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SITUATION PEDIATRIC UNIT

1. Primary purpose of evaluating nursing care

• achieve quality improvement

2. Plan, DO, Check and act,design an assessment stool,phase of the process

• plan phase

3. Team evaluate care as a being administered to pedia clients, this represents

• concurrent audit

4. Sentinel events

• signal the needs for immediate investigation and response

5. Not a goal of risk management

• reduce incident reporting system

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CBQ-

A nurse is implementing quality performance standards in a public health department. Which of the
following best describes the importance of this action?
a. Quality performance standards are used to guide improvement in the public health system.
b. Quality performance standards rigidly control public health.
c. Quality performance standards guide administrators to monitor public health at the national level.
d. Quality performance standards can be used as hiring guidelines for nurses.

ANS: A
These standards were developed by the Centers for Disease Control and Prevention in 1998. They set
the bar for the level of performance that is necessary to deliver essential public health services (PHSs).
These standards were developed around the 10 essential PHSs. They focus on the overall public health
system rather than on single organizations and describe an optimal level of performance. They are
intended to support a process of quality improvement. State and local communities can assess their
performance using certain available tools. They are not meant to control public health or be used for
hiring guidelines.
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FILARIASIS awareness month is observed every November according to the Department of Health (DOH)
pursuant to Executive Order No. 369 of 2004.

in the Philippines, filariasis is likewise caused by a mosquito called Aedes poecilius that carries the
parasite Wuchereria bancrofti, Brugia malayi or Brugia timori , which are believed to be transmitted
through mosquitos bites.

The Center for Disease and Control (CDC) informs that Brugia malayi and Brugia timori are most
common in Aisa.

[Lymphatic] Filariasis, as defined by Community Health Nursing and Development, is a chronic parasitic
infection caused by parasites that live inside the lymphatics.

As a chronic condition, its development takes time with the disease process staying with the patient for
a significant period. As a matter of fact, literatures support that the life span of the adult parasites is
between 10 to 40 years.

[The] thread-like parasitic filarial worms lodge in the nodes and vessels of the lymphatic system.

Furthermore, In the Philippines, over 25 million people live in endemic areas for this disease, it adds.

According to epidemiologic statistics, Aedes poecilius is a home to 45 provinces in the country with the
highest prevalence of Filariasis in Regions V, VIII, XI and CARAGA.

On the other hand, the same statistical data claim that Cebu has the lowest rate ever recorded in
history.

Some literatures call this parasitic disease as Elephantiasis due to the abnormal enlargement and
disfigurement it causes on the affected body part.

As the term lymphatic applies, the lymphatic system is part of the circulatory system that carry clear
fluids called lymph towards the heart.

Health experts explain that the lymphatic system plays an important part of the immune system on top
of its primary function of maintaining fluid balance to the circulatory system.

CDC explains that as this infection spreads from person to person by mosquito bites, the adult worm
lives in the human lymph vessels, mates, and produces millions of microscopic worms, also known as
microfilariae.

And then, these Microfilariae circulate in the person's blood and infect the mosquito. In the event that
this infected mosquito bites another person, the latter becomes infected.

CDC maintains that these parasites grow into adult worms and that the entire process takes six months
or more.
An adult worm lives for about five to seven years and that the adult worms mate and release millions of
microfilariae into the blood.

On the other hand, the Public Health Nursing in the Philippines shares that the following are some of the
manifestations of lymphatic filariasis: hydrocele ( swelling of scrotum); lymphedema (temporary
swelling of upper and lower extremities); and elephantiasis (enlargement and thickening of the skin of
the lower and upper extremities, scrotum and breast).

laboratory exams that confirm such diagnosis by the doctor include Nocturnal blood exam (blood are
taken from the patient after 8 p.m.) and Immunochromatographic test (a rapid antigen test done at
daytime).

The World Health Organization (WHO) shares that treatment for Filariasis may include anti-filarial drugs
(Diethylcarbamazine Citrate or DEC) and surgery when necessary.

Unfortunately, fever has been reported as the most common side effect of this medication.

As a mass-based program, the susceptible population is given DEC as the dosage of 6 mg per kg of body
weight taken as a single dose.

For WHO, lymphatic Filariasis afflicts over 25 Million men with genital disease.

The Public Health Nursing suggests the following preventive measures in protecting individuals and
families in endemic areas: use of mosquito nets; use of long sleeves, pant and socks; application of
insect repellents; screening of houses; and health education.

Fearless forecast!!

1. Which of the following BEST defines a disaster?

a. Any event that results in multiple deaths
b. Devastation that cannot be relieved without assistance
c. Devastation that covers a broad geographical area
d. When the event results in multiple injuries and deaths as well as property damage

b. Devastation that cannot be relieved without assistance

A disaster is any human-made or natural event that causes destruction and devastation that cannot be
relieved without assistance.

2. A community health nurse has invited several agencies in the community to a meeting to discuss the
disaster plan for the community. Which of the following BEST describes the purpose of this meeting?
a. To increase stability in the community
b. To improve overall community functioning
c. To manage response to disasters in the community
d. To enhance communication among agencies in the community

c. To manage response to disasters in the community

The level of community preparedness for a disaster is only as good as the people and organizations in
the community make it. Although natural disasters cannot be prevented, much can be done to minimize
further increases in accidents, death, and destruction after impact. A concise, realistic, and well-
rehearsed disaster plan is essential for managing the response to disaster.

3. Which of the following BEST describes countries that bear the greatest burden of disasters?
a. Arid regions that are prone to drought
b. Developing countries with limited resources
c. Industrialized countries with much to lose
d. Water-boundary regions that are prone to floods and hurricanes

b. Developing countries with limited resources

Disasters create the most devastation in developing countries, where the death rate is up to 12 times
higher than in developed countries. The people of low socioeconomic status suffer the most because
their houses are less sturdy and they have fewer resources and less means of social security.

4. Which of the following levels of prevention is being used by a nurse who is helping to develop a
community-wide disaster management plan?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. All prevention levels

a. Primary prevention

Primary prevention takes place before a condition occurs. Primary prevention occurs when one
participates in developing a disaster management plan for the community.

5. After a house fire, a 4-year-old child begins sucking his thumb and wetting his bed. Which of the
following would be the MOST appropriate action for the nurse to take?
a. Explain to the child that it is important to be strong and not act like a baby.
b. Explain to the family that this behavior is a normal reaction to disaster.
c. Recommend admission for inpatient psychological counseling.
d. Recommend behavior therapy as a means to overcome regression.

b. Explain to the family that this behavior is a normal reaction to disaster.

The effects on young children can be especially disruptive. They can resort to regressive behaviors such
as sucking their thumbs, wetting their beds, crying, and clinging to parents. This regression is normal in
response to the event.
Fearless Forecast
#astignurse
#jonastradamus

1. QUALITY MANAGEMENT, BIRTHING CENTER

Basic clinical service equipment,except

Answer: ambulance

First step to do
-----refer to DOH guidelines

One requirements to establish nurse-led birthing home ーーーーPRC license

What classification is the birthing home

-------primary care facilities

Birthing home service capability, except

------detection & referral of high risk pregnancies

2. CRISIS SITUATION

Best describes maturational crisis

------marriage

Assessment-situations not causing strain

------selective inattention

Ecomap is ?
----------connection and rapport within and outside family

Paraplegic,home modification,level of intervention

--------tertiary prevention

Best description of strengths,observed in the family ---------resilience

3. Delivery ROOM

Earliest feeding cue -------drooling

First step to prevent hypothermia

------- drying thoroughly and cover

Prevent hypothermia, ensure correct temp

------- 25-26 centigrade
Not included hypothermia is dangerous to NB
----tetralogy of fallot

Not to do for umbilical care

------ use binder

4. MANAGEMENT

Time management
------ good and feasible NCP

Not permit watcher to help you when

------ administering medications

1st of all, keeping patients and all

------safe

Conserving water
------ reporting leak and closing faucets (1 and 3 only)

Best strategy to manage supplies

------inventory of supplies

5. CHILD ABUSE

Fails to report a case

-------- breach of duty

Prevention for incidence to not happen again in

-------service training

Appropriate remarks during blood extraction

-------its alright to cry

Utmost important ----document findings

Proven guilty ------suspension

5. LEAD POISONING

Common among whic age group------ toddlers

Earliest sign of lead poisoning

-----easy fatigability, pallor

Safety measures,
-------not included medicines placed in purse of bags
Irreversible damage to ---------brain

Read labels ------safety markings

FEARLESS FORECAST!!!!
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Research Paper Sections

Contains the paper's title, the author's name, address, phone number, e-mail, and the day's date.
Answer: title/cover page

What section in the article can expect to find the research question and study purpose?
Answer: Introduction

description of the type of measurement used in the study. You find this in which section o article?
Answer: Methods

A brief explanation of data collection and analysis procedure is found in which section of the article?
Answer: Abstract

The list of references used in the study can be found

Answer: at the end of the article

It contains material that is appropriate for enlarging the reader's understanding, but that does not fit
very well into the main body of the paper. Such material might include tables, charts, summaries,
questionnaires, interview questions, lengthy statistics, maps, pictures, photographs, lists of terms,
glossaries, survey instruments, letters, copies of historical documents, and many other types of
supplementary material.
Answer: Appendices

FEARLESS FORECAST NLE 2019

1. The nurse demonstrates effective communication by ensuring all of the following EXCEPT

a. two-way exchange of information among clients and health providers.

b. making sure that unilateral information is exchanged between clients and nurses.
c. making sure that the expectations and responsibilities of all are clearly understood.
d. recognizing that effective communication is an active process for all involved.

Answer: B. making sure that unilateral information is exchanged between clients and nurses.
2. A preoperative assessment shows that a client's hemoglobin level is dropping. The anesthetist orders
3 units of blood to be administered. The nurse administers the first unit before discovering that the
client is a Jehovah's Witness, as documented in the record. This is an example of
a. professional conduct.
b. a negligent act.
c. physical abuse.
d. breaching client confidentiality.

Answer: B. a negligent act

3. Which of the following is a violation of client confidentiality? Reporting

a. certain communicable diseases.
b. child abuse.
c. gunshot wounds.
d. client data to a colleague in a nonprofessional setting.

Answer: D. client data to a colleague in a nonprofessional setting

4. A 16-year-old trauma victim arrives in the emergency department with a life-threatening condition
and requires emergency surgery. The nurse knows that
a. a parent/guardian must give consent.
b. the client can give consent if she provides proof of emancipation.
c. the client must first be evaluated for competency before obtaining consent.
d. surgery can be performed without consent.

Answer: D. surgery can be performed without consent

5. In regard to informed consent, which of the following statements is true?

a. Only legally incompetent adults can give consent.
b. Only parents can give consent for minor children.
c. It is not required that the client be told about costs and alternatives to treatment.
d. Consent must be voluntary.

Answer: D. consent must be voluntary

6. The client has a living will in which he states he does not want to be kept alive by artificial means. The
client's family wants to disregard the client's wishes and have him maintained on artificial life support.
The most appropriate initial course of action for the nurse would be to
a. tell the family that they have no legal rights.
b. tell the family that they have the right to override the living will because the patient cannot speak.
c. report the situation to the hospital ethics committee.
d. allow the family to verbalize their feelings and concerns, while maintaining the role of client advocate.

Answer: D. allow the family to verbalize their feelings and concerns, while maintaining the role of client
advocate

7. During a routine visit, the nurse notes that a child has several bruises at various stages of healing. The
child reports having fallen down. Failure to report these findings is an example of
a. negligence.
b. reasonable prudence.
c. Malpractice
d. Observance of confidentiality

Answer: A. negligence

8. The nurse practices "here and now" focus on problem identification, with an emphasis on quickly
understanding the context in which the problem is embedded during which of the following phases of
the nurse-client relationship?

a. Orientation
b. Preinteraction
c. Termination
d. Working

Answer: A. orientation

9. Self-disclosure by the nurse refers to the intentional revealing of personal experiences or feelings that
are similar to or different from those of the client. The purpose of self-disclosure is to

a. deepen trust, to be a role model of self-disclosure as a beneficial mode of communicating.

b. to find out how the client would like to be.
c. to determine how things would be if the problems were solved.
d. to work toward resolution of the client's self-care needs.

Answer : A. deepen trust, to be a role model of self-disclosure as a beneficial mode of communicating

10. The student nurse has finished her rotation on the outpatient psychiatric unit. Her client, who was
diagnosed with borderline personality disorder, suddenly displays superficial scratches to both forearms.
Which of the following is a nursing diagnosis for the client related to losses and endings in the nurse-
client relationship?

a. Noncompliance about impending termination of nurse-client relationship

b. Knowledge deficit about impending termination of nurse-client relationship
c. Self-care deficit related to impending termination of nurse-client relationship
d. Anxiety related to impending termination of nurse-client relationship

Answer: D. anxiety related to impending termination of nurse-client relationship

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Situation– Ethical issues on a day-to-day basis often involve patient communication and advocacy.

What is the appropriate approach for the community/public health nurse in balancing individual privacy
and autonomy and the community’s needs for safety and security?.
D. Seek a balance between individual needs and the community’s needs.

In regard to informed consents, which of the following statements is TRUE?

B. Consent must be voluntary.

The client has a ‘living will’ in which he states he does not want to be kept alive by artificial means even
at home. The client’s family wants to disregard the client’s wishes and have him maintained on artificial
life support. The most appropriate initial course of action for the nurse would be to:
A. Allow the family to ventilate their feelings and concerns, while maintaining the role of the client
advocate.

During a routine visit, the nurse noted that Perlita, 20-year old wife and mother, has several bruises at
various stages of healing. She tells the nurse that she fell down. Failure to report your findings is an
example of _____________.
D. negligence

Which of the following examples would indicate observance of client confidentially?

B. Describing a difficulty with a client in a health teaam
Conference

A preoperative assessment shows that a client's hemoglobin level is dropping. The anesthetist orders 3
units of blood to be administered. The nurse administers the first unit before discovering that the client
is a Jehovah's Witness, as documented in the record. This is an example of
b. a negligent act.

Which of the following is a violation of client confidentiality? Reporting

D. client data to a colleague in a nonprofessional setting

A 16-year-old trauma victim arrives in the emergency department with a life-threatening condition and
requires emergency surgery. The nurse knows that
D. surgery can be performed without consent

The nurse observes a client pacing the floor. The nurse validates an inference when speaking to the
client by stating,
c. "You seem anxious. Will you tell me what is going on?"

A client who is scheduled for a bilateral inguinal hernia repair the next day is observed pacing the unit.
After validating that the client is anxious about his upcoming surgery because he is afraid of pain, a
relevant nursing diagnosis would be
C. anxiety related to fear of postoperative pain as evidenced by pacing
Fearless Forecast

Gouty arthritis pain site assessment---- Big Toe

Mother of child with epilepsy ask, what activity to avoid

------- rock climbing

A nurse is providing dietary instructions to a client with systemic lupus erythematosus. Which of the
following dietary items would the nurse instruct the client to avoid?
-----Steak/Beef/Ham/pork

The nurse is assigned to care for a client with systemic lupus erythematosus (SLE). The nurse plans care
knowing that this disorder is:
-------An inflammatory disease of collagen contained in connective tissue

The nurse provides home care instructions to a client with systemic lupus erythematosus and tells the
client about methods to manage fatigue. Which statement by the client indicates a need for further
instructions?
--------"I should take hot baths because they are relaxing."

A 26-year-old woman has been diagnosed with early systemic lupus erythematosus (SLE) involving her
joints. In teaching the patient about the disease, the nurse includes the information that SLE is a(n):
-----C. Disorder of immune function, but it is extremely variable in its course, and there is no way to
predict its progression.

A patient with an acute exacerbation of systemic lupus erythematosus (SLE) is hospitalized with
incapacitating fatigue, acute hand and wrist pain, and proteinuria. The health care provider prescribes
prednisone (Deltasone) 40 mg twice daily. Which nursing action should be included in the plan
------C. Monitor intake and output.

pt. first initial visit – to assess use for quick assessment

Answer: KARDEX

Abdominal aortic aneurism assessment finding

Answer: BRUIT sound in the abdomen

Meningitis
----DROPLET PRECAUTIONS

3 feet distance or less

-----Droplet

Best time for handwahing

---- 60 seconds

Standard V/S monitoring

-----Every 4 hours

Telephone call orders

----Sign within 24 hours

INITIAL MANIFESTATION of ACROMEGALY ----PROGNATHISM

Triad of ADHD:
-----Inattention, Hyperactivity, Impulsivity

Control the progression of glaucoma or IOP -----Latanoprost eye solution

Oral Inhalation Therapy

-----Breathes through the mouth.

50% of cases of MASTOIDITIS are required to -----Mastoidectomy

Emergency conjuctivitis
-----pink eye disease

Complication of conjunctivitis
-----corneal perforation