CHN
In determining priorities among health conditions,
1. Primary Health Care is essential health care made
universally accessible to individuals and families in the
community by means acceptable to them through their
full participation at a cost they can afford. Primary
Health Care was adopted in the Philippines through LOI
949 as signed by President Marcos. According to this
strategy, responsibility for health is placed on:
a) The local government units
b) The Department of Health
c) The basic primary health care team
d) The individual, his family, and the community
2. PHC has four pillars: active community participation,
multi-sectoral linkages, use of appropriate technology
and support mechanism made available. The goal of
PHC is to achieve self-reliance. Nurse Anna should use
which of the following as the framework for achieving
the mission of PHC?
a) Organization strategy
b) Fourmula One
c) Getting support from community members
d) Collaboration with patient leader in the
community
3. There are two levels of primary health care workers;
Village or Barangay Health workers and
Intermediate level health workers. One of the BHWs
asked Nurse Anna who are supposed to be included in
the basic primary health care team. Nurse Anna would
be correct in stating the following as members of the
basic team:
a) Physician, a public health nurse, midwives,
sanitation inspector
b) Physician, a public health nurse, midwives
c) Public health nurse, midwife, traditional birth
attendant
d) Public health nurse, midwife, health auxillary
volunteer, traditional healer.
4. Community health purposes and goals are realized
through the application of a series of steps that lead to
desired results. The nursing process is central to all
nursing actions which include assessment, planning,
implementation and evaluation. When Nurse Alicia, a
PHN in the RHU is analyzing and interpreting data, she
is in what phase of the nursing process?
a) Assessment
b) Planning
c) Implementation
d) Evaluation
5. A health threat is defined as a condition that promotes
disease or injury. In the above conditions, Nurse Angeli
would be correct in stating which of the following as
health nurses?
I. Youngest child with no immunizations
II. Eldest child with chicken pox
III. House with poor ventilation
IV. Mother who recently lost her job
V. Father who was diagnosed with TB
a) I and IV
b) II and V
c) I and III
d) IV and V
6.
there are four criteria. When Nurse Angeli is
determining the probability of success in minimizing or
eradicating the existing problem, she is using which
criterion in prioritization?
a) Nature of the problem
b) Modifiability of the problem
c) Preventive potential
d) Salience
7. A cardinal principle in goal setting states that goals
must be set jointly with the family. This ensures the
family’s commitment to their realization. There are
several barriers as to why the nurse and the family can’t
set goals together. Which of the following will be
considered the biggest barrier to collaborative goal
setting between the Nurse Angeli and the Brandes
family?
a) Failure of the Brades family to perceive the
existence of a problem
b) Brades family refuses to do something about
the situation
c) Failure of nurse Angeli to develop a working
relationship with the family
d) Failure of the Brades family to see the
seriousness of a situation
8. The family nursing care plan is the blueprint of the care
that the nurse designs to systematically minimize or
eliminate the health and family nursing problems. All of
the following are features of the FNCP, except:
a) The FNCP is based upon identified health and
nursing problems
b) The FNCP relates to the future
c) The FNCP is an end it self
d) The FNCP focuses on actions designed to solve
a problem
9. There are specific qualities of a nursing care plan, which
help to maximize its effectiveness. FNCP should be
based on a problem, realistic, prepared with the family
and in written form. Which quality of the FNCP is Nurse
Angeli adhering to when the FNCP she and the family
developed can be implemented with reasonable chance
of success?
a) It should be based on clear, explicit definition
of a problem
b) It is realistic
c) It is prepared jointly with the family
d) It is most useful in written form
10. Nurse Sarah is a PHN in Barangay Bunga Menor. She is
handling the maternal health services in her RHU.
Pregnancy poses a risk to the life of every woman. Every
woman has to visit the nearest health facility for
antenatal registration and to avail prenatal services. The
minimum number of prenatal visits is 4. If the mother
can only have 4 visits, when should Nurse Sarah ask the
mother to return for her 2nd prenatal visit?
a) 1st trimester
b) 2nd trimester
c) 6th – 7th month
d) 8th month of pregnancy
11. After delivery, it is important to inform the mother
about the following MCH messages: birth
registration, importance of breastfeeding. Newborn
 screening, and schedule of post-partum visits.
When Clara gives birth, when should be the
recommended schedule for the 2nd post-partum
visit?
a) 1 week after delivery
b) 2-4 weeks after delivery
c) On the 6th week post-partum
d) 4 weeks after the first post-partum visit
12. Nurse Rachelle is a nurse in the RHU. Several
mothers in her community are interested about
family planning and would like to know more about
this program.
Family planning has four pillars: Birth spacing,
Respect for life, Responsible parenthood and
Informed choice. Nurse Rachelle will inform the
mothers that the recommended number of year’s
interval between births by the Family Planning
program would be?
a) 1-2 years
b) 2-4 years
c) 3-5 years
d) 4-6 years
13. Fertility Awareness-Based (FAB) methods are
contraceptive methods hinged on the awareness of
the end of the fertile time of a woman’s menstrual
cycle. Nurse Rachelle would be correct in stating
that all but one of the following are examples of
FAB methods:
a) Basal Body Temperature
b) Billing’s Method
c) Lactational Amenorrhea Method
d) Standard Days Method
14. The overall goal of Family Planning is to provide
universal access to family planning information
and services wherever and whenever these are
needed. It addresses the need to help couples
achieve their desired family size within the
context of responsible parenthood. Margie, who
just gave birth to her 2nd child came to the family
planning clinic because she was interested in using
an intrauterine device for family planning. When
should Nurse Rachelle recommend the device be
inserted?
a) At the end of the puerperium
b) Any time within 48 hours after childbirth
c) When the client has menstrual bleeding
d) Immediately after childbirth and before
expulsion of the placenta
15. Methods to be used by breastfeeding mothers
immediately after birth include: LAM, BTL, IUD
and Condom. Celeste, 6 weeks post-partum is at the
RHU for her 2nd post-partum visit. She is
exclusively breastfeeding. Which method of family
planning can Nurse Rachelle recommend to
Celeste?
a) Combined oral contraceptive pills
b) Standard days method
c) DMPA
d) Calendar Method
16. Male sterilization is one of the 2 permanent
methods of family planning. This involves cutting
the vas deferens through a small opening on the
scrotal skin. All of the following statements are true
with regards to vasectomy, except:
a) It has no apparent long term health risks
b) It is very effective 3 months after the
procedure
c) It does not affect male hormonal function,
erection and ejaculation
d) It cannot be done in the RHU
17. PD 996 requires the compulsory immunization of
all children below 8 years of age, against the six
childhood immunizable diseases. Nurse Tony is
aware that all of the following statements are true
with regards to vaccinating children, except:
a) It is safe and immunologically effective to
administer all EPI vaccines on the same
day
b) Use one syringe, one needle per child
during vaccination
c) Fever and systemic symptoms result as an
abnormal immune response to vaccination
d) Do not immunize a child that needs to be
hospitalized
18. The standard routine immunization schedule for
infants is adopted to provide maximum immunity
against the seven vaccine preventable diseases
before the child’s first birthday. A 6 weeks old
infant was brought to the health center for her
regular well-baby check-up. The infant is to receive
her scheduled immunization. Upon assessment,
Nurse Tony noted that the temperature of the child
is 38.1C and with no other signs and symptoms.
What is his best course of action?
a) Refer the infant to the hospital
b) Give paracetamol for fever and when the
fever is gone, administer the immunization
c) Give the immunization as scheduled
d) Advise mother to go home and return when
the baby’s fever is gone
19. Situation – The nurse is involved in community
organizing activities of Barangay Malusog. The
following questions pertain to this situation.
The nurse makes an ocular survey of Barangay
Malusog. Upon reaching the barangay, it is
appropriate for her to:
a) Encourage community involvement
b) Introduce self to the community
c) Assemble community members for a
meeting
d) Pay a visit to the barangay captain
20. Carrying out the planned activities involving
maximum community participation is referred to
as:
a) Community assembly
b) Mobilization
c) Community organization
d) Integration
21. To ensure collective participation of the people,
community organization should be formed through
a community assembly. The purposes of having
community assemblies are the following EXCEPT:
a) Undertake measures to solve existing
problems of the community
b) Help people identify their own problem
c) Gain cooperation, pledge support and
work together their own
d) Plan for solution of identified problem/s
22. Which of the following approaches is the BEST in
applying community organization in Community
Health?
a) Community-oriented organization
b) Primary Health Care
c) Community Development
d) Universal Health Care
23. Community organizing ends when the community
is already self-reliant. This signals that the
community organizers are now ready to pull out of
the community because:
a) It indicates that community organization is
finished
b) It can evaluate the outcomes of the
programs
c) It will prevent dependency of the
community
d) Organizers can expand to other poor
communities
24. The occurrence of non-communicable diseases
(NCDs) is on the rise and is attributed to the
changing lifestyle of the Filipinos. The major NCDs
are cardiovascular diseases (CVDs), cancer, chronic
obstructive diseases (COPD) and diabetes mellitus
(DM). The community health nurse can help
address these problems.
The major risk factors common to the above
mentioned 4 major NCDs are:
a) Obesity, sedentary lifestyle, and smoking
b) Unhealthy diet, alcoholism, and sedentary
lifestyle
c) Hypertension, sedentary lifestyle and poor
stress management
d) Unhealthy diet, physical inactivity and
smoking
25. Diabetes has become a major problem. The nurses
can help to reduce the incidence of diabetes by?
a) Establishing of organization among
diabetes patients
b) Extensive screening of diabetes patients
c) Increasing the community awareness of
diabetes prevention
d) Helping implement Republic Act 8191 –
National Diabetes Act
26. The learning process whereby knowledge,
attitudes and practice of the people are changed to
improve the health of individuals, families and
communities is:
a) Disease prevention
b) Counseling
c) Motivation
d) Health education (tama according kay
google)
27. The BEST strategies to address the nutrition
problems of Filipinos related to Non-
Communicable diseases are the following EXCEPT:
a) Consider food preferences of family
members
b) Aim for ideal body weight
c) Build healthy nutrition-related practices
d) Choose food wisely
28. In the practice of Community Health Nursing the
nurse utilizes specialized knowledge and skills and
collaboration with other government and non-
government agencies. The concept of Primary
Health Care and Health Promotion are crucial in
community health development.
Which does NOT describe primary health care?
a) It stresses the use of appropriate
technology
b) It emphasizes partnership between health
care providers and the people
c) It aims to provide free health service to the
people
d) It is a total approach to community
development
29. Primary Health Care advocates for the use of
appropriate technology in the delivery of health
services. This is demonstrated by any of the
following EXCEPT:
a) Teaching mothers how to prepare low-
cost, easily digestible and highly nutritious
protein powders to feed children with
malnutrition
b) Use of komiks in information and
educational campaign against dengue
c) Use of Bayabas/Guava for washing wounds
and for diarrhea
 d) Use of portable X-ray machines in far-flung c) Tertiary prevention
communities d) Primary prevention
30. Which of the following is a mark of success in 36. In-patient and diagnostic care including surgery
primary health care? belongs to what level of health care?
a) Barangay officials participate actively in a) Secondary level
health related activity b) Tertiary level
b) The people are able to attain the highest c) Primary level
level of health through their own effort d) Specialized level
c) The people utilize health service according 37. PRIMARY HEALTH CARE embraces all of the
to their needs following concepts, EXCEPT:
d) Health workers are able to provide a) People’s participation is essential
efficient and acceptable service. b) Community organizing as the core of PHC
31. Accessibility of health service implies that: c) Use of appropriate technology
a) Health care providers maximize the service d) It is an approach to provide the basic
of traditional healers whom people needs of the community
commonly approach for health problems 38. One of the member of the family also experiencing
b) The people and the government can afford rheumatism which is brought about by high uric
the health services being provided acid, the nurse can tell to them that they can use:
c) Health service providers are within 5 a) Niyug-niyogan
kilometers from most of the catchment b) Ampalaya
population c) Ulasimangbato
d) Health services are available in health d) Sambong
facilities on a round the clock basis 39. GERMAN MEASLES
32. A major lesson of the Alma-Ata and the different A group of students were at Eruptive ward. They
charters of health promotion is that: had pre-conference with their clinical instructor
a) Health workers must be effective in prior to their exposure to the area. The students
advocacy and mediation to enable the respond correctly that in German Measles the
people to gain control over their lives. infectious sources is/are;
b) Community participation is a fundamental I. Infected blood
requirement to achieve health and II. Infected stool, urine
sustainable development III. Nasopharyngeal secretions of persons with
c) Creation of supportive environment is apparent infection
crucial to achieving health and sustainable IV. Nasopharyngeal secretion of person with
development in apparent infection
d) Meaningful improvements in the a) I, II, III, IV
socioeconomic determinants of health are b) I, II, III
required to have significant improvements c) I, III
in people’s health d) III only
33. The basic unit of care in CHN is: 40. The typical rash is described as;
a) Community a) Vesicular starting from face
b) Groups b) Vesicular starting from trunk
c) Family c) Maculopapulo on the face first
d) Individual client d) Maculopapulo on the trunk first
34. The most important role of a community health 41. The rashes generally disappear on the 3 rd day or
nurse is in the area of: 4th. When rashes fade it results to:
a) Change agent a) Ulceration
b) Health education b) Desquamation
c) Advocacy c) No desquamation
d) Care provider d) Scar formation
35. The focus of activities in specific protection is a 42. Situation – The vision-mission of the Dept. of
level of prevention classified is: Health is health for all Filipino and ensure
a) Secondary intervention accessibility and quality health care.
b) Intervention prevention
 Which of the following is the BASIC principle to
achieve improvement in health?
a) Strengthen health care
b) Universal access to health services
c) Support local health system
d) Develop national standard
43. The ultimate goal of Community Health nursing is:
a) Upholding the worth and dignity of man
b) Raising the level of health of the citizenry
c) Health promotion and disease prevention
d) Enhancing health capabilities of the people
towards self-reliance in health.
44. The philosophy of the community health nursing is:
a) Upholding the worth and dignity of man
b) Raising the level of health of the citizenry
c) Health promotion and disease prevention
d) Enhancing health capabilities of the people
towards self-reliance in health
45. The primary goal of community health nursing is:
a) Upholding the worth and dignity of man
b) Raising the level of health of the citizenry
c) Health promotion and disease prevention
d) Enhancing health capabilities of the people
towards self-reliance in health
46. The theoretical basis of community health nursing
practice are theories and principles of:
a) Community development
b) Public health and research
c) Nursing and public health
d) Nursing and health sciences
47. The Community/Public Health Bag is
a) A requirement for home visits
b) An essential and indispensable equipment
of the community health nurse
c) Contains basic medication and articles
used by the community health nurse
d) A tool used by the community health nurse
is rendering effective nursing procedure
during a home visit
48. What is the rationale in the use of bag technique
during home visit?
a) It helps render effective nursing care to
clients or other members of the family
b) It saves time and effort to the nurse in the
performance of nursing procedures
c) It should minimize or prevent the spread
of infection from individuals to families
d) It should not overshadow concerns for the
patient
49. Which of the following vaccines are the most
sensitive to heat?
a) Measles and BCG
b) DPT and TT
c) TT and BCG
d) Measles and OPV
50. Which of the following vaccines are the LEAST
sensitive to heat?
a) Measles and BCG
b) DPT and TT
c) TT and BCG
d) Measles and OPV
PEDIA
1. A 5-year-old girl Hannah is recently diagnosed with
Kawasaki disease. Apart from the identified
symptoms of the disease, she may also likely
develop which of the following?
a) Aneurysm formation
b) Meningitis
c) Sepsis
Rationale: Kawasaki disease is a rare childhood illness that affects the blood
vessels. 20% to 25% of children can develop aneurysm formation if not
intervened. Treatment depends on the degree of the disease, but is often
immediate treatment with IV gamma globulin or aspirin. Corticosteroids can
sometimes lessen impending complications. Children who experience the
disease usually need lifelong follow-up appointments to keep an eye on
heart health
d) Mitral valve disease
2. Appropriate pharmacologic treatment for
Kawasaki disease includes which of the following?
a) Aspirin 80 to 100 mg/kg/day for anti-
inflammatory effects
b) Aspirin 3 to 5 mg/kg/day for anti-
inflammatory effects
c) Acetaminophen for analgesia and fever
d) Ibuprofen and acetaminophen alternated
to prevent fever
3. Clay is an 8-year-old boy diagnosed with heart
failure. Which of the following shows that he is
strictly following the directed therapeutic
regimen?
a) Pulse rate less than 50 beats/minute
b) Daily use of an antibiotic
c) Normal weight for age
d) Elevation in red blood cell (RBC) count
Rationale: Adequate weight for height demonstrates adequate nutritional
intake and lack of edema. A: Daily use of antibiotic is not indicated in heart
failure. B. A pulse rate less than 50 beats/minute, bradycardia, probably
indicates digoxin toxicity. D: An elevated RBC count demonstrates
polycythemia.
4. The Foley Family is caring for their youngest child,
Justin, who is suffering from tetralogy of Fallot.
 Which of the following are defects associated with
this congenital heart condition?
a) Coarctation of aorta, aortic valve stenosis,
mitral valve stenosis, and patent ductus
arteriosus
b) Ventricular septal defect, overriding aorta,
pulmonic stenosis (PS), and right
ventricular hypertrophy
c) Aorta exits from the right ventricle,
pulmonary artery exits from the left
ventricle, and two non-communicating
circulations
d) Tricuspid valve atresia, atrial septal defect,
ventricular septal defect, and hypoplastic
right ventricle
5. When creating a teaching program for the parents
of Jessica who is diagnosed with pulmonic stenosis
(PS), Nurse Alex would keep in mind that this
disorder involves which of the following?
a) A single vessel arising from both ventricles
b) Return of blood to the heart without entry
to the left atrium
c) Obstruction of blood flow from the left
ventricle
d) Obstruction of blood flow from the right
ventricle
6. Bryce is a child diagnosed with coarctation of
aorta. While assessing him, Nurse Zach would
expect to find which of the following?
a) Severe cyanosis at birth
b) Cyanotic (“tet”) episodes
c) Squatting posture
d) Absent or diminished femoral pulses
7. Which of the following instructions would Nurse
Courtney include in a teaching plan that focuses on
initial prevention for Sheri who is diagnosed with
rheumatic fever?
a) Treating streptococcal throat infections
with an antibiotic
b) Giving penicillin to patients with rheumatic
fever
c) Using corticosteroid to reduce
inflammation
d) Providing an antibiotic before dental work
8. Which of the following would Nurse Tony suppose
to regard as a cardinal manifestation or symptoms
of digoxin toxicity to his patient Clay diagnosed
with heart failure?
a) Extreme bradycardia
b) Constipation
c) Headache
d) Respiratory distress
Rationale: Extreme bradycardia is a cardinal sign of digoxin toxicity
A,B,D: Headache, respiratory distress, and constipation are not
related to digoxin toxicity.
9. Appropriate intervention is vital for many children
with heart disease in order to go on to live active,
full lives. Which of the following outlines an
effective nursing intervention to decrease cardiac
demands and minimize cardiac workload?
a) Feeding the infant over long periods
b) Allowing the infant to have her way to
avoid conflict
c) Scheduling care to provide for
uninterrupted rest periods
d) Developing and implementing a consistent
care plan
10. Which of the following disorders leads to cyanosis
from deoxygenated blood entering the systemic
arterial circulation?
a) Aortic stenosis (AS)
b) Coarctation of aorta
c) Patent ductus arteriosus (PDA)
d) Tetralogy of Fallot
Rationale: Tetralogy of Fallot consists of four major anomalies: ventricular
septal defect, right ventricular hypertrophy, pulmonic stenosis (PS), aorta
overriding the ventricular septal defect.
 PS impedes the flow of blood to the lungs, causing increased pressure in the
right ventricle, forcing deoxygenated blood through the septal defect the left
ventricle.
 As a result of this decreased pulmonary flow, deoxygenated blood is shunted
into the systemic circulation.
 The increased workload on the right ventricle causes hypertrophy.
 The overriding aorta receives blood from both the right and left ventricles.
 This is the definition of defect with decreased pulmonary blood flow where
unoxygenated blood is shunted into the systemic circulation.
11. It is considered as the bluntly rounded portion of
the heart
a) Apex
b) Aorta
c) Pericardium
d) Base
12. Arrange these parts of the conduction system of
the heart in the correct order as an action
potential would pass through them
Rationale: Rheumatoid fever results from improperly treated group beta-
hemolytic streptococcal infections, usually pharyngitis. Therefore, prompt
treatment of streptococcal throat infections with an antibiotic is a key
preventive measure.
I. AV node
 II. Purkinje fibers left in the ER. Based on the following information,
III. Atrioventricular bundle which child should be seen first?
IV. R and L bundle of His a) A 5-year-old who is speaking in complete
V. SA node sentences, is pink in color, is wheezing
a) 2-4-3-5-1 bilaterally, and has an O2 saturation of
b) 3-5-2-4-1 93%
c) 2-5-3-4-1 b) A 9-year-old who is quiet, is pale in color,
d) 2-5-4-3-1 has diminished breath sounds, and has an
13. Which of these statements regarding the O2 saturation of 92%
conduction system of the heart is NOT correct? c) A 12-month-old who has a mild cry, is pale
Select all that apply. in color, has diminished breath sounds,
I. The sinoatrial (SA) node of the heart acts and has an O2 saturation of 93%
as the pacemaker d) A 16-year-old who is speaking in short
II. The SA node is located on the upper wall sentences, is wheezing, is sitting upright,
of the left atrium and has an O2 saturation of 93%
III. The AV node conducts action potentials 17. A 6-month-old is admitted to the hospital with
rapidly through it RSV. The nurse is assessing the child. Which of the
IV. Action potentials are carried slowly following physical findings should be of most
through the atrioventricular bundle concern?
a) 4-1-2 a) The baby has tachypnea
b) 2-3-4 b) The baby has mild retractions
c) 1-2-3 c) The baby is wheezing
d) 3-4-1 d) The baby is grunting
14. The procedure that has to be performed in order 18. Betty is a 9-year old girl diagnosed with cystic
to shift the high pressure from the right ventricle fibrosis. Which of the following must Nurse Archie
to the left ventricle in Transposition of the Great keep in mind when developing a care plan for the
Arteries (TGA) is: child?
a) Rastelli Procedure a) CF is an autosomal dominant hereditary
b) Pulmonary Artery Bleeding disorder - It is a chronic, inherited disorder, particularly
c) Jatene Procedure an autosomal recessive hereditary disorder concerning the
exocrine, not endocrine glands.
d) Rashkind Procedure
b) Elevated levels of potassium are found in
15. The ductus arteriosus is another fetal structure
the sweat - Diagnosis of CF is based on elevated
that is important in the intrauterine life. It chloride levels detected in sweat.
functions to: c) Obstruction of the endocrine gland occurs
a) Shunts the combined cardiac output from - The thick mucus blocks the exocrine glands.
the pulmonary artery to the aorta going to d) Pulmonary secretions are abnormally thick
the lungs - CF is identified by abnormally thick pulmonary
b) Shunts the combined cardiac output from secretions.
the pulmonary artery to the systemic 19. Veronica’s parents were told that their daughter
circulation needs ribavirin (Virazole). This drug is used to treat
c) Shunts the combined cardiac output from which of the following?
the aorta to the pulmonary artery and a) Otitis media
later to the pulmonary veins b) Bronchitis
d) Shunts the combined cardiac output from c) Cystic fibrosis
the aorta to the pulmonary artery to the d) Respiratory syncytial virus (RSV)
right ventricle Rationale: Ribavirin is an antiviral medication used for treating
16. There are several children in the ER waiting area RSV infection and for children with RSV who are compromised
(such as children with bronchopulmonary dysplasia or heart
who all have asthma. The nurse has only one room disease).
 The drug is not used to treat bronchiolitis, otitis media, or CF.
20. Beta-adrenergic agonists such as albuterol are
given to Reggie, a child with asthma. Such drugs
are administered primarily to do which of the
following?
a) Dilate the bronchioles - Beta-adrenergic agonists,
such as albuterol, are highly effective bronchodilators and
are used to dilate the narrow airways associated with
asthma.
b) Reduce airway inflammation - Corticosteroids
may be used for their anti-inflammatory effect.
c) Decrease post-nasal drip - Decongestants may be
given to decrease postnasal drip.
d) Reduce secondary infections - Antibiotics are
used to prevent secondary infection.
21. The Andrews family has been taking good care of
their youngest, Archie, who was diagnosed with
asthma. Which of the following statements
indicate a need for further home care teaching?
a) "He should increase his fluid intake
regularly to thin secretions."
b) "We'll make sure that he avoids exercise to
prevent attacks."
c) "He is to use his bronchodilator inhaler
before the steroid inhaler."
d) "We need to identify what things trigger
Rationale: Additional teaching is needed if the family states that the
child with asthma should avoid exercise to prevent attacks. Children
with asthma should be encouraged to exercise as tolerated. A,C,D:
Identifying triggers, using a bronchodilator inhaler before a steroid
inhaler, and increasing fluid intake are appropriate measures to be
included in a home care teaching program for the child with asthma
and his family.
his attacks."
22. Which is the most frequently occurring congenital
heart defect?
a) Ventricular septal defect
b) Atrial septal defect
c) Mitral valve prolapse
d) Transposition of great vessels
23. Alice is rushed to the emergency department
during an acute, severe prolonged asthma attack
and is unresponsive to usual treatment. The
condition is referred to as which of the following?
a) Intrinsic asthma - Intrinsic is a term used to denote
internal precipitating factors, such as viruses.
b) Reactive airway disease - Reactive airway disease
is another general term for asthma.
c) Status asthmaticus - Status asthmaticus is an
acute, prolonged, severe asthma attack that is
unresponsive to usual treatment. Typically, the child
requires hospitalization.
d) Extrinsic asthma - Extrinsic is a term used to denote
external precipitating factors, such as allergens.
24. Which of the following infants is least probable to
develop sudden infant death syndrome (SIDS)?
a) Baby Angela who was premature
b) Baby Gabriel with prenatal drug exposure
c) Baby Gabby who sleeps on his back
d) A sibling of Baby Angie who dies of SIDS
Rationale: Infants who sleep on their back are least likely to develop
SIDS. However, SIDS has been associated with infants who sleep on
their abdomens. Being premature, having a sibling who died of SIDS,
and being prenatally exposed to drugs all place the infant at high risk
for developing SIDS
25. Baby Melody is a neonate who has a very low-
birth-weight. Nurse Josie carefully monitors
inspiratory pressure and oxygen (O2)
concentration to prevent which of the following?
a) Respiratory syncytial virus (RSV) - RSV is a
group of viruses that cause respiratory tract infections,
such as bronchiolitis and pneumonia.
b) Respiratory distress syndrome (RDS) - RDS, a
disorder caused by lack of surfactant, usually is found in
premature neonates.
c) Meconium aspiration syndrome - Meconium
aspiration syndrome is a respiratory disorder created by
the aspiration of meconium in perinatal period.
d) Bronchopulmonary dysplasia (BPD)
Rationale: Close monitoring of inspiratory pressure and O2 concentration
is necessary to prevent BPD, which is related to the use of high
inspiratory pressures and O2concentrations especially in very low-birth-
weight and extremely low-birth-weight neonates with lung disorders.
26. Archie who weighs 44 lbs. has been given an order
for amoxicillin 500 mg b.i.d. The drug text notes
that the daily dose of amoxicillin is 50 mg/kg/day
in two divided doses. What dose in milligrams is
safest for this child?
a) 1000 mg
b) 500 mg
c) 750 mg
d) 250 mg
Rationale: First, calculate the child’s weight in kg: 44/2.2 = 20 kg.
Then calculate the appropriate daily dose according to the drug text:
50 mg/kg/day = 50 mg x 20 kg = 1,000 mg/day. The abbreviation b.i.d.
means twice daily; therefore 1,000 divided by 2 equals 500 mg.
27. Which of the following respiratory conditions is
always considered a medical emergency?
a) Asthma
b) Cystic fibrosis (CF)
c) Epiglottiditis
d) Laryngotracheobronchitis (LTB)
Rationale: Epiglottiditis, acute and severe inflammation of the epiglottis, is
always considered an acute medical emergency because it can lead to
acute, life-threatening airway obstruction.
 Asthma is a chronic disease; however, status asthmaticus and acute
attacks require prompt treatment.
 CF is a chronic disease and is not considered an emergency.
 Acute LTB requires close observation for airway obstruction, but this
28. Immunization of children with Hemophilus upright position because feeding the child in the supine
position may actually precipitate otitis by allowing the
influenza type B (Hib) vaccine decreases the
formula to pool in the pharyngeal cavity.
incidence of which of the following conditions?
b) Giving prescribed amoxicillin (Amoxil) on
a) Pneumonia - The most common bacterial organisms
causing pneumonia in children are pneumococci,
an empty stomach - Amoxicillin, when prescribed,
streptococci, and staphylococci. should be given with food to prevent stomach upset.

b) Bronchiolitis - Bronchiolitis is usually caused by c) Cleaning the inside of the ear canals with
Respiratory Syncytial Virus (RSV). cotton swabs - Cotton swabs can cause injuries such
c) Laryngotracheobronchitis (LTB) - Acute LTB is as tympanic perforation. They may be used to clean the
of viral origin. outer ear, but they should never be inserted into the ear
canal.
d) Epiglottis - Epiglottitis is a bacterial infection of the
epiglottis primarily caused by Hib. Administration of the
d) Avoiding contact with people who have
vaccine has decreased the incidence of epiglottitis. upper respiratory tract infections - Otitis
media is commonly precipitated by an upper respiratory
29. When assessing a child’s cultural background, the tract infection. Therefore, children prone to otitis should
nurse in charge should keep in mind that: avoid people known to have an upper respiratory tract
infection.
a) Physical characteristics mark the child as
part of a particular culture - Physical 33. Fred is a 12-year-old boy diagnosed with
characteristics do not indicate a child’s culture. pneumococcal pneumonia. Which of the following
b) Behavioral patterns are passed from one would Nurse Nica expect to assess?
generation to the next - A family’s behavioral a) Bulging fontanel - A bulging fontanel may be seen in
patterns and values are passed from one generation to the infants with meningitis or increased intracranial pressure.
next. b) Mild cough - A mild cough is commonly assessed with
c) Cultural background usually has little viral pneumonia.
bearing on a family’s health practices - c) Slight fever - A slight fever is commonly assessed with
Cultural background commonly plays a major role in viral pneumonia.
determining a family’s health practices. d) Chest pain - Older children with pneumococcal
d) Heritage dictates a group’s shared values - pneumonia may complain of chest pain.
Although heritage plays a role in culture, it does not dictate 34. D
a group’s shared values and its effect on culture is weaker 35. D
than that of behavioral patterns.
36. Dd
30. Which of the following is the best method for
37. D
performing a physical examination on a toddler?
38.
a) From least to most intrusive - When examining
a toddler or any small child, the best way to perform the
exam is from least to most intrusive.
b) Distally to proximally - Proceeding from distal to
proximal is inappropriate at any age.
c) From abdomen to toes, to head
d) From head to toe - Starting at the head or abdomen
is intrusive and should be avoided.
31. Nurse Veronica is teaching a group of parents
about otitis media. When discussing why children
are predisposed to this disorder, the nurse should
mention the significance of which anatomical
feature?
a) Nasopharynx
b) Eustachian tubes
c) External ear canal
d) Tympanic membrane
32. Which of the following instructions should Nurse Rationale: In a child, Eustachian tubes are short and lie in a
Cheryl include in her teaching plan for the parents horizontal plane, promoting entry of nasopharyngeal secretions into
the tubes and thus setting the stage for otitis media.
of Reggie with otitis media?  The nasopharynx, tympanic membrane, external ear canal have
a) Placing the child in the supine position to no unusual features that would predispose a child to otitis media.
bottle-feed - A bottle-fed child should be fed in an