes if the delivery is not completed within
six to eight hours.
11. The first assessable objective sign of a seizure in a client with eclampsia is frequently
a. Epigastric pain, nausea, and vomiting
b. Persistent headache and blurred vision
c. Spots or flashes of light before the eyes
d. Rolling of the eyes to one side with a fixed stare
RATIONALE: Rolling of the eyes to one side with a fixed stare is a sign of central nervous system
involvement that the nurse can see without obtaining subjective data from the client. It is a sign
of an impending seizure.
12. Which of the following would be the definitive treatment for pregnancy-induced
hypertension? a. Oral antihypertensives
b. Magnesium sulfate
c. Diuretics
d. Delivery
RATIONALE: The definitive treatment of preeclampsia is delivery
13. When giving magnesium sulfate to a severely preeclamptic mother who is at 25 weeks
AOG, the nurse must prepare which of the following medications at the bedside in case
magnesium toxicity occurs?
a. Potassium chloride
b. Aluminum hydroxide
c. Calcium gluconate
d. Spironolactone
RATIONALE: Calcium gluconate is the antidote for magnesium sulfate toxicity. Calcium
Gluconate is the gluconate salt of calcium. An element or mineral necessary for normal nerve,
muscle, and cardiac function, calcium as the gluconate salt helps to maintain calcium balance
and prevent bone loss when taken orally.
14. Which of the following assessment findings from the patient would the nurse suspect for
her to have pregnancy-induced hypertension?
a. Nausea and vomiting usually felt by the mother in the morning
b. The mother tells you that she no longer can wear her wedding ring
c. Complains that she has difficulty defecating
d. Reports of frequency of urination especially in the afternoon
RATIONALE: One of the signs of having preeclampsia is edema of the hands and face. If the
mother can no longer wear her wedding ring this may indicate that her fingers are edematous
due to PIH.
15. The nurse understands that the diabetic mother’s metabolism is significantly altered
during pregnancy as a result of
a. The lower renal threshold for glucose
b. The increased effect of insulin during pregnancy
c. An increase in the glucose tolerance level of the blood
d. The effect of hormones produced in pregnancy on carbohydrate and lipid metabolism
RATIONALE: In pregnancy, the hormones that are secreted by the placenta make the mother’s
body less responsive to insulin. This is known as insulin resistance. It should be noted that all
pregnancies have a degree of insulin resistance in order to make nutrients in the maternal
bloodstream available for the growing fetus.
16. Which of the following conditions may happen to the fetus in a mother who is diagnosed to
have gestational diabetes?
a. Small-for gestational age
b. Hydrocephaly
c. Large-for gestational age
d. Low birth weight
RATIONALE: The increased risk of macrosomia in GDM is mainly due to the increased insulin
resistance of the mother. In GDM, a higher amount of blood glucose passes through the placenta
into the fetal circulation. As a result, extra glucose in the fetus is stored as body fat causing
macrosomia, which is also called ‘large for gestational age'.
17. A mother was assessed for the type of abortion that she may have, the cervix is still
closed, there is slight bleeding and mild uterine contractions, the fetus is still in the womb
of the mother. Which among the following is happening?
a. Threatened abortion
b. Missed abortion
c. Complete abortion
d. Incomplete abortion
RATIONALE: A threatened abortion is defined as vaginal bleeding before 20 weeks gestational
age in the setting of a positive urine and/or blood pregnancy test with a closed cervical os, without
passage of products of conception and without evidence of a fetal or embryonic demise.
18. Which of the following is NOT a characteristic of ectopic pregnancy
a. Any gestation outside the uterine cavity
b. Most frequent in the fallopian tubes, where the tissue is incapable of the growth needed to
accommodate pregnancy, so rupture of the site usually occurs before 12 weeks.
c. Any condition that diminishes the tubal lumen may predispose a woman to ectopic
pregnancy.
d. There is also a low lying placenta present during the ultrasonography
RATIONALE: Choices A, B, and C is true for ectopic pregnancy while letter
D is not true and is indicative of a condition known as placenta previa
19. Which of the following laboratory findings would be significant in the mother who has
ectopic pregnancy a. Increased hematocrit and hemoglobin levels
b. Decreased hematocrit and hemoglobin levels
c. Elevated red blood cell count
d. Decreased white blood cell count
RATIONALE: Low hemoglobin and hematocrit values, together with higher gravidity at the time
of admission, may indicate an increased risk of tubal rupture.
20. The characteristic pain of a mother who has ectopic pregnancy is
a. Pain felt just above the symphysis pubis of the mother
b. Pain felt during contractions of the uterus
c. Pain felt at one side of the abdomen
d. Pain felt at the right lower quadrant of the abdomen
RATIONALE: The pain felt by the mother with ectopic pregnancy is usually one-sided in the
lower abdomen. Since only one fallopian tube is affected in this type of pregnancy
SAS 7
1. A 22-year old woman named Riza has been brought into the delivery room and was
diagnosed to have tachysystole labor. What would be the characteristic of tachysystole labor?
a. Infrequent and brief contractions
b. More than 5 contractions per 10 minute intervals in 2 consecutive intervals
c. Prolonged active phase
d. Uterus can be easily indented by the fingertip
RATIO: Uterine tachysystole (more than 5 contractions per 10 minutes in 2 consecutive intervals)
is common during labour, particularly with use of labour-stimulating agents. Tachysystole may
reduce fetal oxygenation by interrupting maternal blood flow to the placenta during contractions.
Reducing uterine contractions may improve placental blood flow, improving fetal oxygenation.
2. Which of the following would contribute to the pain felt by the mother during tachysystole
labor?
a. Cephalopelvic disproportion
b. Malpresentation
c. Anoxia
d. Malposition
RATIO: Malpositions are abnormal positions of the vertex of the fetal head (with the occiput as
the reference point) relative to the maternal pelvis. Malpresentations are all presentations of the
fetus other than vertex.
3. A 25-year old woman named Josefina is in the delivery room has been diagnosed to have
hypotonic labor. The nurse would confirm the diagnosis with the presence of which of the
following characteristics?
a. Contractions has more than 90 seconds duration
b. Frequency of contractions are less than 2 minutes
c.
The number of contractions is usually infrequent which isnot more than 2 or
3 occurring in a 10-mute period
d. Strong and frequent contractions
RATIO: Hypotonic labor is an abnormal labor pattern, notable especially during the active phase
of labor, characterized by poor and inadequate uterine contractions that are ineffective to cause
cervical dilation, effacement, and fetal descent, leading to a prolonged or protracted delivery.
4. Which of the following cases would strongly contribute to the hypotonic labor of
the mother?
a. Nulliparity
b. Polyhydramnios
c. Small for gestational age fetus
d. Grand multiparity
RATIO: Hypotonic contractions occur as a result of fetopelvic disproportion, fetal malposition,
overstretching of the uterus caused by a large newborn, multifetal gestation, or excessive
maternal anxiety. The woman with
hypotonic contractions can become exhausted and
dehydrated.
5. In order for the nurse to prevent the occurrence of hypotonic labor, the nurse should avoid
excessive use of which of the following medications?
a. Oxytocin
b. Methergine
c. Sedatives
d. Analgesic
RATIO: Sedatives can cause uterine muscle relaxation which can worsen the labor of a mother
who is suffering from a hypotonic labor. In order to increase the force of contractions of mothers
with this condition, oxytocin is further increased.
6. During hypotonic labor the fetus may be in distress. When the obstetrician has performed
amniotomy, which of the following is the nurse going to do?
a. Observe for the odor of the amniotic fluid
b. Determine the amount of amniotic fluid present
c. Observe for the color of the amniotic fluid
d. Check for the presence of blood in the amniotic fluid
RATIO: Amniotic fluid usually is clear and odorless. However, in certain circumstances, the
fluid may either contain meconium or may be blood tinged. It is important to note the color of
the fluid at the time of rupture.
7. When assessing the mother who is undergoing hypotonic labor the nurse must assess signs
of infection if the labor is already prolonged. Which of the following would indicate that the
mother has an infection?
a. Fetal bradycardia
b. Presence of meconium in the amniotic fluid
c. Fever and chills
d. Distended bladder
RATIO: Fever and chills are indication that mother has an infection.
8. If induction of labor is unsuccessful and full dilatation has not occurred when the mother has
hypotonic labor the next step that the nurse is going to expect for the obstetrician to do is
a. Prep the mother for caesarean section
b. Use assistive tools such as forceps
c. Help the mother in the labor through vacuum extraction
d. d. Perform an episiotomy
RATIO: If all measures by the obstetrician has been made and are unsuccessful the next thing
that the nurse is going to anticipate is for the physician to perform CS. Letters B, C, and D
are no longer helpful since these choices need the full dilatation of the cervix.
9. During an ultrasonography the physician has noticed that the baby’s hips and knees are flexed
so that the baby is sitting cross-legged, with feet beside the bottom. What is being presented in
this situation?
a. Frank breech
b. Incomplete breech
c. Complete breech
d. Footling breech
RATIO: Complete breech is when both of the baby's knees are bent and his feet and bottom are
closest to the birth canal. Incomplete breech is when one of the baby's knees is bent and his
foot and bottom are closest to the birth canal. Frank breech is when the baby's legs are folded
flat up against his head and his bottom is closest to the birth canal. There is also footling breech
where one or both feet are presenting.
10. Which of the following conditions must the nurse alert to the obstetrician when
performing a delivery?
a. Cord prolapse
b. Rupture of membranes
c. Crowning of head
d. External rotation of the head
RATIO: Umbilical cord prolapse is an uncommon but potentially fatal obstetric emergency. When
this occurs during labor or delivery the prolapsed cord is compressed between the fetal presenting
part and the cervix. This can result in a loss of oxygen to the fetus, and may even result in a
stillbirth.
11. When the fetus is in a breech presentation, the nurse must perform which of the
following procedures early in labor?
a. Ritgen’s maneuver
b. Episiotomy
c. External cephalic version
d. Fundal push
RATIO: ECV is one way to turn a baby from breech position to head down position while it’s still
in the uterus. It involves the doctor applying pressure to your stomach to turn the baby from the
outside. Sometimes, they use ultrasound as well.
12. Vaginal breech delivery is done by a skilled health care provider and is safe and feasible
under the following conditions EXCEPT
a. Adequate clinical pelvimetry
b.
Complete or frank breech
c.
Had a previous caesarean section for cephalopelvic disproportion 2 years
ago
d.
d. Fetus has a flexed head
RATIO: Cephalopelvic disproportion (CPD) is a pregnancy complication in which there is a size
mismatch between the mother’s pelvis and the fetus’ head or in this case the baby’s feet and
bottom. The baby’s head/ bottom is proportionally too large or the mother’s pelvis is too small
to easily allow the baby to fit through the pelvic opening. This can make vaginal delivery
dangerous or impossible.
13. During ultrasonography the obstetrician has found out that the fetus is in a complete breech
presentation on the 28th week age of gestation. The doctor will attempt to perform external
version at what week?
a. 37 weeks
b. 32 weeks
c. 38 weeks
d. 30 weeks
RATIO: If your baby is still in a breech position at 36 weeks, your doctor or midwife might
suggest you consider an external cephalic version, or ECV. The aim is to turn your baby so that
it is head-down when labour starts.
An ECV is performed after 37 weeks of pregnancy.
14. Caesarean section will be performed if the type of breech presented is
a. Complete breech
b. Frank breech
c. Double footling breech
d. None of the above
RATIO: A frank breech presentation is preferred when vaginal delivery is attempted. Complete
breeches and footling breeches are still candidates, as long as the presenting part is well applied
to the cervix. For transverse babies, It is almost impossible to deliver a transverse baby
vaginally. So if a baby is still lying sideways at term or when labor begins, a C-section
(caesarean) may be the safest option for delivering the baby.
15. In a transverse type of position, the presenting part is usually
a. One of the shoulders
b. An iliac crest
c. A hand
d. Any of the above
RATIO: In the transverse lie, the presentation is usually the back or shoulder; in the oblique lie,
it is usually the shoulder or the arm.
16. This type of presentation is caused by hyper-extension of the fetal head so that neither
the occiput nor the sinciput is palpable on vaginal examination
a. Sinciput
b. Occiput
c. Transverse
d. Face
RATIO: Face presentation is caused by hyper-extension of the fetal head so that neither the
occiput nor the sinciput are palpable on vaginal examination. On abdominal examination, a
groove may be felt between the occiput and the back. On vaginal examination, the face is
palpated, the examiner’s finger enters the mouth easily and the bony jaws are felt.
17. Which of the following is true with regards to face chin-anterior position
malpresention?
type of
a. Descent and delivery of the head may occur
b. The fully extended head is blocked by the sacrum which prevents descent and labor
is arrested
c. Labor progress is slowed with slowed descent of the fetal head
d. Fetus lies horizontally in the pelvis so that the longest fetal axis is perpendicular to that of the
mother
RATIO: The chin serves as the reference point in describing the position of the head. It is
necessary to distinguish only chin-anterior positions in which the chin is anterior in relation to
the maternal pelvis. In the chinposterior position, however, the fully extended head is blocked
by the sacrum. This prevents descent and labour is arrested.
18. Which of the following medical procedures is avoided during a face presentation?
a. Augmentation of labor with oxytocin
b. Caesarean section
c. Delivery by forceps
d. Vacuum extraction
RATIO: There is an increased risk of trauma to the baby when the face presents first, and the
physician should not internally manipulate (try to rotate) the baby. In addition, the physician
must not use vacuum extractors
or manual extraction (grasping the baby with hands) to pull the baby from the uterine cavity.
19. When assessing for the well-being of the fetus the nurse must monitor which of the following
if the fetus is malpresented?
a. Vital signs of the mother
b. Fetal heart beat
c. Maternal contractions
d. Maternal respirations
RATIO: If there are fetal heart rate abnormalities (less than 100 or more than 180 beats per
minute), suspect fetal distress.
20. Kiara the mother who is already prolonged in labor says to the nurse,
“This is hopeless; I really can’t do it anymore. I’m so much frustrated.”
Which of the following nursing responses is most therapeutic
a.
“The doctor is doing everything she can in order to help you get past this labor.”
b.
“Would you opt to be placed in a caesarean section instead?”
“It must be hard for you to be experiencing this. But let’sthink positive and be
patient, you can still do this.”
c.
d.
“We’ll see other options that we can do in order to augment this labor that you are
experiencing.”
RATIO: Comfort measures that provide natural pain relief can be very effective during labor
and childbirth. Birthing techniques such as hydrotherapy, hypnobirthing, patterned breathing,
relaxation, and visualization can increase the production of endogenous endorphins that bind
to receptors in the brain for pain relief.
SAS 8
1. Nurse Nami is currently visiting the Dimatulac family 2 weeks after being discharged from the
hospital. Upon observation, the nurse notes that the umbilical cord has dried and fallen off. The
area appears to have healed with no discharges or erythema present. The mother can be taught
to
a.Cover the umbilicus with a band-aid
b. Continue to clean the stump with 70% alcohol for a week
c. Apply an antibiotic ointment on the stump
d. Give the infant a tub bath now
RATIONALE: When your baby is born the umbilical cord is cut and there is a stump left. The
stump should dry and fall off by the time your baby is 5 to 15 days old. ... Sponge bathe the rest
of your baby, as well. DO NOT put your baby in a tub of water until the stump has fallen off.
2. Aling Jona a mother of a term newborn has curiously asked about the thick, white, cheesy
coating on her son’s skin. The nurse must correctly describe this as a. lanugo
b. milia
c. café-au-lait spots
d. vernix caseosa
RATIONALE: Vernix caseosa, also known as vernix or birthing custard, is the waxy white
substance found coating the skin of newborn human babies. It is produced by dedicated cells and
is thought to have some protective roles during fetal development and for a few hours after birth.
3. When Nurse Kiara is assessing the newborn, she has noted that the newborn has caput
succedaneum. Which of the following statements about this condition is correct?
a. It usually resolves within 3 to 6 weeks
b. It involves swelling of tissue over the presenting part of the presenting head
c. It doesn’t cross the cranial suture lines
d. It’s a collection of blood between the skull and the periosteum
RATIONALE: Caput succedaneum involves diffuse swelling of the scalp, with subcutaneous fluid
collection unrelated to the periosteum with poorly defined margins.
4. Nurse Diwata is attending a newborn. To help her limit the development of hyperbilirubinemia
in the newborn, her plan of care for her patient should include
a. Monitoring for the passage of meconium each shift
b. Instituting phototherapy for 30 minutes every 6 hours
c. Substituting breastfeeding for formula during the 2nd day after birth
d. Supplementing breastfeeding with glucose water during the first 24 hours
RATIONALE: Bilirubin is excreted via GI tract; if meconium is retained, the bilirubin is reabsorbed.
5. Nurse Gian is preparing to administer a vitamin K shot to a newborn. Aling Julia is asking
the nurse why her newborn infant needs the injection. The best nursing response would be
a.
“Your infant needs vitamin K to develop immunity passive artificial immunity.”
b.
“Vitamin K will protect your infant from having jaundice.”
c.
“Newborn infants are deficient in vitamin K, and this shot will prevent your infant from any
abnormal bleeding.”
d.
“Newborns have sterile bowels, and vitamin K will help promote the growth of good bacteria
in the digestive tract.”
RATIONALE: Vitamin K helps the blood to clot and prevents serious bleeding. In newborns,
vitamin K injections can prevent a now rare, but potentially fatal, bleeding disorder called 'vitamin
K deficiency bleeding' (VKDB), also known as 'haemorrhagic disease of the newborn' (HDN).
6. A preterm neonate is to be fed with breast milk through the nasogastric tube. The nurse
recognizes that breast milk is preferred over formula milk because it
a. Has fewer fatty acids
b. Provide antibodies
c. Is higher in carbohydrates
d. Contains more lactose
RATIONALE: Breast milk is ideal for the preterm baby who needs additional protection against
infection through maternal antibodies.
7. Nurse Santibanez is admitting a preterm newborn to the nursery. The nurse should assess
which of the following from this newborn?
a. Clavicle fracture
b. Palsies
c. Respiratory distress
d. Shoulder dystocia
RATIONALE: Respiratory distress syndrome (RDS) is a common problem in premature babies.
It can cause babies to need extra oxygen and help with breathing. RDS occurs most often in
babies born before the 28th week of pregnancy and can be a problem for babies born before 37
weeks of pregnancy.
8. Nurse Mikasa is caring for a newborn who has just been diagnosed with hypospadias. After
discussing the defect with the parents, the nurse must teach that
a. Surgery will be performed in stages
b. Initial repair is delayed until the age of 6 to 8
c. post-operative appearance will be normal
d. Circumcision can be performed at any time
RATIONALE: Hypospadias repair is done most often when boys are between 6 months and 2
years old. The surgery is done as an outpatient. The child rarely has to spend a night in the
hospital.
9. A full-term newborn was just born. Nurse Sasha must know that the most important
nursing intervention to perform first would be
a. Assessing the APGAR score
b. Remove the wet blankets
c. Apply eye prophylaxis
d. Elicit the Moro reflex
RATIONALE: When newborns are wet they can become hypothermic from heat loss resulting from
evaporation. They may then develop cold stress syndrome.
10. Which of the following newborns is at highest risk for cold stress syndrome?
a. Neonate who has Trisomy 21
b. Infant who has a diabetic mother
c. Infant with erythroblastosis fetalis
d. post-term infants
RATIONALE: Cold stress syndrome (CSS) in the Florida manatee Trichechus manatus latirostris
has been defined as morbidity and mortality resulting from prolonged exposure to water
temperatures <20°C.
11. A newborn is born with erythroblastosis fetalis. Which of the following signs and symptoms
would the nurse expect to observe?
a. Ruddy complexion
b. Erythema toxicum
c. Anasarca
d. Alopecia
RATIONALE: Babies born with erythroblastosis fetalis often are in severe congestive heart failure
and, therefore, exhibit anasarca.
12. Four newborns with the following conditions are in the well-baby nursery. The baby with
which of the following conditions is at high risk for physiological jaundice?
a. Mongolian spots
b. Harlequin coloring
c. Cephalhematoma
d. Caput succedaneum
RATIONALE: Newborns with a cephalhematoma have a collection of blood that will need to be
reabsorbed and will be at greater risk for developing physiological jaundice.
13. Nurse Angel notes that a 6-hour-old newborn has cyanotic hands and feet. Which of
the following nursing interventions would be appropriate?
a. Assess oxygen saturation with the pulse oximeter
b. Swaddle the newborn in a blanket
c. Place the child under the UV light
d. Administer oxygen
RATIONALE: The baby's extremities are cyanotic as a result of the baby's immature circulatory
system. Swaddling helps to warm the baby's hands and feet. Acrocyanosis, or bluish discoloration
of the hands and feet in the neonate (also called peripheral cyanosis), is a normal finding and
shouldn't last more than 24 hours after birth.
14. The nursing history for a newborn suspected of having pyloric stenosis would most likely
reveal which of the following?
a. Frequent vomiting of bile-stained fluid
b. Cyanosis and vomiting immediately after feedings
c. Mild emesis progressing to projectile vomiting
d. Absence of gastrointestinal peristalsis
RATIONALE: Pyloric stenosis is a problem that affects babies between birth and 6 months of age
and causes forceful vomiting that can lead to dehydration. It is the second most common problem
requiring surgery in newborns. The lower portion of the stomach that connects to the small
intestine is known as the pylorus.
15. Nurse Alyana is assessing the reflexes of a newborn. The nurse assesses which of
the following reflexes by placing a finger in the newborn’s mouth?
a. Sucking reflex
b. Landau reflex
c. Babinski reflex
d. Moro reflex
RATIONALE: The sucking reflex is tested by placing something, such as a finger, in the infant’s
mouth and seeing if the infant begins to suck on the object. The Moro reflex is tested by suddenly
lowering the newborn’s body. The infant should demonstrate a bilateral arm extension and leg
flexion. The rooting reflex is tested by stroking the cheek. The infant may open the mouth. The
Babinski reflex is tested by firmly stroking the plantar surface. The anticipated response is the
incurving of the toes as in plantar the grasp, with uncurling and fanning out
16. Nurse Kim is assessing a newborn on admission to the NICU. Which of the following
findings should the nurse report to the attending physician?
a. Intercostal retractions
b. Caput succedaneum
c. Epstein’s pearls
d. Harlequin sign
RATIONALE: Intercostal retractions occur when the muscles between the ribs pull inward. The
movement is most often a sign that the person has a breathing problem. Intercostal retractions
are a medical emergency.
17. An indirect bilirubin level at birth is 1 to 4 mg/100 ml. any increase over this amount reflects
the release of bilirubin as excessive red blood cells begin their breakdown. To treat the occurrence
of jaundice brought by these events it is important for the newborn to undergo?
a. Vaccination
b. Phototherapy
c. Cord dressing
d. APGAR scoring
RATIONALE: Phototherapy is a type of medical treatment that involves exposure to fluorescent
light bulbs or other sources of light like halogen lights, sunlight, and light emitting diodes (LEDs)
to treat certain medical conditions.
18. If the newborn’s APGAR score is zero. Which of the following would be the best nursing
intervention?
a. Resuscitate the patient
b. Place the patient in close monitoring
c. Do nothing since the patient is a well-baby
d. Inject IV epinephrine
RATIONALE: An Apgar score that remains 0 beyond 10 minutes of age may, however, be useful
in determining whether continued resuscitative efforts are indicated because very few infants
with an Apgar score of 0 at 10 minutes have been reported to survive with a normal neurologic
outcome 3 4 5.
19. Assess the Apgar score of the female infant with the following assessments: the infant
appears blue overall, she grimaces when slapped on the foot and when a catheter is placed in
her nostril, the heart has 72 beats per minute, there is some flexion of the extremities and
there is a slow weak cry. What is the APGAR score?
a. 2
b. 3
c. 4
d. 5
RATIONALE: Appears blue overall – 0; grimaces when slapped on the foot –
1; heart rate of 72 bpm – 1; some flexion of extremities – 1; slow weak cry – 1; (0+1+1+1+1=4)
20. Upon assessing the newborn child on his fifth minute you have observed for the following:
the child’s heart rate is 123 beats per minute, there is a slow, irregular weak cry, he sneezes
when a catheter is placed in his nostril, he grimaces when the foot is slapped and there is
acrocyanosis.
What is the APGAR score?
a. 6
b. 7
c. 8
d. 9
RATIONALE: The Apgar score describes the condition of the newborn infant immediately after
birth and, when properly applied, is a tool for standardized assessment 18. It also provides a
mechanism to record fetal to neonatal transition. Apgar scores do not predict individual mortality
or adverse neurologic outcome.
SAS 9
1.
The relationship that is of extreme importance in the formation of the personality is the
a. Peer
b. Sibling
c. Parent-child
d. Heterosexual
RATIO: The Parent-Child Relationship is one that nurtures the physical, emotional and social
development of the child. It is a unique bond that every child and parent will can enjoy and
nurture. This relationship lays the foundation for the child's personality, life choices and overall
behaviour.
An infant child named Giselle would learn to explore the environment through which of
the following?
a. mouth
b. hands
c. feet
d. eyes
2.
RATIO: Infants explore the world by mouthing objects or fingering them. This also helps
them separate self from environment.
A mother of a child tells the nurse, “I constantly see my five-year-old son fondling with
his genitals.” She appears tensed because according to him this may seem deviant for a
preschooler. The nurse should tell the father that
a. “This behavior is abnormal. You should scold your child when
you see him next time.”
b. “Just ignore the behavior of the child.”
c. “This act is to deviant. He probably will develop sexual disorders later on.”
d. “Tell the child to do it privately in his room. And make no issue out of it.”
3.
RATIO: Proper sex education must be done by parents that they should explain that certain
things are done in some places but not in others. Children can relate to this kind of direction
without feeling inhibited, just as they can accept the fact that they use bathroom in private or
eat only at the table.
A mother tells the nurse, “My 4-year-old daughter tells me that she hates me. What
should I do?” As a nurse you are going to tell her
a. “You may be mistreating your daughter. That’s why she hates you.”
b. “You should take your daughter out for a play sometimes for her to like you.”
c. “You should tell your daughter that you love her very much.”
d. “You should be patient about your daughter. She is undergoing a stage which
is normal for her. Just be supportive.”
RATIO: Electra complex is the strong emotional attachment of a preschool girl toward her father
is normal phenomenon
4.
A 2-year-old child named James is very curious about his environment. Which of the
following statements would be true about a toddler?
a. Allowing the toddler to explore his environment for him to learn while
providing him with safety.
5.
b. Inhibit all of the child’s desires.
c. Give in always to the child’s temper tantrums to stop the child from crying.
d. Be strict in the child’s toilet training.
RATIO: Babies are born learners, with a natural curiosity to figure out how the world works.
Curiosity is the desire to learn. It is an eagerness to explore, discover and figure things out.
Parents and caregivers don't have to “make” their children curious or “push” their children
to learn.
Which of the following would indicate that the adolescent has already developed a sense
of identity?
a. A teenager is performing poorly in his course because his parents chose the course for
him.
b. A teenager who is not satisfied with his course because her
friends goaded her to join them.
c. A teenager who secretly hides his sexuality to everyone, but in his thoughts, he is a
homosexual.
d. A teenager who excels very well in a course, and loves what he is studying.
6.
RATIO: Those who are able to develop a strong sense of identity are
better able to have self-confidence, or a sense of trust in their abilities, qualities, and
judgements.
7.
The infant named Juliana at this stage can say mam-ma and dad-da, plus 2 words such
as milk and water. She can also take her first few steps at this stage. Her birth weight has
already tripled. What month is she in?
a. 12 months
b. 11 months
c. 9 months
d. 10 months
RATIO: At 12 months, the weight of an infant triples and they can generally say two words
besides “ma-ma” and “da-da”; they use those two words with meaning.
Which of the following behaviors would a newly born infant who is named Kyla going to
demonstrate?
a. Playing with mobile toys
b. Patty Cake
c. Peek-a-Boo
d. Enjoys face of caregiver
8.
RATIO: Newborn enjoys watching a simple mobile.
A mother named Susan asks Nurse Joyce about the type of toys that are appropriate for
her child who is 10 months old. Which of the following must Nurse Joyce advise to the mother?
a. Mobile toys
b. Push or pull toys
c. Jack-in-the-box
d. Walker
9.
RATIO: 10 months old may enjoy playing with egg cartons, blocks, balls, stacking toys, and
push-pull toys.
Lavender Brown is crawling or creeping on the floor with her abdomen of it. She already
can exhibit the pincer grasp by using her thumb and forefinger. What month can she be in?
a. 6 months
b. 10 months
c. 11 months
d. 9 months
10.
RATIO: A major milestone of 10 months is the ability to bring the thumb and the first finger
together in a pincer grasp and the baby at 10 months could pulls self to standing from creeping
or crawling.
11.
During the assessment of the newborn Nurse Stella is stroking the side of the sole of the
foot in an inverted “J” curve from the heel upward, the newborn fans the toes. This is known
as
a. Moro reflex
b. Extrusion reflex
c. Babinski reflex
d. Rooting reflex
RATIO: Babinski reflex is one of the normal reflexes in infants. Reflexes are responses that occur
when the body receives a certain stimulus. The Babinski reflex occurs after the sole of the foot
has been firmly stroked. The big toe then moves upward or toward the top surface of the foot.
A mother named Janella is asking Nurse Jade when her son will be able to do toilet
training. Nurse Jade must know that physical readiness for toilet training occurs at age
a. 18-24 months
b. 36-42 months
c. 12-17 months
d. 43-50 months
12.
RATIO: Many children show signs of being ready for potty training between ages 18 and 24
months. However, others might not be ready until they're 3 years old. There's no rush. If you
start too early, it might take longer to train your child.
A her toddler son Charlie. When leaving the department toys he has seen.
When dealing with temper tantrums the parents must take into consideration the
following interventions EXCEPT
a. Give the toddler frequent opportunities to make developmentally appropriate choices.
b. Give in always to the child’s wants in order to prevent the child from having temper
tantrums.
c. Give the child advance warning of a request to help prevent temper tantrums.
d. Ignore tantrums when the toddler is seeking attention or trying to get what he
wants.
RATIO: The best approach for parents is to tell their child simply that they disapprove of the
tantrum and then ignore it. They might say, “I’ll be in the bedroom. When you’re done
kicking, you come into the bedroom, too.” Children who are left alone in a room this way
will usually not continue a tantrum but will stop after 1 or 2 minutes and rejoin their parents.
Parents should then accept the child warmly and proceed as if tantrum had not occurred.
13.
14.
A mother named Janine is observing her 6-year old daughter play with her friends at the
playground. She has seen them playing tag. This would be an example of which of the following
types of play?
a. Parallel play
b. Solitary play
c. Cooperative play
d. Competitive play
RATIO: Tag (also called tig, it, tiggy, tips, tick, tip) is a playground game involving two or more
players chasing other players in an attempt to "tag" and mark them out of play, usually by
touching with a hand.
Maria has belonged to a series of clubs for 9-year-old girls. A usual characteristic of clubs
for this age is
a. The club has formal rules and regulations
b. It is designed to help shy children socialize
c. It is designed for same-sex to spite or exclude another child
d. Clubs include both boys and girls
15.
RATIO: Nine-year-olds take the values of their peer group very seriously. They are much more
interested in how other children dress than in what their parents want them to wear. This is
typically the gang age because children form clubs, usually “spite clubs.” This means if there
are four girls on the block, three form a club and exclude the fourth. The reason for exclusion
is often unclear; it might be that the fourth child has a chronic disease, that she has more or
less money than the others, that she was at the dentist’s the day the club was formed, or simply
that the club cannot exist unless there is someone to exclude. Such clubs typically have a secret
password and secret meeting place. Membership is generally all girls or all boys.
A mother named Alison has consulted her nurse friend with regard to the types of play
that her school-aged child can do. Suggested play for the 9-12 years old include the following
EXCEPT
a. Sculpturing materials such as pottery clay
b. Model kits, collections and hobbies
c. Video game of a more mature content
d. Handicrafts of all kind
RATIO: Pottery is a fun and educational activity ideal for kids older than 4 years old.
16.
17.
This is one of the strongest motivating forces of behavior of the adolescents
a. Peers
b. Celebrities
c. Parents
d. Siblings
RATIO: Adolescence develop values through talking to peers and they
interact with peers to learn more about themselves and others.
have a need to
18.
Sharon a 15-year-old female has recently consulted the school nurse about certain fears.
What would be the major fear of the adolescent?
a. Fear of the dark
b. Fear of separation
c. Fear of body image disturbance
d. Fear of intrusive procedures
RATIO: During adolescence, physical changes are occurring that sometimes bother them.
A 4-yeard old child named Levi is talking to his toy cars and action figures. The mother
of this child seems bothered because she thinks that
her child may be developing
developmental disorders. What would be the best response by the nurse?
a. “Your son may really have a developmental disorder like autism. You need to see a
psychiatrist at once.”
b. “Your son’s behavior is normal for a preschooler. Just don’t make any issue out
of it.”
c. “Your son’s behavior is deviant. You should further observe your son for other signs.”
d. “You should apprehend your child immediately if you see this type of behavior again.”
RATIO: Preschoolers do not need many toys. Their imaginations are keener than they will be at
any other time in their lives, so they enjoy games that use imitation such as pretending to be
teachers, cowboys, firefighters, and store clerks. They imitate exactly what they see parents
doing: eating meals, mowing the lawn, cleaning the house, arguing, and so forth, so parents’
actions directly influence their behavior. Many preschoolers have imaginary friends as a normal
part of having an active imagination.
19.
Which is NOT true regarding the toddler’s toilet training?
a. Physical maturation must be reached before training is possible.
b. Helping the toddler understand the physiologic signals by pointing out behaviors
they display when they need to void or defecate.
c. Helping the toddler make the connection between dry pants and the toilet or potty
chair.
d. Bladder training comes first before bowel training.
RATIO: Toilet training need not start this early, however, because cognitively and socially, many
children do not understand what is being asked of them until they are 2 or even 3 years old. The
markers of readiness are subtle, but as a rule children are ready for toilet training when they
begin to be uncomfortable in wet diapers
20.
SAS 10
Situation 1: An infant named Russell was diagnosed to have Down syndrome. This syndrome
has a trisomy in the 21st chromosome causing certain abnormalities in the child.
The doctor explained to Russell’s parents that the type of Down syndrome that he has
is Mosaicism. Which of the following statements would best explain this type?
a. This kind of Down syndrome is frequently associated to women with advanced age.
b. There is mixture of normal cells and cells that are trisomic for 21.
c. Chromosome is transmitted by the mother who is a carrier but age is not a factor.
d. This type is inherited when the father is carrier of the genes that are trisomic for 21 and
a mother who is normal.
1.
RATIO: Mosaic Down syndrome, or mosaicism, is a rare form of Down syndrome. Down
syndrome is a genetic disorder that results in an extra copy of chromosome 21. People with
mosaic Down syndrome have a mixture of cells. Some have two copies of chromosome 21,
and some have three.
Nurse Gina, who is taking care of baby Russell noticed that there is speckling of the iris
of the child. This speckling is commonly known as
a. Mongolian spots
b. Kayser-Fleischer Ring
c. Brushfield’s Spots
d. Roth’s Spot
2.
RATIO: Spots, Brushfield's: Speckled iris. Little white spots that(are)slightly elevated on the
surface of the iris and are arranged in a ring concentric with the pupil. These spots occur in
normal children but are far more frequent in Down's syndrome (trisomy 21).
Russell is further assessed for other signs of Down syndrome. The nurse would indicate
that positive signs of Down syndrome are the following EXCEPT
a. Delayed or incomplete sexual development (men with Down syndrome usually are
infertile)
b. Inner epicanthic folds and oblique palpebral fissures
c. Hypotonic musculature (protruding abdomen, umbilical hernia)
d. Small head with a sloping forehead
3.
RATIO: Option A, B, and D are positive signs of Down syndrome.
The nurse is about to take the history of the parents of Russell. Which of the following
findings would show that the mother of Russell would indicate a high-risk factor to have a
child with Down syndrome?
a. The mother is suffering from adult-onset diabetes mellitus.
b. The mother during pregnancy took in liberal amounts of ferrous sulfate.
c. The mother is age 45 during her pregnancy.
d. The mother did not properly medicate herself with insulin during
pregnancy
4.
RATIO: One factor that increases the risk for having a baby with Down syndrome is the mother's
age. Women who are 35 years or older when they become pregnant are more likely to have a
pregnancy affected by Down syndrome than women who become pregnant at a younger age.
After teaching the parents about their child’s condition, which of the following
statements would need further teaching?
a. “Our son will need supervision when he will grow up because he may be cognitively
challenged.”
b. “Russell must avoid crowded places as to prevent him from having an infection.”
c. “We will try to take him to a regular school and help him mingle with children
the same age as his.”
d. “We may need to bring Russell to a speech therapist to help him talk.”
5.
RATIO: A person with Down's syndrome will have some degree of learning disability, but
the level of ability will be different for each individual. A child with Down's syndrome
might take longer than other children their age to reach certain milestones and to develop
certain skills.
Situation 2: A child named Christian is seen to have both unilateral cleft lip and palate. He was
born to have deformity. He is now 9 months of age and the parents brought their child to the
hospital to have a repair.
The child will have to undergo Cheiloplasty as the surgeon has advised the parents. The
following is NOT true regarding this kind of operation.
a. Age for repair is usually after the child has grown but before speech is well developed.
b. Helps parents with the visible aspects of the defect
c. Aids infant’s ability to suck
d. Performed soon after birth – further modification may be necessary
6.
RATIO: Surgery of the lip will be performed at approximately 4-6 months of age. The child
must be healthy and gaining weight. The guideline followed is that children must weigh ten
pounds before the surgery will be done.
After the operation the nurse should expect which of the following equipment at the
bedside of the child?
a. Tracheostomy set
b. Defibrillator
c. Ambu bag
d. Endotracheal tube and suction
7.
RATIO: Removal of secretions may improved breathing.
It is imperative to teach the parents to turn their child from side to side to prevent which
of the following complications of prolonged immobility on the bed?
a. Orthostatic hypotension
b. Hypostatic pneumonia
c. Aspiration pneumonia
d. Anemia
8.
RATIO: Hypostatic pneumonia usually results from the collection of fluid in the dorsal region
of the lungs and occurs especially in those (as the bedridden) confined to a supine position for
extended periods.
The child is sent home after everything has already been stabilized but the doctor again
advised the parents to return with their child for the next operation which is palatoplasty?
When would be the best time to do this?
a. 1 1⁄2 years old
b. 5 years old
c. 7 years old
d. 3 years old
9.
RATIO: Surgery of the palate generally occurs between 9-15 months of age. It is done at this
time in an effort to provide the child with the best physiological mechanisms for language and
speech development.
After the child has had palatoplasty, which of the following position should the child be
placed unto to prevent aspiration pneumonia and drainage of secretions?
a. High-Fowlers
b. Supine
c. Reverse-Tredenlenburg
d. Prone
10.
RATIO: A child with only a cleft palate repair may sleep on their stomach. It is important to
keep the stitches clean and without crusting. Prone position is a good way to prevent aspiration
pneumonia.
Situation 3: Mark was observed to have spina bifida upon birth. This condition is a
malformation of the spine that is caused by certain factors. Immediate interventions should
be done in order for the child to develop properly. The mother of mark is also suffering from
seizure disorders and is known to take anticonvulsant medications during her pregnancy.
11.
spinal
a.
b.
c.
d.
The doctor upon observing Mark’s spina bifida has seen protrusion of both meninges and
cord. This kind of spina bifida is known as
Spina bifida occulta
Meningocele
Myelomeningocele
Anencephaly
RATIO: Myelomeningocele is the most severe form of spina bifida. It happens when both the
meninges and the bottom end of the spinal cord push through the hole in the spine, forming
a large fluid-filled sac that bulges out of a baby's back.
The father of Mark asks the nurse what is the common cause of this kind of condition.
The nurse is utterly correct when she says
a. “Spina bifida is primarily caused by intake of a teratogen known as thalomid.”
b. “This condition is caused by a deficiency in folate during the pregnancy
of your wife.”
c. “Spina bifida is passed on genetically and your wife is a probable carrier of this
ailment.”
12.
d. “The condition of your child can be caused in the deficiency of thiamine and
riboflavin during pregnancy.”
RATIO: Not having enough folic acid during pregnancy is one of the most important factors that
can increase your chances of having a child with spina bifida. Folic acid (also known as vitamin
B9) occurs naturally in some foods, such as broccoli, peas and brown rice.
This is the defect of the occipito-cervical region with swelling and displacement of the
medulla and spinal cord
a. Hydrocephalus
b. Chiari malformation
c. Galeazzi’s sign
d. Kernig’s sign
13.
RATIO: This malformation occurs during fetal development and is characterized by downward
displacement by more than four millimeters, of the cerebellar tonsils beneath the foramen
magnum into the cervical spinal canal. This displacement may block the normal pulsations of
CSF between the spinal canal and the intracranial space. This form of Chiari malformation may
be associated with syringomyelia/hydromyelia.
When taking care of the sac of the child with spina bifida it is essential for the nurse to
do which of the following EXCEPT?
a. Avoid pressure on the sac
b. The area must be kept clean, especially from urine and feces
c. Sterile gauze with antibiotic solution may be placed over the sac
d. Administer oral paracetamol to reduce fever
RATIO: Only option A, B, C are appropriate and applicable to patients with spina bifida.
14.
Which of the following drugs for seizure would most likely cause the child to have neural
tube defects?
a. Valproic acid (Depakene)
b. Carbamazepine (Tegretol)
c. Lamotrigine (Oxtellar)
d. Topiramate (Topimax)
15.
RATIO: Valproate and carbamazepine have been associated specifically with the development
of neural tube defects (NTDs), especially spina bifida.
Situation 4: A newborn named Julie is seen to have hydrocephalus. Her head circumference
was larger than what is normal. She also has protruding eyeballs. There are prominent scalp
veins.
Julie’s intracranial pressure is expected to above the normal range. What would be the
normal intracranial pressure in infants?
a. 10 to 15 mm Hg
b. Less than 3 to 7 mm Hg
c. Less than 1.5 to 6 mm Hg
d. 20 to 25 mm Hg
16.
RATIO: Normal ICP values are less than 10 – 15 mmHg for older children, less than 3 – 7 mmHg
for younger children and less than 1.5 – 6 mmHg in term infants. ICP values greater than 20 –
25 mmHg are considered to be increased and require treatment in most instances.
Which of the following signs and symptoms would indicate that Julie is suffering from
increased intracranial pressure?
a. Projectile vomiting not associated with feeding, irritability, anorexia, high shrill
cry, seizures
b. Dizziness, there is low-pitched cry, increased feeding, fever and weight loss
c. Child appears calm, lethargy, leakage of cerebrospinal fluid from the ears and nose
d. There are rashes on the scalp, bloodshot eyes, epistaxis, and gum bleeding
17.
RATIO: Option A are accurate signs and symptoms of infants having an increased intracranial
pressure.
The doctor of Julie advised the parents to undergo treatment to relieve the
hydrocephalus of the child. What would be the best intervention for the child’s condition?
a. Ventriculo-peritoneal shunting
b. Ventriculostomy
c. Burr-hole drainage
d. Craniotomy
18.
RATIO: A ventriculoperitoneal (VP) shunt is a medical device that relieves pressure on the
brain caused by fluid accumulation. VP shunting is a surgical procedure that primarily treats
a condition called hydrocephalus.
19.
If hydrocephalus is left untreated the child may grow up to be
a. Cognitively challenged
b. Autistic
c. Attention-deficit hyperactive disorder
d. Conduct disorder
RATIO: If left untreated, hydrocephalus can cause developmental delays, personality changes and
memory loss. In severe cases, untreated hydrocephalus may result in nerve damage, vision loss
and even death.
When monitoring for the child’s intracranial pressure it is important that the nurse must
avoid giving the child which of the following medications?
a. Diuretics
b. Sedative
c. Analgesics
d. Antipyretics
20.
RATIO: Diuretics draw water out of the neurons. This helps to reduce the fluid within the
intracranial space.Analgesia and sedation (particularly in the pre-hospital, ER, and intensive care
setting) are used to reduce agitation and metabolic needs of the brain, but watch for side effects,
since these medications may cause low blood pressure. Antipyretic is not indicated as a
medication for increase ICP.
SAS 11
1. Which of the following statement best describe pyloric stenosis?
a. Failure of the membrane separating the rectum from the anus to absorb during eighth week
of fetal life
b. Absence of parasympathetic ganglion cells in a portion of the bowel, which causes
enlargement of the bowel proximal to the defect
c. Telescoping of one portion of the intestine into another; occurs more frequently at the
ileocecal valve
d. Congenital hypertrophy of muscular tissue of the pyloric sphincter, usually
asymptomatic until 2 to 4 weeks after birth
RATIONALE: Pyloric stenosis is a condition that affects an infant's pylorus, a muscle at the end of
the stomach. When the pylorus thickens, food can’t pass through. Pyloric stenosis symptoms
include forceful vomiting, which may cause dehydration.
2.What site is commonly affected to a child who is suffering from
megacolon?
a. Ascending colon
b. Descending colon
c. Transverse colon
d. Rectosigmoid colon
aganglionic
RATIONALE: Hirschsprung’s disease (congenital megacolon) is caused by the failed migration of
colonic ganglion cells during gestation. Varying lengths of the distal colon are unable to relax,
causing functional colonic obstruction. Hirschsprung’s disease most commonly involves the
rectosigmoid region of the colon but can affect the entire colon and, rarely, the small intestine.
3. Which of the following is the characteristic of stools in an infant who has aganglionic
megacolon?
a. Passage of ribbonlike or pellet-like stools
b. Currant-jelly stools
c. Rice-watery stools
d. d. Black tarry stools
RATIONALE: Constipation results from absence of ganglion cells in the rectum and colon, and is
present since the neonatal period with passage of frequent foul-smelling, ribbon-like, or pelletlike stools.
4. If an olive-mass is palpated on the abdomen of the child, the child is positive for pyloric
stenosis. Where is this usually palpated?
a. Right lower quadrant
b. Left upper quadrant
c. Right upper quadrant
d. Left lower quadrant
RATIONALE: An enlarged pylorus, classically described as an "olive," can be palpated in the right
upper quadrant or epigastrium of the abdomen in 6080% of infants with pyloric stenosis. Palpation
of an olive is pathognomonic for pyloric stenosis.
5. What is the description of the vomitus of the patient who is suffering from pyloric stenosis?
a. Projectile, non-bile stained
b. Non projectile, red stained
c. Projectile, brown stained
d. Non projectile, yellow stained
RATIONALE: Babies with pyloric stenosis usually have progressively worsening vomiting during
their first weeks or months of life. The vomiting is often described as non-bilious and projectile
vomiting, because it is more forceful than the usual spit ups commonly seen at this age.
6.After feeding the infant who has undergone an abdominal surgery because of pyloric stenosis.
The child must be placed on which of the following position afterwards?
a. Supine
b. Left side lying
c. Prone
d. Right side lying
RATIONALE: Prone with the head of the bed elevated
7.When positioning the infant who has diaphragmatic hernia it is best to place the infant on
a. The affected side
b. The stomach
c. The unaffected side
d. The back
RATIONALE: To allow greater respiration in the unaffected side.
8.Which of the following types of enema would help relieve the intussusception
of the child?
a. Barium enema
b. Fleet enema
c. Carminative enema
d. Cleansing enema
RATIONALE: In a barium enema, a liquid mixture called barium is used instead of air to fix
the blockage in the same way.
9.A child named Paul Macchiato is diagnosed to have β-Thalassemia, his parents are of Italian
descent. He tells you that he is constantly tired even by doing a small amount of activity. Which
of the following is the best nursing diagnosis for him?
a. Body image disturbance
b. Activity intolerance
c. Altered family processes
d. Impaired gas exchange
RATIONALE: Activity intolerance related to imbalance of oxygen supply and consumption needs.
10. β – Thalassemia is an autosomal disorder with varied expressivity. The basic defect of this
disease is found to be associated with which of the following deficiencies?
a. α-chain polypeptide deficiency
b. Iron deficiency
c. β – chain polypeptide deficiency
d. Vitamin B12 deficiency
RATIONALE: Beta thalassemia is a blood disorder that reduces the production of hemoglobin .
Hemoglobin is the iron-containing protein in red blood cells that carries oxygen to cells throughout
the body. In people with beta thalassemia, low levels of hemoglobin lead to a lack of oxygen in
many parts of the body.
11. This is known as the excessive storage of iron in various tissues of the body, especially the
spleen, heart, and pancreas.
a. Hemosiderosis
b. Hemochromatosis
c. Ferrosis
d. Hematoma
RATIONALE: Hemochromatosis, or iron overload, is a condition in which your body stores too
much iron. It's often genetic. It can cause serious damage to your body, including to your heart,
liver and pancreas.
12. A child who has Wilm’s tumor (nephroblastoma) also has cryptorchidism which is
a. Undescended testes
b. Abnormal enlargement of the testes
c. Absence of the testes
d. Swelling of the testes
RATIONALE: An undescended testicle (cryptorchidism) is a testicle that hasn't moved into its
proper position in the bag of skin hanging below the penis (scrotum) before birth. Usually just
one testicle is affected, but about 10 percent of the time both testicles are undescended.
13. A child named Robert is being diagnosed for the presence of tumor in the kidneys. It was
found that he has nephroblastoma. The tumor is only encapsulated within the kidney. What stage
of cancer is the child on?
a. Stage I
b. Stage II
c. Stage III
d. Stage IV
RATIONALE: Stage I: Cancer is found in one kidney only and can be completely removed by
surgery. About 41% of all Wilms tumors are stage
I.
14. If the child has the presence of an encapsulated tumor in the kidney, the most appropriate
nursing diagnosis for him is
a. Fear
b. Altered family processes
c. Risk for injury
d. Altered nutrition
RATIONALE: Wilms tumor (also called Wilms' tumor or nephroblastoma) is a type of childhood
cancer that starts in the kidneys. It is the most common type of kidney cancer in children. About
9 of 10 kidney cancers in children are Wilms tumors
15. When caring for the child with nephroblastoma the priority nursing intervention for the child
is
to
a. Palpate the abdomen for tender swelling and a nontender mass which is usually
confined to one side of the abdomen
b. Observe for the presence of blood in the urine which is indicative of stage III cancer
c. Look for signs of metastasis such as cough, dyspnea, shortness of breath.
d. Place a sign over the bed saying, “Do not palpate the abdomen.”
RATIONALE: Other findings associated with compression of neighboring organs or metastasis
(e.g., lungs: cough, dyspnea, shortness of breath)
Situation: A 5-year old female named Erina Nakiri was brought to the hospital. According to her
mother she has been experiencing fever for more than 5 days. Upon assessment Nurse Alice has
observed polymorphous rash on the trunk. Aside from those she has observed peeling of the
palms and soles. The child also has a strawberry-tongue.
16. The possible diagnosis of the child would be
a. Measles
b. Scarlet fever
c. Kawasaki disease
d. Rubella
RATIONALE: Kawasaki disease (KD), or mucocutaneous lymph node syndrome, is an illness that
causes inflammation in arteries, veins, and capillaries. It also affects your lymph nodes and causes
symptoms in your nose, mouth, and throat. It's the most common cause of heart disease in
children.
17. The cause of Erina’s disease would be
a. Viral
b. Allergic reaction
c. Unknown
d. Bacterial
RATIONALE: Scientists haven't found an exact cause for Kawasaki disease. It might be linked to
genes, viruses, bacteria, and other things in the world around a child, such as chemicals and
irritants. The disease probably isn't contagious, but it sometimes happens in clusters in a
community.
18. One of the possible complications from this disease would be
a. Aneurysms
b. Hypertension
c. Seizures
d. Asthma
RATIONALE: Without prompt treatment, Kawasaki disease can damage the coronary arteries and
the heart muscle itself in as many as 1 in 4 children. Over the first few weeks, a weakening of a
coronary artery can result in enlargement of the vessel wall (an aneurysm).
19.With Erina’s disease, Nurse Alice must know that it is common from which geographic
location?
a. Mediterranean
b. Pacific
c. Middle East
d. Caribbean
RATIONALE: Children of Asian or Pacific Island descent, such as Japanese or Korean, have higher
rates of Kawasaki disease.
20. The doctor has started acetylsalicylic acid (Aspirin) therapy for Erina. The nurse must know
that the purpose of the drug therapy is
a. Prevent thrombus formation
b. Control the child’s hypertension
c. Increase the blood volume
d. Improve cardiac contractility
RATIONALE: They'll probably be given high-dose aspirin until their fever subsides. They may
then be prescribed low-dose aspirin until 6 to 8 weeks after the start of their symptoms. This is
to reduce blood clots if there are problems developing in the blood vessels that supply blood to
the heart.
SAS 12
1. Which is the primary goal of community health nursing?
a. To support and supplement the efforts of the medical profession in the promotion
of health and prevention of illness
b. To enhance the capacity of individuals, families and communities to cope
with their health needs
c.
To increase the productivity of the people by providing them with services that will
increase their level of health
d. To contribute to national development through promotion of family welfare,
focusing particularly on mothers and children.
RATIO: To contribute to national development through promotion of family welfare, focusing
particularly on mothers and children.
2. CHN is a community-based practice. Which best explains this statement?
a. The service is provided in the natural environment of people.
b. The nurse has to conduct community diagnosis to determine nursing needs and
problems.
c. The services are based on the available resources within the community.
d. Priority setting is based on the magnitude of the health problems identified.
RATIO: Community-based practice means providing care to people in their own natural
environments: the home, school and workplace, for example.
3. Population-focused nursing practice requires which of the following processes?
a. Community organizing
b. Nursing process
c.
Community diagnosis
d. Epidemiologic process
RATIO: Population-focused nursing care means providing care based on the greater need of the
majority of the population. The greater need is identified through community diagnosis.
4. R.A. 1054 is also known as the Occupational Health Act. Aside from number of employees,
what other factor must be considered in determining the occupational health privileges to
which the workers will be entitled?
a. Type of occupation: agricultural, commercial, industrial
b. Location of the workplace in relation to health facilities
Classification of the business enterprise based on net profit
d. Sex and age composition of employees
RATIO: Based on R.A. 1054, an occupational nurse must be employed when there are 30 to 100
employees and the workplace is more than 1 km. away from the nearest health center.
c.
5. A business firm must employ an occupational health nurse when it has at least how many
employees?
a. 21
b. 101
c.
201
d. 301
RATIO: Based on R.A. 1054, an occupational nurse must be employed when there are 30 to 100
employees and the workplace is more than 1 km. away from the nearest health center.
6. When the occupational health nurse employs ergonomic principles, she is performing which of
her roles?
a. Health care provider
b. Health educator
c. Health care coordinator
d. Environmental manager
RATIO: Ergonomics is improving efficiency of workers by improving the worker's environment
through appropriately designed furniture, for example.
7. A garment factory does not have an occupational nurse. Who shall provide the occupational
health needs of the factory workers?
a. Occupational health nurse at the Provincial Health Office
b. Physician employed by the factory
c. Public health nurse of the RHU of their municipality
d. Rural sanitary inspector of the RHU of their municipality
RATIO: Since there is no occupational nurse in the factory, the nearest health center with a public
health nurse will be the one to cater their occupational health needs and not the regional.
8. “Public health services are given free of charge.” Is this statement true or false?
a. The statement is true; it is the responsibility of government to provide basic services.
b. The statement is false; people pay indirectly for public health services.
c.
The statement may be true or false, depending on the specific service required.
d. The statement may be true or false, depending on policies of the government concerned.
RATIO: Community health services, including public health services, are prepaid paid services,
through taxation, for example.
9. According to C.E. Winslow, which of the following is the goal of Public Health?
a. For people to attain their birthrights of health and longevity
b. For promotion of health and prevention of disease
c. For people to have access to basic health services
d. For people to be organized in their health efforts
RATIO: According to Winslow, all public health efforts are for people to realize their birthrights of
health and longevity.
10. We say that a Filipino has attained longevity when he is able to reach the average lifespan
of Filipinos. What other statistic may be used to determine attainment of longevity?
a. Age-specific mortality rate
b. Proportionate mortality rate
c. Swaroop’s index
d. Case fatality rate
RATIO: Swaroop’s index is the percentage of the deaths aged 50 years or older. Its inverse
represents the percentage of untimely deaths (those who died younger than 50 years).
11. Which of the following is the most prominent feature of public health nursing?
a. It involves providing home care to sick people who are not confined in the hospital.
b. Services are provided free of charge to people within the catchment area.
c.
The public health nurse functions as part of a team providing a public health nursing
services.
d. Public health nursing focuses on preventive, not curative, services.
RATIO: The catchment area in PHN consists of a residential community, many of whom are well
individuals who have greater need for preventive rather than curative services.
12. According to Margaret Shetland, the philosophy of public health nursing is based on which of
the following?
a. Health and longevity as birthrights
b. The mandate of the state to protect the birthrights of its citizens
c. Public health nursing as a specialized field of nursing
d. The worth and dignity of man
RATIO: This is a direct quote from Dr. Margaret Shetland’s statements on Public Health Nursing.
13. Region IV Hospital is classified as what level of facility?
a. Primary
b. Secondary
c. Intermediate
d. Tertiary
RATIO: Regional hospitals are tertiary facilities because they serve as training hospitals for the
region.
14. Which is true of primary facilities?
a. They are usually government-run.
b. Their services are provided on an out-patient basis.
c. They are training facilities for health professionals.
d. A community hospital is an example of this level of health facilities.
RATIO: Primary facilities government and non-government facilities that provide basic out-patient
services.
15. Which is an example of the school nurse’s health care provider functions?
a. Requesting for BCG from the RHU for school entrant immunization
b. Conducting random classroom inspection during a measles epidemic
Taking remedial action on an accident hazard in the school playground
d. Observing places in the school where pupils spend their free time
RATIO: Random classroom inspection is assessment of pupils/students and teachers for signs of
a health problem prevalent in the community.
c.
16. When the nurse determines whether resources were maximized in implementing Ligtas
Tigdas, she is evaluating
a. Effectiveness
b. Efficiency
c.
Adequacy
d. Appropriateness
RATIO: Efficiency is determining whether the goals were attained at the least possible cost.
17. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where will
you apply?
a. Department of Health
b. Provincial Health Office
c.
Regional Health Office
d. Rural Health Unit
RATIO: R.A. 7160 devolved basic health services to local government units (LGU’s). The public
health nurse is an employee of the LGU.
18. 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
To empower the people and promote their self-reliance
d. To make basic services more accessible to the people
RATIO: People empowerment is the basic motivation behind devolution of basic services to LGU’s.
c.
19. Who is the Chairman of the Municipal Health Board?
a. Mayor
b. Municipal Health Officer
c. Public Health Nurse
d. Any qualified physician
RATIO: The local executive serves as the chairman of the Municipal Health Board.
20. Which level of health facility is the usual point of entry of a client into the health care delivery
system?
a. Primary
b. Secondary
c.
Intermediate
d. Tertiary
RATIO: The entry of a person into the health care delivery system is usually through a consultation
in out-patient services.
SAS 13
1. According to Freeman and Heinrich, community health nursing is a developmental service.
Which of the following best illustrates this statement?
a. The community health nurse continuously develops himself personally and professionally.
b. Health education and community organizing are necessary in providing
community health services.
c. Community health nursing is intended primarily for health promotion and prevention and
treatment of disease.
d. The goal of community health nursing is to provide nursing services to people in their own
places of residence.
RATIO: The community health nurse develops the health capability of people through health
education and community organizing activities.
2.Which disease was declared through Presidential Proclamation No.4 as a target for eradication
in the Philippines?
a. Poliomyelitis
b. Measles
c. Rabies
d. Neonatal tetanus
RATIO: Presidential Proclamation No. 4 is on the Ligtas Tigdas Program.
3.The public health nurse is responsible for presenting the municipal health statistics using
graphs and tables. To compare the frequency of the leading causes of mortality in the
municipality, which graph will you prepare?
a. Line
b. Bar
c. Pie
d. Scatter diagram
RATIO:A bar graph is used to present comparison of values, a line graph for trends over time
or age, a pie graph for population composition or distribution, and a scatter diagram for
correlation of two variables.
4.Which step in community organizing involves training of potential leaders in the community?
a. Integration
b. Community organization
c. Community study
d. Core group formation
RATIO: In core group formation, the nurse is able to transfer the technology of
community organizing to the potential or informal community leaders through a
training program.
5.In which step are plans formulated for solving community problems?
a. Mobilization
b. Community organization
c. Follow up/extension
d. Core group formation
RATIO: Community organization is the step when community assemblies take place. During the
community assembly, the people may opt to formalize the community organization and make
plans for community action to resolve a community health problem.
6.The public health nurse takes an active role in community participation. What is the primary
goal of community organizing?
a. To educate the people regarding community health problems
b. To mobilize the people to resolve community health problems
c. To maximize the community’s resources in dealing with health problems
d. To maximize the community’s resources in dealing with health
problems
RATIO: To maximize the community’s resources in dealing with health problems Community
organizing is a developmental service, with the goal of developing the people’s self-reliance
in dealing with community health problems. A, B and C are objectives of contributory
objectives to this goal.
7. An indicator of success in community organizing is when people are able to
a. Participate in community activities for the solution of a
community problem
b. Implement activities for the solution of the community problem
c. Plan activities for the solution of the community problem
d. Identify the health problem as a common concern
RATIO: Participation in community activities in resolving a community problem may be in any
of the processes mentioned in the other choices.
8.Tertiary prevention is needed in which stage of the natural history of disease?
a. Pre-pathogenesis
b. Pathogenesis
c. Prodromal
d. Terminal
RATIO: Tertiary prevention involves rehabilitation, prevention of permanent disability and
disability limitation appropriate for convalescents, the disabled, complicated cases and the
terminally ill (those in the terminal stage of a disease)
9.Isolation of a child with measles belongs to what level of prevention?
a. Primary
b. Secondary
c. Intermediate
d. Tertiary
RATIO: The purpose of isolating a client with a communicable disease is to protect those who
are not sick (specific disease prevention).
10.On the other hand, Operation Timbang is _____ prevention.
a. Primary
b. Secondary
c. Intermediate
d. Tertiary
RATIO: Operation Timbang is done to identify members of the susceptible population who are
malnourished. Its purpose is early diagnosis and, subsequently, prompt treatment.
11.
Which type of family-nurse contact will provide you with the best opportunity to observe
family dynamics?
a. Clinic consultation
b. Group conference
c. Home visit
d. Written communication
RATIO: Dynamics of family relationships can best be observed in the
environment, which is the home.
family's natural
12.
The typology of family nursing problems is used in the statement of nursing diagnosis
in the care of families. The youngest child of the de los Reyes family has been diagnosed as
mentally retarded. This is classified as a
a. Health threat
b. Health deficit
c. Foreseeable crisis
d. Stress point
RATIO: Failure of a family member to develop according to what is expected, as in mental
retardation, is a health deficit.
13. The de los Reyes couple have a 6-year old child entering school for the first time. The de
los Reyes family has a
a. Health threat
b. Health deficit
c. Foreseeable crisis
d. Stress point
RATIO: Entry of the 6-year old into school is an anticipated period of unusual demand on the
family.
14. Which of the following is an advantage of a home visit?
a. It allows the nurse 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 experiences among people with similar health problems.
d. It develops the family’s initiative in providing for health needs of its members.
RATIO: Choice A is not correct since a home visit requires that the nurse spend so much time
with the family. Choice C is an advantage of a group conference, while choice D is true of a
clinic consultation.
15.Which is CONTRARY to the principles in planning a home visit?
a. A home visit should have a purpose or objective.
b. The plan should revolve around family health needs.
c. A home visit should be conducted in the manner prescribed by the
RHU.
d. Planning of continuing care should involve a responsible family member
RATIO: The home visit plan should be flexible and practical, depending on factors, such as the
family's needs and the resources available to the nurse and the family.
16. The PHN bag is an important tool in providing nursing care during a home visit. The most
important principle of bag technique states that it
a. Should save time and effort.
b. Should minimize if not totally prevent the spread of infection.
c. Should not overshadow concern for the patient and his family.
d. May be done in a variety of ways depending on the home situation, etc.
RATIO: Should minimize if not totally prevent the spread of infection. Bag technique is
performed before and after handling a client in the home to prevent transmission of
infection to and from the client.
17.To maintain the cleanliness of the bag and its contents, which of the following must the nurse
do?
a. Wash his/her hands before and after providing nursing care to the family
members.
b. In the care of family members, as much as possible, use only articles taken from the bag.
c. Put on an apron to protect her uniform and fold it with the right side out before putting it
back into the bag.
d. At the end of the visit, fold the lining on which the bag was placed, ensuring that the
contaminated side is on the outside.
RATIO: Wash his/her hands before and after providing nursing care to the family members.
Choice B goes against the idea of utilizing the family’s resources, which is encouraged in
CHN. Choices C and D goes against the principle of asepsis of confining the contaminated
surface of objects.
18.The public health nurse conducts a study on the factors contributing to the high mortality
rate due to heart disease in the municipality where she works. Which branch of epidemiology
does the nurse practice in this situation?
a. Descriptive
b. Analytical
c. Therapeutic
d. Evaluation
RATIO: Analytical epidemiology is the study of factors or determinants affecting the patterns of
occurrence and distribution of disease in a community.
19. Which of the following is a function of epidemiology?
a. Identifying the disease condition based on manifestations presented by a client
b. Determining factors that contributed to the occurrence of pneumonia in a 3 year old
c. C. Determining the efficacy of the antibiotic used in the treatment of the 3 year old client
with pneumonia
d. Evaluating the effectiveness of the implementation of the Integrated Management
of Childhood Illness
RATIO: Epidemiology is used in the assessment of a community or evaluation of interventions in
community health practice.
Which of the following is an epidemiologic function of the nurse during an epidemic?
a. Conducting assessment of suspected cases to detect the communicable disease
b. Monitoring the condition of the cases affected by the communicable disease
c. Participating in the investigation to determine the source of the
epidemic
d. Teaching the community on preventive measures against the disease
RATIO: Epidemiology is the study of patterns of occurrence and distribution of disease in the
community, as well as the factors that affect disease patterns. The purpose of an epidemiologic
investigation is to identify the source of an epidemic, i.e., what brought about the epidemic.
20.
SAS 14
1. In the census of the Philippines in 1995, there were about 35,299,000 males and about
34,968,000 females. What is the sex ratio?
A. 99.06:100
B. 100.94:100
C. 50.23%
D. 48.76%
2. Primary health care is a total approach to community development. Which of the following is
an indicator of success in the use of the primary health care approach?
a. Heath services are provided free of charge to individuals and families.
b. Local officials are empowered as the major decision makers in matters of health.
c. Health workers are able to provide care based on identified heath needs of the people.
d. Health programs are sustained according to the level of development of the community.
3. Sputum examination is the major screening fool for pulmonary tuberculosis. Clients would
sometimes get false negative results in this exam. This means that the fest is not perfect in
terms of which characteristic of a diagnostic examination
a. Effectiveness
b. Efficacy
c. Specificity
d. Sensitivity
4. Use of appropriate technology requires knowledge of indigenous technology. Which medicinal
herb is given for fever, headache and cough?
a. Sambong
b. Tsaang guba
c. Akapulko
d. Lagundi
5. What is the legal basis for Primary Health Care approach in the Philippines?
a. Alma Ata Declaration on PHC
b. Letter of Instruction No. 949
c. Presidential Decree No. 147
d. Presidential Decree 996
6. Which of the following demonstrates intersectoral linkages?
e. Two-way referral system
f. Team approach
g. Endorsement done by a midwife to another midwifeh. Cooperation between the PHN and public-school teacher
7. The municipality assigned to you has a population of about 20,000. Estimate the number of 14-year-old children who wit be given Retinol capsule 200,000 I.U, every 6 months
A. 1,500
B. 1800
С. 2.000
D. 2,300
8. Estimate the number of pregnant women who will be given tetanus toxoid during an
immunization outreach activity in a barangay with a population of about 1.500.
A. 265
B.300
C. 375
D. 400
9. To describe the sex composition of the population, which demographic tool may be used?
a. Sex ratio
b. Sex proportion
c. Population pyramid
d. Any of these may be used.
10. Which of the following is a natality rate?
a. Crude birth rale
b. Neonatal mortally rate
c. Infant mortally rate
d. General fertility rale
11. You are computing the crude death rate of your municipality, with a total population of about
18,000, for last year. There were 94 deaths. Among those who died, 20 died because of diseases
of the heart and 32 were aged 50 years or older. What is the crude death rate?
A. 4.2/1,000
B. 5.2/1,000
C. 6.3/1,000
D. 7.3/1.000
12. Knowing that malnutrition is a frequent community health problem, you decided to conduct
nutritional assessment. What population is particularly susceptible to protein energy malnutrition
(PEMI)?
a. Pregnant women and the elderly
b. Under-5-year-oid children
c. 1-4 year-old children
d. School age children
13. In the past year, Barangay A had an average population of 1655. 46 babies were born in that
year, 2 of whom died less than 4 weeks after they were born. There were 4 recorded stilbirths.
What is the neonatal mortality rate?
A. 27.8/1,000
B.43.5/1,000
C. 86.8/1,000
D. 130.4/1,000
14. Which statistic best reflects the nutritional status of a population?
a. 1-4-year-old age-specific mortality rate
b. Proportionate mortality rate
c. Infant mortally rate
d. Swaroop's index
15, What numerator is used in computing general fertility rate?
a. Estimated midyear population
b. Number of registered live births
c. Number of pregnancies in the year
d. Number of females of reproductive age
16. You will gather data for nutritional assessment of a purok. You will gather information only
from families with members who belong to the target population for PEM. What method of data
gathering is best for this purpose?
a. Census
b. Survey
c. Record review
d. Review of civil registry
17. In the conduct of a census, the method of population assignment based on the actual physical
location of the people is termed
a. De jure
b. De locus
c. De facto
d. De novo
18. The Field Health Services and Information System (FHSIS) is the recording and reporting
system in public health care in the Philippines. The Monthly Field Heath Service Activity Report is
a form used in which of the components of the FHSIS?
a. Tally report
b. Output report
c. Target/client list
d. Individual health record
19. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy. which
component will be most useful?
e. Tally report
f. Output report
g. Target/client list
h. Individual health record
Civil registries are important sources of data. Which law requires registration of births within
30 days from the occurrence of the birth?
a. PD 651
b. Act 3573
c. R.A. 3753
d. R.A. 3375
21.
SAS 15
1. Integrated Management of Childhood Illness (IMCI) is promulgated by the UNICEF together
with DOH in order to properly treat common childhood diseases usually in the
a. Hospital
b. Community
c. Clinic
d. School
2 A 2-year-old boy was brought by his mother to the health center for a regular yearly check-up.
As a nurse in the health center, you one going to observe first for the general danger signs. All
but one is the danger sign
a. Lethargic or unconscious
b. The child has had convulsions
c. There is bulging fontanel
d. The child vomits everything he eats
3. If the child presents with no symptoms of the general danger signs the next thing to do is
assess for:
a. fever
b. cough or difficulty breathing
c. anemia or malnutrition
d. ear infection
4. When observing the 2-year-old child for signs of pneumonia you documented that the child is
having 45 breaths/min, there is chest indrawing and stridor. You are going to classily this as
a. cough or colds.
b. pneumonia.
c. no pneumonia.
d. severe pneumonia or very severe disease.
5. When assessing for the child's breath sounds you heard a specific adventitious breath sound
which is stridor. This is best described as
a. harsh sound upon inhalation
b. harsh sound upon exhalation
c. clicking and rattling noises upon auscultation
d. course crackling sound.
6, In order to relieve the cough of the child you are going to recommend the mother the following
treatment except:
a. Breastfeed the child
b. Offer the child calamansi juice
c. Give the child codeine cough syrup
d. Offer the child with ginger ale
7. When assessing the child who is having diarrhea you observed that the child is restless, has
sunken eyes, and is thirsty and drinking eagerly while the skin pinch goes back slowly. You are
going to classify this as
a. Some dehydration
b. Severe dehydration
c. Moderate dehydration
d. No dehydration
8. If you are going to check for the skin pinch of the child or the skin turgor, where is the best
area to check for this?
a. Forearm
b. thigh
c. cheek
d. abdomen
9. When asking the mother for the history of the child’s diarrhea the mother tells you that her
child defecates with blood in the stool. You will suspect for what type of infection?
a. Typhoid lever
b. Dysentery
c. Cholera
d. Acute gastroenteritis
10. A mother brought her child to the health center and you observed that the child has stiff neck
and is having convulsions. They are living in a malaria endemic area. You are going to classify this
as?
a. Malaria
b. Very severe febrile disease
c. No malaria
d. Measles
11. If the child is under the pink category of malaria which antimalarial would be best for the initial
treatment
a. Quinine
b. Sulfadoxine
c. Primaquine
d. Artemeter lumefantine
12. When assessing the child for measles you have observed that the child has pus draining from
the eye and there are mouth ulcers. How will you classily this type of measles?
a. Measles
b. Measles with eye or mouth complications
c. No measles
d. Severe complicated measles
13. This is the drug of choice for a child with clouding and pus draining from the eyes with severe
measles
a. Tetracycline
b. Amoxicillin
c. Gentian valet
d. Cotrimoxazole
This is the medication used to paint the mouth for a child who is experiencing mouth ulcer
which is a complication of measles infection
a. Gentian violet
b. Tetracycline
c. ORS
d. Amoxicillin
13.
This is one way of diagnosing dengue hemorrhagic fever wherein you are going to use a
sphygmomanometer on the arm of the patient and count the number of rashes upon its
inflammation. This is known as
14.
a.
b.
c.
d.
Rumpel Leede's test
ELISA lest
Blood smear
BP test
16. When assessing the child with ear infection you’ve seen that there is pus draining from the
ears. The mother tells you that the pus has been present for more than two weeks. What is the
classification of this ear infection?
a. No ear infection
b. Mastoiditis
c. Chronic ear infection
d. Acute ear infection
17. Upon observing the child's palms that the child has some palmar pallor. You are going to
suspect the child to have?
a. No anemia
b. Severe anemia
c. Some anemia
d. Anemia
18. When the child is anemic you are going to give the child, aside from iron, mebendazole. The
mother asks you what the drug is for. You are going to say that
a. "This drug is an antibiotic lo help eradicate the bacterial infection causing your child's
anemia.”
b. "Mebendazole helps in purging helminthes or worms inside the gastrointestinal tract of your
child that are responsible for your child's anemia."
c. "This drug helps in the absorption of iron in the gastrointestinal tract to improve the chide
oxygenation.”
d. "Mebendazole is a potent antiviral that kills the virus that damages the red blood cells of
your child causing severe anemia
19. In checking the child immunization status of a 3-months old infant. The infant should already
have which of the following vaccines?
a. BCG, a dose of DPT. OPV and HEP-B
b. BCG, 2 doses of DPT. OPV and 3rd dose of HEP-B
c. BCG, 3 doses of DPT. OPV. HEP-B and a dose of Measles
d. BCG and HEPA-B
20. When checking a 14-month-old child’s Vitamin a status. The child should already have how
many doses of the vitamin?
A. 1
B. 2
C. 3
D. 4