ARELLANO UNIVERSITY

COLLEGE OF NURSING

CAPP – 1

MIDTERM LONG TEST

1. While on their MCN class, the instructor provides that the portion of the uterus whose significant
characteristic is to stretch during vaginal birth is the:

A) Corpus

B) Fundus

C) Cervix

D) Internal os

2. Normal delivery of the fetus requires a lot of factors to be assured to exist. The normal female pelvis
is well suited for labor and birth and has:

A) A rounded inlet, nonprominent ischial spines, straight side walls, and a deep and roomy posterior
segment

B) A heart shaped inlet, prominent ischial spines, convergent side walls, and a shallow posterior segment

C) An oval inlet, variable ischial spines, straight side walls, and a deep posterior segment

D) A transversely oval inlet, variable ischial spines, parallel side walls, and a wide transverse diameter.

3. Which gland is responsible for initiating the menstrual cycle?

A) Ovary

B) PPG

C) APG

D) Hypothalamus

4. The nurse is preparing teaching plan for a group of adolescent girls. She will be discussing the monthly
cycle of the woman. Included in the discussion are the phases of the uterine cycle. Ovulation takes place
during which of the following phases of the menstrual cycle?

A) Menstrual phase
B) Proliferative phase

C) Ischemic phase

D) Secretory phase

5. To help a woman recognize the best time for conceiving, a nurse would to monitor for which of the
following manifestation of ovulation?

A) Drop in the body temperature lasting several days

B) Increase in the amount of clear and stretches mucus

C) Abdominal bloating that occurs suddenly

D) Breast tenderness accompanied by slight nipple discharge

6. After instructing about side effect of oral contraceptives, the nurse determines that further
instruction is needed when the client states which of the following as a side effect?

A) Weight gain

B) Nausea

C) Headache

D) Ovarian cancer

7. The mother, who has just been diagnoses pregnant, asked the nurse on which germ layer does the
fetal heart and kidneys are formed. The nurse would correctly respond that it arises from the:

A) Mesoderm

B) Endoderm

C) Ectoderm

D) Dermis

8. In explaining the development of the baby, you identified in chronological order of growth of the
fetus as it occurs in pregnancy as?

A) Zygote,ovum,embryo, fetus

B) Zygote, ovum, fetus, embryo

C) Ovum, embryo, zygote, fetus

D) Ovum, zygote, embryo fetus

9. A client at eight weeks gestation asks why she is experiencing nausea and vomiting. Which statement
by the nurse best explains how the hormones of pregnancy contribute to nausea and vomiting?

A) “Increased levels of human chorionic gonadothropin contribute to nausea and vomiting.”

B) “Increased levels of prostaglandin contribute to nausea and vomiting.”

C) “Increased levels of progesterone contribute to nausea and vomiting.”

D) “Increased levels of estrogen contribute to nausea and vomiting.”

10. While a pregnant client lies on her back, she reports that she is experiencing dizziness. What is the
priority action of the nurse?

A) Take the client’s blood pressure

B) Position the client on her side

C) Give the client a drink of water

D) Place the client in a Trendelenburg position

11. Which of the following is not true regarding physiologic maternal changes?

A) Constipation as a result of decreased GI motility

B) Retention of sodium and water may occur

C) Total red cell volume decreases

D) Decreased bladder capacity

12. Which finding is considered positive signs of pregnancy?

A) Fatigue and skin changes

B) Quickening and breast enlargement

C) Fetal heartbeat and and fetal movement on palpation

D) Abdominal enlargement and Braxton hicks contraction

13. A client at 20 weeks gestation tells the nurse she is concerned by the contractions she feels when
she places her hand on her abdomen. What is the best reply by the nurse?
A) “Come to the office immediately.”

B) “This is nothing unusual, don’t’ worry about it.”

C) “How often do you feel these contractions?”

D) “What other concerns do you have?”

14. What is the most helpful response by the nurse when a client at seven weeks gestation states, “I’m
not sure if I want to be pregnant. How will I know if I’ll be a good mother?”

A) “This is big change for you.”

B) “Would you like to consider other options for the pregnancy?”

C) “You have signs of depression. You should make an appointment with family services.”

D) “I am wondering why you feel this way.”

15. A nurse midwife assesses a client at 14 weeks gestation. The mucous membranes of the cervix are
inspected and found to be bluish-purple in color. How would the nurse midwife document this
assessment?

A) Chadwick’s sign (Bluish-purple in color)

B) Goodell’s sign (Softening of the cervix)

C) Hegar’s sign (Softening of the isthmus of the uterus)

D) McDonald’s sign (Flexing the body of the uterus against the cervix)

16. What statement by a woman who is 28 weeks pregnant would indicate that she understands the
pattern of normal prenatal visits?

A) “My next visit will be in one month.”

B) “I will be back at 34 weeks for my next visit.”

C) “I need to come for prenatal check ups every week.”

D) “My next visit will be in two weeks.”

17. When is the first time the nurse will prepare the Doppler transducer to listen to the fetal heart beat?

A) 5 weeks gestation

B) 10 weeks gestation
C) 15 weeks gestation

D) 20 weeks gestation

18. The nurse is preparing a prenatal client for an initial examination. What is the first task the nurse
should perform to increase the client’s comfort?

A) Provide the client with a gown

B) Instruct the client to provide a clean urine specimen

C) pare the client for a pelvic exam

D) Assist the client to a supine position on the exam table

19. A client tells the nurse her last period was May 18 to 24. The nurse uses Naegele’s rule to compute
the expected date of birth. Based on this information, what would the nurse document as the expected
date of birth?

A) February 11 (of the next year)

B) February 18 (of the next year)

C) February 25 (of the next year)

D) March 1 (of the next year)

20. Using Leopold’s maneuver to determine fetal position, the nurse finds that Mrs. L’s fetus is in a
vertex position with the back on the left side. Where is the best place for the nurse to listen for fetal
heart tones?

A) In the right upper quadrant of the mother’s abdomen.

B) In the left upper quadrant of the mother’s abdomen.

C) In the right lower quadrant of the mother’s abdomen.

D) In the left lower quadrant of the mother’s abdomen.

21. A nurse is making a home visit to a 10-week gestation client who is experiencing nausea and
vomiting. Which statement by the client indicates that the nurse needs to give further instructions?

A) “I will drink liquid with meals.”

B) “I will eat crackers before I get up in the morning.”

C) “I will eat less fried food.”

D) “I like to eat small amounts throughout the day.”

22. When a client has round ligament pain, the nurse should include which of these instructions in the
teaching plan for the pregnant woman and her family?

A) Apply a cold pack to the lower abdomen

B) Drink warm fluids

C) Apply a heating pad to the area

D) Avoid aggravated movement

23. The laboratory results of a client who is pregnant indicate the hemoglobin is 10.4g/dL. The nurse
would be most concerned by which statement from this client?

A) “I don’t like to drink water.”

B) “I eat banana every day.”

C) “I find the smell of broccoli makes me feel nauseated.”

D) “I am not eating meat since I found out I was pregnant.”

24. To reduce the risk of fetal neural tube defects, a nurse would evaluate the child bearing woman’s
need for which of the following nutrients supplements?

A) Ferrous sulfate

B) Calcium

C) Folate

D) Ascorbic acid

25. A client at 38 weeks gestation begins a non stress test. After 20 minutes, the nurse concludes the
test, and documents the findings to be reactive. Which of these comments should the nurse make?

A) “This test showed that the baby’s heart rate got faster when the baby moved.”

B) “There was not enough data. We will need to do further testing.”

C) “The baby was sleepy, and so we will schedule another type of test.”

D) “Come back tomorrow for another test.”

SITUATION: High-risk pregnancy results when the expecting mother and/or the growing baby develop a
condition(s) that places them at higher-than-normal risk for complications during pregnancy. 26. The
nurse is preparing an antenatal client for an initial assessment. What is the first task that the nurse
should perform?

A) Provide the client with a gown.

B) Instruct the client to provide a clean urine specimen.

C) Prepare the client for a pelvic exam.

D) Draw blood for routine tests.

27. The nurse in the prenatal clinic is planning care for a pregnant 15-year-old client. The nurse knows
that this adolescent is at risk for which maternal complication?

A) Postpartum hemorrhage (complication of multiparaty)

B) Hypoglycemia (complication of diabetes)

C) Cesarean birth (over 35 years of age)

D) Pre-eclampsia (Adolescent)

28. The nurse has completed the initial assessment on four prenatal clients. Which client is at greatest
risk for a spontaneous preterm birth?

A) A 26-year-old client with a history of diabetes

B) A 17-year-old client with a hyperthyroid disorder

C) A 19-year-old client with twins

D) A 40-year-old client with anemia

29. A nurse is completing an assessment on a first-trimester antepartal client. Which of the following
statements would indicate a psychological risk factor and a need to evaluate further for possible
intervention?

A) "I'm not sure I'm happy about being pregnant right now."

B) "My boyfriend said it better be a boy."

C) "I can't think of any names I like."

D) " I might have to quit my job."

30. A client who is 8 weeks pregnant gives the following pregnancy history to the nurse: This is her
fourth pregnancy; she had one abortion at 12 weeks, she had a girl born at home at 35 weeks, and she
gave birth to a stillborn at 38 weeks. Which of the following is the correct documentation for this client's
obstetric history?

A) Gravida 4 para 1111 (tpal Term, preterm, Abortion, labor)

B) Gravida 3 para 0110

C) Gravida 3 para 1111

D) Gravida 4 para 2102

SITUATION: A female client is being treated in a methadone maintenance program. On her next visit to
the clinic she tells the counselor that she is three months pregnant and is receiving prenatal care. 31.
The client has been taking 40 mg of methadone daily for treatment of an opiate addiction. The nurse
should inform the client to do which of the following with regards to her medication treatment as per
doctor’s order?

A) Continue with the methadone as prescribed to prevent withdrawal symptoms

B) Discontinue the methadone immediately to improve fetal and neonatal outcome

C) Discontinue the methadone slowly over the next two weeks to block drug cravings

D) Withdraw from the methadone maintenance program while she is pregnant and reenter when she
has delivered

32. Aware of the client’s history of opiate abuse, the nurse’s initial plans for providing pain relief
measures during labor should include:

A) Scheduling pain medication at regular intervals

B) Administering the medication only when the pain is severe

C) Avoiding the administration of medication unless it is requested

D) Recognizing that she will not need as much pain medication as others

33. The nurse should be aware that a postpartum client with a history of drug abuse may be
experiencing drug withdrawal if she develops:

A) Paranoia and evasiveness

B) Extreme hunger and thirst

C) Depression and tearfulness

D) Irritability and muscle tremors

34. Another client tells the nurse that she takes methamphetamine almost daily. A fetus of a drug-
addicted mother receives approximately what percentage of the mother’s drug concentration?

A) 20%

B) 50%

C) 70%

D) 100%

35. The nurse caring for newborns whose mothers are drug abuser wants to conduct a study. The
hypothesis of her study is stated as “infants born to heroine addicted mother have lower birth weight
than infants with non-addicted mothers”. Her hypothesis is an example of which type of research?

A) Complex and Directional

B) Simple and Directional (1 dependent variable and 1 independent variable)

C) Complex and Non-directional

D) Simple and Non-directional

SITUATION: Gestational diabetes is the third type of diabetes which occurs during pregnancy may be
caused from inadequate insulin response to carbohydrate or from excessive resistance to insulin; or a
combination of both. 36. A 30-year-old multigravid client at 8 weeks’ gestation has a history of insulin-
dependent diabetes since age 20. When explaining about the importance of blood glucose control
during pregnancy, which of the following should the nurse expect to occur regarding the client’s insulin
needs during the first trimester?

A) They will increase

B) They will decrease

C) They will remain constant

D) They will be unpredictable

37. After teaching a diabetic mother about symptoms of hyperglycemia and hypoglycemia, the nurse
determines that the client understands the instruction when she says that hyperglycemia is be
manifested by:

A) Dehydration
B) Pallor –(hypo)

C) Sweating (hypo)

D) Nervousness (hypo)

38. At 38 weeks’ gestation, a primigravid client with poorly controlled diabetes and severe preeclampsia
is admitted for a caesarean delivery. The nurse explains to the client that delivery helps to prevent:

A) Neonatal hyperbilirubinemia

B) Congenital anomalies

C) Perinatal asphyxia

D) Stillbirth

39. When developing a teaching plan for a primigravid client with insulin-dependent diabetes about
monitoring blood glucose control and insulin dosages at home, what would the nurse expect to include
as a desired target range for blood glucose levels?

A) 40 to 60 mg/dl between 2:00 and 4:00pm (mababa)

B) 60 to 100 mg/dl before meals and bedtime snacks

C) 110 to 140 mg/dl before meals and bedtime snacks (mataas)

D) 140 to 160 mg/dl 1 hour after meals (100-120 lang dapat)

40. A client with Type I diabetes is admitted to the labor and birthing unit. What nursing actions should
take priority in the intrapartal management of the patient with diabetes? Select all that apply 1.
Maintaining seizure precautions 2. Maintaining two patent IV lines 3. Hourly monitoring of blood sugar
level 4. Hourly monitoring of coagulation studies

A) 2 and 3

B) 1, 2, 3

C) 2, 3, 4

D) 1 and 3

41. The nurse, caring for a 16-year-old female post-abortion, begins to answer the client's questions on
birth control options. Which legal/ethical issue does this nurse's action support?

A) Advance directives
B) Moral dilemma

C) Mature minor

D) Emancipated minor

42. The nurse, caring for a 15-day-old premature infant with a congenital heart condition, realizes this
client might be at risk for early mortality up to age one. What may be another cause for early mortality
for this client?

A) Short gestation (and low birthweight no.1 risk for early mortality up to age 1 )

B) SIDS (3rd leading cause of early death between 1 to 12 months old)

C) Injury

D) Pneumonia

43. The nurse goes to a newborn client's home to assess the latest response to prescribed medical
treatment. In which setting is this nurse practicing maternal-newborn nursing care?

A) General medical surgical floor in an acute care hospital

B) Rehabilitation center

C) Home environment

D) Hospice

44. The nurse is caring for a childbearing family of a different cultural background. In order to provide
culturally appropriate and competent care, the nurse should execute which nursing action?

A) Impose personal cultural values on the family

B) Utilize a standardized nursing care plan for the family

C) Dismiss religious beliefs when developing the care plan

D) Incorporate the family's cultural values into the care plan

45. A nurse is teaching a class on primary care for the neonate. Which statement is true regarding
primary care?

A) Health promotion is a secondary benefit.

B) Primary care is best provided in a hospital setting.

C) Individuals are responsible for their own health.

D) Primary care focuses on the illness and disease process.

46. A nurse is reading about the evolution of home care. Which statement is related to the emergence
of home care as a dimension of community-based nursing care?

A) Individuals receive thorough support and teaching before discharge from the hospital.

B) Nurses cannot function autonomously in the home care setting.

C) Physicians play a major role in coordinating services.

D) Nurses are the major providers of home care services.

47. A client is preparing to have a baby by cesarean section. Which individual is ultimately responsible
for obtaining an informed consent from this client prior to her cesarean section?

A) The admitting nurse

B) The staff nurse

C) The obstetrician

D) The unit manager

48. The nurse is teaching a class on infertility. Which of the following statements correctly describes
infertility?

A) Lack of conception despite unprotected sexual intercourse for at least 12 months

B) An absolute factor preventing reproduction (sterility)

C) Difficulty conceiving because both partners have decreased fecundity (subfertility)

D) Women over 35 who are having difficulty conceiving

49. The nurse is teaching a couple about fertility during the female reproductive cycle. The couple asks
the nurse, "When is the most fertile time for intercourse?" What is the best response by the nurse?

A) Three days before and after ovulation

B) During the follicular phase

C) 12-24 hours before and after ovulation

D) During the luteal phase

50. A nurse is reviewing a basal body temperature chart with a couple. Which change would indicate
probable ovulation?

A) Decrease in temperature followed by an increase for several days.

B) Increase in temperature followed by a decrease for several days.

C) Decrease in temperature that remains until menses begins.

D) Steadily increasing temperature over seven days.

1. The nurse discusses dental care with the parents of a 3-year-old. The nurse explains that by the age of
3, their child should have:

A) 5 "temporary" teeth.

B) 10 "temporary" teeth.

C) 15 "temporary" teeth.

D) 20 "temporary" teeth. (by the age of 2 complete na dapat ang milk teeth) (4months-24 th ang pag
irrupt)

2. The mother of a 6-month-old infant is concerned that the infant's anterior fontanel is still open. The
nurse would inform the mother that further evaluation is needed if the anterior fontanel is still open
after:

A) 6 months.

B) 10 months.

C) 18 months. (Anterior 12month posterior )

D) 24 months.

3. The nurse has discussed appropriate support of the young infant to prevent injuries from falls. The
mother who needs further education is the mother who states:

A) "My child is not allowed to have his walker near the stairs."

B) "I never leave my baby unattended on my bed.

C) "By the time my infant is 6 months old, he will be able to sit without support." 8 months

D) "Before my child is standing, I need to place the crib mattress at its lowest level."
4. The 9-year-old child is at the 98th percentile for weight and at the 40th percentile for height. The
school nurse will interpret that this child is:

A) Underweight or small in stature.

B) Overweight or large in stature. Normal is up to 95th

C) Experiencing a prepubescent growth spurt.

D) Normal for size.

5. In discussing sexual maturation with a health class, the nurse would include the information that
secondary sex characteristics begin to appear at:

A) 10 years in girls, 12 years in boys.

B) 12 years in girls, 16 years in boys.

C) 8 years in boys, 10 years in girls.

D) 12 years in girls and boys.

6. A recently hospitalized 2-year-old client screams and shouts that he wants a "bottle." His parents are
puzzled, and state that he has drank from a cup for the past year. The nurse explains that:

A) Irritability is exhibited in all age groups.

B) Temper tantrums often represent the child's need for parental attention.

C) Various forms of punishment are necessary when such behaviors occur.

D) Regression to an earlier behavior often helps the child cope with stress and anxiety.

7. A friend is shopping for a toy to give to her nephew. The friend knows nothing about children and asks
what would be the most appropriate toy to give an 18-month-old child. Based on growth and
developmental skills, the nurse recommends a:

A) Tricycle.

B) Large ball.

C) Pull toy.

D) Stuffed animal.

8. The nurse is preparing an 8-year-old child for a procedure. What is the most appropriate nursing
intervention?
A) Provide visual aids, such as dolls, puppets, and diagrams in the explanation.

B) Provide a written pamphlet for the child to review prior to the procedure.

C) Discourage any display of emotional outbursts.

D) Request that parents wait outside while the nurse provides instructions to the child.

9. The nurse explains that the Philippine Academy of Pediatrics recommends formula be continued in a
child's dietary intake up until what age?

A) 6 months

B) 12 months

C) 18 months

D) 24 months

10. Piaget identifies that the 2- to 7-year-old child is in a preoperational stage. The nurse observes a
toddler take a toy from another. The nurse recognizes the child unable to put him- or herself in the place
of another is displaying:

A) Centration.

B) Negativism.

C) Egocentrism.

D) Selfishness.

11. A mother asks the pediatric nurse about what she should begin to feed her 6-month-old infant. The
correct response is:

A) Egg whites are the least allergenic food to be introduced into the baby's diet.

B) Rice cereal is the first solid introduced that is least allergenic of the cereals.

C) Formula is the only source of nutrition given for the first year.

D) Fruits and vegetables are good sources of iron.

12. A 1-year-old male child is scheduled for a routine exam at the pediatric clinic. The child's birth weight
was 8 lbs. 2 oz. The child now weighs 18 pounds, 4 oz. The nurse knows that this weight is:

A) Below the expected weight.

B) Appropriate for the child's age.

C) Above the expected weight.

D) Individualized and thus unpredictable.

13. The nurse provides anticipatory guidance to parents of a 3-year-old child. Instructions should
include:

A) To restrain the child in the car seat facing rear in the back seat of the car.

B) The use of syrup of ipecac for accidental poisonings.

C) Drug and alcohol education.

D) The proper use of sports equipment.

14. A school nurse prepares a lecture on puberty for 5th- and 6th-grade girls. She asks the group, "What
is the first sign of puberty?" A student correctly replies:

A) "The appearance of breast buds."

B) "An increase in energy and appetite."

C) "The occurrence of the first menarche."

D) "Appearance of body odor."

15. The mother discusses with the nurse that her toddler asks every night for a bedtime story. The
mother asks why the child does this. The nurse would explain that this behavior demonstrates:

A) Ritualism.

B) Object permanence.

C) Dependency.

D) Conservation.

16. Whenever the parents of a 10-month-old leave their hospitalized child for short periods, he begins
to cry and scream. The nurse explains that this behavior demonstrates that the child:

A) Needs to remain with his parents at all times.

B) Is experiencing separation anxiety.

C) Is experiencing discomfort.
D) Is extremely spoiled.

17. A teenager refuses to wear the clothes his mother bought for him. He states he wants to look like
the other kids at school and wear clothes like they wear. The nurse explains this behavior is an example
of teenage rebellion related to internal conflicts of:

A) Autonomy vs. shame and doubt.

B) Trust vs. mistrust.

C) Identity vs. role confusion.

D) Initiative vs. inferiority.

18. In providing her 8-month-old child's medical history, the mother states the child has received one
MMR vaccine. The nurse taking the history should:

A) Ask the mother if the child has received the MMR booster.

B) Plan to administer the MMR booster.

C) Explain that one MMR vaccine is all that is required.

D) Plan to administer another MMR vaccine after the child is 1 year old.

19. The mother of a 5-year-old expresses concern about her child who believes that "Grandma is still
alive" 3 months after the grandmother's death. The nurse explains that:

A) Magical thinking often accounts for a preschooler who believes that dead people will come back.

B) There is a need for psychological counseling for this child and family.

C) This is a form of regression exhibited by the preschooler.

D) The child is in denial regarding Grandma's death.

20. Hospitalization of a child results in disturbance of the dynamics in family life. The most appropriate
nursing diagnosis is:

A) Diversional activity deficit related to separations from siblings and peers.

B) Sleep patterns disturbance related to unfamiliar surroundings.

C) Altered family processes related to hospitalization.

D) Ineffective individual coping related to procedures.

21. A 7-month-old infant has all of the following abilities. Which skill was most recently acquired?

A) Smiling at self in a mirror (5 months)

B) Transferring a rattle from one hand to the other

C) Rolling from back to abdomen (3 months) Rolling over (6 months)

D) Imitating sounds (6months)

22. The school health nurse is doing vision testing. Visual acuity is assessed using:

A) The Snellen eye chart.

B) An ophthalmoscope.

C) The cover-uncover test.

D) The Weber test.

23. Children are usually brought to the clinic for health care by a parent. At what age is it appropriate for
the nurse to question the child about presenting symptoms?

A) 3 years

B) 5 years

C) 7 years

D) 9 years

24. When recording the health history of a child, what information that is uniquely pertinent to children
is important for the nurse to obtain?

A) Past hospitalizations

B) Coping strategies

C) Immunization status

D) Past accidents

25. A mother overhears a nurse state that the nurse is going to complete a genogram and asks the nurse
what that means. The nurse's reply would be based on knowledge that a genogram is useful for visually
showing what information?
A) Treatment protocols

B) Family history

C) Past history

D) Immunization status

26. The nurse is caring for a child with a common cold (nasopharyngitis). The primary goal of nursing
care is directed toward:

A) Preventing injury.

B) Promoting nutrition.

C) Relieving symptoms.

D) Administering antibiotics.

27. The nurse obtains a health history on a pediatric client. A sign alerting the nurse to possible hearing
impairment in the child is:

A) Distractability and short attention span.

B) Disinterest in reading story books.

C) Turning up the volume on the family television set.

D) Temper tantrums.

28. The nurse is caring for a 1-month-old client who is blind, secondary to retinopathy of prematurity.
The nurse is teaching the parents about activities to promote their infant's development. Which of the
following statements by the nurse is correct?

A) "Infants with visual impairment respond to tactile stimuli rather than auditory stimuli."

B) "Talking, holding, and singing to your baby are appropriate activities at this age."

C) "You should expect your baby to smile in response to your voice by 4 months of age."

D) "Position the baby side-lying in the crib at all times, and avoid loud noises which could startle the
infant."

29. The nurse is assessing a child with conjunctivitis (pink eye). Which of the following would the nurse
most likely assess?

A) Serous drainage from the affected eye

B) Severe eye pain

C) Periorbital edema

D) Crusting of eyelids and eyelashes

SITUATION: During pregnancy, the need for folic acid supplementation is stressed to prevent the
occurrence of neural tube defects. All these disorders occur because of lack of fusion of the posterior
surface of the embryo in the early intrauterine life. Failure to comply with it may lead to serious
complications such as spina bifida, which is most oftenly used as a collective term for all spinal cord
disorders. 30. The nurse is caring for a newborn with myelomeningocoele who has not yet undergone
surgical repair of the defect. Which of the following measures will be used to prevent the site from
becoming infected? 1. Give antibiotics as a prophylactic measure 2. Cover the sac with saline soaked
sterile dressing 3. Maintain the newborn in supine position 4. Place a plastic protective covering over the
dressing 5. Change the dressing every 4 hours

A) 1, 2, and 3

B) 1, 2, and 4

C) 1, 2 and 5

D) 1, 2, 3, 4 and 5

31. When caring for an infant with a myelomeningocoele, the primary goal before surgical correction is
to:

A) Observe for increasing paralysis

B) Prevent trauma to the sac

C) Prevent infection

D) Observe for bowel and bladder control

32. Which of the following is frequently associated with myelomenigocoele?

A) Intussusception

B) Pneumonia

C) Hydrocephalus

D) Mental retardation
33. When assessing an infant admitted to the pediatric unit with upper lumbar myelomeningocoele,
which characteristic should the nurse anticipate to find?

A) Minimal movement of the lower extremities

B) Upper extremity paralysis (cervical spine)

C) Urinary bladder prolapsed (Rectal prolapse dapat)

D) Respiratory problems

SITUATION: Pretend that you are working in a pediatric clinic where most of your patients are diagnosed
with disorders, although not related by etiology, typically share a common feature in that there is a
delay in one or more areas of development. 34. She asked you the defining criteria to diagnose the child
with ADHD. Which of the following is not true about the disorder?

A) The child is able to be controlled in school but manifested uncontrollable hyperactivity at home

B) Boys are affected more frequently than girls

C) The child with this disorder is easily disturbed and often may not seem to listen

D) The disorder is commonly diagnosed before age of 7-years-old

35. The doctor prescribed Methylphenidate hydrochloride (Ritalin), a stimulant, to Joshua. As his nurse
giving instructions to his mother, you will tell that the best time to take the drug is:

A) Every after meal

B) After breakfast

C) Before hour of sleep

D) Before breakfast (it could cause insomnia)

36. Suppose Dingdong has symptoms of autism. Which of the following symptoms is common in this
disorder?

A) Severe depression or feelings of sadness

B) Whirling and whirling around in circle

C) Lack of short-term memory

D) Hallucinations of voices talking

SITUATION: Hector, an 11-year-old boy, together with his parents, was admitted to the hospital due to
persistent fever and rash. And after a day or two, he is moaning about severe joint pain. Nurse Rose, the
nurse in charge for the care of Hector, suspects that he is suffering from Juvenile Arthritis based on his
health history and clinical manifestations. 37. Hector’s father asks Nurse Rose about a test to definitely
diagnose Juvenile Idiopathic Arthritis, formerly known as Juvenile Rheumatoid arthritis. Nurse Rose
response is based on the knowledge of:

A) The latex fixation test is diagnostic

B) An increased erythrocyte sedimentation rate is diagnostic

C) A positive synovial fluid culture is diagnostic

D) No specific laboratory test is diagnostic

38. Hector was confirmed to have JIA. The parents tell Nurse Rose that the diagnosis frightens them
because they know nothing about the prognosis. What should she include when teaching them about
the disease?

A) Half of the affected children recover without joint deformity

B) Many affected children go into long remission but have severe deformities

C) The disease usually progresses to crippling rheumatoid arthritis

D) Most affected children recover completely within a few years

39. Hector’s mother asks Nurse Rose what is the common method used to reduce pain brought about by
the child’s disorder?

A) Apply ice to painful joints to reduce inflammation

B) Have the joint scraped during arthroscopy

C) Apply hydrocortisone ointment to affected joints

D) Take a nonsteroidal anti-inflammatory drug daily

40. The mother of Hector expresses that she is worried that her child will have to stop attending school
because of the illness. Which of the following responses by Nurse Rose would be most appropriate?

A) “It may be difficult for your child to attend school because of the side effects of the medication he will
be prescribed.”

B) “Your child should be encouraged to attend school but he’ll need extra time to work for the early
morning stiffness.”
C) “You should keep your child at home from school whenever he experiences discomfort or pain in his
joints.”

D) “Your child will probably need to wear splints and braces so that his joints will be supported
properly.”

41. Nonsteroidal anti-inflammatory drugs are the first choice in treating a child with juvenile idiopathic
arthritis. Which adverse effects should the nurse not include in the teaching plan for the parents?

A) Weight gain

B) Abdominal pain

C) Blood in the stool

D) Reduced blood clotting ability

42. What should Nurse Rose include when developing a teaching plan for the parents of Hector, who is
being treated with naproxen (Naprosyn)?

A) Anti-inflammatory effect will occur in approximately 8 weeks

B) Within 24 hours, the child will have anti-inflammatory relief

C) The nurse should be called before giving the child any over-the-counter medications

D) If a dose is forgotten or missed, that does not made up

43. Which of the following medications is usually tried first when a child is diagnosed with juvenile
idiopathic arthritis (JIA)?

A) Aspirin

B) Corticosteroids

C) Cytotoxic drugs such as methotrexate

D) Nonsteroidal antiinflammatory drugs (NSAIDs)

SITUATION: A 15-month-old child is seen in the clinic for a check-up for the first time. The nurse notices
that the toddler limps when walking. 44. Which of the following would be appropriate to use when
assessing this toddler for developmental dysplasia of the hip?

A) Ortolani’s manuever

B) Barlow’s manuever
C) Adam’s position (to detect scoliosis)

D) Trendelenburg’s sign

45. The nurse teaches the parents of an infant with developmental dysplasia of the hip on how to handle
their child in a Pavlik harness. Which of the following interventions would be most appropriate?

A) Fitting the diaper under the straps

B) Leaving the harness off while the infant sleeps

C) Checking for skin redness under straps every other day

D) Putting powder on the skin under the straps every day

SITUATION: Trauma is the leading cause of death in children older than age 1 year and an important
cause of disability during childhood and adolescence. 46. Which of the following is a physiological effect
of immobilization on children?

A) Metabolic rate increases.

B) Increased joint mobility can lead to contractures in a short time.

C) Venous stasis can lead to thrombi and/or emboli formation.

D) Bone calcium increases, releasing excess calcium into the body (hypercalcemia).

47. A young girl has just injured her ankle at school. In addition to calling the child’s parents, the most
appropriate, immediate action by the school nurse is which of the following?

A) Apply ice. (next should be Rested, elevated and applied compression)

B) Observe for edema and discoloration.

C) Encourage child to assume a position of comfort.

D) Obtain parental permission for administration of acetaminophen or aspirin.

48. A 7-year-old has just had a cast applied for a fractured arm with the wrist and elbow immobilized.
Which of the following should be included in the home care instructions?

A) Swelling of the fingers is to be expected. Notify a health professional if it persists more than 48 hours.

B) The shoulder should be kept as immobile as possible to avoid pain.

C) Elevate casted arm when both upright and resting.

D) No restrictions of activity are indicated.

49. A child has just returned to the orthopedic unit after being placed in a hip spica cast. The instructions
to parents for home care should include which of the following?

A) Turn every 8 hours.

B) Diapers should be avoided to reduce soiling of the cast.

C) Use abduction bar between legs to aid in turning.

D) Specially designed car seats are indicated and required.

50. Which of the following would be the most appropriate play activity for a 3-year-old child in a spica
cast, considering both safety and development?

A) Marbles

B) Game of checkers

C) Coloring with crayons

D) Playing with toy telephone