COMPETENCY OPTIMIZING REVIEW (CORe) weakening of the rubber making condom lose it strength

GUIDED NLE REVIEW and may tear eventually.

Options B, C and D are all correct safe sex practices
Reference: Adelle Pillitteri. Maternal and Child Health
DIAGNOSTIC EXAMINATION II
Nursing. 5th Edition. Page 91.
SITUATION: Nursing Process always must be implemented
3. A 22-year old woman has missed two of her regular
with an awareness of the interrelationship, during
menstrual periods. Her doctor confirms an early,
childbearing, of the maternal and fetal needs and their
intrauterine
manifestations. The nurse needs to keep in mind that
pregnancy. To determine her expected due date, which of
interventions for the mother may have an impact on the
the following assessments is most important?
developing fetus and vice versa.
a. Date of her first menstrual period c. Date of last
normal menstrual period
1. Knowledge of sexual functioning is defined as the extent
b. Date of sexual intercourse d. Age of menarche
of understanding conveyed about sexual development and
ANSWER: C
responsible sexual practices. The following are specific
The dates of the last menstrual period, especially the first
indicators that suggest that this outcome has been
day of that period, will be used in applying Naegele’s rule
achieved
to
except:
determine the estimated date of delivery.
a. Ability of the client to describe effective contraception
Reference: Pilliterri, A. Maternal and Child Health Nursing:
b. The client was able to describe the societal influences
Care of the Childbearing and Childrearing Family. 5th ed.
on sexual behavior
c. The client was able to describe the inner sense of
4. A primigravid client asks Nurse Isabelle how the action
his/her identity
of hormones during pregnancy affects her body. Nurse
d. The client was able to describe measures to prevent
Isabelle responds on the basis that hormones:
sexually transmitted diseases
a. Raises resistance to insulin c. Prevents the liver
ANSWER: C
from metabolizing glycogen
Gender identity or sexual identity is the inner sense a
b. Blocks the release of insulin from the pancreas d.
person has of being male or female, which may be the
Enhances the conversion of food to glucose
same as
ANSWER: A
or different from biologic gender.
Hormonal influences during pregnancy cause a resistance
Options A, B and D are all indicators that the outcome had
to insulin utilization at the cellular level. It allows sufficient
been achieved if the client’s has the ability to describe the
glucose for placental transport to the fetus, and also
following
prevents the blood sugar in the nondiabetic client from
Reference: Adelle Pillitteri. Maternal and Child Health
falling to
Nursing. 5th Edition. Page 88.
dangerous levels. In the diabetic client, it requires increase
in her insulin doses.
2. To preserve the reproductive health of the woman and
Reference: Pilliterri, A. Maternal and Child Health Nursing:
man, guidelines for safer sex practices were established.
Care of the Childbearing and Childrearing Family. 5th ed.
Which of the following statements is not included?
a. The use of condoms is the best protection against
5. Nurse Hannah is caring for a young diabetic woman who
infection. Condoms are latex, use oil-based lubricant
is in her first trimester of pregnancy. As the pregnancy
rather than
continues Nurse Hannah should anticipate which change in
water-based lubricant because it can weaken the rubber
her medication needs?
b. Be selective in choosing sexual partners
a. A decrease in the need for short-acting insulins
c. For safer oral-vaginal sex, a condom split in two or a
b. A steady increase in insulin requirements
plastic dental dam covering the mouth should be used to
c. Oral hypoglycemic drugs will be given several times daily
protect against the exchange of body fluids
d. The variable pattern of insulin absorption throughout
d. Use oil lubricants for anal penetration to keep bleeding
the pregnancy requires constant adjustment
and condom resistance to a minimum
ANSWER: B
ANSWER: A
During the first trimester of pregnancy, there is little
Condoms should be latex; the chance of the condom
change in insulin requirements. In the second trimester,
tearing is less if it is a pre-lubricated brand. Use of water-
gradually increasing amounts of insulin are needed, with
based
the insulin dose doubling by the end of pregnancy.
lubricants such as KY jelly on condoms made aid its
Reference: Pilliterri, A. Maternal and Child Health Nursing:
smooth penetration, the use of oil-based lubricant may
Care of the Childbearing and Childrearing Family. 5th ed.
cause
6. As early as the 3rd week of intrauterine life, fetal blood
begins to exchange nutrients with the maternal circulation
across the chorionic villi. Fetal circulation differs from
extrauterine circulation in all but one of the following
aspects:
a. The blood that enters the lungs is oxygenated in fetal
circulation while it is unoxygenated in an adult circulation
b. Fetal oxygen in the blood is derived from the placenta
while in adult the oxygen is from the lungs
c. The vein (carrying oxygenated blood) in the umbilicus of
the fetus carries blood away from the heart and the artery
(carrying unoxygenated blood) carries blood toward the
fetus. In an adult, it is the vein which carries
unoxygentaed blood toward the heart and the arteries
that carry oxygenated blood away from the heart
d. In fetal circulation, shunting of blood is present while in
an adult circulation, there is normally no shunting of
blood. ANSWER: C
In a fetal circulation, the umbilical vein (carrying
oxygenated blood) carries blood toward the heart of the
fetus and
the artery (carrying unoxygenated blood) carries blood
away from the heart. In an adult, it is the vein that carries
unoxygenated blood toward the heart and the arteries
that carry oxygenated blood away from the heart. The
others
choices are true when it comes to fetal circulation. The
blood entering the blood vessels of the lungs is not for
oxygen
exchange but to supply cells of the lungs themselves.
During the fetal life, the lungs are not yet mature enough
to
function as that during birth. Therefore, specialized
structures present in the fetus shunt blood flow to supply
the most
important organs of the body; brain, liver, heart and
kidneys.
Reference: A. Pillitteri. Maternal and Child Nursing. 5th
Edition. Page 190-191.
7. Maricar asks Nurse Sarah at what age of gestation is the
product of conception prone to teratogenic insults to the
cardiovascular system?
a. 4th week b. 8th week c. 12th week
d. 16th week
ANSWER: A
At the end of 4th week of gestation the human embryo is a
rapidly growing formation of cells and the rudimentary
heart appears as a prominent bulge on the anterior
surface; chambers at this time is already visible and major
veins
are formed thus teratogenic insults at this time may cause
future congenital heart defect/s. At the end of 8th week is
the completion of the organogenesis the heart will now
develop septum and valves, and is beating rhythmically. At
the
12th week the heart beat is now audible with the use of a
Doppler and the completion of the first trimester. At the
end
of the 16th week fetal heart sounds are audible to a
fetoscope.
Reference: A. Pillitteri. Maternal and Child Nursing. 5th
Edition. Page 195-196.
8. Nurse Mian discusses the fetal circulation to the
students. To check whether the student understands her
teaching
she asks, “What is the fetal structure that carries
oxygenated blood from the umbilical cord to the inferior
vena cava”.
The student correctly answers, “It is the:
a. Ductus Venosus b. Ductus Arteriosus c.
Pulmonary Artery d. Formane Ovale
ANSWER: A
The ductus venosus carries oxygenated blood from the
umbilical vein to the inferior vena cava which allows
oxygenated blood to be supplied directly to the fetal liver.
Oxygenated blood then empties into the IVC and is carried
to right side of the heart. Because there is no need for the
bulk of the blood to pass through the lungs, it is shunted,
as it enters the right atrium, into the left atrium through
the opening in the atrial septum, called foramen ovale.
From
the left atrium, it follows the course of normal circulation
into the left ventricle and into the aorta. A small amount of
blood that returns to the heart via the vena cava does
leave the right atrium by the adult circulatory route; that is
the
tricuspid valve into the right ventricle and the n into the
pulmonary artery and lungs to service the lung tissue.
However, the larger portion of this blood is shunted away
from the lungs through additional structure, the ductus
areteriosus, directly into the descending aorta. Pulmonary
artery arises from the right ventricle of the heart and
caries
unoxygenated blood to the lungs.
Reference: A. Pillitteri. Maternal and Child Nursing. 5th
Edition. Page 190.
9. The day after a client has cesarean birth, the indwelling
catheter is removed. The nurse can best evaluate that the
client’s urinary function has returned to normal when:
a. Client’s urinalysis indicates no bacteria present
b. Client has residual urine of 90 ml after voiding
c. Client’s daily urinary output is at least 1000 ml
d. Client voids at least 300 ml four hours after catheter
removal
ANSWER: D
This would indicate that the urinary sphincter tone has not
been affected by the catheter and urinary retention with
overflow is not present.
Option A – the absence of bacteria indicates the absence
of infection but does not portend the return of urinary
function, urine culture may be ordered to check for the
possibility of a urinary tract infection after catheter
removal
Option B – this indicates retention with overflow; the
client urinates small amounts but does not completely
empty the
bladder, this voiding pattern is potentially dangerous
because it means that the woman’s bladder is held
continuously
under tension
Option C – it indicates that urine retention is present
Reference: A. Pillitteri. Maternal and Child Nursing. 5th
Edition. Page 580-581.
10. A nurse is working with a particular cultural group in
which it is not uncommon for grandparents to live with
their
married children and to assist with child rearing and
discipline issues. This is an example of which of the
following?
a. Blended family b. Traditional family c. Two-
career family d. Intragenerational family
Answer: D
In some cultures and as people live longer, more than two
generations may live together in an intragenerational
setting, as described. A two-career family is one where
both partners are employed. A blended family occurs
when
existing family units join together to form new families. A
traditional family is viewed as an autonomous unit in
which
both parents reside in the home.
Reference: Kozier and Erb’s Fundamentals of Nursing 8th
edition Page 430
11. Nurse Isabel is conducting a family assessment to a
pregnant client and asks the following question: "How, as
a After ovulation, the formation of progesterone in the
family, do you deal with disappointments or stressful
changes that occur and affect the members of your
family?" The
nurse is trying to identify:
a. Health beliefs c. Family coping mechanisms
b. Family communication patterns d. Potential family
problems
ANSWER: C
Family coping mechanisms are behaviors that families use
to deal with stress or changes imposed from either within
or without. The coping mechanisms families and
individuals develop reflect their individual resourcefulness.
The
assessment of coping mechanisms is a way to determine
how families relate to stress.
Reference: Kozier and Erb’s Fundamentals of Nursing 8th
edition Page 434-435
12. Regardless of whether someone is planning on
childbearing, everyone is wiser by being familiar with
reproductive
anatomy and physiology and his or her own body’s
reproductive and sexual health. Which of the following is
true
about the reproductive development?
a. Male and female reproductive systems arise from the
same embryonic origin
b. The sex of an individual is determined 10 weeks after
conception
c. If testosterone is not present at 5 weeks, the gonadal
tissue differentiates into ovaries
d. Estrogen influences the enlargement of the labia majora
and clitoris
ANSWER: A
Although the structures of the female and male
reproductive systems differ greatly in both appearance
and function,
they are homologous—that is, they arise from the same or
matched embryonic origin. Option B: The sex of an
individual is determined at the moment of conception by
the chromosome information supplied by the particular
ovum
and sperm. Option C: If testosterone is not present at 10
weeks, the gondola tissue differentiates into ovaries.
Option
D: Testosterone, not estrogen, influences the enlargement
of the labia majora and clitoris and formation of axillary
and pubic hair.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 86
13. During the secretory phase of menstrual cycle, the
glands of the uterine endometrium becomes corkscrew in
appearance and dilated with quantities of glycogen and
mucin. This activity is stimulated by which hormone?
a. Progesterone b. Estrogen c. Glycogen d. Prolactin
ANSWER: A
corpus luteum (under the direction of LH) causes the
glands of
the uterine endometrium to become corkscrew or twisted
in appearance and dilated with quantities of glycogen and
mucin (a protein).
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 101
14. A client expresses concern about his son who is a
homosexual. He states, "Nag-aalala ako sa kanya, alam ko
sa
impyerno ang tuloy nya.” In responding to this client, the
nurse should consider which of the following important
information?
a. Sexual development is genetically determined and not
affected by environment.
b. What constitutes normal sexual expression varies
among cultures and religions.
c. Normal sexuality is described as whatever behaviors
give pleasure and satisfaction to those adults involved.
d. Since alternative lifestyles are now so well accepted in
society, this parent should not feel so much concern.
ANSWER: B
This nurse should remember that culture and religion have
a big impact upon what a person believes to be normal
sexual behavior. Even though many consider whatever
activity gives pleasure and satisfaction to the involved
adults
to be normal, some cultures and religions do not hold that
belief. While alternative lifestyles are well accepted in
some
cultures, apparently that is not true in this parent's belief
patterns. Sexual development has both genetic and
environmental components.
Reference: Kozier and Erb’s Fundamentals of Nursing 8th
edition page 1025-1026
15. The nurse working in a family planning clinic is aware
that oral contraceptives are not contraindicated for which
of
the following patients?
a. A 30-year old woman who smokes more than 15
cigarettes a day
b. A 30-year old diabetic woman
c. A 10 week postpartum client who is not breastfeeding
d. A client who experiences migraine with aura
ANSWER: C
One contraindication for OCs use is those who are
breastfeeding and those clients who are less than 6 weeks
postpartum. Therefore option C is the correct answer
since the client is at 10 weeks postpartum and does not
breastfeed. Other options are contraindicated.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 125
16. An Intrauterine device is being fitted to a client. The
nurse understands that IUD prevents pregnancy by:
a. Creating a sterile inflammatory process that prevents
implantation
b. Suppressing secretion of FSH and LH
c. Blocking the fallopian tube to prevent entry of the ovum
d. Killing the spermatozoa before they can enter the
cervix
ANSWER: A
The intrauterine device (IUD) is a small plastic object that
is inserted into the uterus through the vagina. Today, the
IUD is thought to be preventing fertilization as well as
creating a local sterile inflammatory condition that
prevents
implantation. When copper is added to the device, sperm
mobility appears to be affected. These decrease the
possibility that the sperm will successfully cross the
uterine space and reach the ovum. In some IUD’s (not
copper
based) there is a drug reservoir of progesterone in the
stem. This drug reservoir gradually diffuses into the uterus
through the plastic. It both prevents endometrium
proliferation and thickens cervical mucus. Option B: COCs.
Option
C: Incorrect. Option D: Action of the spermicides.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 129-130
17. The nurse will advise a pregnant client, who is
scheduled for amniocentesis, to perform which of the
following?
a. Increase the fluid intake to help aspirate more amniotic
fluid during the procedure
b. Lie in side lying-position to avoid supine hypotension
during the procedure
c. Ask the client to take a deep breath and hold it during
insertion of needle
d. Rest for 30 minutes after the procedure
ANSWER: D Amniocentesis is a technically easy procedure,
but it can be frightening to a woman. In preparation for
amniocentesis,
ask the woman to void to reduce the size of the bladder
and prevent an inadvertent puncture. Place her in supine
position with a folded towel under her right buttock to tip
her body slightly to the left and move the uterus off the
vena cava to prevent supine hypotension. Do not suggest
to the client to take a deep breath and hold it as a
distraction against discomfort during insertion; this lowers
the diaphragm against the uterus and shifts intrauterine
contents. After the needle is removed, the woman rests
quietly for about 30 minutes. The nurse monitors the fetal
heart rate during and for 30 minutes afterward.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 213-214
18. A high-risk pregnant client will go through a non-stress
test. The result indicates a reactive non-stress test. The
client asks the nurse what it means. The nurse aptly replies
by saying:
a. “The fetus is receiving adequate oxygen”
b. “The fetal heart rate is decreasing, instead of increasing,
with every contraction”
c. “There is no fetal movement during stimulation”
d. “You are at risk for premature labor; the doctor may
prescribe tocolytic drug”
ANSWER: A
A non-stress test measures the response of fetal heart rate
to fetal movement. When the fetus moves, the FHR should
increase about 15 beats per minute and remain elevated
for 15 seconds. It should decrease to its average rate again
as the fetus quiets. If no increase in beats per minute is
noticeable on fetal movement, poor oxygen perfusion of
the
fetus is suggested. The test is said to be reactive if two
accelerations of fetal heart rate (by 15 beats or more)
lasting
for 15 seconds occur after movement within chosen time
period. The test is non-reactive if no accelerations occur
with
the fetal movements. Other options are incorrect
statement.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 208
19. Which of the following common emotional reactions to
pregnancy would the nurse expect to occur during the first
trimester?
a. Introversion, egocentrism, narcissism c. Anxiety,
passivity, extroversion
b. Awkwardness, clumsiness, and unattractiveness d.
Ambivalence, fear, fantasies
ANSWER: D
During the first trimester, common emotional reactions
include ambivalence, fear, fantasies, or anxiety. The
second
trimester is a period of well-being accompanied by the
increased need to learn about fetal growth and
development.
Common emotional reactions during this trimester include
narcissism, passivity, or introversion. At times the woman
may seem egocentric and self-centered. During the third
trimester, the woman typically feels awkward, clumsy, and
unattractive, often becoming more introverted or
reflective of her own childhood.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 221-225
20. Which of the following statements, if made by a
woman who is 12 weeks pregnant, would be essential for a
nurse
to further evaluate?
a. “I thought I wanted to be pregnant, but now I don’t
know”
b. “My husband is angry because I got pregnant”
c. “Being pregnant makes me feel very tried”
d. “I don’t want to get too fat while I’m pregnant”
ANSWER: B
The most important person to the pregnant woman is
generally the father of the child. A major need during a
woman’s pregnancy is to secure her partner’s acceptance
of the child and assimilate the child into the family. Option
A: Ambivalence is a normal response to pregnancy. Even
woman who are please to be pregnant may experience
feelings of hostility toward the pregnancy or unborn child
from time to time. It these feelings intensify and persist
through the third trimester, this may indicate unresolved
conflict with the motherhood role. Option C: Fatigue is
common in early pregnancy. Option D: For most women
the feeling of liking or not liking their bodies during
pregnancy is temporary and does not cause permanent
changes in their perceptions of themselves.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page
21. Mrs. Selena complains of morning sickness during the
first trimester of pregnancy. A nurse would suggest that
she
take which of the following measures to help alleviate the
symptoms?
a. Consume a clear liquid diet c. Eat foods that are low
in protein
b. Take prenatal vitamins with milk d. Avoid exposure to
noxious odors
ANSWER: D
The nurse should instruct the patient to avoid odorous
food if morning sickness occurs. Options A, B and C:
Morning
sickness is due to fluctuating hormone levels. Dry foods
such as crackers before arising seem to alleviate some of
the
nausea.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 311
22. Nurse Heart is caring for a woman who is admitted to
the hospital in active labor. What information is most
important for Nurse Heart to assess to avoid respiratory
complications during labor and delivery?
a. Family history of lung disease c. Number of cigarettes
smoked daily
b. Food or drug allergies d. When the client last ate
ANSWER: D
Gastric motility is decreased during pregnancy. Food eaten
several hours prior to the onset of labor may still be in the
stomach undigested. This will influence the type of
anesthesia the client may receive. Inhalation of vomitus
from
pressure of the uterus on the stomach can be fatal if a
woman’s airway becomes occluded by the foreign matter.
Some anesthesiologists may order IV ranitidine or an oral
antacid such as cimetidine to be given before general
anesthesia is administered, to reduce the level of acid in
stomach contents should aspiration occur.
Reference: A. Pillitteri. Maternal and Child Health Nursing
6th edition Page 408
23. Mrs. Pilapil is admitted to the hospital in labor. Vaginal
examination reveals that she is 8 cm dilated. At this point
in her labor, which of the following statements would the
nurse expect her to make?
a. “I can’t decide what to name my baby” c. “Take your
hand off my stomach when I have a contraction”
b. “It feels good to push with each contraction” d. “This
isn’t as bad as I expected”
ANSWER: C
At 8 cm dilated is in the transition stage of her labor. Many
women experience hyperesthesia of the skin at this time
and would not want to be touched during a contraction.
Reference: A. Pillitteri. Maternal and Child Health Nursing
6th edition Page 361
24. A postpartum client has a temperature of 101.4ºF,
with a uterus that is tender when palpated, remains
unusually
large, and not descending as normally expected. Which of
the following should the nurse assess next?
a. Lochia b. Breasts c. Incision d. Urine
ANSWER: A
The data suggests an infection of the endometrial lining of
the uterus. The lochia may be decreased or copious, dark
brown in appearance, and foul smelling, providing further
evidence of a possible infection. All the client’s data
indicate
a uterine problem, not a breast problem. Typically,
transient fever, usually 101ºF, may be present with breast
engorgement. Symptoms of mastitis include influenza-like
manifestations. Localized infection of an episiotomy or C-
section incision rarely causes systemic symptoms, and
uterine involution would not be affected. The client data
do not
include dysuria, frequency, or urgency, symptoms of
urinary tract infections, which would necessitate assessing
the
client’s urine.
Reference: A. Pilliteri. Maternal and Child Health Nursing
6th edition Page 425, 432
25. Nurse Hannah is assessing a postpartum client whose
uterus is palpable 6 days after delivering the baby. Nurse
Hannah documents this as:
a. An expected finding c. Abnormal finding that needs
further assessment
b. Possible uterine atony d. Possible retained placenta
ANSWER: A
The uterus decreases in size at a predictable rate during
postpartal period. On the first postpartal day, it will be
palpable one fingerbreadth below the umbilicus; on the
second day, two fingerbreadths below the umbilicus; and
so
on. After 10 days, it recedes under the pubic bone and is
no longer palpable.
Reference: A. Pilliteri. Maternal and Child Health Nursing
6th edition Page 422
26. A nurse observes a new mother breast feeding her
newborn. Which of the following actions would indicate to
a occur. If no
nurse that the mother has a correct understanding of
breastfeeding techniques?
a. Cleansing the breast with soap and water prior to
feeding the newborn
b. Scheduling the newborn to feed every six hours around
the clock
c. Initiating the newborn’s feeding on the same breast for
each feeding
d. Placing the nipple and areola into the newborn’s mouth
ANSWER: D
The baby should be put to breast by guiding the nipple and
areolar tissue into the infant’s mouth and over the tongue.
Compress the breast with fingers above and thumb below
the areola to permit the infant to latch on effectively.
Option A: Daily washing of the breast with water is
sufficient for cleanliness. Option B: Newborns need to be
fed every
two to three hours for a total of eight to 12 minutes each
24 hours for at least one month. Option C: The mother will
be able to tell which breast to start with next time by
feeling the weight of the breast. The heaviest one has the
most
milk and should be used for that feeding.
Reference: A. Pilliteri. Maternal and Child Health Nursing
6th edition Page 493-500
27. A newborn who is being cared for in an open warming
unit has an axillary temperature of 96.2deg F (35.7 deg C).
It is essential that the nurse take which of the following
actions?
a. Wrap the newborn in a blanket c. Increase the heat-
control setting on the warming unit
b. Notify the parents of the findings d. Perform a heel
stick to check the capillary blood glucose
ANSWER: C
Increasing the temperature of the warming unit is the
action of choice. Option A: An infant in a warming unit
should
not be wrapped because the blanket will interrupt the
thermal environment. Option B: Parents are not routinely
informed of the temperature instability of an infant under
a radiant warmer. Option D: Glucose is needed for
increased
energy but a heelstick is not the priority nursing action.
Reference: A. Pilliteri. Maternal and Child Health Nursing
6th edition Page 474
28. Signs of imminent miscarriage are noted by Nurse
Hannah in a woman at 8 weeks’ gestation. Which of the
following would be an appropriate medical management
approach for this woman?
a. The woman will undergo sonogram c. Teach her the
need for bedrest for 2 weeks
b. Prepare her for D&C d. Increase fluid intake
ANSWER: B
A threatened miscarriage becomes an imminent
miscarriage if uterine contractions and cervical dilation
fetal heart tones are detected, the physician may perform
D and C to ensure all products of conception are removed.
Sonogram is used to determine the integrity of the
gestational sac and the viability of the fetus.
Reference: Pilliterri, A.(2003) Maternal and Child Health
Nursing: Care of the Childbearing and Childrearing Family.
4th ed. Page 384
29. Ectopic pregnancy is the second most frequent cause
of bleeding early in the pregnancy. It occurs more
frequently
in the following women. Which is not included?
a. Woman who smokes c. Woman who uses IUD’s
b. Woman who douches d. Woman who uses oral
contraceptives
ANSWER: D
Ectopic pregnancy occurs more frequently in women who
smoke compared to those who not. It also occurs more
frequently in women who douche, possibly due to the risk
of introducing an infection. There is also evidence that the
use of intrauterine devices used for contraception may
slow down the transport of the zygote and lead to ovarian
or
tubal implantation. Oral contraceptives may reduce the
possibility of ectopic pregnancy.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 559
30. Nurse Mara is caring for a client with suspected
pregnancy induced hypertension (PIH). She expects to find
which
findings if PIH is present?
a. Edema, obesity, ketonuria c. Edema, proteinuria,
hypertension
b. Edema, tachycardia, ketonuria d. Hyportension,
edema, hyperalbunemia
ANSWER: C
Pregnancy-induced hypertension is the most common
hypertensive disorder in pregnancy. It is characterized by
the
development of hypertension, proteinuria, and edema.
Glycosuria and ketonuria occur in diabetes mellitus.
Tachycardia and obesity are not specifically related to
diagnosing PIH.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 575
31. Because a woman who is confirmed to be at 30 weeks
gestation has sudden painless bright red vaginal bleeding,
a nurse would suspect the woman is experiencing:
a. Abruption placenta b. An ectopic pregnancy
c. Placenta previa d. A molar pregnancy
ANSWER: C
Manifestations of placenta previa include minimal to
severe bright red blood from the vagina and absence of
pain.
Option A: Abruptio placentae is manifested by uterine
tenderness or pain and dark red or absent bleeding.
Option B:
Pain and dark red or no vaginal bleeding also is associated
with a ruptured tubal pregnancy. Option D: Molar
pregnancy is a uterine growth that contains no fetus,
placenta or amniotic sac vaginal bleeding occurs in 45% of
patients. The vaginal discharge may be dark brown or
bright red, either scant or profuse. It may continue for a
few
days, or continue intermittently for weeks.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 563
32. A woman who frequently abuses cocaine during
pregnancy is at risk for developing which of the following
complications?
a. Incompetent cervix c. Gestational diabetes
b. Abruptio placenta d. Hyperremesis gravidarum
ANSWER: B
With cocaine abuse during pregnancy uterine blood
vessels are maximally dilated but vasoconstrict rapidly in
the face
of catecholamines, placing the woman at risk for
separation of the placenta (abruption) or acute onset of
preterm
labor. The patient also is put at risk for precipitous birth.
Women who abuse cocaine during pregnancy are not at
risk
for incompetent cervix, gestational diabetes or
hyperemesis gravidarum.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 6th ed.
Page 564
33. The nurse is planning for the care of a 30-year-old
primigravida with pre-gestational diabetes. What is the
most
important factor affecting this client's pregnancy
outcome?
a. Mother's age. c. Degree of glycemic control during
pregnancy.
b. Amount of insulin required prenatally. d. Number of
years since diabetes was diagnosed.
ANSWER: C
Clients with tight glucose control and no blood vessel
disease should have positive pregnancy outcomes (C). Risk
assessment is best done by evaluating the woman's blood
glucose and blood vessels, not by evaluating mother's age
(A), number of years since diabetes was diagnosed (D), or
the amount of insulin required prenatally (B).
Reference: A. Pillitteri. Maternal and Child Health Nursing
6th edition Page 538
34. While caring to a postpartal client, nurse Hannah
noticed an increase in her respirations and the client is
complaining of chest pain. Nurse Hannah should first:
a. Notify the physician c. Obtain an order for
antianxiety
b. Assess vital signs d. Provide supportive care
ANSWER: A
The woman is experiencing pulmonary embolism, the
nurse should promptly notify the physician. Pulmonary
embolism is an emergency. A woman needs oxygen
administered immediately and is at high-risk for cardio-
pulmonary arrest. Other signs of PE are tachycardia,
orthopnea, and cyanosis. Because of the seriousness of the
condition, a woman with PE is transferred immediately to
an ICU for continuing care.
Reference: Adele Pilitteri. Maternal and Child Health
Nursing 5th edition Page 689
35. The nurse is assessing Nancy who is now in her third
trimester with known maternal hypertenstion. She was
scheduled to have her ultrasonography today. Based on
her health history, what could be the possible defect
brought
about by her condition may be manifested by her fetus?
a. Hypoglycemia b. Fetal lung maturity delays c. Small
for gestational age d. All of the above
ANSWER: C
The mother’s nutrition during pregnancy plays a major role
in fetal growth, so lack of adequate nutrition may be a
major contributor to intrauterine growth restriction.
Pregnancy induced hypertension is a common cause of
late
pregnancy fetal growth retardation. Vasoconstriction
reduces placental exchange of oxygen and nutrients.
Option A – is not a caused by the woman’s condition
Option B – for an unexplained reason, fetal lung maturity
appears to advance rapidly with PIH, (possibly from the
intrauterine stress), so even though the fetus is younger
than 36 weeks, the lecithin-sphingomyelin ration may
indicate fetal lung maturity
Reference: Pilliteri, A. (2007). Maternal & Child Health
Nursing: Care of the Childbearing & Childbearing Family.
5th
Edition, Vol. 1. Page 432-433, 757-758.
36. A client was admitted to the maternity unit with
symptoms of preeclampsia. The nurse is concerned that
the client
may be developing HELLP syndrome if which of the
following are noted?
a. Deep tendon reflex (4+) c. Decrease in AST
b. Decrease in platelet count d. Sudden increase in
weight
ANSWER: B
HELLP is a laboratory diagnosis for a variant of severe
preeclampsia and is characterized by hemolysis (H),
elevated
liver enzymes (EL), and low platelets (LP). One of the signs
of HELLP syndrome is a decrease in the platelet count.
Other laboratory findings are: hemolysis of red blood cells
and elevated liver enzymes due to hemorrhage and
necrosis of the liver. Therapy for this condition is to
improve the platelet count by transfusion of fresh frozen
plasma
or platelets.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 5th ed.
433.
37. Oyo Hermosa, 24-year old, comes to the clinic because
she thinks she is pregnant. Which of the following is a
probable sign of pregnancy that the nurse would expect
the client to have?
a. Fetal heart tone b. Nausea and vomiting c.
Amenorrhea d. Chadwick’s sign
ANSWER: D
Probable signs of pregnancy are the result of physiologic
changes in the pelvic organs and hormonal influences; for
example, the mucous membranes of the vulva, vagina and
cervix becomes bluish (Chadwick’s sign) as a result of
hyperemia and proliferation of cells
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 5th ed.
38. A woman, 30 weeks gestation, is being discharged to
home care with a diagnosis of placenta previa. What
statement by the client indicates she understands her care
at home?
a. “As I get closer to my due date I will have to remain in
bed”
b. “I can continue with my office job because it’s mostly
sitting”
c. “My husband won’t be too happy with this ‘no sex’
order”
d. “I’m disappointed that will need a caesarean section”
ANSWER: C
In placenta previa, any sexual arousal is contraindicated
because it can cause the release of oxytocin, which can
cause
the cervix to pull away from the low-lying placenta; this
results in bleeding and potential bleeding and potential
jeopardy to the fetus.
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 5th ed.
39. Which nursing action should be included in the care of
the infant with caput succedaneum?
a. Aspiration of the trapped blood under the periosteum
c. Gentle rubbing in a circular motion to decrease size
b. Explanation to the parents about the cause/prognosis
d. Application of cold to reduce size
ANSWER: B
Caput succedaneum (scalp edema) will regress in a few
days without interventions and without residual damage
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 5th ed.
40. The nursery nurse carries a newborn baby into his
mother’s room. The mother states, “I think my baby’s
afraid of
me, everytime I make a loud noise, he jumps.” What
should be the nurse’s initial action?
a. Encourage her not to be so nervous with her baby
b. Reassure her that this is normal reflexive reaction for
her baby
c. Take the baby back to the nursery for neurologic
evaluation
d. Wrap the baby more lightly in warm blankets
ANSWER: B
The startle reflex, normally present in neonates, is
characterized by symmetric extension and abduction of
the arms
with fingers extended. The parent perceives the response
as jumping
Reference: Pilliterri, A. Maternal and Child Health Nursing:
Care of the Childbearing and Childrearing Family. 5th ed.
41. The nurse should refer the parents of an 8-month-old
child to a health care provider if the child is unable to do
which of the following?
a. Stand momentarily without holding onto furniture. c.
Stoop to recover an object.
b. Stand alone well for long period of time. d. Sit without
support for long periods of time.
ANSWER: D
An 8-month-old child can sit without additional support for
long periods of time. This is a major milestone in
development that should always be considered in
assessment. Children with delayed cognitive or motor
development
may not accomplish this step at this time.
Option A - An 8-month-old child does not have the ability
to stand without hanging on to a stationary object for
support. This development is observed in a child who is 12-
months old.
Option B - His muscles are not developed enough to
support all his weight without assistance, at 12-months, a
child
stands alone at least momentarily
Option D - His balance has not developed to the point that
he can stand and stoop over to reach an object.
Reference: Pillitteri, A. (2007). Maternal and Child Health
Nursing: Care of the childbearing and childrearing
family. Volume. 5th edition. Lippincot William & Wilkins.
Page 830-831.
42. A mother comes to the clinic complaining about her 7-
month-old son having colic. Nurse Hannah should not
include which teaching?
a. “I should avoid over feeding my child.”
b. "this discomfort is more common in infants who are
formula fed.”
c. “I should let my infant burp after every feeding.”
d. “I should try to place hot water bottle on my infant’s
abdomen for comfort.”
ANSWER: D
A basic rule for any abdominal discomfort is to avoid heat
in case appendicitis is developing. Although it is highly
unlikely to young infant, doing this often may give the
wrong notion that it always help to relieve discomforts in
the
abdomen and used it again when the child is older. In
addition, hot water bottles and heating pads also might
burn the delicate skin of the infants. The cause of colic is
unclear. It may occur in susceptible infants from
overfeeding or
from swallowing too much air while feeding. Formula-fed
babies are morel likely to have colic than breast-fed
babies,
possibly because they swallow more air while drinking or
because formula is harder to digest. Having the baby burp
every after feeding may expel the air ingested.
Reference: A. Pillitteri. Maternal and Child Nursing. 5th
Edition Page 852.
43. A baby undergoes surgery to correct an esophageal
atresia and tracheoesophageal fistula. Which nursing
diagnosis has the highest priority during the first 24 hours
postoperatively?
a. Ineffective airway clearance c. Interrupted breast-
feeding
b. Imbalanced nutrition: Less than body requirements d.
Hypothermia
ANSWER: A
Ineffective airway clearance is the priority nursing
diagnosis in the immediate postoperative period. The
infant's
airway must be carefully assessed and frequent suctioning
may be necessary to remove mucus while taking care not
to pass the catheter as far as the suture line. Assess breath
sounds, respiratory rate, skin color, and ease of
breathing. Because of the risk of edema and airway
obstruction, keep a laryngoscope and endotracheal
intubation
equipment readily available. Imbalanced nutrition,
Interrupted breast-feeding, and Hypothermia are also
important
during the postoperative period but only after a patent
airway is ensured.
Reference: Wong’s Nursing Care of Infants and Children
8th
edition Page
44. It is now recommended that children with asthma who
are taking long-term inhaled steroids should be assessed
frequently because which of the following may develop?
a. Cough b. Osteoporosis c. Slowed growth
d. Cushing syndrome
ANSWER: C
The growth of children on long-term inhaled steroids
should be assessed frequently to assess for systemic
effects of
these drugs. Option A: Cough is prevented by inhaled
steroids. Option B: No evidence exists that inhaled steroids
cause osteoporosis. Option D: Cushing syndrome is caused
by long-term systemic steroids.
Reference: Wong’s Nursing care for Infants and Children
8th
edition Page

45. Which of the following explains why iron-deficiency
anemia is common during toddlerhood?
a. Milk is a poor source of iron. c. Fetal iron stores are
depleted by age 1 month.
b. Iron cannot be stored during fetal development. d.
Dietary iron cannot be started until age 12 months.
ANSWER: A
Children between the ages of 12 to 36 months are at risk
for anemia, because cow’s milk is a major component of
their diet, and it is a poor source of iron. Option B: Iron is
stored during fetal development, but the amount stored is
dependent on maternal iron stores. Option C: Fetal iron
stores are usually depleted by age 5 to 6 months. Option
D:
Dietary iron can be introduced by breast-feeding, iron-
fortified formula, and cereals during the first 12 months of
life.
Reference: Wong’s Nursing Care of Infant and children 8th
edition
46. A 6-month-old infant is receiving digoxin (Lanoxin). The
nurse should notify the practitioner and withhold the
medication if the apical pulse is less than which of the
following?
a. 60 b. 70 c. 90 to 110 d. 110 to 120
ANSWER: C
If the 1-minute apical is below 90 to 110, the digoxin
should not be given to a 6-month-old. Option A: This is the
cut-
off for holding the digoxin dose in an adult. Option B: This
is the determining heart rate to hold a dose of digoxin for
an older child. Option D: This is an acceptable heart rate to
administer digoxin to a 6-month-old.
Reference: Wong’s Nursing care for Infants and Children
8th
edition Page
47. The nurse is discharging from the hospital a 7-month-
old who weighs 15 lb. The parents have put the child in the
back seat of the car with the car seat facing the front seat.
Upon seeing the parents’ action, what should the nurse
prioritize to do?
a. Ask the parents to wait while the nurse obtains the
correct car seat.
b. Complete the discharge with the child sitting facing the
front seat.
c. Give the parents a manual on proper car seat
placement.
d. Show the parents’ proper placement of the car seat
facing the back seat.
ANSWER: D
The proper placement for a car seat for a child less than 20
lb and younger than 1 year is in the back seat, facing the
rear of the car because inflating front-seat airbag could
suffocate an infant. Demonstrating proper car seat
placement
and explaining the reason for this position reinforces
correct car seat positioning and may motivate the parents
to
continue this practice the next time they place the child in
a vehicle.
Option A - The car seat is not in question and does not
need to be replaced.
Option B - Keeping the child in an improperly installed car
seat while the nurse continues the discharge only
reinforces
incorrect placement of the car seat.
Option C - The parents are not likely to read a manual,
especially since the child is 7 months old already and they
have probably been placing the child in this position since
birth.
Reference: Pillitteri, A. (2007). Maternal and Child Health
Nursing: Care of the childbearing and childrearing
family. Volume. 5th edition. Lippincot William & Wilkins.
Page 839.
48. Which nursing intervention is appropriate when caring
for this child’s surgical incision one day after the cleft lip
repair?
a. Clean the incision only when serous exudates forms
b. Rub the incision gently with a sterile cotton-tipped swab
c. Rinse the incision with sterile water after feeding
d. Replace the Logan Bar carefully after cleaning the
incision
ANSWER: C
The incision should be rinsed with sterile water after every
feeding. Rubbing alters the integrity of the suture line.
Rather, the incision should be patted or dabbed. The
purpose of the Logan bar is to maintain the integrity of the
suture line. Removing the Logan bar on the first
postoperative day would increase tension on the surgical
incision.
Reference: A. Pillitteri. Maternal and Child Nursing. 5th
Edition. Page 1187.
49. When taking a diet history from the mother of a 7-
year-old child with phenylketonuria, a report of an intake
of
which of the following foods should cause the nurse to
become concerned?
a. Coke Zero b. Carrots c. Orange
juice d. Bananas
ANSWER: A
As children grow older and have solid foods added to their
meals, these foods also must be low in phenylalanine so
that the phenylalanine level of the child’s blood stays
below 8 mg/dl. Foods with low phenylalanine levels
include
vegetables, fruits, and juices. Foods high in phenylalanine
include meats and dairy products, which must be
restricted
or eliminated. Cola (like Coke zero) contain more
phenylalanine than the fruits listed.
Reference: A. Pillitteri. Maternal and Child Nursing. 5th
Edition Page 1535.

50. A toddler who has been treated for a foreign body
aspiration begins to fuss and cry when the parents attempt
to
leave the hospital for an hour. The parents will be
returning to take the toddler home. As the nurse tries to
take the
child out of the crib, the child pushes the nurse away. The
nurse interprets this behavior as indicating separation
anxiety involving which of the following?
a. Protest b. Despair c. Regression d. Detachment
ANSWER: A
Young children have specific reactions to separation and
hospitalization. In the protest stage, the toddler physically
and verbally attacks anyone who attempts to provide care.
Here, the child is fussing and crying and visibly pushes the
nurse away. In the despair stage, the toddler becomes
withdrawn and obviously depressed (for example, not
engaging in play activities and sleeping more than usual).
Regression is a return to a developmentally earlier phase
because of stress of crisis (for example, a toddler who
could feed himself before this event is not doing so now).
Denial or detachment occurs if the toddler’s stay in the
hospital without the parent is prolonged because the
toddler
settles in to the hospital life and denies the parent’s
existence (for example, not reacting when the parent
come to
visit).
Reference: A. Pillitteri. Maternal and Child Nursing. 5th
Edition Page 1078t.
51. Which of the following foods should the nurse
encourage the mother to offer to her child with iron
deficiency
anemia?
a. Rice cereal, whole milk, and yellow vegetables c.
Macaroni, cheese, and ham
b. Potato, peas, and chicken d. Pudding, green
vegetables, and rice
ANSWER: B
Potatoes, peas, chicken, green vegetables and rice cereal
contain significant amounts of iron and therefore would be
recommended. Milk and yellow vegetables are not good
source of iron sources. Rice by itself also is not a good
source
of iron. Macaroni, cheese, and ham are not high in iron.
While pudding (made with fortified milk) and green
vegetables contain some iron, the better diet has protein
and iron from the chicken and potato.
Reference: A. Pillitteri. Maternal and Child Nursing. 5th
Edition Page 1394.
52. The mother asks the nurse why her child’s hemoglobin
was normal at birth but now the child has S hemoglobin.
Which of the following responses by the nurse would be
most appropriate?
a. “The placenta bars passage of the hemoglobin S from
the mother to the fetus.”
b. “The red bone marrow does not begin to produce
hemoglobin S until several months after birth.”
c. “Antibodies transmitted from you to the fetus provide
the newborn with temporary immunity.”
d. “The newborn has a high concentration of fetal
hemoglobin in the blood for some time after birth.”
ANSWER: D
Sickle cell disease is an inherited disease that is present at
birth. However, 60% to 80% of a newborn’s hemoglobin is
fetal hemoglobin, which has a structure different from that
of hemoglobin S or hemoglobin A. Sickle cell symptoms
usually occur about 4 months after birth, when
hemoglobin S begins to replace the fetal hemoglobin.
Option A - The gene for sickle cell disease is transmitted at
the time of conception, not passed through the placenta.
Some hemoglobin S is produced by the fetus near term.
Option B - The fetus produces all its own hemoglobin from
the earliest production in the first trimester.
Option C - Passive immunity conferred by maternal
antibodies is not related to sickle cell disease, but this
transmission of antibodies is important to protect the
infant from various infections during early infancy.
Reference: Pillitteri, A. (2007) Maternal and Child Health
Nursing: Care of the Childbearing and Childbearing Family.
5th Edition. Vol. 2. Page 1396.
53. The child was confirmed to have UTI and was confined
to the hospital. The father tells Nurse Joey, “My wife and I
are concerned because our child refuses to obey us
concerning the preventions of UTI. Our child refuses to
take her
medication unless we buy her a present. We don’t want to
use discipline because of the illness, but we’re worried
about the behavior.” Which response by the nurse is best?
a. “I sympathize with your difficulties, but just ignore the
behaviour for now.”
b. “I understand it’s hard to discipline a child who is ill, but
things need to be kept as normal as possible.”
c. “I understand that things are difficult for you right now,
but your child is ill and deserves a special treatment.”
d. “I understand your concern, but this type of behaviour
happens all the time, your child will get over it when
feeling better.”
ANSWER: B
To ensure appropriate psychosocial development, a child
needs to have normal patterns maintained as much as
possible during illness. It is tempting to give ill children
special treatment and to relax discipline. However, family
routines and discipline should be kept as normal as
possible. The child needs to know the limits to ensure
feelings of
security. When they are ill, children commonly attempt to
stretch the rules and limits. If this occurs, returning to the
previous well-behavior patterns will take time.
Reference: Hockenberry/Wilson. Nursing Care of Infants
and Children. 8th Edition. Wong’s. Page 1240.

SITUATION: CHN
54. Public health systems are operating within a context of
ongoing changes. Which of the following exerts a number
of pressures on the public health system?
a. Shifts in demographic and epidemiological trends in
diseases. c. New technologies
b. Health reforms d. All of the above ANSWER: D
Public health systems are operating based on ongoing
changes brought by option A that includes emergence and
re-
emergence of new diseases and prevalence of risk and
protective factor; option B health reforms or new
programs;
option C new technologies for health care,
communication, and information; additionally is the
existing and emerging
environmental hazards and some of this is related to
globalization.
Reference: Public Health Nursing in the Philippines by
DOH, p. 2
55. In response to above trends, the global community,
represented by UN General Assembly, decided to adopt a
common vision exemplified by the Millennium
Development Goal that includes:
i. eradicate extreme poverty and hunger
maternal health
ii. achieve universal primary education vi. combat HIV
iii. promote gender equality vii. ensure environmental
sustainability
iv. reduce child mortality viii. develop global partnership
a. i, ii, iii, iv b. v, vi, vii, viii c. i, iii, iv, vii, viii d. all of the
above
ANSWER: D
Millennium developmental goals are based on
fundamental values of freedom, equality, solidarity,
tolerance, health,
and respect for nature and shared responsibility. All of the
above are included in this goal.
Reference: Public Health Nursing in the Philippines by
DOH, p. 3
56. Nurse should remember which of the following as
essential in the achievement of the Millennium
Development
Goal and stand as the major overarching goal of poverty
reduction?
a. Health b. Health-related c. Participation of all
members of society d. FOURmula one
ANSWER: A
The 8 Millennium Development Goal are all health related
except for gender equality and achievement of universal
primary education. Health is essential to the achievement
of these goals and is a major contributor to the
overarching
goal of poverty reduction. Option B: Participation of all
members of society from both developing and developed
countries is required to achieve the goals but not the
essential or the major contributor in poverty reduction.
FOURmula One is an initiative from various countries to
implement cost-effective health care services.
Reference: Public Health Nursing in the Philippines by
DOH, p. 3
57. Community Health Nursing is responsible to:
a. Individuals c. Families
b. Local government units (LGU’s) d. Individuals, families,
population groups, community
ANSWER: D
Choose the answer that encompasses all answers
The primary goal of community health nursing is the
promotion and preservation of health of its different
clients – the
individual, family, population groups and the community.
It deals with individuals – sick or well on a daily basis. A
population group is a group of people who share common
characteristics, developmental stage or common exposure
to a particular environmental factor and consequently,
common health problems. Example of population groups
are
children, men, women, farmers, military men, elderly, etc.
A community is a group of people sharing common
geographic boundaries and/or common values and
v. improve interests.
Reference: Maglaya, Araceli S. (2004). Nursing Practice in
the Community. 4th ed. Page 10
58. What is the basic principle in Community Health
Nursing?
a. Promote a self-reliant community c. Control of
communicable diseases
b. Eradicate the immunizable diseases d. Rehabilitation to
the previous level of functioning the clients
ANSWER: A
The primary goal of community health nursing is the
promotion, prevention and preservation of health of its
different
clients. Priority is placed over the health promotive and
disease preventive strategies over curative or
rehabilitative
interventions and to be able to promote a self-reliant
community.
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
Health Nursing in the Philippines. 10th Ed., page 3- 5
59. The goal of conceptual framework for Primary Health
Care (PHC) is:
a. 2020Health Promotion for all Filipinos by year 2020
b. Health services readily made available to the Filipinos in
the year 2020
c. To promote self-reliant community
d. Health for All Filipinos and Health in the hands of the
people by the year
ANSWER: D
Primary Health Care was declared during the First
International Conference on Primary Health Care held in
Alma Ata,
USSR on September 6-12, 1978 by WHO. The goal was
“Health for All by the year 2000.” This was adopted in the
Philippines through Letter of Instruction 949 signed by
President Marcos on October19, 1979 and has an
underlying
them of “Health in the Hands of the People by 2020.”
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
Health Nursing in the Philippines. 10th Ed., page 30
60. What is the legal basis of Primary Health Care?
a. RA 9173 b. EO 2009 c. LOI 949 d. EO 51
ANSWER: C
Through Letter of Instruction 949 signed by President
Marcos on October19, 1979 and has an underlying theme
of
“Health in the Hands of the People by 2020.”
Option A – Philippine Nursing Act 2002
Option B – Family Code of the Philippines
Option D – Milk Code
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
Health Nursing in the Philippines. 10th Ed., page 140,342
61. Framework for implementation of Health Sector
Reform Agenda (HSRA) is:
a. Rationalization for Health c. Primary Health Care
(PHC)
b. National Objective for Health (NOH) d. Fourmula One
for Health (F1)
ANSWER: D The framework for implementation of HSRA is
FOURmula One for Health. Goals of FOURmula ONE for
Health: 1)
Better health outcomes 2) More responsive health
systems. 3) Equitable health care financing.
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
Health Nursing in the Philippines. 10th Ed., page 26
62. Nurse Isabelle will conduct teaching regarding Family
Planning Program. Which of the following statements is
true
regarding family planning?
a. All contraceptives causes sterility c. Tubal ligation can
be irreversible
b. Some Family Planning methods causes abortion d.
Using contraceptive methods will result to loss of sexual
desire
ANSWER: C
Vasectomy and tubal ligation in women are considered
permanent methods and chosen by couples who have
completed their desired family size. Option A:
Contraceptive such as pills, IUD, injectables and condoms
which are
used for birth spacing, when pregnancy is desired, a
couple can stop using the contraceptive method and they
can
have children again. Option B: This is not true. Abortion is
termination of pregnancy, while family planning prevents
pregnancy through the use of contraceptives, and
abstinence during fertile periods, blocking of tubes, all of
which
prevent the meeting of egg and sperm. It prevents induced
abortion by preventing unplanned pregnancies. Option D:
Sexual desires are not affected by contraceptive use. In
fact, the use of contraceptives frees the couple from the
fear
of unwanted pregnancies. This enhances the couple’s
sexual relationship
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
health nursing in the Philippines. 10th edition, Page 133
63. Nurse Sinka, a community health nurse, motivates the
people to share their ideas on how to manage their
concerns during which phase of COPAR?
a. Pre-entry phase b. Entry phase c. Organization-building
phase d. Sustenance Phase
ANSWER: B
Option A is more on project site selection, C is more on
immersion and its activities, and D is more on the transfer
of
KAS and community self-reliance.
Reference: Jimenez, Carmen, E.. (2002). Community
Organizing Participatory Action Research (CO-PAR) for
Community Health Development.
64. Upon entry to the community, the organizer can start
the following, except:
a. Social preparation b. Deepening social investigation c.
Core-group formation d. Community integration
ANSWER: C
Core group formation is done on the later part of entry.
Reference: Jimenez, Carmen, E.. (2002). Community
Organizing Participatory Action Research (CO-PAR) for
Community Health Development.
65. Integration to the community is best done through:
a. House-to-house visits c. Visits to where people are
b. Participation in work setting d. Attending community
occasions
ANSWER: C
It presents a broader concept where most people will
listen to your advocacy.
Reference: Jimenez, Carmen, E.. (2002). Community
Organizing Participatory Action Research (CO-PAR) for
Community Health Development.
66. The delivery of basic health services was devolved to
the local government units. The legal basis for this is
embodied in:
a.RA 7610 b. EO 119 c. RA 7160 d. EO 226
ANSWER: C
Under the RA 7160, the LGU now is the responsible in the
implementation of health programs. Non-government
organizations participate in the local health systems
development.
Reference: Public Health Nursing in the Philippines by
DOH, p. 24
67. The components of FHSIS are the following except:
a. Family treatment record b. Reporting forms c.
Target client listing d. Input forms
Answer: D
Option A, B and C are components of FHSIS. Option D
should be output form not input form.
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
health nursing in the Philippines. 10th edition, Page 80
68. Alvira brought her 2-month old infant to the clinic for
immunization. She asks you when will her child can be
considered fully immunized. A child is said to be “Fully
Immunized Child” when a child receives:
a. One dose of BCG, 3 doses of OPV, 3 doses of DPT, 3
doses of HB and one dose of measles before a child’s first
birthday.
b. One dose of BCG, 3 doses of OPV, 3 doses of DPT, 2
doses of HB and one dose of measles before a child’s first
birthday
c. One dose of BCG, 4 doses of OPV, 3 doses of DPT, 2
doses of HB and one dose of MMR before a child’s first
birthday
d. One dose of BCG, 3 doses of OPV, 3 doses of DPT, 3
doses of HB and one dose of measles before five years old.
ANSWER: A
A child is said to be “Fully Immunized Child” when a child
receives One dose of BCG, 3 doses of OPV, 3 doses of
DPT, 3 doses of HB and one dose of measles before a
child’s first birthday.
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
health nursing in the Philippines. 10th edition, Page 149
69. The student nurse is investigating different types of
practice settings. In looking at community health nursing,
the
student recognizes that it:
a. Requires a Master’s degree to become a Public Health
Nurse
b. Is the same as public health nursing
c. Focuses on the incidence of disease
d. Includes direct care and services to subpopulations
ANSWER: D Community health nursing strives to safeguard
and improve the health of populations in the community
as well as
providing direct care services to subpopulations within a
community. Option A: Nurses who become expert in
community health practice may have advanced nursing
degrees; BSN degree and a RN can become quite
competent
in formulating and applying population-focused
assessments and interventions. Option B: Public health
nursing
focuses on the needs of populations. Community health
nursing has a broader focus, with an emphasis on the
health
of a community. The community health nurse merges
public health knowledge with nursing theory. The
community
health nurse considers the needs of populations and is
prepared to provide direct care services to subpopulations
within a community. Option C: Public health nursing is
concerned with trends and patterns influencing the
incidence of
disease within populations. A community health nurse
may be involved in direct client care for disease within a
community.
Reference: Cuevas. Public Health Nursing in the Philippines
10th edition page 7, 365
70. There are different ways to look on health and illness.
When formulating a definition of “health,” a person should
consider that health, within its current definition, is:
a. The absence of disease c. A state of well being
involving the whole person
b. A function of the physiological state d. The ability to
pursue activities of daily living
ANSWER: C
When formulating a definition of “health,” a person should
consider the total person, as well as the environment in
which the person lives. Health generally implies a state of
well being, which is ultimately defined in terms of the
individual. Option A: Health is considered to be more than
merely the absence of disease. Option B: The definition of
health has broadened beyond the physiological state to
include mental, social, and spiritual well being. Option D:
An
individual who has the ability to pursue activities of daily
living may not define himself or herself as being healthy.
Life
conditions such as environment, diet and lifestyle practices
may negatively affect one’s health long before one is
unable to perform activities of daily living.
Reference: Potter and Perry Fundamentals of Nursing 6th
edition page 91
71. When working as a community health nurse, the nurse
works to improve the health of:
a. Infants and preschool children c. Mothers and
children
b. Elderly clients in an aggregate d. The entire
community
ANSWER: D
Nurses who work in the community make a commitment
to improving the health of the entire community and not
just
infants, preschool children, mothers, or elderly clients.
Reference: Cuevas. Public Health Nursing in the Philippines
10th edition
72. There are three major roles of the Department of
Health as a national authority in health. Which one is not
included?
a. Decision-maker of people’s health c. Administrator of
specific services
b. Enabler and Capacity builder d. Leader in health
ANSWER: A
The three major roles of the Department of Health as a
national authority in health are the following: Leadership
in
health, Enabler and Capacity builder, and Administrator of
specific services.
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
health nursing in the Philippines. 10th edition, Page 24
73. PHC is based on which of the following concept?
a. Empowerment of the private health care service
providers c. Effective provision of essential health
services
b. Partnership with the people d. All of the above
ANSWER: B
The concept of PHC is characterized by partnership and
empowerment of the people that shall permeate as the
core
strategy in the effective provision of essential health
services that are community based, accessible, acceptable
and
sustainable at a cost which the community and
government can afford.
Reference: Public Health Nursing in the Philippines by
DOH, p. 30
74. Type of nursing assessment whereby existing problems
of the family are determined:
a. First- level assessment c. On-going assessment
b. Second-level assessment d. Third-level assessment
ANSWER: A
First-level assessment is a process whereby existing and
potential health conditions or problems of the family are
determined. Second-level assessment defines the nature
or type of nursing problems that the family encounters in
performing the health tasks with respect to a given health
condition or problem, and the etiology or barriers to the
family’s assumption of these tasks.
Reference: Maglaya. Nursing Practice in the Community
4th edition page 54
75. Baby Monmon, 12 months old, did not receive his
scheduled measles vaccine at 9 months. Nurse Jaika
identifies
categorize this health problem as:
a. Health threat b. Health deficit c. Stress points d.
Foreseeable crisis
ANSWER: A
Health threats are conditions that promote disease or
injury and prevent people from realizing their health
potential.
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
health nursing in the Philippines. 10th edition, Page 44
76. It is the model that scientists have developed for
studying health problems. It can help students understand
infectious diseases and how they spread:
a. Epidemiology b. Vital statistics c. Epidemiologic
triangle d. Health education
ANSWER: C
The Epidemiologic Triangle is a model that scientists have
developed for studying health problems. It can help your
students understand infectious diseases and how they
spread. It also gives students a chance to apply a scientific
model to a variety of circumstances and facts. The Triangle
has three corners: Agent, or microbe that causes the
disease (the “what” of the Triangle); Host, or organism
harboring the disease (the “who” of the Triangle);
Environment, or those external factors that cause or allow
disease transmission (the “where” of the Triangle)
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
health nursing in the Philippines. 10th
edition, Page 63
77. Nurse Hannah had documented an unusually large
number of cases of measles in barangay Pito-pito from
January
to July. This is known as:
a. Endemic b. Sporadic c. Pandemic d. Epidemic
ANSWER: D
In epidemiology, an epidemic is a classification of a disease
that appears as new cases in a given human population,
during a given period, at a rate that substantially exceeds
what is "expected," based on recent experience.
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
health nursing in the Philippines. 10th edition, Page 67
78. Isabel, a new public health nurse, is evaluating the
general health condition of Barangay Tralala. Which data
will
be most helpful to Nurse Isabel?
a. Infant Mortality Rate (IMR) c. Maternal Mortality
Rate (MMR)
b. Crude Death Rate (CDR) d. Crude Birth Rate (CBR)
ANSWER: A
Infant Mortality Rate (IMR) measures the risk of dying
during the first year of life. It is a good index of the general
health condition of a community since it reflects the
changes in the environment and medical condition of a
community.
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
health nursing in the Philippines. 10th
edition, Page 76
79. It is a major component of the work information
sources developed by the Department of Health (DOH) to
better
manage nationwide health service delivery:
a. Field health services and information system c. Public
health surveillance
b. Family treatment record d. Target client listing
ANSWER: A
Field health services and information system has the
objective of providing summary of data on health services
delivery and selected program accomplished indicators at
the barangay, municipality, provincial and national level.
Reference: Cuevas, Frances P., et. al. (2007) DOH’s Public
health nursing in the Philippines. 10th edition, Page 80
80. A project launched by the DOH is the Project
Entreprenurse which encourages nurses not only to seek
but create
jobs and engage in income augmentation programs. The
underlying concept of this project is based on:
a. Bringing into awareness of nurses the opportunity for
wider horizon of the profession
b. Bringing primary health care to the community thru
home health care
c. The fulfillment of the DOH millennium developmental
goals for better health care services and healthy nation
d. Maximizing employment opportunities for the country’s
unemployed nurses
ANSWER: B
ENTREPRENURSE is rooted from the original concept of
INTRODUCING A HOME HEALTH CARE INDUSTRY IN THE
PHILIPPINES. This project aims to promote nurse
entrepreneurship by introducing a home health care
industry to
reduce the cost of health care for the country’s indigent
population by (1)bringing primary health care services to
poor
rural communities, (2) to maximize employment
opportunities for the country’s unemployed nurses and (3)
to utilize
the country’s unemployed human resources for health for
the delivery of public health services and the achievement
of the country’s Millennium Development Goals on
maternal and child health, consistent with the Fourmula
One for
Health framework of the Department of Health. Options B,
C and D are components of the health care industry and
the means to effectively achieve its goal of reducing the
cost of health care.
Reference: Souvenir Program. Oathtaking Ceremony for
New Professional Nurses. March 2010. Page 227.
: BON Newsletter. March 8, 2010, Volume 6. Page 10.
81. Mang Indoy, who is one of the attendees in your
seminar, asks you what can be done to prevent the spread
of a
disease. Your appropriate response would be based on the
easiest link to break, which is:
a. Causative agent b. Reservoir c. Mode of transmission
d. Portal of entry
ANSWER: C
The mode of transmission is the means by which the
infectious agent passes from the portal of exit from the
reservoir
to the susceptible host. Of the six links in the chain of
infection, the mode of transmission is the easiest link to
break.
Reference: David L. Longworth. Handbook of Infectious
Diseases. Springhouse. Page 17-18.
82. Which statement is not true about infection and
colonization?
a. Infection is the invasion and multiplication of
microorganisms in body tissue with cellular injury.
b. Colonization is the multiplication of microorganisms on
or within a host that does not result in cellular injury.
c. Colonies of microorganisms are incapable of ever
causing infection to the host.
d. There are two types of flora: resident and transient.
ANSWER: C
Infection is an invasion and multiplication of
microorganisms in body tissue that results in cellular
injury. Colonization
is the multiplication of microorganisms on or within a host
that does not result in cellular injury. However,
microorganisms that are colonized on a host may be a
potential source of infection. Flora are the vegetation of
microorganisms on the human body. There are two types
of flora: resident and transient.
Reference: Rick Daniels Fundamentals of Nursing
83. A client asks Nurse Hannah, “how can you say that a
disease is communicable?” Nurse Hannah correctly
respond
by saying that a disease is said to be communicable if:
a. It is capable of producing s secondary infection c. It is
transmitted directly from one person to another
b. It persists for a long period of time d. Lifestyle factors
contribute to the disease process
ANSWER: C
Infectious pathologies are usually qualified as
communicable diseases due to their potentiality of
transmission from
one person or species to another.
Reference: Kozier, B. et. al. (2008) Fundamentals of
Nursing: Concepts, Process and Practice. 8th ed. Pearson
Prentice Hall. Page
:Potter and Perry Fundamentals of Nursing 6th edition
Page 774
84. During an initial exposure to an antigen, the T cells
stimulate the production of B cells, which then produce
antibodies specific to the antigen. This process is
collectively referred to as:
a. Acquired immunity b. Humoral immunity c. Specific
immune defense d. Vaccination
ANSWER: B
T cells are produced and moved to the injured area,
releasing chemical substances and activating other cells to
assist
in destroying the antigen. T cells also stimulate production
of B cells, which produce antibodies specific to the
antigen;
this process is known as humoral immunity.
Reference: White. Foundations of Nursing 3rd edition
85. Which action indicates a break in handwashing
technique?
a. Removing jewelry
b. Keeping hands and forearms in the down position when
washing
c. Rinsing with hands in the up position
d. Drying in the direction of fingers to wrists and forearms
ANSWER: C
When handwashing, jewelry is to be removed. Keep hands
and forearms in the down position when washing. Rinsing
should be done with the hands in the down position,
elbows straight. Drying should be done from the hands up
to the
forearms.
Reference: White. Foundations of Nursing 3rd edition
86. An appropriate technique for Nurse Isabelle to
implement for the client on isolation precautions is to:
a. Double bag all disposable items and linens
b. Put another gown over the one worn if it has become
wet
c. Place specimen containers in plastic bags for transport
d. Hand items to be reused directly to a nurse standing
outside of the room
ANSWER: C
Transfer specimen to container without soiling outside of
container. Place container in a plastic bag and label the
outside of the bag or as per agency policy- Specimens of
blood and body fluids are placed in well-constructed
containers with secure lids to prevent leaks during
transport.
A. Use single bags that are impervious to moisture and
sturdy to contain soiled articles. Use double bag if
necessary
for heavily soiled linen or heavy wet trash. Linen or refuse
should be totally contained to prevent exposure of
personnel to infective material.
B. Avoid allowing isolation gown to become wet; carry
wash basin outward away from gown; avoid leaning
against
wet tabletop. Moisture allows organisms to travel through
gown to uniform
D. Remove all reusable pieces of equipment. Clean any
contaminated surfaces with hospital approved
disinfectant. All
items must be properly cleaned, disinfected, or sterilized
for reuse.
Reference: Clinical Nursing Skills and technique 6th edition
page 203, 204
87. In taking the history of a client suspected of having
bacterial meningitis, which question is most important for
the
nurse to ask?
a. “Do you live in a crowded residence?” c. “Have you
had any viral infections recently?”
b. “When was your last tetanus vaccination?” d. “Have
you traveled out of the country in the last month?”
ANSWER: A
Meningococcal meningitis tends to occur in outbreaks. It is
most likely to occur in areas of high-density population,
such as college dormitories, prisons, and military barracks.
Reference: Ignatavicius. Medical Surgical Nursing 7th
edition
88. The causative agent for tetanus is:
a. Bordetella b. Clostridium tetani c. Neisseria
Gonorrheae d. Enterobius vermicularis
ANSWER. B.
Tetanus is an infectious disease caused by Clostridium
tetani which produces potent exotoxin with prominent
systemic
neuromuscular efforts manifested by generalized
spasmodic contractions of the skeletal musculator.
Reference: Dionesia Mondejar-Navales. Handbook of
Common Communicable and Infectious Diseases. Revised
Edition. 274.
89. The disease is caused by four species of protozoa. The
specie which is considered as the most serious malarial
infection is known as:
a. Plasmodium vivax b. Plasmodium falciparum c.
Plasmodium malariae d. Plasmodium ovale
ANSWER: B
Plasmodium falciparum is considered as the most serious
malarial infection because of the development of high
parasitic densities in blood (RBC) with tendency to
agglutinate and form into microemboli. This is the most
common in
the Philippines.
Option A – this is nonlife threatening except for the very
young and the old, it is manifested by chills every 48 hours
on the 3rd
day onward especially if untreated
Option C – it is less frequently seen, this specie is nonlife
threatening
Option D – is the rare type of protozoan species and is rare
in the Philippines
Reference: Dionesia Mondejar-Navales. Handbook of
Common Communicable and Infectious Diseases. Revised
Edition. 185-186.
90. For paucibacillary type of leprosy, after taking how
many months of doses of MDT, a person is considered
cured
and should be discharged at:
a. 3 months b. 6 months c. 10 months d. 12 months
ANSWER: B
The drugs used in MDT are a combination of Rifampicin,
clofazimine, and dapsone for Multibacillary leprosy and
Rifampicin and dapsone for paucibacillary. For PB patients
– after taking 6 monthly doses of MDT this person may be
declared cured and may be discharged. For MB patients –
after taking 12 monthly doses of MDT this person is cured
and should be removed from the register. Reference:
Dionesia Mondejar-Navales. Handbook of Common
Communicable and Infectious Diseases. Revised
Edition. Page 177.
91. As an RHU nurse, you are aware that the duration of
treatment for patient classified under category 1 with
tuberculosis meningitis or spinal disease with neurologic
complication is:
a. 9 months b. 7 months c. 8 months d. 4 months
ANSWER: A
The maintenance phase of Category 1 is extended from 4
months to 7 months in patients with this type of TB or
complication
Reference: Cuevas, Public Health Nursing in the
Philippines. 10th
Edition, 2007. Page 244.
: Maria Loreto Evangelista-Sia. Community Health and
Communicable Diseases. 2008 Edition. Page 163.
92. The following statements do not represent the nature
of tuberculosis, except:
a. Diagnosis of TB is confirmed by a positive tuberculin
test, chest x-ray, and sputum culture
b. TB is essentially not an airborne disease
c. One negative sputum examination alone rules out active
or inactive TB infection
d. Reactivation of TB will not occur after being dormant for
5 years
ANSWER: A
All TB symptomatic identified shall be asked to undergo
DSSM for diagnosis before start of treatment, regardless of
whether or not they have available X-ray results or
whether or not they are suspected of having extra-
pulmonary TB.
Since DSSM is the primary diagnostic tool, no TB diagnosis
shall be made based on the results of X-ray examinations
alone. Likewise, results of the skin test for TB infection
(PDD skin test) should not be used as bases for TB
diagnosis in
adults.
TB is an airborne disease; the patient is placed on airborne
precautions, in a negative air pressure room to avoid the
spread of the disease.
3 positive sputum smear is used to confirm a diagnosis of
TB
Reactivation is possible even treatment if immunity level
decreases and exposure to M. tubercle
Reference: Cuevas, Public Health Nursing in the
Philippines. 10th
Edition, 2007. Page 243.
: Dionesia-Mondejar-Navales, Handbook of Common
Communicable and Infectious Diseases. Revised Edition.
Page
284.
93. Hepatitis A is a liver disease cause by the hepatitis A
virus. Lulu was concerned about the change in her skin
color
when she asks the nurse about the occurrence of this
symptoms. The nurse can best respond by saying:
a. The color change is due to the stimulation of the liver to
produce an excess quantity of bile
b. The color change is due to the increased destruction of
the red blood cells during the acute phase of the disease
c. The color change is due to the decreased prothrombin
levels which lead to the multiple site of spontaneous
bleeding
d. The color change is due to the inability of the liver to
remove normal amounts of bilirubin from the blood
ANSWER: D
Jaundice is a condition characterized by yellow colored
skin due to the presence of bilirubin. Hepatitis causes
hepatic
jaundice which is due to the inability of the liver to remove
normal amounts of bilirubin from the blood. Option B is an
example of haemolytic jaundice.
Reference: David L. Longworth. Handbook of Infectious
Diseases. Springhouse. Page 131.
94. The strategy being implemented by the DOH in the
fight against dengue is called:
a. The 4 “S” b. “Tapat Mo, Linis Mo” c. “Hithit-
Buga” d. “L.A.M.O.K puksa”
ANSWER: A
Efforts are continuously focused on the 4S strategy against
dengue.
1. Search and destroy possible breeding places of dengue-
causing mosquitoes like flower pots, vases, discarded
plastic bags, bottles, old tires, cans, earthen jars, coconut
husks, roof gutters, water drums, and other containers
that
might hold clean stagnant water. Preventing dengue can
be easier achieved by doing your part in keeping the
environment clean. Change water in vases frequently.
Make sure all water containers are kept covered.
2. Self-protection measures include wearing long sleeves
or long pants. It is also best to avoid dark-colored clothes
like dark shades of blue and black, as dark clothing has
been observed to attract mosquitoes. Apply mosquito
repellant on the skin to deter mosquito bites. Mosquito
repellant lotions and liquid sprays are available on the
market;
however, parents are cautioned against using strong
repellants on small children because of potentially harsh
chemicals. There are organic mosquito repellant
alternatives such as all-natural citronella bug spray. You
can also use
mosquito coils, electric vapour mats and mosquito spray
during the daytime. Screens and mosquito nets are also
good
deterrents against mosquitoes.
3. Seek early consultation because dengue is crucial. See a
doctor immediately if you show early signs and symptoms
of dengue.
4. Say no to indiscriminate fogging. In the past, fogging
was considered as a temporary solution against dengue-
carrying mosquitoes. At present, fogging is only advisable
and recommended when outbreaks and epidemics are
positively determined in a particular area. Fogging can only
kill the adult infected mosquito; it cannot get rid of the
larvae, locally known as kiti-kiti. Indiscriminate fogging will
only drive away other mosquitoes to other places to find
new breeding grounds.
Reference: www.doh.gov.ph
95. Which of the following is true of the organism that
causes malaria?
a. It is transmitted by respiratory droplets. c. It causes
symptoms within 24 hours after transmission.
b. It is transmitted by sexual intercourse. d. It enters the
body and destroys red blood cells.
ANSWER: D
This is what produces most of the clinical manifestations of
malaria. Option A: It enters the bloodstream either by the
bite of a mosquito or by the blood of an infected person.
Option B: It is not a sexually transmitted disease. Option C:
It usually does not cause symptoms until one-to-two
weeks after transmission.
Reference: http://www.who.int/topics/malaria/en/
96. Dolor brought her 2-year-old daughter to the health
center because of 2 days cough and 3 days colds. On
assessment, the nurse counted the child’s respiration to be
56 cycle/minute. Based on IMCI, the following statements
are true and applicable:
A. The child has pneumonia C. Soothe the throat
and relieve cough with a safe remedy
B. The child has to be referred to the hospital immediately
D. The child can be treated at home
a. A, B, C b. A, C, D c. B, C d. C, D
ANSWER: B
A child having fast breathing only is classified as having
pneumonia. Management for a child with pneumonia: give
an
appropriate antibiotic for 3 days. If wheezing (even if it
disappeared after rapid-acting bronchodilator), give an
inhaled
bronchodilator for 5 days. Soothe the throat and relieve
the cough with a safe remedy that can be done at home.
If
coughing for more than 3 weeks or if having recurrent
wheezing, refer for assessment for TB or asthma. Advise
the
mother when to return immediately. Follow-up in 2 days.
Reference: WHO. IMCI Manual. 2009 Edition. Page 2.
97. Based on the IMCI guidelines, the following are safe
remedies to soothe the throat of the client. This does not
include:
a. Cough syrups c. Calamansi
b. Breastmilk especially to those exclusively breast fed d.
Tamarind
ANSWER: A
Safe remedies recommended to soothe the sore throat are
breastmilk for exclusively breastfed infants, tamarind,
calamansi and ginger. Harmful remedies to discourage are
the following: codeine cough syrup, and other cough
syrups and oral and nasal decongestants.
Reference: IMCI Manual. Page 9.
98. Which of the following findings indicate fast breathing?
a. Respiratory rate of 30 or more breaths for a 15 months
old child
b. Respiratory rate of 40 or more breaths for a 2 months
old child
c. Respiratory rate of 50 or more breaths for a 2 weeks old
infant
d. Respiratory rate of 60 or more breaths for a 6 weeks old
infant
ANSWER: D
There is fast breathing if a child whose age is:
1 week to 2 months old infant have 60 or more breaths
per minute
2 to 12 months old child have 50 or more breaths per
minute
12 months to 5 years old child have 40 or more breaths
per minute
Reference: WHO. IMCI Manual. 2009 Edition. Page 2.
99. A correlation coefficient of –0.80 between the number
of hours studied for a test and the scores on the test
indicates that:
a. As the number of hours studied decreases, test scores
increase.
b. As the number of hours studied increases, test scores
increase.
c. There is a strong correlation between the number of
hours studied for a test and test scores.
d. The number of hours studied is correlated with test
scores.
ANSWER: A
Students may have difficulty answering this question
because they would expect a positive relationship, not a
negative relationship, between the number of hours
studied and test scores. However, the minus sign in front
of the
correlation coefficient indicates a negative relationship.
The –.80 correlation is a fairly strong correlation.
Reference: Polit and Beck. Nursing Reseach. 8th
edition Page 453
100. Probability sampling involves:
a. The use of a random selection process c. Haphazardly
selecting names from a telephone book
b. Asking one subject to recommend three more d. The
use of sequential lists
ANSWER: A
The term “random” seems haphazard but is actually a
determined selection process with the goal to examine
representative units of populations. Random sampling is a
very systematic and scientific process.
Reference: Polit and Beck. Nursing Reseach. 8th
edition Page 344