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Nurse Harry is caring for Delilah who is
receiving education about cervical
cancer. The following questions apply.
1. When is the earliest time when a
female can receive a human
papillomavirus (HPV) vaccine for
prevention of cervical cancer?
a. 11 years old – 11 to 12 y/o
b. 15 years old
c. 18 years old
d. 21 years old
2. Ms. Delilah is being evaluated for
her knowledge about cervical cancer.
Which among the following statements
require follow-up?
a. Symptoms of cervical carcinoma
include vaginal spotting in between
menstrual periods, vaginal discharge,
and postcoital spotting.
b. It is the most frequent type of
reproductive tract malignancy.
c. There is increased risk for cervical
cancer in females with herpes simplex
1 infection.
d. It can be diagnosed by colposcopy.
3. Ms. Delilah is asked about the
possible therapeutic modalities to
address cervical cancer. Which would
require follow-up?
a. Conization
b. Intracavitary teletherapy -
brachytherapy
c. Excision by surgery
d. Trachelectomy
4. Three specimens are required
when obtaining smears for a Pap test.
The following are areas where smear is
obtained aside from: (-)
a. Endocervix
b. Anterior vaginal fornix
c. Posterior vaginal fornix – vaginal
pool
d. Cervical os
5. The following women are
recommended to have more frequent
Pap smears except:
a. A 31-year old with history of human
papillomavirus infection.
b. A 25-year old who smokes
cigarettes.
c. A 23-year old who had her coitarche
at 15 years old. – coitarche means first
sex
d. A 27-year old with excessive alcohol
intake.
R: A,B,C are risk factors
Situation:
Nurse Rocket is counselling Zoey about
normal changes in pregnancy. Zoey
just found out that she is pregnant and
has visited the health center for
prenatal consult.
6. Zoey verbalized to Nurse Rocket
that she is not very much sure how to
feel about the news of her pregnancy.
The nurse correctly replies to Patient
Zoey by saying the following except:
a. Often women immediately
experience something less than
pleasure and closer to disappointment
or anxiety at the news that they are
pregnant.
b. The positive feelings counteract
negative feelings, that is why you can
be left feeling nothing toward your
pregnancy. – ambivalence: 2 opposing
feelings, coexist
c. This is normal. Most women are able
to change their attitude toward the
pregnancy by the time they feel the
child move inside them.
d. Ambivalence is common. It refers to
the interwoven feelings of wanting and
not wanting that can exist at high
levels.
7. The commonly used laboratory
tests for pregnancy are based on
detecting the presence of human
chorionic gonadotropin (hCG). Which
among the following is an exception to
these commonly used tests?
a. Radioimmunoassay
b. Radioreceptor assay
c. Urine test – not lab test
d. Enzyme-linked immunosorbent
assay
8. Nurse Rocket is discussing the
presumptive signs and symptoms that
Zoey must expect during the course of
her pregnancy. Which among the
following is not correct?
a. Breast changes at 6 weeks age of
gestation. – 2 weeks AOG instead
b. Linea nigra at 24 weeks age of
gestation.
c. Quickening at 18 weeks age of
gestation.
d. Uterine enlargement at 12 weeks
age of gestation.
9. Nurse Rocket is discussing the
probable signs and symptoms that
Zoey must expect during the course of
her pregnancy. Which among the
following is not correct?
a. Chadwick’s sign is the color change
of the vagina from pink to violet.
b. Ultrasound of gestational sac shows
evident characteristic spots. - ring
c. Fetal outline felt can be palpated by
examiner.
d. Ballottement is when lower uterine
segment is tapped, the fetus can be
felt to rise against abdominal wall.
10. Nurse Rocket has also noticed
that there is slight enlargement in the
thyroid gland of Zoey. The following
statements are true except:
a. The basal body metabolic rate
increases by about 20%.
b. Emotional lability and diaphoresis
are to be expected by Zoey.
c. Zoey should be tested further for
thyroid hormone to determine
possible thyroid problem.
d. Zoey could be mistaken for a case of
hyperthyroidism if pregnancy was not
determined.
R: In pregnancy, enlarged thyroid is
normal d/t inc metabolism by 20%
Situation:
Nurse Jenny is educating a group of
pregnant women regarding nutritional
health during pregnancy.
11. To supply adequate calcium and
phosphorus for bone formation,
pregnant women need to eat foods
high in calcium and vitamin D. The
recommended amount of calcium
during pregnancy is:
a. 1300 mg
b. 1000 mg
c. 2000 mg
d. 800 mg
12. A woman asks, “Do I need to
take calcium to support the bone and
teeth development of my baby inside
my womb?” The correct explanation of
Nurse Jenny is:
a. Yes. Tooth formation begins as early
as 8 weeks in utero. Bones begin to
calcify at 12 weeks.
b. Correct. The skeleton and teeth
constitute a major portion of a fetus.
Tooth formation begins as early as 10
weeks in utero. Bones begin to calcify
at 12 weeks.
c. Yes. The skeleton and teeth
constitute a major portion of a fetus.
Tooth formation begins as early as 8
weeks in utero. Bones begin to calcify
at 16 weeks.
d. Correct. Tooth formation begins as
early as 10 weeks in utero. Bones begin
to calcify at 16 weeks.
13. The daily recommended intake
of calories for pregnant women is:
a. 2200 calories
b. 2500 calories
c. 3000 calories
d. 3200 calories
R: Non-pregnant = 2,200cal
Pregnant (+300) = 2,500cal
14. To fulfill the fat needs of the
pregnant women, Jenny teaches them
to also try to consume foods high in
omega-3 oils(Iinolenic acid) such as
the following except:
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a. Salmon – deep sea fish – tune,
mackerel
b. Cage-free chicken
c. Chia seeds
d. Seaweed
15. The following foods should be
avoided or limited by the pregnant
woman because these could have
potentially teratogenic effects, except:
a. Swordfish - mercury
b. Foods with caffeine – early
miscarriage
c. Artificial sweetener - saccharin
d. Vitamin A – teratogenic at 1st tri
start at 2nd trim
Situation:
Nurse Patpat is conducting health
education classes to pregnant women
regarding teratogenicity and
preventing fetal exposure to these
factors.
16. Which two infections can cause
abnormalities in organs that were
originally formed normally?
a. Syphilis and toxoplasmosis
b. Cytomegalovirus and syphilis
c. Rubella and toxoplasmosis
d. Lyme disease and cytomegalovirus
17. To prevent toxoplasmosis, which
is considered a teratogenic infection,
the following measures must be
instituted by the pregnant woman
except:
a. Removing cats from the home
during pregnancy.
b. Avoid undercooked meat.
c. Refrain from changing a cat litter
box.
d. Work in soil in an area where cats
may defecate.
R: RF = exposure to cat litter
18. The following statements are
correct regarding rubella virus aside
from:
a. The rubella virus usually causes only
a mild rash and mild systemic illness.
b. A titer of greater than 1:8 suggests
that a woman is susceptible to viral
invasion.
c. After a rubella immunization, a
woman is advised not to become
pregnant for 3 months, until the
rubella virus is no longer active.
d. All pregnant women should avoid
contact with children with rashes.
R: Rubella Titer = 1:8 or more with
immunity
Less than 1:8 w/o immunity
19. Thalidomide(anti emetic) is a
classic example of a teratogenic drug
that was prescribed for morning
sickness in Europe. The teratogenic
effect of thalidomide is:
a. Patent ductus arteriosus
b. Neural tube defect
c. Amelia
d. Low-birth weight
R: Thalidomide CX =
1. phocomelia – shortened
limbs
2. amelia – no limbs
20. Certain drugs are being
considered as teratogenic. Which of
the following statements requires
further questioning?
a. Tetracycline, used to treat
infections, can cause teeth and bone
deformities.
b. Tretinoin, used to treat acne, can
cause CNS anomalies.
c. Valproic acid, used to treat seizures,
can cause neural tube defects.
d. NSAIDs, used to treat mild pain, can
cause fetal bleeding. – patent ductus
arteriosus
Situation:
Nurse Lei is caring for patient Dany
who experienced miscarriage. The
following questions apply.
21. Patient Dany stated that she
suffered from incomplete miscarriage
and asked what it means. Nurse Lei
correctly responds by stating that
incomplete miscarriage occurs when:
a. The entire products of conception
(fetus, membranes, and placenta) are
expelled spontaneously without any
assistance.
b. The fetus dies in utero but is not
expelled.
c. Part of the conceptus (usually the
fetus) is expelled, but the membrane
or placenta is retained in the uterus.
d. There is scant and usually bright red
vaginal bleeding, but no cervical
dilatation.
22. Dany asked Nurse Lei what could
have caused her condition. The
following questions could be used by
Nurse Lei to assess the patient’s
predisposition to miscarriage except:
a. Have you had any urinary tract
infections during your pregnancy?
b. Did you use creams or ointments to
treat acne?
c. Were you drinking alcohol during
your pregnancy?
d. How long did the bleeding episode
last and how much bleeding occurred?
23. Nurse Lei was informed by the
manager that another patient, 16-
week aog, was admitted for missed
miscarriage. Which among the
following statements about this
condition requires follow-up?
a. An ultrasound confirms fetal death.
b. Dilatation and evacuation is the
treatment for this condition.
c. Labor will be actively induced
primarily with oxytocin then followed
by misoprostol.
d. There is a high risk for the
development of disseminated
intravascular coagulation (DIC) if the
active termination of pregnancy was
not done.
R: Misoprostol(prostaglanding along)
first then oxytocin(oxytocic)
24. Nurse Lei is about to administer
RhIG to patient Dany. As she was about
to give it, Dany asked Nurse Lei what it
is for. Nurse Lei correctly responds
that:
a. You will receive this to prevent the
buildup of antibodies in the event the
conceptus was Rh positive.
b. You will receive this to promote
isoimmunization thereby preventing
the buildup of antibodies.
c. If you are Rh negative, and in case
the baby is Rh positive, this will
promote the production of antibodies
against Rh-positive blood.
d. These antibodies you will receive
would attempt to protect the red
blood cells of your Rh positive infant
during the months that infant is in
utero.
R: Rh incompatibility
Mom: Rh-
Baby: Rh+
Isoimmunization - PREVENT! Mom
develops anti-Rh+ antibodies
28 weeks AOG
72 hours PP
25. During the immediate period
after patient Dany suffered from
miscarriage, which among the
following actions should be the priority
of Nurse Lei?
a. Infection
b. Septic Abortion
c. Powerlessness
d. Shock – miscarriage means bleeding
: hypovolemia
Situation:
Nurse Miley is attending to patient
Diana who is about to undergo
Caesarean birth. The following
questions apply.
26. Diana asks Nurse Miley what is
the possible reason why she was
recommended to undergo Caesarean
delivery rather than normal delivery.
The following could be possible
indications except: hindi indication of
CS
a. Cervical cerclage - stitching
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b. Previous Caesarean birth
c. Microcephaly
d. As an elective procedure
27. Diana is concerned if she will lose
a lot of blood in the process. Which
among the following is the correct
response by Nurse Miley?
a. You will lose more blood as
compared to normal delivery, and this
is a little bit concerning.
b. A total of 1,500mL of blood will be
lost. This is considered normal and
there is nothing to worry about.
c. There will be an additional 200-
500mL of blood loss in Caesarean
delivery.
d. During a Caesarean birth, a woman
usually loses 300 to 500 mL of blood.
R: NVSD: 300-500mL
CS (+200-500mL): 500-1000mL
28. Nurse Miley is preparing the
patient for the surgery. She is
facilitating preoperative diagnostic
procedures. Which of the following is
not an expected laboratory parameter
to assess preoperatively?
a. Leukocyte count – leukocyte count is
expectedly high
b. Serum electrolytes and pH
c. CBC
d. Ultrasound
29. Diana does not want the incision
to be easily seen. She is very
concerned about the body image
issues it could bring her. Which among
the following incision types do you
anticipate the physician to recommend
to the patient?
a. Midline
b. Pfannenstiel – bikini cut, low
transvers
c. Kocher
d. Transverse
30. A student nurse is teaching Diana
during the preoperative period. Which
among the following statements by the
student requires intervention?
a. “After the surgery, take 5 to 10 deep
breaths each hour to prevent
infections.” - pneumonia
b. “You will be placed on NPO before
the surgery to prevent any possible
aspiration when you are already in the
operating room.” – jargons increase
anxiety
c. “A pair of TEDS will be fitted on your
legs to encourage circulation.”
d. “You will use an incentive
spirometer after the surgery to aerate
the lungs. This works by inhaling using
the device.”
Situation:
Nurse Jane is caring for an adolescent
pregnant client, Chantel. The following
questions apply.
31. The following statements are
true about pregnancy during
adolescent years aside from: (-)
a. Teenage pregnancies still continue
due to increase in the rate of sexual
activity among teenagers.
b. A girl in the process of separating
from her parents may be devastated
by the reality of someone else being
dependent on her.
c. Many adolescents do not seek
prenatal care until late in their
pregnancies.
d. Adolescents are considered high-risk
clients because they have a high
incidence of ectopic pregnancy.
R: Preterm labor, PIH, IDA, CPD, LBW
HINDI ECTOPIC PREGNANCY
32. Chantel asks Nurse Jane, “Do I
have higher risk of complications
because of my age?” The nurse would
reply that Chantel has high risk for
developing the following conditions
except:
a. Pregnancy-induced hypertension
b. Folate deficiency anemia – IDA
dapat
c. Premature labor
d. Cephalopelvic disproportion
33. When caring for Chantel, Nurse
Jane communicates with careful
consideration of the patient’s
circumstance. The following
statements are considered acceptable
when explaining to the patient her
health status except:
a. “Oh, you’re starting to have
colostrum.” - jargons
b. “Your blood pressure is
110/80mmHg. It is considered
normal.”
c. “If you find it difficult to refrain from
consuming soft drinks, I suggest that
you may continue to do so but choose
the non-caffeinated ones.”
d. “There are ways to maintain
companionship of your friends such as
watching movies together or joining a
club.”
34. Young adolescents are more
prone to postpartum hemorrhage than
the average woman. Nurse Chantel
knows that the reason for this is:
a. If a uterus is not yet fully developed,
it becomes overdistended by
pregnancy. – inc risk for bleeding
b. If a laceration occurs, it usually heals
relatively slower.
c. The blood supply in an adolescent’s
uterus is richer than that of an adult
woman.
d. An adolescent may have difficulty
following instructions by the health
care provider.
35. Factors that contribute to the
lack of prenatal care among adolescent
pregnant females are the following
except:
a. Denial of pregnancy
b. Peer pressure
c. Knowledge deficit
d. Fear of vaginal examination
Situation:
Nurse Minya is caring for patient
Vanessa, a 24-week aog pregnant
client with pregnancy-induced
hypertension. The following questions
apply:
36. Nurse Minya is teaching a
student nurse about PIH. Which among
the following statements by the
student requires follow-up? (-)
a. PIH is a condition in which
vasospasm occurs during pregnancy in
both small and large arteries.
b. Proteinuria occurs once
hypertension and edema are present.
– proteinuria → edema
c. PIH is classified as gestational
hypertension, mild preeclampsia,
severe pre-eclampsia, and eclampsia.
d. Any status below a point of seizures
is pre-eclampsia.
37. Which among the following are
clinical manifestations of severe pre-
eclampsia?
I. 160/110mmHg or above
II. 2+ or 3+ on a random urine sample –
3+ to 4+
III. 140/90mmHg or above
IV. Edema over bony prominences
V. Seizure
VI. Facial edema
VII. Oliguria
VIII. Polyuria
a. I, IV, VI, VII – edema → fluid volume
deficit
b. II, III, IV, VII
c. I, II, VI, VIII
d. II, IV, V, VIII
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38. Eclampsia is the most severe
classification of PIH. Nurse Minya
knows that the fetal prognosis with
eclampsia is poor because of:
a. Fetal hypoxia and acidosis
b. Maternal convulsions
c. Circulatory overload
d. Hyperalbuminemia
R: Eclampsia : seizures – dec fetal
blood supply
39. Nurse Minya noted that the PIH
of Chantel was classified as severe. The
following nursing actions are
appropriate to be performed by the
nurse except:
a. Place in a private room.
b. Darken the room.
c. Administer nifedipine as ordered.
d. Weigh the patient every morning
and afternoon. – once a day only to
minimize stimulation
40. On the next day, during the start
of her shift, Nurse Minya noted in the
chart that Chantel’s condition has
complicated into eclampsia. She will
plan the following nursing
interventions but:
a. Apply an external fetal heart
monitor.
b. After a seizure episode, encourage
the preterm delivery of the baby.
c. Check for vaginal bleeding to detect
low-lying placenta.
d. Administer magnesium sulfate as
ordered.
Situation:
HELLP syndrome occurs in 4% to 12%
of patients with PIH. It is a serious
syndrome because it results in a
maternal mortality rate as high as 24%
and an infant mortality rate as high as
35%. The following questions apply.
41. HELLP syndrome is a variation of
PIH named for the common symptoms
that occur, specifically as follows,
except:
I. RBC destruction
II. Thrombocytopenia
III. Low hemoglobin
IV. Decreased AST, ALT
V. Clotting tendencies
a. I, III, IV
b. II, IV, V
c. I, II, III
d. III, IV, V
BONUS
CORRECT ANSWER: IV & V
R: HELLP
Hemolysis → anemia
Elevated liver enzymes (AST, ALT)
Low platelet (thrombocytopenia) →
bleeding
42. Other than the hallmark signs of
HELLP syndrome, the following are
associated clinical manifestations
except:
a. Proteinuria
b. Epigastric pain
c. General malaise
d. Right lower quadrant tenderness –
right upper quadrant : liver
inflammation
43. The following are complications
associated with HELLP syndrome aside
from:
a. Renal failure
b. Hyperglycemia – hypoglycemia :
impaired glycogen storage
impaired glycogenolysis : glycogen to
glucose
c. Hemorrhage
d. Encephalopathy
44. The nurse caring for a patient
with HELLP syndrome shall anticipate
the following therapeutic interventions
except:
a. Acetylsalicylic acid for abdominal
pain as ordered. - Acetylsalicylic
acid/ASA/aspirin : bleed or antiplatelet
b. Infusion of intravenous glucose.
c. Infant is delivered as soon as
possible even if preterm.
d. Transfusion of fresh frozen plasma.
45. All of the following statements
about HELLP syndrome are correct
except:
a. Women with the HELLP syndrome
need close observation for clotting
tendencies. - bleeding
b. The liver enzyme levels are elevated
from necrosis of the liver.
c. Fetal complications can include
growth restriction and preterm birth.
d. Laboratory studies reveal
erythrocytes that appear fragmented
on a peripheral blood smear.
Situation:
You are assigned in an OB outpatient
clinic for a month. Aside from the
maternal and fetal wellbeing, one
should also look out for infections that
may cause danger to the fetus and
pregnancy itself.
46. Chloe, 25 years old, visited the
clinic for her second check-up of the
first trimester. This is her first
pregnancy and admitted that she has
no one near to guide her during the
pregnancy. Lately, she has been
experiencing vaginal discharge
characterized by very foul-smelling
odor, frothy, yellow-greenish in color.
What is the likely causative agent of
this infection?
A. Syphilis – painless chancre
B. Trichomoniasis
C. Bacterial Vaginosis – fishy odor
D. Moniliasis – cheese-like
47. Upon assessment and history
taking, you found out that Chloe had a
previous infection of Syphilis during
her teenage years in which she
completed treatment for. Which of the
following is incorrect about the
infectious disease?
A. It is a chronic infectious disease
caused by the organism Treponema
pallidum.
B. Organism may cross the placenta
and is passed to the fetus after the
second month of pregnancy as
congenital syphilis – it happens during
4th month of pregnancy
C. A serum test called Venereal Disease
Research Laboratory is done on the
first prenatal visit
D. Most infectious stage of syphilis is
the primary stage.
48. Sam, 27 years old, came to the
clinic due to the appearance of small
and large wartlike growths on her
genitals. Upon history taking, she
stated that she has multiple sex
partners and does not usually use
protection. She was diagnosed with an
infection Condyloma
acuminatum(HPV). Which of the
following are included in your health
teaching for Sam?
I. Condyloma acuminatum is caused by
HPV
II. Condyloma acuminatum is caused by
Moniliasis
III. Encourage Papanicolaou test every
year
IV. Encourage Papanicolaou test every
2 years once treatment is completed
V. HPV is associated with cervical
malignancies
VI. Infection affects the cervix, urethra
and does not affect the anus, penis,
and scrotum
VII. Transmission does not occur during
vaginal birth
a. I, III, V, VI, VII
b. I, IV, V, VII
c. I, III, V, VI
d. I, III, V
49. Monica, 25 years old on, 8 weeks
AOG, came to the clinic with
complaints of fever, night sweats,
chills, fatigue, and productive cough
with yellow sputum. She is very
worried as this is similar to the signs of
pulmonary tuberculosis that her father
has when they visited him last month.
She wasn’t aware that she was
pregnant during that visit. Which of the
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following are true about tuberculosis
during pregnancy?
a. If a chest radiograph is required for
the client, it is done only after 12
weeks of gestation, and a lead shield
for the abdomen is required
b. Transplacental transmission is rare
c. Tuberculin skin testing is safe during
pregnancy; however, the PHCP may
want to delay testing until after 2nd
trimester
d. Active disease during pregnancy has
been associated with an increase in
hyperglycemia in pregnancy
50. Monica also has a 9-month-old
baby. She asked if it is still possible to
breastfeed(it taking RIPE for 2 weeeks)
if she is confirmed to have PTB?
a. No, in all cases
b. Yes, if the baby is above 6 months
old.
c. Yes, if the mother is under
medications
d. Yes, if the client is noninfectious.
Situation:
Daria, an HIV+ infant was brought to
the hospital due to having severe
diarrhea. Her mother Kyla was
concerned about her child’s prognosis
and admits that she does not have
enough knowledge about her
daughter’s condition. You, being a
proficient nurse was tasked to educate
Kyla about the facts on HIV in children.
51. Which of the following vaccines
would the nurse expect to give to Daria
who is extremely
immunocompromised?
a. IPV – inactivated polio vaccine
b. OPV – live attenuated vaccine
c. BCG – live attenuated vaccine
d. MMR – live attenuated vaccine
52. The Centers for Disease Control
and Prevention has developed a
classification system to describe the
spectrum of HIV disease in children.
Which of the following manifestations
belong to the moderately symptomatic
category?
a. Lymphoid interstitial pneumonitis
(LIP)
b. Pneumocystis carinii pneumonia
c. Hepatosplenomegaly
d. Lymphadenopathy
53. What kind of transmission occurs
between a mother who is HIV+ and her
infant?
a. Diagonal transmission
b. Horizontal transmission
c. Vertical transmission – mother w/
HIV can breastfeed as long as taking
antiretroviral(ritonavir)
d. Airborne transmission
54. What is the drug of choice for
Pneumocystis carinii(Pneumocystis
jirovecii) pneumonia in children with
HIV?
a. dapsone
b. Trimethoprim/sulfamethoxazole –
co-trimoxazole
c. Pentamidine
d. Atovaquone
55. What is the preferred test used in
detecting HIV for infants older than 1
month?
a. Polymerase Chain Reaction test
b. Enzyme-Linked Immunosorbent
Assay
c. Western blot
d. CD4 count
56. When are virologic diagnostic tests
performed on breastfed infants older
than six months who were perinatally
exposed to HIV?
a. Every 1 month
b. Every 3 months
c. Every 6 months
d. Every 1 year
Situation:
Nurse Nikki was doing her rounds and
was preparing to administer
medications in the pediatric ward.
Before going into each of her patients’
rooms, she adheres to the ten rights of
medication administration to promote
her patients’ safety and prevent
medication errors.
57. Which of the following statements
is true regarding the administration of
medication to pediatric patients?
a. Dosages should be calculated based
on adult weight.
b. Pediatric patients require lower
dosages compared to adults. – lower
BSA, weight
c. All medications can be administered
using the same dosage guidelines for
adults.
d. Medication administration is not
necessary for pediatric patients.
58. What is the preferred site for
infants under 1 year receiving an
intramuscular injection?
a. Lateral aspect of the vastus lateralis
muscle
b. Medial portion of the vastus lateralis
muscle
c. Medial portion of the dorsogluteal
muscle
d. Lateral aspect of the ventrogluteal
muscle
R: Bawal ang IM Dorsogluteal or
Ventrogluteal for <1 y/o may cause
paralysis it should be IM Vastus
Lateralis
59. Cassie, a 7-year-old girl, will be
given an antibiotic intravenously in her
dominant hand. What would be the
most appropriate activity for her to do
while her medicine is infusing?
a. Drawing flowers on a paper
b. Making origami figures
c. Fingerpainting
d. Listening to her favorite music
R: A,B,C risk for dislodgement
60. Nurse Nikki is going to administer
acetaminophen in one of her pediatric
patients. What is the best way to
identify him?
a. Ask the child his name
b. Read the name on the ID band
c. Read the name on the chart and ask
the child of that was him
d. Ask the other nurses if they know
who the child is
61. What is the correct way of
instilling eardrops in a 6-year-old
pediatric patient?
a. Allow the child to place the eardrops
by herself for a sense of control.
b. Pull the pinna of her ear down and
back to straighten the canal.
c. Pull the pinna of her ear up and back
to straighten the canal.
d. Refrigerate the drug first so it numbs
the ear canal.
R: <3 y/o = down and back
3 y/o and up = up and back
Situation:
Ian, a 2-year-old boy, is transported to
the emergency room due to cyanosis
precipitated by crying. His mother
noticed that he becomes fatigued after
playing. Tetralogy of Fallot was his
diagnosis.
62. What position would Ian
automatically assume?
a. Low Fowlers
b. Squatting
c. High Fowlers
d. Sitting – relieve the test spells
(dyspnea, cyanosis)
4 Defects:
1. VSD
2. Pulmonary stenosis
3. Overriding aorta
4. RV hypertrophy
63. Hypoxic spells or tet spells could
cause which of the following, EXCEPT?
a. Polycythemia
b. Alkalosis – respiratory acidosis d/t
dyspnea
c. Thrombophlebitis
d. Cerebrovascular accident
64. "Why do my child's fingertips look
like that?" his mother asks the nurse.
The nurse responds based on the
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concept that clubbing happens as a
result of:
a. chronic hypoxia
b. a left-to-right shunting of blood
c. decreased cardiac output
d. untreated congestive heart failure
R: no diamond upon assessment – (+)
schamroth sign - clubbing
65. Among the four common
anomalies of Tetralogy of Fallot, which
one develops as a compensatory
mechanism?
a. Pulmonary stenosis
b. Overriding of aorta
c. Right ventricular hypertrophy
d. Ventricular septal defect
66. Ian will undergo a procedure that
utilizes a synthetic shunt between the
subclavian artery and the pulmonary
artery in order to prevent scarring of
the subclavian artery. What is
procedure is going to be performed?
a. Classic Blalock-Taussig Shunt
b. Modified Blalock-Taussig Shunt
c. Brock procedure
d. Waterson shunt
67. After performing the Blalock-
Taussig procedure, the nurse assessed
Ian and cannot seem to find a palpable
pulse in his right arm after the
procedure. This is _______.
a. Normal, because the subclavian
artery is used.
b. Abnormal, because the pulse should
still be palpable after the procedure.
c. Abnormal, this might be a lethal
complication post-surgery.
d. None of the above
Situation:
Growth and development refer to the
physical, cognitive, emotional, and
social changes that occur throughout
an individual's lifespan. It encompasses
various aspects of human
development, from infancy to
adulthood.
68. Which of the following infant
reflex groups is present at birth and
remains throughout adulthood?
a. Rooting, blink, cough, gag
b. Blink, cough, sneeze, stepping
c. Blink, sneeze, cough, gag
d. Rooting, sneeze, cough, swallowing
69. Which statement is true about the
principles of growth and development?
a. Different children pass through the
predictable stages at the same rates.
b. All body systems develop at the
same rate.
c. Gross motor skills are developed first
before fine motor skills. –
cephalocaudal proximodistal gross to
fine motor skills
d. Development proceeds from distal
to proximal body parts.
70. According to Erikson, what should
the nurse anticipate when assessing a
toddler?
a. Taking pride in pulling off the
lollipop wrapper – autonomy vs shame
and doubt
b. Participating in school activities
c. Questioning sexual identity
d. Engaging in fantasy activities
71. The mother of an 8-month-
old(INFANT) told the nurse that her
child continually cries whenever she
goes to work. This attitude displayed
by the infant is in what stage of
Piaget’s Theory?
a. Sensorimotor stage - infant
b. Preoperational thought
c. Concrete operational thought
d. Formal operational thought
72. In what stage of Kohlberg's theory
of moral development is a person
linked with obeying a law even if it is
discriminatory towards a racial group?
a. Society-maintaining orientation
b. Universal ethical principle
orientation
c. Instrumental relativist orientation
d. Social contract orientation
73. Callie, 4 years old believes that
there is more chocolate milk in her
sister’s tall thin glass that her short,
wide glass. She has not yet achieved
with of the following principles of
Piaget?
a. Object permanence
b. Assimilation
c. Conservation – conservation of mass
7 y/o
d. Accommodation
74. Which of the following best
describes the cognitive development of
an 18-month-old child?
a. The child can follow one-part
directions - toddler
b. The child understands the concept
of "forever"
c. The child can name six body parts
d. The child has an attention span of
approximately 5 minutes
75. A nurse is assisting a client and her
nine-month-old daughter. The mother
says, "Sometimes, she is so naughty! I
had to put her in time-out yesterday
for throwing toys!" What is the nurse's
most suitable response?
a. “Where do you place her when she
goes to time-out?”
b. “Keep doing that to teach her the
right way; eventually she will stop
throwing toys."
c. “At this age, she should stay in time-
out for nine minutes."
d. “Remind her not to throw toys but
don't discipline her for this behavior."
Situation:
Edward, a 2-year-old boy was
hospitalized with pneumonia. His
mother reported that he has been
vomiting for 3 days and has a fever of
38.7°C. Upon assessment, he exhibited
the following signs and symptoms:
chills, tachypnea, tachycardia, chest
pain and crackles was auscultated.
76. The nurse was making rounds and
took Edward’s temperature which
went up to 40°C. What physiological
process explains why Edward is at risk
for developing dyspnea?
a. Fever raises metabolic demands,
requiring more oxygen.
b. Blood glucose levels are low, and
cells lack the energy to utilize oxygen.
c. Hyperventilation causes an increase
in carbon dioxide production.
d. Hyperventilation causes a decrease
in carbon dioxide production.
77. What behavior would Edward
most likely exhibit?
a. lie quietly as the nurse auscultates
his lungs
b. ask many questions about what the
nurse is doing
c. cry and push the nurse away
d. plays cheerfully with a stethoscope
78. Edward complains of discomfort
on his right side and that ibuprofen is
not effective. Which instruction should
the nurse provide to the mother?
a. Increase the dose of ibuprofen. –
hindi ka MD
b. Administer another ibuprofen. –
nephron/hepatotoxicity
c. Encourage the child to lie on the left
side.
d. Encourage the child to lie on the
right side
79. Edward is going to be given
oxygen. When the nurse came near, he
became agitated and began to cry.
What is the best course of action for a
child who is afraid of receiving oxygen?
a. tightly secure the oxygen mask
straps to the face.
b. place oxygen tubing through a hole
in a paper cup. – conceal the O2
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c. use a face mask instead of a
nonrebreather mask.
d. have a parent restrain the child as
you give oxygen.
80. The nurse is about to administer
the last dose of ceftriaxone
(Rocephin) but discovers that the IV
has become obstructed. The nurse
should?
a. Contact the prescriber to request a
prescription change. – change route
from IV to IM
b. Arrange for early discharge.
c. Start the IV line on the other hand
d. Administer the medication
intramuscularly.
Situation:
Faye, is an 8-year-old with sickle cell
anemia. She was rushed into the
emergency room due to having a vaso-
occlusive crisis.
Sickled RBCs:
- short lifespan(max 90 days)
- May cause obstruction
81. Which amino acid takes the place
of glutamic acid in sickle cell anemia?
a. Valine
b. Isoleucine
c. Alanine
d. Tyrosine
82. What kind of hemoglobin does a
child with sickle cell anemia have?
a. Hemoglobin AC
b. Hemoglobin SS – simply put,
hemoglobin S (HbS)
c. Hemoglobin AS
d. Hemoglobin O
83. This type of crisis occurs when
there is a pooling and increased
destruction of sickled cells in the liver
and spleen causing the spleen to
become
enlarged(splenomegaly/hypersplenism
) and tender.
SPLEEN: graveyard of RBCs
a. Megaloblastic crisis
b. Sequestration crisis
c. Hyper hemolytic crisis
d. Aplastic crisis
84. Which of the following
manifestations will the nurse expect to
assess in Faye following her vaso-
occlusive crisis?
a. Epistaxis
b. Petechiae
c. Hematuria
d. Melena
R: Organ damage ex. Kidney
85. Which of the following blood
components is increased in sickling cell
crisis?
a. Erythrocyte
b. Hematocrit
c. Hemoglobin
d. Reticulocyte – immature RBCs
Situation:
: A 3-year-old child named James was
admitted in the hospital. His mother
stated that he has raised, red, ring-like
rash with central clearing on his lower
back. She also reported that James
cries at night because it was very
itchy.
Tinea/dermatophytosis d/t ring worms
86. What would be the appropriate
diagnosis for James?
a. Tinea cruris - groin
b. Tinea capitis - scalp
c. Tinea pedis - feet
d. Tinea corporis - body
87. Whichof the following statements
is true regarding dermatophytosis?
a. The causative agent is a worm and
cannot be transferred from one person
to another.
b. The causative agent is a fungus and
can be transferred from one person to
another.
c. The causative agent is a bacteria and
cannot be transferred from one person
to another.
d. The causative agent is a virus and
can be transferred from one person to
another.
Situation:
Another child, Kiera presented to the
emergency department with an itchy
irritated scalp and infected areas on
her head. Assessment reveals lice and
nits(kuto eggs) in her hair.
Pediculosi capitis
88. Which of the following discharge
instructions would the nurse include?
a. Manual removal of nits for several
days to ensure they do not hatch
b. Permethrin 10% applied to hair and
body after shower and shampoo –
permethrin 1%
c. Child should not return to school
until all lice and nits are gone
d. Washing sheets and towels in hot
water
R: Alternative: petroleum jelly – soak 8
hours
89. Which of the following indicates
incorrect understanding regarding the
use of permethrin shampoo?
a. Apply the shampoo to the head and
scalp only.
b. Allow the shampoo to sit in the hair
for 1 hour. – 10 mins
c. Cover the areas behind the ears and
on the back of the neck.
d. When the hair is dry, comb the hair
with a fine-toothed comb to remove
any remaining nits.
90. This medication for pediculosis is
not recommended to be used anymore
due to its toxic effects.
a. Lindane - seizures
b. Permethrin
c. Griseofulvin
d. Terbinafine
91. June, a 4-month-old is brought to
the emergency department with
severe dehydration. Upon assessment
he has a heart rate of 196 and a blood
pressure of 60/30. The anterior
fontanel appeared to be sunken. The
nurse notes that the infant does not
cry when the intravenous line is
inserted. June’s parents state that he
has not “held anything down” in 18
hours. The nurse obtains a finger-stick
blood sugar of 94. Which would the
nurse expect to do immediately?
a. Administer a bolus of normal saline.
– fluid challenge
b. Administer a bolus of D10W.
c. Administer a bolus of normal saline
with 5% dextrose added to the
solution.
d. Offer the child an oral rehydrating
solution
92. The nurse is caring for an infant
with pyloric stenosis. The parent asks if
any future children will likely have
pyloric stenosis(narrowing of pyloric
sphincter). Which is the nurse’s best
response?
a. “You seem worried; would you like
to discuss your concerns?”
b. “It is very rare for a family to have
more than one child with pyloric
stenosis.”
c. “Pyloric stenosis can run in families.
It is more common among males.”
d. “Although there can be a genetic
link, it is very unusual for girls to have
pyloric stenosis.”
93. Which statement by the parent
would be typical for a child with pyloric
stenosis?
a. “The baby is a very fussy eater and
just does not want to eat.”
b. “The baby tends to have a very
forceful vomiting episode about 30
minutes after most feedings.”
c. “The baby is always hungry after
vomiting, so I feed her again.” – SX:
projectile vomiting (immediately after
eating)
d. “The baby is happy in spite of getting
really upset after spitting up.”
94. The nurse is caring for an infant
with biliary atresia. The parents ask
why the child is receiving
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cholestyramine. Which is the nurse’s
best response?
a. To lower the infant’s cholesterol.
b. To relieve the infant’s itching.
c. To help the infant gain weight.
d. To help feedings be absorbed in a
more efficient manner
R: jaundice – pruritus (itching)
Bile backflows to liver then to the
blood
95. The nurse knows that Nissen
fundoplication(gastric wrap around)
involves which of the following?
a. The fundus of the stomach is
wrapped around the inferior stomach,
mimicking a lower esophageal
sphincter.
b. The fundus of the stomach is
wrapped around the inferior
esophagus, mimicking a cardiac
sphincter.
c. The fundus of the stomach is
wrapped around the middle portion of
the stomach, decreasing the capacity
of the stomach.
d. The fundus of the stomach is dilated,
decreasing the likelihood of reflux.
R: Indxn = GERD, hiatal hernia
96. The nurse is caring for a 6-month-
old infant diagnosed with meningitis.
Findings upon assessment include an
altered level of consciousness,
decreased urine output, and
temperature of 103.4°F (39.7°C). When
the infant is placed in a supine position
and flexes his neck, he also flexes his
knees and hips. What is the best room
assignment for a newly admitted child
with bacterial meningitis.
Brudzinki’s : meningitis - seizures
a. Semiprivate room with a roommate
who has bacterial meningitis but has
received intravenous antibiotics for
more than 24 hours.
b. Semiprivate room with a roommate
who also has bacterial meningitis.
c. Private room that is dark and quiet
with minimal stimulation.
d. Private room that is bright and
colorful and has developmentally
appropriate activities available.
97. A child with Reye syndrome is
described in the nurse’s notes as
follows: comatose with sluggish pupils;
when stimulated, demonstrates
decerebrate posturing. To treat a
common manifestation of Reye
syndrome, which medication would
the nurse expect to have readily
available?
a. Furosemide (Lasix)
b. Insulin
c. Glucose - hypoglycemia
d. Morphine
RF: use of aspirin among children
Affected organs:
- Brain
- liver
98. Which can elicit the Gower sign?
Have the child:
a. Close the eyes and touch the nose
with alternating index fingers.
b. Hop on one foot and then the other.
c. Bend from the waist to touch the
toes.
d. Walk like a duck and rise from a
squatting position.
R: Seen in Duchenne Muscular
Dystrophy
- progressive muscle damage
- does not go beyond teenage years
IF HINDI KAYA, (+) Gower’s
99. A teen who was hospitalized for
chronic kidney disease (CKD) develops
symptoms of polyuria, polydipsia, and
bone pain. Which body mineral might
be causing these symptoms?
a. Elevated calcium – bone resorption
calcium moves: bone to blood
hypercalcemia
b. Low phosphorus
c. Low magnesium
d. High aluminum hydroxide
100. Which classification of
osteogenesis imperfecta (OI) is lethal in
utero and in infancy?
“brittle bone”
Collagen problem
a. Type I.
b. Type II.
c. Type III.
d. Type IV.
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