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Stuation: The primary function of the Department of Health is the promotion, protection, preservation or restoration of the health of the people
though the provision and delivery of health services.
e. The Rural Health Doctor orders Dextran 12% 1000 ml within 8 hours for a client. Drop factor is 12 gtt/ml. Solve for the gtt/min.
a. 24-5 gtts/min
b. 25 gtts/min
c. 25.5 gtts/min
d. 26 gtts/min
f. Baby Boy Noel was admitted and the doctor ordered D5NSS 1L x KVO. The MIDWIFE should calibrate the IVF to:
a. 5 gtts/min
b. 10 gtts/min
c. 15 gtts/min
d. 20 gtts/min
g. Baby Girl Lee, the neighbor of Baby Boy Noel was brought also to the clinic by her mother for the immunization. What immunization will be
given if Baby Girl Lee is 9 months old?
a. BCG
b. Measles
c. DPT
d. Polio 2
h. ORESOL has been introduced to the barangay for dehydration. To prepare for the solution, what will be the desired amount?
a. 2 glasses of water + ½ tbsp. of salt
b. ½ glass of water+1 tbsp. of salt + 3 tbsp. of sugar
c. 2 ½ glasses of :water + 2 tbsp. of salt + ½ tbsp. of sugar
d. 1 glass of water + 1 pinch of salt + 1 tbsp. of sugar
Situation: A place in Brgy. Canla has a common cause of Iodine deficiency where their main products are "Goitrogenics."
i. Which of the following are considered goitrogenics?
a. mandarins
b. kangkong
c. tomato
d. cassava
Situation: These are nutritional needs of the mother during her pregnancy.
12. Nancy who just delivered a baby boy works as an executive for a big company. Which of these should the MIDWIFE first encourage?
a. Mixed feeding
b. Bottle feeding
c. Leave the baby in the Nursery
d. Breastfeeding
Situation: Mr. Reyes, 59 years old is a frequent visitor of Lions Club. Lately, he became inefficient with his work and complaining of dizziness.
13. You stressed to him and to the finally the importance of the following food that will help in the production of RBC, EXCEPT:
a. kangkong
b. egg yolk
c. broccoli
d. ampalaya
14. Your health teaching to his family is to serve food rich In Iron and this is:
a. egg yolk
b. ampalaya
c. liver
d. lean meat
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Situation: The following questions pertain to the MIDWIFE and responsibilities.
15. Concerned with the care of school-children, the MIDWIFE does the following.
EXCEPT:
a. provides for a safe environment
b. detects, diagnose, and treats children with health problems
c. identifies and refers children with eye problems
d. conducts health education classes
16. An important reason why erasures In the patient's chart should be avoided is:
a. chart would look dirty and reflects, the MIDWIFE personality
b. recording maybe illegible
c. chart is a legal document
d. chartings are essential for endorsement and follow-up care of patient
Situation: In one of your conference with the midwives, you answered the question pertaining to computation and presentation of
statistical data at the Rural' Health Unit. Some of the questions are the following among others.
18. The following measures is used as a numerator to capture for the infant mortality rate:
a. Total number of deaths from maternal causes in same year
b. Total number of registered live births of a given year
c. Total number of deaths less than 1 year of age registered in same calendar year
d. Total number of deaths registered in same calendar year
19. In order to present the frequency of occurrence of new cases of PNA In the municipality you have to compute for the:
a. prevalence rate
b. case fatality rate
c. proportionate mortality rate
d. incidence rate
Situation: Nursing as a profession benefits from the use of nursing diagnosis process in professional clinical practice.
20. The most important values of the use of nursing diagnosis in care planning is:
a. highlights your critical thinking and decision-making
b. focuses in cause of the illness
c. helps to define what is health
d. identifies what the MIDWIFE can prescribe
Situation: The following questions pertain to nursing care of child with cardiovascular, disorders.
21. Amy, 6 years old, Is admitted with an impression of rheumatic fever. To help establish the diagnosis of rheumatic fever, which
of these questions should the MIDWIFE ask?
a. Did Amy travel abroad recently?
b. Did Amy remark of fatigability?
c. Did Amy have sore throat recently?
d. Did Amy have viral infections?
22. MIDWIFE Jo reviews the laboratory data of Amy. Of these data, one would be supportive of a diagnosis of rheumatic fever?
a. low hematocrit
b. increased leukocyte count
c. high erythrocyte sedimentation rate
d. elevated antibody level
23. Bob who is diagnosed with rheumatic fever is prescribed with Aspirin. The purpose of this medication is to:
a. reduce inflammation
b. relieve anxiety
c. control headache
d. decrease fever
Situation: Professional nursing practice primarily aims to promote health and prevent illness.
24. The meet basic goal of health promotion is:
a. healthy
b. absence of disease
c. no illness
d. wellness
25. You are a factory MIDWIFE in a bottling industry. What priority health promotion program can you undertake?
Situation: Your 13 year old daughter tells you that she is having her menarche and that she fees awful. To comfort her, you would explain
the menstrual cycle.
26. You start by defining menstruation is:
a. Expelling of the unfertilized egg which causes the bleeding
b. Soughing off the perimetrium
c. Sign of an aborted pregnancy
d. Monthly sloughing off of the uterine tiring that had been prepared to nurture a fertilized egg.
28. The secretory phase is characterized by the secretion or storage nutrients, glycogen and mucin. This is due to the action of:
a. prolactin
b. estrogen
c. androgen
d. progesterone
29. To allay the fears of your daughter regarding losing too much blood during menses, you would tell her that the average blood lost
per cycle is:
a. 80ml
b. lOOml
c. 120 ml
d. 30 ml
Situation: Mrs. Mia Sandoval, a newly-married couple, plan to start a family planning clinic to choose the most appropriate contraceptive
method for them:
30. Mrs. Sandoval is Interested in IUD. The MIDWIFE tells her that its insertion is usually done at this period of the menstrual cycle:
a. 7th to 10th days
b. 18th to 20th days
c. 12th to 16th days
d. 1st 104th days
31. Upon further discussion, the MIDWIFE talks about the diaphragm which after intercourse must be kept in place for:
a. 6-8 hours
b. 12-24 hours
c. 11-20 hours
d. 9-10 hours
32. Mrs. Sandoval talks about friend's infertility problem that was prescribed with Clomid by her physician. The MIDWIFE informs her
that a side effect of this medication may be:
a. multiple gestation
b. headache
c. transitory depression
d. hypertension
Situation: The following pertains to some concepts and principles of community health nursing (CHN) that a MIDWIFE must apply in carrying out
CHN services.
33. Community health Nursing is a service that is provided in an environment that is constantly changing. This implied that the
community health MIDWIFE to be able to provide relevant services.
a. must involve other disciplines In carrying out health care services in various settings
b. must provide a service that is community-based
c. must provide a service that is integrated and comprehensive
d. must update her knowledge on the current and evolving characteristics of health care system
34. Promotion of health is a major responsibility of the CHN, This refers to;
a. Activities that seek to protect clients from potential or actual health threats and their harmful consequences
b. Activities directed toward developing the resources of clients that maintain or enhance well-being
c. Activities directed toward decreasing the probability of specific illness or dysfunctions in individuals
d. Activities aimed to prevent to spread of microorganisms to Individual
Situation: The public health MIDWIFE performs varied functions and activities in her place of work.
35. In dealing with a primigravida who is afraid of childbirth due to her beliefs and misconceptions. The first thing that the MIDWIFEs
should do is:
a. help woman recognize the sign of abnormalities in pregnancy to enable her to report to the midwife
b. identify the beliefs and misconceptions and their source
c. immediately correct the beliefs and misconceptions
d. refer to midwife for regular follow-up visit
36. Kwashiorkor is a condition usually seen among pre- school children. This is characterized by which of the following signs?
38. Grace was referred to you by a midwife. In order to determine whether Grace is suffering from severe calorie deficiency, which of the
following condition will you take note of?
a. thin, sparse hair
b. an extreme wasting away of fat muscle
c. paleness of the inner side of the lips
d. generalized swelling of the body
Situation: You are the new Public Health MIDWIFE in the Municipality of Pontevedra. This municipality has the following data in 2003:
Population - 30,000
Total infants death - 11
Total number of cases examined for PTB - 200
Total births - 500
All causes -74
Number of confirmed positive of PTB cases - 5
39. You need to gather a lot of data about the community. Which of these can be given least priority?
a. community's belief and practice
b. community s political leadership
c. community's knowledge in health
d. community's way of life
40. You studied the figures of disease and accidents that occurred in Pontevedra for the last 2 years. These figures are referred to as:
a. mortality statistics
b. mortality and morbidity statistics
c. rates and ratios
d. morbidity statistics
41. Which of the following gives a good reflection of the state of health of Pontevedra?
a. maternal morbidity rate
b. age-specific death rate
c. infant mortality rate
d. crude death rate
Situation: In one of your home visits you discovered that Tristan, 2 years old who lives with Mang Tero his lolo is still on bottle feeding. No
supplementary feeding given:
43. You're Interested to know whether Tristan has signs of malnutrition. Hence, you will:
a. weigh the child and perform physical assessment
b. weigh the child
c. perform a physical assessment
d. refer to physician or nearest health facility
Situation: Atypical teenager, Susan, 17 years old, is in her 3rdyear high school. Besides sports and other school activities, she volunteers for
community outreach programs in her school, among them going to the slums of Tondo.
44. Susan wears contact lenses. But she claims that these are so comfortable she forgets to removes them at night. As the school
MIDWIFE, you caution that she should not sleep with her soft contact lens because they can damage one of these:
a. sciera
b. optic nerve
c. cornea
d. pupil
45. In one of her information- sharing, Susan mentions that her mother was taking diethyistijbestrd (DES) when she was pregnant
withjier. The MIDWIFE feels that she must suggest 'to Susan one ofthese. \Wch os correct?
a. "I wiH take your Pap smear for laboratory exams."
b. "Do nd use the pi!! for contraception."
c. "Please see a gynecologist as soon as possible."
d. "Avoid us! ng lampoons during menstruation."
Situation: Miss Go is a clinical instructor in Community Health Nursing discussing about vital statistics, epidemiology and laws affecting Public
Health and practice of Community Health Nursing.
46. It is concerned with the study of factors that influence the occurrence and distribution of diseases, defects disability or deaths. This
is:
a. Epidemiology
b. Statistics
c. Public Health
d. Community Health Nursing
47. The Republic Act that refers to the Magna Carta of Public Health Workers:
a. R.A 2382
b. R.A 1062
c. R.A 7305
d. R.A 6425
48. Republic Act 7164 known as the "Philippine Nursing Act of 1991" embodies the regulation of Practice of Nursing in the Philippines. A
member of the Board of Nursing must be:
a. Citizen of the Philippines
b. RN and holder of Master's Degree
c. 10 years of continuous practice of the profession
d. All of the above
Situation: Mr. Laurel, a public MIDWIFE is conducting community class in Brgy. Kawayan about pulmonary tuberculosis.
50. What TB drug is net given to children under age 6 who are too young to report visual disturbances?
a. INH
b. Rifampicin
c. Ethambutol
d. PZA
Situation: Cancer ranks third in leading cause of morbidity and mortality in the Philippines. Early detection Increases the survival rate of those
afflicted. You are a MIDWIFE in a cancer-prevention and screening clinic and are for health education.
52. The following are warning signs of cancer. Which one is not?
a. Change In bladder and bowel habits
b. Indigestion or difficulty in swallowing
c. Weight gain
d. Nagging cough or hoarseness
53. Monthly examination (BSE) can help in early detection of breast CA. When do you perform BSE?
a. once a month after menstruation
b. once a month before menstruation
c. every ether month after menstruation
d. every other month before menstruation
54. There are several risk factors with developing cancer. The following are risk factors of cancer, except:
a. age
b. race
c. ordinal petition In the family
d. lifestyle
55. A form of cancer therapy wherein a beam of high-energy electromagnetic radiation desires the cancer ceils?
a. surgery
b. radiation therapy
c. chemotherapy
d. pallitive treatment
Situation: Mental health covers the psychosocial concerns of daily living covering the stages of life. Efforts to train manpower have been done by
the government through the National Mental Health Programs.
Situation: The following questions are concerned with nutrition.
59. Nutrients are classified according to their structures. Which among these is not a micronutrient?
a. Vitamin A
b. Iron
c. Iodine
d. Amino acids
60. What mineral works with Vitamin E to protect body compounds from oxidation?
a. Sodium
b. Selenium
c. Zinc
d. Manganese
Situation: Osteoporosis is considered a major health and economic problem. One in every four women over age 50 is believed to have this
disease.
61. What is the main reason why Asian women are more in developing osteoporosis than African-American women?
a. There are more post menopausal aged Asian women
b. Banes of Asian women are 30-40% less dense than that of African-American women
c. African-American women eat more compared to Asian women
d. Asian women have lesser bone mass compared to African-American women
62. There are factors that predispose an individual for osteoporosis. What factor is least associated with the disease?
a. Decreased level of oxygen
b. Calcium deficiency
c. Exposure to sunlight
d. Lack of exercise
63. Women over 50 years are very much at risk for fractures. Where Is the most common site of fractures to osteoporosis?
a. femur
b. forearm
c. vertebrae
d. hips
Situation: Mrs. M. has been given a copy of her diet. He consulted you about her prescribed diet.
65. He also asked about Vitamin E. The richest source of Vitamin E is:
a. vegetable oil
b. milk
c. fish
d. cereals
Situation: Mr. S., a patient in MS ward, wants to increase his Vitamin C intake. He also asks you several questions about nutrition.
70. Which of the following features should the MIDWIFE incorporate in her practice of community health nursing (CHN)?
1. CHN is oriented to population
2. CHN emphasize health
3. CHN involves interdisciplinary collaboration
4. CHN promotes client participation in determining their own health
a. 1, 2, 3 & 4
b. 3 & 4 only
c. 1 & 2 only
d. 1, 2 & 3
71. In order to strengthen community participation in health activities in the community, which of this following should be done by the
Public Health MIDWIFE?
1. Identify the existing and potential leaders of the community
2. Form a core group for health
3. Formulate action program for health
4. Tell the community leaders what to do for their health problems
a.1 & 3
b.3 & 4
c.1 & 2
d.2 & 3
73. Which of the following statements about the PHN’s role in the community is/are correct?
1. The PHN will only enjoy her work if she accepts her role and is able to perform that role
2. The PHN is a community health MIDWIFE if she is able to establish rapport with the community officials and members
3. The PHN wish only give bedside nursing care
4. The PHN can walkthrough mud, work under stress and eat with the people in the barangay
a.1 & 2
b.3 & 4
C. 2 & 3
d. 1, 2 & 4
Situation 2. Cynthia Payas at 30 weeks of gestation has been admitted to the labor room. She says she been having moderate contractions every
3-5 minutes lasting almost a minute. Her membranes are placed.
74. From the MIDWIFE's assessment findings of Leopold maneuvers TS revealed a soft, rounded mass, irregular nodules on Cynthia's
right side and a hard prominence on her right, just above the symphisis. Which of the following best describe the fetal presentation and
position?
a. ROP
b. LOA
c. LSA
d. RSP
75. Health teaching during the prenatal period emphasize the expectant mother's need to go to the hospital when:
a. Contractions are 5-10 min, apart lasting 30 seconds and are felt as strong as menstrual cramp.
b. Contractions are 5 min. apart lasting 60 seconds and in increasing intensity
c. Contractions are 3-5 min. apart with rectal pressure and bloody show
d. contractions are 2-3 min apart lasting 90 seconds and membranes have ruptured
76. The MIDWIFE continues with her admission assessment. Which location should the MIDWIFE anticipate finding the fetal heart tones?
a. above the umbilicus on her left side
b. above the umbilicus on her right side
c. below the umbilicus of Mona's left side
d. below the umbilicus of Mona’s right side
77. The MIDWIFE assessed the frequency, duration and intensity of Cynthia's contractions. Which of the following techniques should the
MIDWIFE use?
a. Holding the finger and palm over the area below the umbilicus
b. Moving of her ringers of one hand over the uterus pressing into the muscle
c. Spreading the ringers of one hand tightly over the hand
d. Indenting the uterus in several places during and between contractions
78. During labor, when positioning a client on lithotomy, the MIDWIFE should
a. Make sure the legs are safety strapped on the stirrups
b. Put her on semi-ceiling position first
c. Gradually lift one legs after the other
d. Put up hef client's leg together
Situation 3. An early childhood febrile syndrome affecting the lymphodes was identified by the Public Health Nuse(PHN)
79. Cristina a three years old girl came to RHU due to fever unresponsive to antibiotics. During assessment, the MIDWIFE noticed that
she has "strawberry tongue ". Which the following syndrome her diagnosis?
a. Karachi fever
b. Igarashi fever
c. Kawasaki fever
d. Nagasaki fever
80. Upon assessment, you have observed that Cristina was irritable with mood changes and cervical lymphadenopalhy. What would you
do to her?
a. Blame the mother
b. Give medication
c. Divert bar attention
d. Spank her
81. When the doctor arrived, the mother wanted to bring her child to a tertiary hospital. Which level of bars would you put Cristina in?
a. fourth
b. first
c. second
d. third
82. Which among the treatment below was ordered by the physician for Cristina's mother to buy from the "Botika sa barangay"?
a. Immunoglobuline
b. Antihistamine
c. Paracetamol
d. Salicylatea
83. Susceptibility of the syndrome that Cristina was affected with, is from what ancestry?
a. Aryan
b. Caucasian
c. Asian
d. America
Situation 6. MIDWIFEs provide care to individuals in the various stages of health & illness.
84. Which of the following are internal factors that influence health practices?
a. Family practices
b. Norms of society
c. Religious beliefs
d. Developmental stage
86. One's ideas convictions and attitudes which influence his level of health is referred to as his:
a. Health beliefs
b. Health habits
c. health practice
d. health perceptions
87. Health Beliefs Model states that one takes health action if:
a. Is consistent of his health beliefs
b. Get support from family
c. Agree with the society's norms
d. Will prevent his getting sick
88. Health action that keeps one's present level of health is referred to as:
a. Health enhancement
b. Health promotion
c. Death prevention
d. Health maintenance
90. Cathy asks the MIDWIFE why menstruation ceases once pregnancy occurs. The MIDWIFE's best response would be that this occurs
because of the
a. Reduction in the secretion of hormones by the ovaries
b. Production of estrogen and progesterone by the ovaries.
c. Secretion of luteinizing hormone produced by the pituitary
d. Secretion of follicle-stimulating hormone produced by the pituitary.
91. The MIDWIFE is aware that the nausea and vomiting commonly experienced by many women during the first trimester of pregnancy
is an adaptation to the increased level of
a. Estrogen
b. Progesterone
c. Luteinizing hormone
d. Chorionic gonadothropin
92. The MIDWIFE in the prenatal clinic should provide nutritional counseling to all newly pregnant women because:
a. Most weight gain during pregnancy is fluid retention
b. Dietary allowance should not increase during pregnancy
c. Pregnant women must adhere to a specific pregnancy diet
d. Different sources of essential nutrients are favored by different cultural groups
93. Cathy is now in her 8 weeks of pregnancy and complains of having to go to the bathroom often to urinate. The MIDWIFE explains to
her that urinary frequency often occurs because the capacity of the bladder during pregnancy is diminished by:
a. Atony of the detrusor muscle
b. Compression by the ascending uterus
c. Compromise of the autonomic reflexes
d. Constriction of the ureteral entrance at the trigone
Situation 8. AIDS cases has been all over the country and yet only few are reported cases due to the stigma attach to it.
95. A classic full blown AIDS case is identified by clinical manifestations such as:
a. Persistent generalized lymphadenopathy
b. Sudden loss of weight, afternoon fever and general malaise
c. Tumors and opportunistic infections
d. Fever, weight loss, night sweats and diarrhea
96. Pulmonary complications are the most common problem in caring for AIDS patients. This is caused:
a. Kaposi's Sarcoma
b. Filterable Virus
c. Pneumonia Carnii
d. Staphylococcus bacteria
97. The cause of death of most AIDS patients who develop multiple opportunistic infections is/are the following:
a. Weakened immune system impairs response to therapy
b. AH of these (a, b, c)
c. Weakened immune system impairs resistance to infection
d. Infection cannot be treated effectively
98. Implementation of the following activities can help prevent the transmission of AIDS through the blood.
1. Conduct public education campaign, with the aim of implementation self-deferral of blood donate who are risk of HIV infection
2. Educate health care workers on the correct use of blood
3. Conduct surveillance of women attending anti-natal clinics
4. Use of condoms of those found to be infected with HIV
a. 1 & 2
b. 3 & 4
C. 1 & 3
d. 2 & 3
Situation 10. You are assigned as a public health MIDWIFE to oversee the different health activities in your community.
99. While you were going over the record of Mrs. Uy who missed her prenatal appointment date. Her review of the family folder showed
the following: GR-II, PARA II; with slight edema; BP=150/100. Mra. Uy eldest son in underweight is sick of H-fever. MIDWIFE Linda
planned a home visit. Which of the following would you give priority in planning her for the family?
a. Mrs. Uy's eldest son who is sick with H-fever
b. Mrs. Uy pre-eclampsia
c. Nutritional status of Mrs. Uy’s eldest son
d. Family potential threat of cross-infection from H-fever
100. The midwife refers to you a family who fails to take action regarding a sick member of the family despite her suggestions. In helping
the family decide on what actions to take you will.
1. Explain the consequences of inaction
2. Identify the courses of action open to the family and resources needed for each
3. Discuss the consequences of each course of action available
4. Influence me family to act on what you think is best for the situation
a. 1 & 4
b. 2, 3 & 1
c. 2 & 3
d. 4 only
101. Elisa is on her 1 1/2 month pregnancy. Her first child 3 1/2 months old. She asked you if she should stop breastfeeding her first
baby since she is now pregnant. Your response should be the following. EXCEPT:
a. Breastfeeding during pregnancy is not harmful to either of the babies.
b. Sudden weaning can be harmful and can make the older child ill
c. Breast milk is only valuable until the child is 4 months old
d. She can start giving solid foods in preparation for weaning when her child is 4 to 6 months old
102. Which of the following statements is correct regarding Community Health Nursing (CHN)?
a. Professional growth and development of the PHN is the responsibility of the Department health
b. Provision of CHN care is not any way affected by policies of the agency where the MIDWIFE work
c. The PHN worked with community 19 for 6 years can solely determine the health needs of the community
d. Evaluation of the health status of individuals and families should be done in consultation with them
103. In developing capability of people to assume more responsibility for their health, which of the following statements would you
consider most important?
a. Lead-lag in the health activities
b. Organizing me community for health
c. Identifying health problems with the people
d. Making medicine available
Situation 11. Demographic profile of the elderly population is important in the nursing profession and it is therefore important to know the basic
facts about it
104. According to the definition of UN and WHO elderly people are who belong to the age bracket of
a. 60 years old and above
b. 65 to 74 years old
c. 85 years old and above
d. 75 to 84 years old
105. There are four classifications of elderly, which age group do old-old person, belong
a. 55 to 60 years old
b. 65 to 74 years old
c. 75 to 84 years old
d. 85 years old and above
107. Element of Reproductive Hearth is responsible for the sex education for students,
a. Men's Reproductive Health
b. Adolescent Reproductive Health
c. Family Planning
d. V.A.W
108. Essential Tool used in Community Health Nursing, that saves time and effort,
a. Bag technique
b. Public Health Bag
c. BP Apparatus
d. Thermometer Technique
111. After home delivery, the MIDWIFE should include in her health teaching
a. Circumcision of the Infant
b. Immunization
c. Starting the infant on bottle feeding
d. Breast feeding of infant
112. In giving tetanus toxoid immunization for pregnant women, the first dose should be given.
a. Second Trimester
b. 3rd Trimester
c. 1 year after delivery
d. as early as possible during pregnancy
115. Which of the following statements best explain the concept of people empowerment?
a. People are the health beneficiaries
b. People themselves are health resources
c. People can demand health services
d. People are our partners in health
116. As a PHN you also have an active role in disease surveillance sod epidemiology of disease in the community. Among others you
also do the following.
1. Immediately inform the rural health physician of any unusual increases cases in the community disease.
2. Conduct epidemiological investigation on all reported outbreaks
3. Request the midwife to graph weekly disease incidence cases in the municipality
4. Assist in the planning and implementing disease control measures during outbreak
a. 1, 2 & 4
b. 2 & 4
c. 1 & 4
d. 3 & 4
117. The habitual presence of a disease or infectious agent within a given geographic area is:
a. Epidemic
b. Endemic
c. Pandemic
d. Sporadic
118. Measures the frequency of occurrence of new cases of a certain disease during a given period of time
a. Prevalence rate
b. Endemic
c. Fatality rate
d. Mortality rate
Situation 13. Theories regarding the aging process were formulated in order to guide the health care profession in their care of the elderly patient.
120. In the "Wear and Tear" theory of aging continued use of the body is supposed to lead to worn out parts, similar to the breakdown
and wearing out ®f old machinery. This could not explain aging because:
a. Continued use has little effect
b. Nothing over wears out completely
c. The human body can’t be compared to machinery
d. Greater use leads to improvement in some systems such as muscles
121. The "Somatic Mutation Theory" states that low doses of radiation accelerate aging. The theory has been criticized for three reasons.
Which of the following is not of the reasons why this theory explains little about the aging process.
a. Sunscreens are now available to block out fee harmful ultraviolet rays
b. The effect of the sun occurs mainly in dividing cells while the effects of aging are seen mainly in calls that no longer divide
c. The number of cells that undergo mutation is too small to account for overall aging.
d. Most cells contain mechanisms for the repair of DNA
122. Which of the following explains that the critical factor in framing old age concerns is how well persons function in regards to
activities of daily living?
a. The functional capacity theory
b. The activity theory
c. the disengagement theory
d. the personal meaning theory
123. The view of the older people "Withdraw" from the soclety is:
a. The adics theory
b. The disengagement theory
c. The parling theory
d. The absence theory
Situation 14. Mrs. Castro is one-week post partum. She visits health center because of fever and intense pain over the episiotomy site.
125. Upon inspection the MIDWIFE observes an edematous episiotomy site. Which of the following intervention will you first apply?
a. Administer antimicrobials as ordered
b. Expose the wound to perilight
c. Cleanse the episiotomy with iodine solution
d. Give oral analgesic
126. Upon inspection the MIDWIFE observes an edematous episiotomy site. Which of the following herbal plants can be used to related
perineal infection?
a. Lagundi
b. Banana Leaves
c. Herba Buena
d. Guava Leaves
127. Breast engorgement can also cause temperature elevation, but does not last longer than how many hours?
a. 48 hours
b. 12 hours
c. 10 hours
d. 24 hours
Situation 15. The Department of Health implements various health programs and projects in order to achieve its goals and objectives. As a Public
Health MIDWIFE you are one of the implementers of these programs at the municipal level.
129. The primary function of the Department of Health is the promotion, preservation or restoration of the health of the people through.
a. Regulation and encouragement of providers of health goods and services
b. Provision and delivery of health services
c. All of these except reduction of morbidity and mortality
d. Reduction of morbidity and mortality
130. In recent years, the government have given more emphasis of which of the following.
a. Rehabilitation
b. Treatment of disease
c. Prevention of illness
d. Treatment and rehabilitation
131. In your campaign against sexually transmitted disease which of these groups are your target audience for health education?
a. Commercial social workers
b. All of these groups
c. General population
d. Health workers and private practitioners
132. Knowing the policies if the National Family Planning Program which of these is the best contraceptive method to use for a couple
who have already four children?
a. Use of IUD since she is still on her postpartum period
b. Natural family planning method since her menstruation is still regular
c. A method they will choose and use
d. Tubal ligation as this is more permanent method
133. Under the National Center Control Program, the following are primary prevention measures implemented cancer of the mouth
except
a. Avoidance of inverted cigarette smoking
b. None of these
c. Improved dental hygiene
d. Avoidance of smoking and betel chewing
Situation 16. The Community Health MIDWIFE prepares/participate in the preparation of the community health care plan.
134. In order to plan effectively, the MIDWIFE needs a -working knowledge on the following, except
a. None of these
b. The way people view health and how they are using health care services
c. Health status profile of the community
d. Data on quality assurance
135. In a rural health unit with full man power complement, the MIDWIFE's main contribution in the preparation of the total health care
plan is the.
a. Preparation of the nursing component of the plan
b. Collation of the data on Health Statistics
e. Identification of health problem of the barangays
d. Analysis of the community survey data
136. Which of the following statement would serve as a guide in the preparation, of the community health care plan?
a. Recommendation for action should be stated in quantifiable terms
b. The formulation of criteria for evaluating the effectiveness of the plans must be an aspect of planning
c. All of these statements
d. Problems goals and objectives should be stated in quantifiable terms
137. Which of the following is a well-stated objective of a community health nursing care plan
a. To increase the number of mothers coming for prenatal check-up by 25% in 6 months time.
b. To increase the number of home visits by 50%
c. To increase the coverage for immunization in 1 year time
d. To increase the number of children receiving food assistance
138. If the objectives of the health care plan is to decrease the number of children with parasitism: by 50% by the end of 2 years, which
of these would be an appropriate evaluation indicator?
a. Number of children found positive for ascaris/ amebiasis/ hookworm, infection
b. Number of children examined for parasitism
c. Number of children who consulted for abdominal pain and anemia
d. Number of children who were dewormed
Situation 17. Your head MIDWIFE participated a 2-weeks seminar. You were designated to be an officer-in-charge of your nursing unit.
139. In unit planning which of the following questions initiate the process?
a. How to schedule the activities?
b. Who will do the planning?
c. What is to be accomplished?
d. Where to get unit supplies?
140. This is an example of data that should be analyzed when identifying missing needs.
a. Number of nursing staff
b. Medical diagnosis of patient
c. Ward supplies and materials
d. Patient classification
141. To accomplish the nursing unit work, you should first get information about:
a. Objectives of the unit
c. Nursing budget
b. Nursing service organizational chart
d. Mission of the hospital
143. Which of the following tools can be most helpful in the evaluation of staff performance?
a. Performance assessment
b. Performance standard
c. Performance audit
d. Performance appraisal
Situation 18. Rebecca, a 2 year old and her Mother are consulting the community health MIDWIFE
144. The MIDWIFE observes Rebecca at play in the clinic. She realizes that at this age, Rebecca could be expected to exhibit which of
the following?
a. Build houses with blocks
b. Is extremely possessive of toys
c. Attempts to stay within the hue when coloring
d. Amuses herself with a picture book of 15 minutes
145. When observing Rebecca, the MIDWIFE would expect her to engage in which type of play?
a. Parallel play
b. Solitary play
c. Competitive play
d. tumbling play
146. Rebecca's mother asks the MIDWIFE when it would be appropriate to take her to the dentist for dental prophylaxis. What is the
MIDWIFE most appropriate response?
a. Before starting school
b. Between 2 and 3 years of age
c. When Rebecca begins to lose deciduous teeth
d. The next time another family member goes to the dental
147. Rebecca's mother say's that Rebecca consistently says "no” every time she is offered fluids. Considering Rebecca's development,
how could the MIDWIFE assist the mother to increase Rebecca's fluid intake?
a. Distract her with some food
b. Be firm and hand her the glass
c. Offer her a choice of two things to drink
d. Let Rebecca see that she is making her mother angry
148. Rebecca is well and is to be discharged- Her mother asks the MIDWIFE why Rebecca persists in saying ''no'' to everything. The
MIDWIFE explains to Rebecca's mother that this negativism is helping Rebecca to meet a 2 year old need for which of the following?
a. Trust
b. Attention
c. Discipline
d. Independence
Situation 19. You are the MIDWIFE assigned in the MIDWIFEry unit and your patients are of various ages.
149. Assessment an infant, the MIDWIFE knows that a pincer grasp nornally appears
a. At the same time as the palmar grasp
b. Between 9 & 12 month of age
c. Between 5 & 7 month of age
d. Along with the ability to "rake" objects toward themselves
150. In a child development, the period of negativism begins when the child
a. Can manipulate his or her parents
b. Copies negative behavior of sibling.
c. Is struggling between dependence and independence
d. Is learning manual skills
151. The MIDWIFE is caring for a hospitalized toddler who was toilet trained home. He wets his pants. The best response to this situation
is to say?
a. "Its okay, try not to wet your pants next time”
b. "That's okay. Now lets get you cleaned up”
c. "I know you understand how to use the toilet; what happened?"
d. "Your mom told me you don't wet anymore; what's wrong?"
152. Which of the following behavior would a normal 18 moths old be likely to exhibit during the first few hours of hospitalization?
a. Crying loudly when parents leave
b. Readily accepting the MIDWIFE caring for him
c. Showing considerable interest in new toy
d. Sitting quietly in the comer of the cab, showing little or no interest in his surrounding
153. Evaluating a 1 month old infant normal developmental skills, the MIDWIFE should observe that the infant
a. Actively follow movement of familiar persons with her eyes
b. Responds to "No-No"
c. Turns her head to a familiar noise
d. Discriminates between family and strangers
154. The MIDWIFE knows which of the following indicates protein deficiency?
a. Hypoalbuminemia and pot belly
b. Koionychia (spoon-shaped nails)
c. Beefy red tongued.
d. Bleeding gums
155. Before administering a tube feeding the MIDWIFE knows to perform which of the following assessments?
a. The GI tract including bowel sound, last BM and distention
b. The clients neurologic status, especially gag reflex
c. The amount of air in the stomach
d. The formula used directly from the refrigerator
156. An adult is being taught about a healthy diet. The MIDWIFE can offer:
a. Milk
b. Jello
c. Freshly squeezed orange juice
d. Ice cream
157. An adult has received an injection of immunoglobulin. The MIDWIFE knows that the client will develop which of the following types
of immunity:
a. Active natural immunity
b. Active artificial immunity
c. Passive natural immunity
d. Passive artificial immunity
158. Which of these groups should a MIDWIFE target when planning a community education presentation about testicular cancer?
a. Day care providers
b. Senior citizens
c. Middle - aged men
d. High - school students
159. A woman reports all of the following data when giving his history to a MIDWIFE. Which one would indicate a risk factor for
developing cancer of cervix?
a. Diet high in fat
b. Exposure to pesticides
c. "What does your family want you to do."
d. "I wouldn't have the surgery done without a second opinion."
160. A MIDWIFE is planning a community education presentation about testicular cancer. The large groups should be men aged:
a. 20 to 39 years
b. 40 to 49 years
c. 50 to 64 years
d. 65 years and older
161. A 10-year-old boy who is in the terminal stages of Duchenne muscular dystrophy is being cared for at home. When evaluating for
major complications of this disease, a MIDWIFE would give priority to assessing which of the following body systems?
a. Integumentary
b. Neurological
c. Respiratory
d. Gastrointestinal
162. The physician asks the MIDWIFE to describe the laparoscopy procedure for sterilization to Ms. Bruce. Which of the following is part
of a correct explanation of this procedure?
a. Two small abdominal incisions are made to introduce the instrument
b. Hospitalization for 4 to 5 days is normally required
c. This procedure is performed vaginally
d. This procedure requires the consent of the sexual partner
163. The MIDWIFE is asked to plan a health teaching program for women of child-bearing age with genital herpes. Which one of the
following should the MIDWIFE include in a teaching session?
a. The physician will prescribe an antiviral drug as a pregnancy is confirmed
b. Genital herpes in the mother-has no effect on the infant
c. Wait until the infection has been cured before becoming pregnant
d. If pregnant, in form the physician of a history of genital herpes
164. Ms. Manning is scheduled for Papanicolaou test (Pap Smear) at the time of the next visit to the physician's office. Which one of the
following instructions should the MIDWIFE give to Ms. Manning?
a. Do not douche for 2 to 3 days before this test
b. Do not drink coffee or alcoholic beverages for 2 days before this test
c. It will be necessary to fast from midnight the night before the test
d. Bring a sanitary napkin with you because bleeding usually occurs after this week
165. The MIDWIFE obtains a health history from Ms. Reeves who states that she usually has symptoms when she ovulates. If Ms. Reeves
has a normal menstrual cycle, how many days after ovulation should menstruation begin?
a. 3 days
b. 7 days
c. 14 days
d. 21 days
166. The physician asks the MIDWIFE to discuss the use of an oral contraceptive with Ms. Sheppard. The MIDWIFE should instruct Ms.
Sheppard that oral contraceptive:
a. Are taken at the same time each day, preferably in the evening
b. Must be taken on an empty stomach
c. Are started on the first day of menstruation
d. Are best taken in the morning before breakfast
167. Ms. Dodd has been told by her physician that she has genital warts, which are caused by a human .papilloma-virus-infection. She
asks the MIDWIFE if there is any danger or problems associated with this condition. The most correct response-is based on the fact that
genital warts:
a. Can be treated with an antibiotic, such as penicillin or tetracycline
b. Appear to increase the risk of cancer of the vulva, vagina, and cervix
c. Can be prevented of the individual takes birth control pills
d. Are of no danger and need not be treated
168. Which of the following are included in the instructions for a client having a pelvic examination?
a. Self-administer an enema or take a laxative for 2 nights prior to the examination
b. Void immediately before the examination
c. Douche the day before the examination
d. Do not eat or drink fluids after midnight
169. The MIDWIFE is assigned to teach young women attending a gynecology clinic. The physician suggests that the MIDWIFE include
explaining ways to prevent toxic shock syndrome. Which one of the following suggestions can be included in this teaching session?
a. Avoid using super absorbed tampons
b. Take a diuretic at the onset of menstruation
c. Avoid the use of large sanitary pads
d. Use a tampon only during the night
PART 2
A. To support and supplement the efforts of the medical profession in the promotion of health and prevention of
B. To enhance the capacity of individuals, families and communities to cope with their health needs
C. To increase the productivity of the people by providing them with services that will increase their level of health
D. To contribute to national development through promotion of family welfare, focusing particularly on mothers and children
A. Community organizing .
B. Nursing, process
C. Community diagnosis
D. Epidemiologic process
4. RA 1054 is also known as the Occupational Health Act. Aside from the number of employees, what other factor must be considered in
determining the occupational health privileges to which the workers will be entitled?
5. A business firm must employ an occupational health MIDWIFE when it has at least how many employees.
A. 21
B. 101
C. 201
D. 301
6. When the occupational health MIDWIFE employs ergonomic principles, she is performing which of her roles?
7. A garment factory does not have an occupational MIDWIFE. Who shall provide the occupational health needs of the factory workers?
8. "Public health services are given free of charge". Is this statement true or false?
9. According to C.E. Winslow, which of the following is the goal of Public Health?
10. We say that a Filipino has attained longevity when he is able to reach the average life span of Filipinos. What other statistic may be
used to determine attainment of longevity?
11. Which of the following is the most prominent feature of public health nursing?
A. It involves providing home care to sick people who are not confined in the hospital
B. Services are provided free of charge to people within the catchment area
C. The public health MIDWIFE functions as part of a team providing a public health nursing service
D. Public health nursing focuses on preventive, not curative services
12. According to Margaret Shetland, the philosophy of public health nursing is based on which of the following?
16. Which is an example of the school MIDWIFE's health care provider function?
A. Requesting for BCG from the RHU for school entrance immunization
B. Conducting random classroom inspection during measles epidemic
C. Taking remedial action on an accident hazard in the school playground
D. Observing places in the school where pupils spend their free times
17. When the MIDWIFE determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating:
A. Effectiveness
B. Efficiency
C. Adequacy
D. Appropriateness
18. You are a new B.S.N. graduate. You want to become a Public Health MIDWIFE. Where will you apply?
A. Department of Health
B. Provincial Health Office
C. Regional Health Office
D. Rural Health Unit
19. RA 7160 mandates devolution of basic services from the national government to local government units. Which of the following is
the major goal of devolution?
A. Mayor
B. Municipal Health Officer
C. Public Health MIDWIFE
D. Any qualified physician
21. Which level of health facility is the usual point of entry of a client into the health care delivery system?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
22. The public health MIDWIFE is the supervisor of rural health midwives. Which of the following is a supervisory function of the pubic
health MIDWIFE?
23. One of the participants in a hilot training class asked you to whom she should refer a patient in labor who develops a complication.
You will answer, to the;
A. Public health MIDWIFE
B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals
24. You are the public health MIDWIFE in a municipality with a total population of about 20,000. There are3 health midwives among the
RHU personnel. How many more midwife items will the RHU need?
A. 1
B. 2
C. 3
D. 4
25. If the RHU needs additional midwife items, you will submit the request for additional midwife items for approval to the:
26. As an epidemiologist, the MIDWIFE is responsible for reporting cases or notifiable diseases. What law mandates reporting cases of
notifiable diseases?
A. Act 3573
B. RA.3753
C. RA 1054
D. RA 1082
27. According to Freeman and Heinrich, community health nursing is a developmental service. Which of the following best illustrates
this statement?
A. The community health MIDWIFE continuously develops himself personally and professionally
B. Health education and community organizing are necessary in providing community health services
C. Community health nursing in intended primarily for health promotion and prevention and treatment of disease.
D. The goal of community health nursing is to provide nursing services to people in their own place of .residence
28. Which disease was declared through Presidential Proclamation No. 4 as a target for, eradication in the Philippines?
A. Pioliomyelitis
B. Measles
C. Rabies
D. Neonatal Tetanus
29. The public health MIDWIFE is responsible for presenting the municipal health statistics using graphs and tables. To compare the
frequency of the leading causes of mortality in the municipality, which graph will you prepare?
A. Line
B. Bar
C. Pie
D. Scatter diagram
30. Which step in community organizing involves training of potential leaders in the community?
A. Integration
B. Community organization
C. Community study
D. Core group formation
31. In which step are plans formulated for solving community problems?
A. Mobilization
B. Community organization
C. Follow-up/extension
D. Core group formation
32. The public health MIDWIFE takes an active role in community participation. What is the primary goal of community organizing?
33. An indicator of success in community organizing is when people are able to:
34. Tertiary prevention is needed in which stage of the natural history of disease?
A. Pre-pathogenesis
B. Pathogenesis
C. Predromal
D. Terminal
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
36. On the other hand, Operation Timbang is_____ prevention?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
37. Which type of family-MIDWIFE contact will provide you with the best opportunity to observe family dynamics?
A. Clinic consultation
B. Group conferences
C. Home visit
D. Written communication
38. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of families. The youngest child of
the delos Reyes family has been diagnosed as mentally retarded. This is classified as:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
39. The delos Reyes coupled have 6-year old child entering school for the first time. The delos Reyes family has a:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
42. The PHN bag is an important tool in providing nursing care during a home visit. The most important principle in bag technique states
that it;
43. To maintain the cleanliness of the bag and its contents, which of the following must the MIDWIFE do?
A. Wash his/her hands before and after providing nursing care to the family members
B. In the care of family member's, as much as possible, use only articles taken from the bag
C. Put on an apron to protect her uniform and fold it with the right side out before putting it back into the bag.
D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the contaminated side is on the outside.
44. The public health conducts a study on the factors contributing to the high morality rate due to heart diseases in the municipality
where she works. Which branch of epidemiology does the MIDWIFE practice in this situation?
A. Descriptive
B. Analytical
C. Therapeutic
D. Evaluation
46. Which of the following is an epidemiologic function of the MIDWIFE during an epidemic?
49. In the investigation of an epidemic, you compare the present frequency of the disease with the usual frequency at this time of the
year in this community. This is done during which stage of the investigation?
50. The number of cases of Dengue fever usually increases towards the end of the rainy season. This pattern of occurrence of Dengue
fever is best described as;
A. Epidemic occurrence
B. Cyclical variation
C. Sporadic occurrence
D. Secular occurrence
51. In the year 1980, the World Health Organization declared the Philippines, together with some other countries in the Western Pacific
Region, “free" of which disease?
A. Pneumonic plaque
B. Poliomyelitis
C. Small pox
D. Anthrax
52. In the census of the Philippines in 1995, there were about 35,299,000 males and about 34,968,000 females. What is the sex ratio?
A. 99.06:100
B. 100.94:100
C. 50.23%
D. 49.76%
53. Primary health care is a total approach to community development. Which of the following is an indicator of success in the use of the
primary health care approach?
54. Sputum examination is the major screening tool for pulmonary tuberculosis. Clients would sometimes get false negative results in
this exam. This means that the test is not perfect in terms of which characteristic of a diagnostic examination?
A. Effectiveness
B. Efficacy
C. Specificity
D. Sensitivity
55. Use of appropriate technology requires knowledge of indigenous technology. Which medical herb is given for fever, headache and
cough?
A. Sambong
B. Tsaang gubat
C. Akapulko
D. Lagundi
56. What law created the Philippine institute of Traditional and Alternative Health Care?
A. RA 8483
B. RA4823
C. RA 2483
D. RA 3482
57. In traditional Chinese medicine, the yielding, negative and feminine force is termed:
A. Yin
B. Yang
C. Qi
D. Chai
58. What is the legal basis of Primary Health Care approach in the Philippines?
A. Alma Ata Declaration of PHC
B. Letter of Instruction No 949
C. Presidential Decree No. 147
D. Presidential Decree 996
60. The municipality assigned to you has a population of about 20/000. Estimate the number of 1-4 year old children who be given
Retinol capsule 200.000 every 6 months.
A. 1,500
B. 1,800
C. 2,000
D. 2,300
61. Estimate the number of pregnant women who will be given tetanus toxoid during an immunization outreach activity in a barangay
with a population of about 1,500.
A. 265
B. 300
C. 375
D. 400
62. To describe the sex composition of the population, which demographic tool may be used?
A. Sex ratio
B. Sex proportion
C. Population pyramid
D. Any of these maybe used
64. You are computing the crude rate of your municipality, with a total population o about 18,000 for last year. There were 94 deaths.
Among those who died, 20 died because of diseases of the heart and 32 were aged 50 years or older. What is the crude death rate?
A. 4.1/1000
B. 5.2/1000
C. 6.3/1000
D. 7.3/1000
65. Knowing that malnutrition is a frequent community health problem, you decided to conduct nutritional assessment. What population
is particularly susceptible to protein energy malnutrition (PEM)?
66. Which statistic can give the most accurate reflection of the health status of a community?
67. In the past year, Barangay A had an average population of 1655. 46 babies were born in that year, 2 of whom died less than 4 weeks
after they were born. They were 4 recorded stillbirths. What is the neonatal mortality rate?
A. 27.8/1000
B. 43.5/1000
C. 86.9/1000
D. 130.4/1000
70. You will gather data for nutritional assessment of a purok. You will gather information only from families with members who belong
to the target population for PEM. What method of delta gathering is best for this purpose?
A. Census
B. Survey
C. Record Review
D. Review of civil registry
71. In the conduct of a census, the method of population assignment based on the actual physical location of the people is termed;
A. De jure
B. De locus
C. De facto
D. De novo
72. The Field Health Services and information System (FHSIS) is the recording and reporting system in public health) care in the
Philippines. The monthly field health service activity report is a form used in which of the components of the FHSIS?
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
73. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which component will be most useful?
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
74. Civil registries are important sources of data. Which law requires registration of births within 30 days from the occurrence of the
birth?
A. PD 651
B. Act 3573
C. RA 3753
D. RA 3375
75. Which of the following professionals can sign the birth certificate?
76. Which criterion in priority setting of health problems is used only in community health care?
77. The Sentrong Sigla Movement has been launched to improve health service delivery. Which of the following is/are true of this
movement?
78. Which of the following women should be considered as special targets for family planning?
A. Those who have two children or more
B. Those with medical conditions such as anemia
C. Those younger than 20 years and older than 35 years
D. Those who just had a delivery within the past 15 months
79. Freedom of choice in one of the policies of the Family Planning Program of the Philippines. Which of the following illustrates this
principle?
80. A woman, 6 months pregnant, came to the center for consultation. Which of the following substances is contraindicated?
A. Tetanus toxoid
B. Retinol 200,000 IU
C. Ferrous sulfate 200mg
D. Potassium iodate 200 mg, capsule
81. During prenatal consultation, a client asked you if she can have her delivery at home. After history taking and physical examination,
you advised her against a home delivery. Which of the following findings disqualifies her for a home delivery?
82. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?
A. Niacin
B. Riboflavin
C. Folic Acid
D. Thiamine
83. You are in a client's home to attend to a delivery. Which of the following will you do first?
84. In preparing a primigravida for breastfeeding, which of the following will you do?
85. A primigravida is instructed to offer her breast to the baby for the first time within 30 minutes after delivery. What is the purpose of
offering the breast this early?
86. In a mother's class, you discuss proper breastfeeding technique. Which of these is a sign that the baby has "lactated on" the breast
property?
87. You explain to a breastfeeding mother that breastmilk is sufficient for all of the baby's nutrient needs only up to:
A. 3 months
B. 6 months
C. 1 year
D. 2 years
88. What is given to a woman within a month after the delivery of a baby?
A. Malunggay capsule
B. Ferrous sutfate l00mg O.D.
C. Retinol 200.000 IU 1 capsule
D. Potassium Iodate 200 mg, 1 capsule
A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine
90. Unused BCG should be discarded how many hours after reconstitution?
A. 2
B. 4
C. 6
D. At the end of the day
91. In immunity school entrants with BCG, you not obliged to secure parental consent. This is because of which legal document?
A. PD 996
B. RA 7864
C. Presidential Proclamation No. 6
D. Presidential Proclamation No. 46
A. DPT
B. BCG
C. Measles vaccination
D. Hepatitis B vaccination
93. A 4 week old baby was brought to the health center for his first immunization. Which can be given to him?
A. DPT1
B. OPV1
C. Infant BCG
D. Hepatitis B Vaccin
94. You will not give DPT 2 if the mother says that the infant had?
95. A 2-month old infant was brought to the health center for immunization. During assessment, the infant's temperature registered at
38.1 C. Which is the best course of action that you will take?
96. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her baby will have protection against tetanus for
how long?
A. 1 year
B. 3 years
C. 10 years
D. Lifetime
97. A 4-month old infant was brought to the health center of cough. Her respiratory rate is 42/minute. Using the IMCI guidelines of
assessment, her breathing is considered;
A. Fast
B. Slow
C. Normal
D. Insignificant
98. Which of the following signs will indicate that a young child is suffering from severe pneumonia?
A. Dyspnea
B. Wheezing
C. Fast breathing
D. Chest indrawing
99. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best management for the child?
A. Prescribe antibiotic
B. Refer him urgently to the hospital
C. Instruct the mother to increase fluid intake
D. Instruct the mother to continue breastfeeding
100. A 5-month old infant was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes
back slowly after a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category?
A. No signs of dehydration
B. Some dehydration
C. Severe dehydration
D. The data is insufficient
101. Based on the assessment, you classified a 3-month old infant with the chief complaint of diarrhea in the category of SOME
DEHYDRATION. Based on the IMCI management guidelines, which of the following will you do?
A. Bring the infant to the nearest facility where IV fluids can be given
B. Supervise the mother in giving 200 to 400ml of Oresol in 4 hours
C. Give the infant's mother instructions on home management
D. Keep the infant in your health center for close observation
102. A mother is using Oresol' in the management of diarrhea of her 3-year old child. She asked you what to do if her child vomits. You
will tell her to:
103. A 1 1/2 year old child was classified as having 3rd degree of protein energy malnutrition, kwashjorkor. Which of the following signs
will be most apparent in this child?
A. Voracious appetite
B. Wasting
C. Apathy
D. Edema
104. Assessment of a 2-year old child revealed "baggy pants". Using the IMCI guidelines, how will you manage this child?
A. Refer the child urgently to a hospital for confinement
B. Coordinate with the social worker to enroll the child in a feeding program
C. Make a teaching plan for the mother, focusing on the menu planning for her child
D. Assess and treat the child for health problems like infections and intestinal parasitism
105. During the physical examination of a young child, what is the earliest sign of xerophthalmia that may observe?
A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis
106. To prevent xerophthalmia, young children are given Retinol capsule every 6 months. What is the dose given to preschoolers?
A. 10, 000 IU
B. 20, 000 IU
C. 100, 000 IU
D. 200, 000 IU
107. The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac
108. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. RA 8976 mandates fortification of certain
food items. Which of the following is among these food items?
A. Sugar
B. Bread
C. Margarine
D. Filled milk
109. What is the best course of action when there is a measles epidemic in a nearby municipality?
110. A mother brought her daughter, 4 years old, to the RHU because of cough and colds. Following the IMCI assessment guide, which
of the following is a danger sign that indicates the need for urgent referral to a hospital?
A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days
111. Management of a child with measles includes the administration of which of the following?
112. A mother brought her 10 month old infant for consultation because of fever which started 4 days prior to consultation. To determine
malaria risk, what will you do?
A. Do a tourniquet test
B. Ask where the family resides
C. Get a specimen for blood smear
D. Ask if the fever is present everyday
113. The following are strategies implemented by the DOH to prevent mosquito-borne diseases. Which of these is most effective in the
control of Dengue fever?
A. Stream seeding with larva-eating fish
B. Destroying breeding places of mosquitoes
C. Chemoprophylaxis of non-immune persons going to endemic areas
D. Teaching people in endemic areas to use chemically treated mosquito nets
115. Scotch tape swab is done to check for which intestinal parasite?
A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma
116. Which of the following signs indicates the need for sputum examination for AFB?
A. Hematemesis
B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week
119. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of leprosy?
A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nose bridge
120. Which of the following clients should be classified as a case of mutibacillary leprosy?
121. In the Philippines, which condition is the most frequent cause of death associated by schistosomiasis?
A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation
122. What is the most effective way of controlling schistosomiasis in an endemic area?
A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots
123. When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is:
A. I
B. II
C. III
D. IV
124. For prevention of Hepatitis A, you decided to conduct health education activities. Which of the following is Irrelevant?
125. Which biological used in EPI should not be stored in the freezer?
A. DPT
B. OPV
C. Measles vaccine
D. MMR
126. You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the
barangay.
A. 45
B. 50
C. 55
D. 60
127. In IMCI, severe conditions generally require urgent referral to a hospital. Which of the following severe conditions Does not always
require urgent referral to hospital?
A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease.
128. A client was diagnosed as having Dengue Fever. You will say that there is slow capillary refill when the color of the nailbed that you
pressed does not return within how many seconds?
A. 3
B. 5
C. 8
D. 10
129. A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive
tourniquet test result. In the absence of other signs, which of the most appropriate measure that the PHN may carry out to prevent
Dengue shock syndrome?
130. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the:
A. Nasal Mucosa
B. Buccal mucosa
C. Skin on the abdomen
D. Skin on the antecubital surface
A. Viral conjunctivitis
B. Acute poliomyelitis
C. Diptheria
D. Measles
132. Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
A. Hemophilus Influenzae
B. Morbillivirus
C. Streptococcus Pneumoniae
D. Neisseria meningitides
133. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis
134. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis .
135. Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT
appropriate for malaria control?
136. A 4-year old client was brought to the health center with chief complaint of severe diarrhea and the passage of “rice water”. The
client is most probably suffering from which condition?
A. Giardiasis
B. Cholera
C. Amebiasis
D. Dysentery
A. S. mansoni
B. S. japonicum
C. S. malayensis
D. S. haematobium
138. A 32 year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying
symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera.
History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on this history/ which disease
condition will you suspect?
A. Hepatitis A
B. Hepatitis B
C. Tetanus
D. Leptospirosis
139. MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?
A. I
B. II
C. III
D. IV
140. You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the
best course of action that you may take?
A. Get a thorough history of the client, focusing on the practice of high risk behavior
B. Ask the client to be accompanied by a significant person before revealing the result.
C. Refer the client to the physician since he is the best person to reveal the result to the client
D. Refer the client for a supplementary test, such as Western blot, since the ELISA result maybe false
142. The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic
infections is characterized by tonsilllopharyngitis?
A. Respiratory candidiasis
B. Infectious mononucleosis
C. Cytomegalovirus disease
D. Pneumocystis carinii pneumonia
143. To determine the possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the
public health MIDWIFE?
A. Contact tracing
B. Community survey
C. Mass screening tests
D. Interview suspects
144. Antiretroviral agents, such as AZT are used in the management of AIDS. Which of the following is not an action expected of these
drugs?
145. A barangay had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to
women in the first trimester of pregnancy in the barangay?
1. With regards to Women’s Health and Safe Motherhood Project, the following strategies are included to prevent maternal mortality, except one:
A. Establishment of BEmoNC and CEmoNC networks
B. TBA facilitated home deliveries
C. Improved Family Planning counselling
D. Emphasis on Facility based deliveries
2. The following qualifications reflect possible delivery in the Rural Health Unit, except for one:
A. Cephalic presentation
B. Adequate pelvis
C. History of ceasarian section delivery
D. Less than five pregnancies
3. You are assigned to provide baby care to the newly delivered healthy baby. What procedure are you going to do first?
A. Examine the newborn and check for defects, deformities and birth injuries.
B. Provide warmth to the newborn and have a quick check for breathing
C. Clamp and cut the cord after cord pulsations have stopped.
D. Facilitate the bonding between the mother and the newborn through early skin – to - skin contact
4.The basis for the improvement in strategies in maternal and neonatal care is on Millennium Development Goals, which are:
A. MDGs 1 & 2
B. MDGs 2 & 4
C. MDGs 3 & 5
D. MDGs 4 & 5
5. The following are the intermediate results that can lower the risk for dying from pregnancy and childbirth with the integration of the MNCHN
services in the community:
A. Every delivery is facility- based and managed by skilled birth attendants
B. Every pregnancy is adequately managed during pre and post partum courses
C. Every pregnancy is wanted, planned and supported
D. Only answers A & C
6. Situation II: You have observed that there are reports of dengue hemorrhagic fever in the barangay. You are to perform community awareness
lecture about the said disease. 6. Which is the best preventive measure for dengue hemorrhagic fever?
A. Frequent fogging in the vicinity to kill mosquitoes
B. Use of mosquito nets and mosquito coils
C. Use of mosquito repellent lotions
D. Cleaning of surroundings and proper disposal of coconut shells, tires, and containers
7. What are the signs and symptoms of DHF assessed as Grade II?
A
Herman’s signs, bone and joint pains, fever with headache, and abdominal pain
B
Hypotension, anorexia, nausea and vomiting, fever, and rapid weak pulse
C
Herman’s signs, fever with headache, epistaxis, and melena
D
Narrowing pulse pressure, restlessness, and cold clammy perspiration
8.For planning and implementation during the course of DHF, the following are the necessary nursing considerations:
A
Educate client to avoid dark colored foods and the use of hard bristled toothbrush, razor and other sharp objects
B
Monitoring the intake and output of client
C
Encouraging client to increase fluid intake
D
All of the above
9.What diagnostic procedure will confirm that the client is having DHF?
A
Blood smear
B
Urine and Stool examinations
C
Cerebrospinal fluid examination
D
Sputum examination
10. Dengue hemorrhagic fever can be fatal. The following manifestations are present in DHF, except for one.
A
Thrombocytosis
B
Prolonged bleeding time
C
Thrombocytopenia
D
Positive Rumpel Leade test
11.Situation III: IMCI or the Integrated Management for Childhood Illnesses is an important tool for public health nurses for managing cases of
children seeking health care. 11. What should you look for in assessing the child’s condition?
A
Does the child vomit everything?
B
Is the child able to breastfeed or drink?
C
Is the child lethargic or unconscious?
D
Is the child having some breathing difficulties?
12. If the child is having fever for 9 days everyday and has stiff neck but without runny nose, what color health management will it suggest?
A
Green
B
Yellow
C
Pink
D
Violet
13.In a child reported to having diarrhea, assessment is an essential guide for knowing if the child is experiencing dehydration. What body part
should you assess?
A
Buttocks
B
Abdomen
C
Eyelids
D
Arms
14. Child Isabel is already 12 weeks old. What immunizations should Isabel have received?
A. BCG, OPV-0, DPT+HIB-1, Hepatitis B1, and OPV-1
B. . CG, OPV-0, DPT+HIB-1, Hepatitis B1, DPT+HIB-2, Hepatitis B2, OPV-1 and OPV-2
C. BCG, OPV-0, DPT+HIB-1, Hepatitis B1, OPV-1, and
D. BCG, OPV-0, DPT+HIB-1, and OPV-1
15. In preparing sugar water for the treatment of low blood sugar in a child, includes the following proportion:
a. 200 ml of clean water plus 2 level tbsp. of sugar
b. 400 ml of clean water plus 4 level tsp of sugar
c. 200 ml of clean water plus 4 level tsp of sugar
d. 200 ml of clean water plus 4 level tbsp of sugar
Situation IV: The Aquino Health Agenda (AHA) is focusing on the achievement of Universal Health Care for All Filipinos.
16. The AHA strategic thrusts are the keys for ensuring that all Filipinos especially the poor will receive the benefits of the health reform. These
involve:
a. Attainment of Millennium Development Goals 2 and 3.
b. Financial risk protection through expansion in National Health Insurance Program enrolment and benefit
c. Improved service delivery for health care needs through upgraded quality health care facilities
d. B & C only
e.
17. Last April 2011, the Department of Health together with the LGUs conducted a nationwide campaign on:
a. Reproductive Health Bill
b. Disaster and Preparedness
c. Measles- Rubella
d. Isang Milyong Sepilyo
18. Which is incorrect regarding the training and deployment of unemployed nurses as “RNHeals” to the rural area?A
a. To supply the needs of poor Filipino people in far flung areas
b. To contribute to the eradication of poverty and hunger
c. To assist in the promotion of gender and equality
d. To address the proliferation of “volunteer nurses”
19. According to the AHA, the following instruments are vital in implementing the three strategic thrusts. Which one refers to the access to
professional health providers capable in the provision of their health needs at the appropriate level of care?
a. Service Delivery
b. Governance for Health
c. Human Resources for Health
d. Health Information
20. Encouragement of community integration and self- reliance enhancement in the community is valued, too in this health agenda. Which of these
statements indicate the correct meaning of community health team?
a. It is a group of people composed of NGOs and private organizations
b. It is led by the midwife in the priority population areas
c. The rural health physician is the one who directly tracks the eligible population
d. None of the above
e.
21. It refers to the description of disease occurrence which is constantly present in a given area.
a. Pandemic
b. Sporadic
c. Endemic
d. Epidemic
22. Mang Ernie came to the RHU because he was bitten by their dog. What nursing consideration is your priority?
a. Administration of Anti- rabies vaccine
b. Provision of dim, quiet and non- stimulating room for the client
c. Assessment of wound for classification, severity, and other signs and symptoms
d. Provision of isolation precautions
23. You are about to provide health teachings about pulmonary tuberculosis in your area of assignment. What diagnostic procedure is usually done
early in the morning to confirm PTB?
a. Chest X- ray
b. Sputum Examination
c. Bronchoscopy
d. All of the above
24. Scarlet fever is a febrile contagious condition. Which laboratory procedure is not included in confirming scarlet fever?
a. ASO titer
b. Sputum Examination
c. Throat culture
d. Differential count of white blood cells
25. What skin manifestation can be observed to a child having the 3- day measle?
a. Generalized flushing of the skin
b. Rashes that appears on chest spreading gradually upward and downward
c. Macupapular rashes on the cheeks (slightly elevated)
d. Rose- red papules on the face
*Rationale: Home deliveries are not recommended by the government even it is assisted by a health professional or a trained hilot nowadays.
Maternal complications leading to maternal mortality has been found to be due to this.
*Rationale: Rural health units do not have the capacity and the facilities to facilitate CS delivery. Aside from that women with history of CS
deliveries usually have previous history of serious or potentially serious complications, thus they are usually advised to seek consult to the nearest
hospital during their prenatal period to prepare them for their delivery.
*Rationale: Within the first 30 seconds, the objective of the nurse is to dry and provide warmth to the newborn to prevent from hypothermia.
*Rationale: MDG 4 focuses on reducing child mortality and MDG 5 corresponds to the improvement of maternal health.
*Rationale: Only A & C are correct; Every pregnancy is adequately managed throughout its course, not only during pre natal and post partum
periods.
*Rationale: Fogging is not recommended for it only scares away mosquito and it even causes some respiratory consequences; use of mosquito
nets, coils and repellants are options but the best preventive measure is through searching and destroying of breeding sites by cleaning the
surroundings.
*Rationale: DHF Grade II includes the signs of Grade I plus spontaneous bleeding. Choice A refers only to signs and symptoms found in Grade I,
while options B and D correspond to signs and symptoms of Grade III.
*Rationale: All the above options should be included in plan of care for a client with DHF to easily identify and prevent bleeding, and to prevent the
occurrence of dehydration.
*Rationale: By testing through blood smear DHF will be confirmed. The rest diagnostic procedures are not relevant to the confirmation process of
this said disease.
*Rationale: Thrombocytosis is not a manifestation of DHF instead there is depletion of thrombocytes in the system referring to as
thrombocytopenia; which can be evidenced by prolonged bleeding time and petechial rashes.
*Rationale: Options A and B refers to what you should ask for during assessment, but what you really need to look for is if the child is lethargic –
which is a danger sign. It also refers to as objective data instead of subjective one as verbalized by mother. Option D is asked if you are querying
the child to have pneumonia or not.
*Rationale: Pink, since the child is suggested to be having very severe febrile disease under the high malaria risk management.
*Rationale: Abdomen is assessed for signs of dehydration in children; the rest do not give hints of dehydration.
*Rationale: At birth the child should have received BCG and OPV-0; at 6 weeks, the child can receive DPT+HIB-1, Hepatitis B1, OPV-1 already;
and at 10 weeks, DPT+HIB-2, Hepatitis B2 and OPV-2 can be given to the child. The next immunization is when the child reached the age of 14
weeks.
*Rationale: The right proportion in making sugar water is 200 ml of clean water with 4 tsp of sugar.
*Rationale: There are three strategic thrusts involving financial risk protection, improved access to health care delivery, and attainment of health
related MDGs which are MDGs 4 and 5.
*Rationale: Measles Rubella Campaign was conducted last 2011 to decrease the incidence of MR in the country and to coincide with the MDGs
goal of reducing child mortality
*Rationale: It is only to improve the access of poor communities to quality healthcare and services, not to supply their needs; Take note also that
community health nursing is focusing on the development of self- reliance of the community.
*Rationale: Human Resources for Health refer to health professionals such as midwives, nurses and the like which could provide their needs in the
community. They will be skilfully trained to be competent in the provision of health care in every family’s door steps as much as possible.
*Rationale: It is a group of health volunteers led by the midwife in the barangay. The midwife tracks the eligible population for health care services
while the rural health physician only supervises the community health team. family’s door steps as much as possible.
*Rationale: The constant presence of an infectious agent within a specific area is called endemic. Pandemic refers to an epidemic which has widely
spread in different places; epidemic is the occurrence of a disease condition more than as expected; and sporadic is defined as occurrence of
disease in occasional periods only.
*Rationale: Assessment is always prioritized in doing nursing care. There are guidelines from which the assessment of type, size, and appearance
of bite is classified prior to referral to Animal Bite Center. This classification is the basis for the treatment of anti- rabies vaccine as indicated by the
physician. Provision of dim and non- stimulating room and isolation precautions are only given during the later stages of rabies virus invasion in the
system.
*Rationale: Sputum Examination is usually done early in the morning to detect presence of Mycobacterium Tuberculosis. Chest X- ray is another
confirmatory procedure but could be done anytime of the day. On the other hand, bronchoscopy is an invasive procedure that confirms the extent
of PTB.
*Rationale: An elevated ASO titer, positive throat culture for strep, and an increase in WBC differential count especially the eosinophils conclude
the presence of scarlet fever in the system.
*Rationale: Option A refers to DHF, B for Scarlet fever, and C for Measles.
1. In immunizing school entrants with BCG, you are not obliged to secure parental consent. This is because of which legal document?
a. P.D. 996
b. R.A. 7846
c. Presidential Proclamation No. 6
d. Presidential Proclamation No. 46
2. Which immunization produces a permanent scar?
a. DPT
b. BCG
c. Measles vaccination
d. Hepatitis B vaccination
3. A 4-week old baby was brought to the health center for his first immunization. Which can be given to him?
a. DPT1
b. OPV1
c. Infant BCG
d. Hepatitis B vaccine 1
e.
4. You will not give DPT 2 if the mother says that the infant had
5. A 2-month old infant was brought to the health center for immunization. During assessment, the infant’s temperature registered at 38.1°C. Which
is the best course of action that you will take?
a. Go on with the infant’s immunizations.
b. Give Paracetamol and wait for his fever to subside.
c. Refer the infant to the physician for further assessment.
d. Advise the infant’s mother to bring him back for immunization when he is well.
6. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her baby will have protection against tetanus for how long?
a. 1 year
b. 3 years
c. 10 years
d. Lifetime
7. A 4-month old infant was brought to the health center because of cough. Her respiratory rate is 42/minute. Using the Integrated Management of
Child Illness (IMCI) guidelines of assessment, her breathing is considered
a. Fast
b. Slow
c. Normal
d. Insignificant
8. Which of the following signs will indicate that a young child is suffering from severe pneumonia?
a. Dyspnea
b. Wheezing
c. Fast breathing
d. Chest indrawing
9. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best management for the child?
a. Prescribe an antibiotic.
b. Refer him urgently to the hospital.
c. Instruct the mother to increase fluid intake.
d. Instruct the mother to continue breastfeeding.
10. A 5-month old infant was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes back slowly
after a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category?
a. No signs of dehydration
b. Some dehydration
c. Severe dehydration
d. The data is insufficient.
11. Based on assessment, you classified a 3-month old infant with the chief complaint of diarrhea in the category of SOME DEHYDRATION. Based
on IMCI management guidelines, which of the following will you do?
a. Bring the infant to the nearest facility where IV fluids can be given.
b. Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
c. Give the infant’s mother instructions on home management.
d. Keep the infant in your health center for close observation.
12. A mother is using Oresol in the management of diarrhea of her 3-year old child. She asked you what to do if her child vomits. You will tell her to
a. Bring the child to the nearest hospital for further assessment.
b. Bring the child to the health center for intravenous fluid therapy.
c. Bring the child to the health center for assessment by the physician.
d. Let the child rest for 10 minutes then continue giving Oresol more slowly.
13. A 1 ½ year old child was classified as having 3rd degree protein energy malnutrition, kwashiorkor. Which of the following signs will be most
apparent in this child?
a. Voracious appetite
b. Wasting
c. Apathy
d. Edema
14. Assessment of a 2-year old child revealed “baggy pants”. Using the IMCI guidelines, how will you manage this child?
a. Refer the child urgently to a hospital for confinement.
b. Coordinate with the social worker to enroll the child in a feeding program.
c. Make a teaching plan for the mother, focusing on menu planning for her child.
d. Assess and treat the child for health problems like infections and intestinal parasitism.
15. During the physical examination of a young child, what is the earliest sign of xerophthalmia that you may observe?
a. Keratomalacia
b. Corneal opacity
c. Night blindness
d. Conjunctival xerosis
16. To prevent xerophthalmia, young children are given Retinol capsule every 6 months. What is the dose given to preschoolers?
a. 10,000 IU
b. 20,000 IU
c. 100,000 IU
d. 200,000 IU
17. The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
a. Palms
b. Nailbeds
c. Around the lips
d. Lower conjunctival sac
18. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. R.A. 8976 mandates fortification of certain food items.
Which of the following is among these food items?
a. Sugar
b. Bread
c. Margarine
d. Filled milk
19. What is the best course of action when there is a measles epidemic in a nearby municipality?
a. Give measles vaccine to babies aged 6 to 8 months.
b. Give babies aged 6 to 11 months one dose of 100,000 I.U. of Retinol
c. Instruct mothers to keep their babies at home to prevent disease transmission.
d. Instruct mothers to feed their babies adequately to enhance their babies’ resistance.
20. A mother brought her daughter, 4 years old, to the RHU because of cough and colds. Following the IMCI assessment guide, which of the
following is a danger sign that indicates the need for urgent referral to a hospital?
a. Inability to drink
b. High grade fever
c. Signs of severe dehydration
d. Cough for more than 30 days
21. Management of a child with measles includes the administration of which of the following?
a. Gentian violet on mouth lesions
b. Antibiotics to prevent pneumonia
c. Tetracycline eye ointment for corneal opacity
d. Retinol capsule regardless of when the last dose was given
22. A mother brought her 10 month old infant for consultation because of fever, which started 4 days prior to consultation. To determine malaria
risk, what will you do?
a. Do a tourniquet test.
b. Ask where the family resides.
c. Get a specimen for blood smear.
d. Ask if the fever is present everyday.
23. The following are strategies implemented by the Department of Health to prevent mosquito-borne diseases. Which of these is most effective in
the control of Dengue fever?
a. Stream seeding with larva-eating fish
b. Destroying breeding places of mosquitoes
c. Chemoprophylaxis of non-immune persons going to endemic areas
d. Teaching people in endemic areas to use chemically treated mosquito nets
25. Scotch tape swab is done to check for which intestinal parasite?
a. Ascaris
b. Pinworm
c. Hookworm
d. Schistosoma
26. Which of the following signs indicates the need for sputum examination for AFB?
a. Hematemesis
b. Fever for 1 week
c. Cough for 3 weeks
d. Chest pain for 1 week
27. Which clients are considered targets for DOTS Category I?
a. Sputum negative cavitary cases
b. Clients returning after a default
c. Relapses and failures of previous PTB treatment regimens
d. Clients diagnosed for the first time through a positive sputum exam
29. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of leprosy?
a. Macular lesions
b. Inability to close eyelids
c. Thickened painful nerves
d. Sinking of the nosebridge
30. Which of the following clients should be classified as a case of multibacillary leprosy?
a. 3 skin lesions, negative slit skin smear
b. 3 skin lesions, positive slit skin smear
c. 5 skin lesions, negative slit skin smear
d. 5 skin lesions, positive slit skin smear
1. A client asks the nurse what a third degree laceration is. She was informed that she had one. The nurse explains that this is:
that extended their anal sphincter
through the skin and into the muscles
that involves anterior rectal wall
that extends through the perineal muscle.
2. Betina 30 weeks AOG discharged with a diagnosis of placenta previa. The nurse knows that the client understands her care at home when she
says:
a. I am happy to note that we can have sex occasionally when I have no bleeding.
b. I am afraid I might have an operation when my due comes
c. I will have to remain in bed until my due date comes
d. I may go back to work since I stay only at the office.
3. The uterus has already risen out of the pelvis and is experiencing farther into the abdominal area at about the:
4. Which of the following urinary symptoms does the pregnant woman most frequently experience during the first trimester:
a. frequency
b. dysuria
c. incontinence
d. burning
5. Mrs. Jimenez went to the health center for pre-natal check-up. the student nurse took her weight and revealed 142 lbs. She asked the student
nurse how much should she gain weight in her pregnancy.
a. 20-30 lbs
b. 25-35 lbs
c. 30- 40 lbs
d. 10-15 lbs
6. The nurse is preparing Mrs. Jordan for cesarean delivery. Which of the following key concept should the nurse consider when implementing
nursing care?
a. Explain the surgery, expected outcome and kind of anesthetics.
b. Modify preoperative teaching to meet the needs of either a planned or emergency cesarean birth.
c. Arrange for a staff member of the anesthesia department to explain what to expect post-operatively.
d. Instruct the mother’s support person to remain in the family lounge until after the delivery.
7. Bettine Gonzales is hospitalized for the treatment of severe preecplampsia. Which of the following represents an unusual finding for this
condition?
a. generalized edema
b. proteinuria 4+
c. blood pressure of 160/110
d. convulsions
8. Nurse Geli explains to the client who is 33 weeks pregnant and is experiencing vaginal bleeding that coitus:
a. Need to be modified in any way by either partner
b. Is permitted if penile penetration is not deep.
c. Should be restricted because it may stimulate uterine activity.
d. Is safe as long as she is in side-lying position.
9. Mrs. Precilla Abuel, a 32 year old mulripara is admitted to labor and delivery. Her last 3 pregnancies in short stage one of labor. The nurses
decide to observe her closely. The physician determines that Mrs. Abuel’s cervix is dilated to 6 cm. Mrs. Abuel states that she is extremely
uncomfortable. To lessen Mrs. Abuel’s discomfort, the nurse can advise her to:
a. lie face down
b. not drink fluids
c. practice holding breaths between contractions
d. assume Sim’s position
11. Mrs. Quijones gave birth by spontaneous delivery to a full term baby boy. After a minute after birth, he is crying and moving actively. His birth
weight is 6.8 lbs. What do you expect baby Quijones to weigh at 6 months?
a. 13 -14 lbs
b. 16 -17 lbs
c. 22 -23 lbs
d. 27 -28 lbs
12. During the first hours following delivery, the post partum client is given IVF with oxytocin added to them. The nurse understands the primary
reason for this is:
a. To facilitate elimination
b. To promote uterine contraction
c. To promote analgesia
d. To prevent infection
13. Nurse Luis is assessing the newborn’s heart rate. Which of the following would be considered normal if the newborn is sleeping?
a. 80 beats per minute
b. 100 beats per minute
c. 120 beats per minute
d. 140 beats per minute
14. The infant with Down Syndrome should go through which of the Erikson’s developmental stages first?
a. Initiative vs. Self doubt
b. Industry vs. Inferiority
c. Autonomy vs. Shame and doubt
d. Trust vs. Mistrust
15. The child with phenylketonuria (PKU) must maintain a low phenylalanine diet to prevent which of the following complications?
a. Irreversible brain damage
b. Kidney failure
c. Blindness
d. Neutropenia
16. Which age group is with imaginative minds and creates imaginary friends?
a. Toddler
b. Preschool
c. School
d. Adolescence
17. Which of the following situations would alert you to a potentially developmental problem with a child?
a. Pointing to body parts at 15 months of age.
b. Using gesture to communicate at 18 months.
c. Cooing at 3 months.
d. Saying “mama” or “dada” for the first time at 18 months of age.
18. Isabelle, a 2 year old girl loves to move around and oftentimes manifests negativism and temper tantrums. What is the best way to deal with
her behavior?
a. Tell her that she would not be loved by others is she behaves that way..
b. Withholding giving her toys until she behaves properly.
c. Ignore her behavior as long as she does not hurt herself and others.
d. Ask her what she wants and give it to pacify her.
19. Baby boy Villanueva, 4 months old, was seen at the pediatric clinic for his scheduled check-up. By this period, baby Villanueva has already
increased his height by how many inches?
a. 3 inches
b. 4 inches
c. 5 inches
d. 6 inches
20. Alice, 10 years old was brought to the ER because of Asthma. She was immediately put under aerosol administration of Terbutaline. After
sometime, you observe that the child does not show any relief from the treatment given. Upon assessment, you noticed that both the heart and
respiratory rate are still elevated and the child shows difficulty of exhaling. You suspect:
a. Bronchiectasis
b. Atelectasis
c. Epiglotitis
d. Status Asthmaticus
21. Nurse Jonas assesses a 2 year old boy with a tentative diagnosis of nephroblastoma. Symptoms the nurse observes that suggest this problem
include:
a. Lymphedema and nerve palsy
b. Hearing loss and ataxia
c. Headaches and vomiting
d. Abdominal mass and weakness
22. Which of the following danger sings should be reported immediately during the antepartum period?
a. blurred vision
b. nasal stuffiness
c. breast tenderness
d. constipation
23. Nurse Jacob is assessing a 15 month old child with acute otitis media. Which of the following symptoms would the nurse anticipate finding?
a. periorbital edema, absent light reflex and translucent tympanic membrane
b. irritability, purulent drainage in middle ear, nasal congestion and cough
c. diarrhea, retracted tympanic membrane and enlarged parotid gland
d. Vomiting, pulling at ears and pearly white tympanic membrane
24. Which of the following is the most appropriate intervention to reduce stress in a preterm infant at 33 weeks gestation?
a. Sensory stimulation including several senses at a time
b. tactile stimulation until signs of over stimulation develop
c. An attitude of extension when prone or side lying
d. Kangaroo care
25. The parent of a client with albinism would need to be taught which preventive healthcare measure by the nurse:
a. Ulcerative colitis diet
b. Use of a high-SPF sunblock
c. Hair loss monitoring
d. Monitor for growth retardation
1. In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?
a. Liver cancer
b. Liver cirrhosis
c. Bladder cancer
d. Intestinal perforation
3. When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is
a. I
b. II
c. III
d. IV
4. For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?
a. Use of sterile syringes and needles
b. Safe food preparation and food handling by vendors
c. Proper disposal of human excreta and personal hygiene
d. Immediate reporting of water pipe leaks and illegal water connections
5. Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?
a. DPT
b. Oral polio vaccine
c. Measles vaccine
d. MMR
6. You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
a. 45
b. 50
c. 55
d. 60
7. In Integrated Management of Childhood Illness, severe conditions generally require urgent referral to a hospital. Which of the following severe
conditions DOES NOT always require urgent referral to a hospital?
a. Mastoiditis
b. Severe dehydration
c. Severe pneumonia
d. Severe febrile disease
8. A client was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed does
not return within how many seconds?
a. 3
b. 5
c. 8
d. 10
9. A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test
result. In the absence of other signs, which is the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?
a. Insert an NGT and give fluids per NGT.
b. Instruct the mother to give the child Oresol.
c. Start the patient on intravenous fluids STAT.
d. Refer the client to the physician for appropriate management.
10. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.
a. Nasal mucosa
b. Buccal mucosa
c. Skin on the abdomen
d. Skin on the antecubital surface
a. Viral conjunctivitis
b. Acute poliomyelitis
c. Diphtheria
d. Measles
12. Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
a. Hemophilus influenzae
b. Morbillivirus
c. Steptococcus pneumoniae
d. Neisseria meningitidis
13. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
a. Stream seeding
b. Stream clearing
c. Destruction of breeding places
d. Zooprophylaxis
14. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
a. Stream seeding
b. Stream clearing
c. Destruction of breeding places
d. Zooprophylaxis
15. Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for
malaria control?
a. Use of chemically treated mosquito nets
b. Seeding of breeding places with larva-eating fish
c. Destruction of breeding places of the mosquito vector
d. Use of mosquito-repelling soaps, such as those with basil or citronella
16. A 4-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of “rice water” stools. The
client is most probably suffering from which condition?
a. Giardiasis
b. Cholera
c. Amebiasis
d. Dysentery
17. In the Philippines, which specie of schistosoma is endemic in certain regions?
a. S. mansoni
b. S. japonicum
c. S. malayensis
d. S. haematobium
18. A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were
muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded
in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?
a. Hepatitis A
b. Hepatitis B
c. Tetanus
d. Leptospirosis
19. MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?
a. I
b. II
c. III
d. IV
20. You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course
of action that you may take?
a. Get a thorough history of the client, focusing on the practice of high risk behaviors.
b. Ask the client to be accompanied by a significant person before revealing the result.
c. Refer the client to the physician since he is the best person to reveal the result to the client.
d. Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.
21. Which is the BEST control measure for AIDS?
a. Respiratory candidiasis
b. Infectious mononucleosis
c. Cytomegalovirus disease
d. Pneumocystis carinii pneumonia
23. To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health
nurse?
a. Contact tracing
b. Community survey
c. Mass screening tests
d. Interview of suspects
24. Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is NOT an action expected of these drugs.
a. The older one gets, the more susceptible he becomes to the complications of chicken pox.
b. A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
c. To prevent an outbreak in the community, quarantine may be imposed by health authorities.
d. Chicken pox vaccine is best given when there is an impending outbreak in the community.
28. Complications to infectious parotitis (mumps) may be serious in which type of clients?
a. Pregnant women
b. Elderly clients
c. Young adult males
d. Young infants
Answers and Rationales
Answer: (B) Liver cirrhosis. The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which affects the small intestine
and the liver. Liver damage is a consequence of fibrotic reactions to schistosoma eggs in the liver.
Answer: (C) Proper use of sanitary toilets. The ova of the parasite get out of the human body together with feces. Cutting the cycle at this stage is
the most effective way of preventing the spread of the disease to susceptible hosts.
Answer: (B) II. A communal faucet or water standpost is classified as Level II.
Answer: (A) Use of sterile syringes and needles. Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected
body secretions like blood and semen.
Answer: (A) DPT. DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only. OPV and measles vaccine are highly
sensitive to heat and require freezing. MMR is not an immunization in the Expanded Program on Immunization.
Answer: (A) 45. To estimate the number of infants, multiply total population by 3%.
Answer: (B) Severe dehydration. The order of priority in the management of severe dehydration is as follows: intravenous fluid therapy, referral to a
facility where IV fluids can be initiated within 30 minutes, Oresol/nasogastric tube, Oresol/orem. When the foregoing measures are not possible or
effective, tehn urgent referral to the hospital is done.
Answer: (A) 3. Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.
Answer: (B) Instruct the mother to give the child Oresol. Since the child does not manifest any other danger sign, maintenance of fluid balance and
replacement of fluid loss may be done by giving the client Oresol.
Answer: (B) Buccal mucosa. Koplik’s spot may be seen on the mucosa of the mouth or the throat.
Answer: (D) Measles. Viral conjunctivitis is transmitted by direct or indirect contact with discharges from infected eyes. Acute poliomyelitis is spread
through the fecal-oral route and contact with throat secretions, whereas diphtheria is through direct and indirect contact with respiratory secretions.
Answer: (A) Hemophilus influenzae. Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is in
children less than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and Neisseria meningitidis may cause
meningitis, but age distribution is not specific in young children.
Answer: (D) Zooprophylaxis. Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just before nightfall. The
Anopheles mosquito takes his blood meal from the animal and goes back to its breeding place, thereby preventing infection of humans.
Answer: (A) Stream seeding. Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the
Anopheles mosquito
Answer: (C) Destruction of breeding places of the mosquito vector. Anopheles mosquitoes breed in slow-moving, clear water, such as mountain
streams.
Answer: (B) Cholera. Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary dysentery are characterized by
the presence of blood and/or mucus in the stools. Giardiasis is characterized by fat malabsorption and, therefore, steatorrhea.
Answer: (B) S. japonicum. S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the Middle East; and S.
malayensis only in peninsular Malaysia.
Answer: (D) Leptospirosis. Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated
with urine of infected animals, like rats.
Answer: (C) III. Waterworks systems, such as MWSS, are classified as level III.
Answer: (D) Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false. A client having a reactive ELISA
result must undergo a more specific test, such as Western blot. A negative supplementary test result means that the ELISA result was false and
that, most probably, the client is not infected.
Answer: (A) Being faithful to a single sexual partner. Sexual fidelity rules out the possibility of getting the disease by sexual contact with another
infected person. Transmission occurs mostly through sexual intercourse and exposure to blood or tissues.
Answer: (B) Infectious mononucleosis. Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and
lymphadenopathy.
Answer: (A) Contact tracing. Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted
infections, such as sexually transmitted diseases.
Answer: (D) They are able to bring about a cure of the disease condition. There is no known treatment for AIDS. Antiretroviral agents reduce the
risk of opportunistic infections and prolong life, but does not cure the underlying immunodeficiency.
Answer: (D) Consult a physician who may give them rubella immunoglobulin. Rubella vaccine is made up of attenuated German measles viruses.
This is contraindicated in pregnancy. Immune globulin, a specific prophylactic against German measles, may be given to pregnant women.
Answer: (D) Proper handwashing during food preparation is the best way of preventing the condition. Symptoms of this food poisoning are due to
staphylococcal enterotoxin, not the microorganisms themselves. Contamination is by food handling by persons with staphylococcal skin or eye
infections.
Answer: (A) The older one gets, the more susceptible he becomes to the complications of chicken pox. Chicken pox is usually more severe in
adults than in children. Complications, such as pneumonia, are higher in incidence in adults.
Answer: (C) Young adult males. Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of
the testes and epididymis may cause sterility.
a. To support and supplement the efforts of the medical profession in the promotion of health and prevention of illness
b. To enhance the capacity of individuals, families and communities to cope with their health needs
c. To increase the productivity of the people by providing them with services that will increase their level of health
d. To contribute to national development through promotion of family welfare, focusing particularly on mothers and children.
2. CHN is a community-based practice. Which best explains this statement?
a. Community organizing
b. Nursing process
c. Community diagnosis
d. Epidemiologic process
4. R.A. 1054 is also known as the Occupational Health Act. Aside from number of employees, what other factor must be considered in determining
the occupational health privileges to which the workers will be entitled?
a. 21
b. 101
c. 201
d. 301
6. When the occupational health nurse employs ergonomic principles, she is performing which of her roles?
a. It involves providing home care to sick people who are not confined in the hospital.
b. Services are provided free of charge to people within the catchment area.
c. The public health nurse functions as part of a team providing a public health nursing services.
d. Public health nursing focuses on preventive, not curative, services.
12. According to Margaret Shetland, the philosophy of public health nursing is based on which of the following?
a. Primary
b. Secondary
c. Intermediate
d. Tertiary
15. Which is true of primary facilities?
a. Requesting for BCG from the RHU for school entrant immunization
b. Conducting random classroom inspection during a measles epidemic
c. Taking remedial action on an accident hazard in the school playground
d. Observing places in the school where pupils spend their free time
17. When the nurse determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating
a. Effectiveness
b. Efficiency
c. Adequacy
d. Appropriateness
18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where will you apply?
a. Department of Health
b. Provincial Health Office
c. Regional Health Office
d. Rural Health Unit
19. R.A. 7160 mandates devolution of basic services from the national government to local government units. Which of the following is the major
goal of devolution?
a. Mayor
b. Municipal Health Officer
c. Public Health Nurse
d. Any qualified physician
21. Which level of health facility is the usual point of entry of a client into the health care delivery system?
a. Primary
b. Secondary
c. Intermediate
d. Tertiary
22. The public health nurse is the supervisor of rural health midwives. Which of the following is a supervisory function of the public health nurse?
1
2
3
The RHU does not need any more midwife item.
25. If the RHU needs additional midwife items, you will submit the request for additional midwife items for approval to the
Act 3573
R.A. 3753
R.A. 1054
R.A. 1082
27. According to Freeman and Heinrich, community health nursing is a developmental service. Which of the following best illustrates this
statement?
The community health nurse continuously develops himself personally and professionally.
Health education and community organizing are necessary in providing community health services.
Community health nursing is intended primarily for health promotion and prevention and treatment of disease.
The goal of community health nursing is to provide nursing services to people in their own places of residence.
28. Which disease was declared through Presidential Proclamation No. 4 as a target for eradication in the Philippines?
Poliomyelitis
Measles
Rabies
Neonatal tetanus
29. The public health nurse is responsible for presenting the municipal health statistics using graphs and tables. To compare the frequency of the
leading causes of mortality in the municipality, which graph will you prepare?
Line
Bar
Pie
Scatter diagram
30. Which step in community organizing involves training of potential leaders in the community?
Integration
Community organization
Community study
Core group formation
Answers and Rationales
Answer: (B) To enhance the capacity of individuals, families and communities to cope with their health needs
Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs and problems.
Answer: (C) Community diagnosis. Population-focused nursing care means providing care based on the greater need of the majority of the
population. The greater need is identified through community diagnosis.
Answer: (B) Location of the workplace in relation to health facilities. Based on R.A. 1054, an occupational nurse must be employed when there are
30 to 100 employees and the workplace is more than 1 km. away from the nearest health center.
Answer: (B) 101. Again, this is based on R.A. 1054.
Answer: (D) Environmental manager. Ergonomics is improving efficiency of workers by improving the worker’s environment through appropriately
designed furniture, for example.
Answer: (C) Public health nurse of the RHU of their municipality. You’re right! This question is based on R.A.1054.
Answer: (B) The statement is false; people pay indirectly for public health services. Community health services, including public health services,
are pre-paid services, though taxation, for example.
Answer: (A) For people to attain their birthrights of health and longevity. According to Winslow, all public health efforts are for people to realize their
birthrights of health and longevity.
Answer: (C) Swaroop’s index. Swaroop’s index is the percentage of the deaths aged 50 years or older. Its inverse represents the percentage of
untimely deaths (those who died younger than 50 years).
Answer: (D) Public health nursing focuses on preventive, not curative, services.The catchment area in PHN consists of a residential community,
many of whom are well individuals who have greater need for preventive rather than curative services.
Answer: (D) The worth and dignity of man. This is a direct quote from Dr. Margaret Shetland’s statements on Public Health Nursing.
Answer: (B) Ensure the accessibility and quality of health care
Answer: (D) Tertiary. Regional hospitals are tertiary facilities because they serve as training hospitals for the region.
Answer: (B) Their services are provided on an out-patient basis. Primary facilities government and non-government facilities that provide basic out-
patient services.
Answer: (B) Conducting random classroom inspection during a measles epidemic. Random classroom inspection is assessment of pupils/students
and teachers for signs of a health problem prevalent in the community.
Answer: (B) Efficiency. Efficiency is determining whether the goals were attained at the least possible cost.
Answer: (D) Rural Health Unit. R.A. 7160 devolved basic health services to local government units (LGU’s ). The public health nurse is an
employee of the LGU.
Answer: (C) To empower the people and promote their self-reliance. People empowerment is the basic motivation behind devolution of basic
services to LGU’s.
Answer: (A) Mayor. The local executive serves as the chairman of the Municipal Health Board.
Answer: (A) Primary. The entry of a person into the health care delivery system is usually through a consultation in out-patient services.
Answer: (B) Providing technical guidance to the midwife. The nurse provides technical guidance to the midwife in the care of clients, particularly in
the implementation of management guidelines, as in Integrated Management of Childhood Illness.
Answer: (C) Municipal Health Officer. A public health nurse and rural health midwife can provide care during normal childbirth. A physician should
attend to a woman with a complication during labor.
Answer: (A) 1. Each rural health midwife is given a population assignment of about 5,000.
Answer: (D) Municipal Health Board. As mandated by R.A. 7160, basic health services have been devolved from the national government to local
government units.
Answer: (A) Act 3573. Act 3573, the Law on Reporting of Communicable Diseases, enacted in 1929, mandated the reporting of diseases listed in
the law to the nearest health station.
Answer: (B) Health education and community organizing are necessary in providing community health services. The community health nurse
develops the health capability of people through health education and community organizing activities.
Answer: (B) Measles. Presidential Proclamation No. 4 is on the Ligtas Tigdas Program.
Answer: (B) Bar. A bar graph is used to present comparison of values, a line graph for trends over time or age, a pie graph for population
composition or distribution, and a scatter diagram for correlation of two variables.
Answer: (D) Core group formation. In core group formation, the nurse is able to transfer the technology of community organizing to the potential or
informal community leaders through a training program.
1. Nurse Bella explains to a 28 year old pregnant woman undergoing a non-stress test that the test is a way of evaluating the condition of the fetus
by comparing the fetal heart rate with:
Fetal lie
Fetal movement
Maternal blood pressure
Maternal uterine contractions
2. During a 2 hour childbirth focusing on labor and delivery process for primigravida. The nurse describes the second maneuver that the fetus goes
through during labor progress when the head is the presenting part as which of the following:
Flexion
Internal rotation
Descent
External rotation
3. Mrs. Jovel Diaz went to the hospital to have her serum blood test for alpha-fetoprotein. The nurse informed her about the result of the elevation
of serum AFP. The patient asked her what was the test for:
5 weeks of gestation
10 weeks of gestation
15 weeks of gestation
20 weeks of gestation
5. Mrs. Bendivin states that she is experiencing aching swollen, leg veins. The nurse would explain that this is most probably the result of which of
the following:
Thrombophlebitis
PIH
Pressure on blood vessels from the enlarging uterus
The force of gravity pulling down on the uterus
6. Mrs. Ella Santoros is a 25 year old primigravida who has Rheumatic heart disease lesion. Her pregnancy has just been diagnosed. Her heart
disease has not caused her to limit physical activity in the past. Her cardiac disease and functional capacity classification is:
Class I
Class II
Class III
class IV
7. The client asks the nurse, “When will this soft spot at the top of the head of my baby will close?” The nurse should instruct the mother that the
neonate’s anterior fontanel will normally close by age:
2-3 months
6-8 months
10-12 months
12-18 months
8. When a mother bleeds and the uterus is relaxed, soft and non-tender, you can account the cause to:
Hematocrit 33.5%
WBC 8,000/mm3
Rubella titer less than 1:8
One hour glucose challenge test 110 g/dL
11. Aling Patricia is a patient with preeclampsia. You advise her about her condition, which would tell you that she has not really understood your
instructions?
Weekly during the 8th month because this is her third pregnancy.
During the second trimester, if amniocentesis indicates a problem.
To her infant immediately after delivery if the Coomb’s test is positive.
Within 72 hours after delivery if infant is found to be Rh positive.
14. A baby boy was born at 8:50pm. At 8:55pm, the heart rate was 99 bpm. She has a weak cry, irregular respiration. She was moving all
extremities and only her hands and feet were still slightly blue. The nurse should enter the APGAR score as:
5
6
7
8
15. Billy is a 4 year old boy who has an IQ of 140 which means:
average normal
very superior
above average
genius
16. A newborn is brought to the nursery. Upon assessment, the nurse finds that the child has short palpebral fissures, thinned upper lip. Based on
this data, the nurse suspects that the newborn is MOST likely showing the effects of:
Chronic toxoplasmosis
Lead poisoning
Congenital anomalies
Fetal alcohol syndrome
17. A priority nursing intervention for the infant with cleft lip is which of the following:
an excess of RBC
an excess of WBC
a deficiency of clotting factor VIII
a deficiency of clotting factor IX
19. Celine, a mother of a 2 year old tells the nurse that her child “cries and has a fit when I have to leave him with a sitter or someone else.” Which
of the following statements would be the nurse’s most accurate analysis of the mother’s comment?
Anxiety
Body image disturbance
Ineffective individual coping
Social isolation
21. The foul-smelling, frothy characteristic of the stool in cystic fibrosis results from the presence of large amounts of which of the following:
Turner’s syndrome
Down’s syndrome
Marfan’s syndrome
Klinefelter’s syndrome
24. A 4 year old boy most likely perceives death in which way:
A. Community organizing .
B. Nursing, process
C. Community diagnosis
D. Epidemiologic process
4. RA 1054 is also known as the Occupational Health Act. Aside from the number of employees, what other factor must be considered in
determining the occupational health privileges to which the workers will be entitled?
5. A business firm must employ an occupational health nurse when it has at least how many employees.
A. 21
B. 101
C. 201
D. 301
6. When the occupational health nurse employs ergonomic principles, she is performing which of her roles?
A. Health care provider
B. Health educator
C. Health care coordinator
D. Environment manager
7. A garment factory does not have an occupational nurse. Who shall provide the occupational health needs of the factory workers?
8. “Public health services are given free of charge”. Is this statement true or false?
9. According to C.E. Winslow, which of the following is the goal of Public Health?
10. We say that a Filipino has attained longevity when he is able to reach the average life span of Filipinos. What other statistic may be used to
determine attainment of longevity?
11. Which of the following is the most prominent feature of public health nursing?
A. It involves providing home care to sick people who are not confined in the hospital
B. Services are provided free of charge to people within the catchment area
C. The public health nurse functions as part of a team providing a public health nursing service
D. Public health nursing focuses on preventive, not curative services
12. According to Margaret Shetland, the philosophy of public health nursing is based on which of the following?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
16. Which is an example of the school nurse’s health care provider function?
A. Requesting for BCG from the RHU for school entrance immunization
B. Conducting random classroom inspection during measles epidemic
C. Taking remedial action on an accident hazard in the school playground
D. Observing places in the school where pupils spend their free times
17. When the nurse determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating:
A. Effectiveness
B. Efficiency
C. Adequacy
D. Appropriateness
18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where will you apply?
A. Department of Health
B. Provincial Health Office
C. Regional Health Office
D. Rural Health Unit
19. RA 7160 mandates devolution of basic services from the national government to local government units. Which of the following is the major
goal of devolution?
A. Mayor
B. Municipal Health Officer
C. Public Health Nurse
D. Any qualified physician
21. Which level of health facility is the usual point of entry of a client into the health care delivery system?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
22. The public health nurse is the supervisor of rural health midwives. Which of the following is a supervisory function of the pubic health nurse?
23. One of the participants in a hilot training class asked you to whom she should refer a patient in labor who develops a complication. You will
answer, to the;
24. You are the public health nurse in a municipality with a total population of about 20,000. There are3 health midwives among the RHU
personnel. How many more midwife items will the RHU need?
A. 1
B. 2
C. 3
D. 4
25. If the RHU needs additional midwife items, you will submit the request for additional midwife items for approval to the:
26. As an epidemiologist, the nurse is responsible for reporting cases or notifiable diseases. What law mandates reporting cases of notifiable
diseases?
A. Act 3573
B. RA.3753
C. RA 1054
D. RA 1082
27. According to Freeman and Heinrich, community health nursing is a developmental service. Which of the following best illustrates this
statement?
A. The community health nurse continuously develops himself personally and professionally
B. Health education and community organizing are necessary in providing community health services
C. Community health nursing in intended primarily for health promotion and prevention and treatment of disease.
D. The goal of community health nursing is to provide nursing services to people in their own place of .residence
28. Which disease was declared through Presidential Proclamation No. 4 as a target for, eradication in the Philippines?
A. Pioliomyelitis
B. Measles
C. Rabies
D. Neonatal Tetanus
29. The public health nurse is responsible for presenting the municipal health statistics using graphs and tables. To compare the frequency of the
leading causes of mortality in the municipality, which graph will you prepare?
A. Line
B. Bar
C. Pie
D. Scatter diagram
30. Which step in community organizing involves training of potential leaders in the community?
A. Integration
B. Community organization
C. Community study
D. Core group formation
31. In which step are plans formulated for solving community problems?
A. Mobilization
B. Community organization
C. Follow-up/extension
D. Core group formation
32. The public health nurse takes an active role in community participation. What is the primary goal of community organizing?
33. An indicator of success in community organizing is when people are able to:
34. Tertiary prevention is needed in which stage of the natural history of disease?
A. Pre-pathogenesis
B. Pathogenesis
C. Predromal
D. Terminal
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
37. Which type of family-nurse contact will provide you with the best opportunity to observe family dynamics?
A. Clinic consultation
B. Group conferences
C. Home visit
D. Written communication
38. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of families. The youngest child of the delos
Reyes family has been diagnosed as mentally retarded. This is classified as:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
39. The delos Reyes couple have 6-year old child entering school for the first time. The delos Reyes family has a:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
40. Which of the following is an advantage of a home visit?
42. The PHN bag is an important tool in providing nursing care during a home visit. The most important principle in bag technique states that it;
43. To maintain the cleanliness of the bag and its contents, which of the following must the nurse do?
A. Wash his/her hands before and after providing nursing care to the family members
B. In the care of family member’s, as much as possible, use only articles taken from the bag
C. Put on an apron to protect her uniform and fold it with the right side out before putting it back into the bag.
D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the contaminated side is on the outside.
44. The public health conducts a study on the factors contributing to the high morality rate due to heart diseases in the municipality where she
works. Which branch of epidemiology does the nurse practice in this situation?
A. Descriptive
B. Analytical
C. Therapeutic
D. Evaluation
46. Which of the following is an epidemiologic function of the nurse during an epidemic?
49. In the investigation of an epidemic, you compare the present frequency of the disease with the usual frequency at this time of the year in this
community. This is done during which stage of the investigation?
50. The number of cases of Dengue fever usually increases towards the end of the rainy season. This pattern of occurrence of Dengue fever is
best described as;
A. Epidemic occurrence
B. Cyclical variation
C. Sporadic occurrence
D. Secular occurrence
51. In the year 1980, the World Health Organization declared the Philippines, together with some other countries in the Western Pacific Region,
“free” of which disease?
A. Pneumonic plaque
B. Poliomyelitis
C. Small pox
D. Anthrax
52. In the census of the Philippines in 1995, there were about 35,299,000 males and about 34,968,000 females. What is the sex ratio?
A. 99.06:100
B. 100.94:100
C. 50.23%
D. 49.76%
53. Primary health care is a total approach to community development. Which of the following is an indicator of success in the use of the primary
health care approach?
54. Sputum examination is the major screening tool for pulmonary tuberculosis. Clients would sometimes get false negative results in this exam.
This means that the test is not perfect in terms of which characteristic of a diagnostic examination?
A. Effectiveness
B. Efficacy
C. Specificity
D. Sensitivity
55. Use of appropriate technology requires knowledge of indigenous technology. Which medical herb is given for fever, headache and cough?
A. Sambong
B. Tsaang gubat
C. Akapulko
D. Lagundi
56. What law created the Philippine institute of Traditional and Alternative Health Care?
A. RA 8483
B. RA4823
C. RA 2483
D. RA 3482
57. In traditional Chinese medicine, the yielding, negative and feminine force is termed:
A. Yin
B. Yang
C. Qi
D. Chai
58. What is the legal basis of Primary Health Care approach in the Philippines?
60. The municipality assigned to you has a population of about 20/000. Estimate the number of 1-4 year old children who be given Retinol capsule
200.000 every 6 months.
A. 1,500
B. 1,800
C. 2,000
D. 2,300
61. Estimate the number of pregnant women who will be given tetanus toxoid during an immunization outreach activity in a barangay with a
population of about 1,500.
A. 265
B. 300
C. 375
D. 400
62. To describe the sex composition of the population, which demographic tool may be used?
A. Sex ratio
B. Sex proportion
C. Population pyramid
D. Any of these maybe used
64. You are computing the crude rate of your municipality, with a total population o about 18,000 for last year. There were 94 deaths. Among those
who died, 20 died because of diseases of the heart and 32 were aged 50 years or older. What is the crude death rate?
A. 4.1/1000
B. 5.2/1000
C. 6.3/1000
D. 7.3/1000
65. Knowing that malnutrition is a frequent community health problem, you decided to conduct nutritional assessment. What population is
particularly susceptible to protein energy malnutrition (PEM)?
66. Which statistic can give the most accurate reflection of the health status of a community?
67. In the past year, Barangay A had an average population of 1655. 46 babies were born in that year, 2 of whom died less than 4 weeks after they
were born. They were 4 recorded stillbirths. What is the neonatal mortality rate?
A. 27.8/1000
B. 43.5/1000
C. 86.9/1000
D. 130.4/1000
70. You will gather data for nutritional assessment of a purok. You will gather information only from families with members who belong to the target
population for PEM. What method of delta gathering is best for this purpose?
A. Census
B. Survey
C. Record Review
D. Review of civil registry
71. In the conduct of a census, the method of population assignment based on the actual physical location of the people is termed;
A. De jure
B. De locus
C. De facto
D. De novo
72. The Field Health Services and information System (FHSIS) is the recording and reporting system in public health) care in the Philippines. The
monthly field health service activity report is a form used in which of the components of the FHSIS?
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
73. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which component will be most useful?
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
74. Civil registries are important sources of data. Which law requires registration of births within 30 days from the occurrence of the birth?
A. PD 651
B. Act 3573
C. RA 3753
D. RA 3375
75. Which of the following professionals can sign the birth certificate?
76. Which criterion in priority setting of health problems is used only in community health care?
77. The Sentrong Sigla Movement has been launched to improve health service delivery. Which of the following is/are true of this movement?
78. Which of the following women should be considered as special targets for family planning?
A. Those who have two children or more
B. Those with medical conditions such as anemia
C. Those younger than 20 years and older than 35 years
D. Those who just had a delivery within the past 15 months
79. Freedom of choice in one of the policies of the Family Planning Program of the Philippines. Which of the following illustrates this principle?
80. A woman, 6 months pregnant, came to the center for consultation. Which of the following substances is contraindicated?
A. Tetanus toxoid
B. Retinol 200,000 IU
C. Ferrous sulfate 200mg
D. Potassium iodate 200 mg, capsule
81. During prenatal consultation, a client asked you if she can have her delivery at home. After history taking and physical examination, you
advised her against a home delivery. Which of the following findings disqualifies her for a home delivery?
82. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?
A. Niacin
B. Riboflavin
C. Folic Acid
D. Thiamine
83. You are in a client’s home to attend to a delivery. Which of the following will you do first?
84. In preparing a primigravida for breastfeeding, which of the following will you do?
A. Tell her that lactation begins within a day after delivery
B. Teach her nipple stretching exercises if her nipples are everted
C. Instruct her to wash her nipples before and after each breastfeeding
D. Explain to her that putting the baby to breast will lessen blood loss after delivery
85. A primigravida is instructed to offer her breast to the baby for the first time within 30 minutes after delivery. What is the purpose of offering the
breast this early?
86. In a mother’s class, you discuss proper breastfeeding technique. Which of these is a sign that the baby has “lactated on” the breast property?
87. You explain to a breastfeeding mother that breastmilk is sufficient for all of the baby’s nutrient needs only up to:
A. 3 months
B. 6 months
C. 1 year
D. 2 years
88. What is given to a woman within a month after the delivery of a baby?
A. Malunggay capsule
B. Ferrous sutfate l00mg O.D.
C. Retinol 200.000 IU 1 capsule
D. Potassium Iodate 200 mg, 1 capsule
A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine
90. Unused BCG should be discarded how many hours after reconstitution?
A. 2
B. 4
C. 6
D. At the end of the day
91. In immunity school entrants with BCG, you not obliged to secure parental consent. This is because of which legal document?
A. PD 996
B. RA 7864
C. Presidential Proclamation No. 6
D. Presidential Proclamation No. 46
A. DPT
B. BCG
C. Measles vaccination
D. Hepatitis B vaccination
93. A 4 week old baby was brought to the health center for his first immunization. Which can be given to him?
A. DPT1
B. OPV1
C. Infant BCG
D. Hepatitis B Vaccin
94. You will not give DPT 2 if the mother says that the infant had?
95. A 2-month old infant was brought to the health center for immunization. During assessment, the infant’s temperature registered at 38.1 C.
Which is the best course of action that you will take?
96. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her baby will have protection against tetanus for how long?
A. 1 year
B. 3 years
C. 10 years
D. Lifetime
97. A 4-month old infant was brought to the health center of cough. Her respiratory rate is 42/minute. Using the IMCI guidelines of assessment, her
breathing is considered;
A. Fast
B. Slow
C. Normal
D. Insignificant
98. Which of the following signs will indicate that a young child is suffering from severe pneumonia?
A. Dyspnea
B. Wheezing
C. Fast breathing
D. Chest indrawing
99. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best management for the child?
A. Prescribe antibiotic
B. Refer him urgently to the hospital
C. Instruct the mother to increase fluid intake
D. Instruct the mother to continue breastfeeding
100. A 5-month old infant was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes back
slowly after a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category?
A. No signs of dehydration
B. Some dehydration
C. Severe dehydration
D. The data is insufficient
101. Based on the assessment, you classified a 3-month old infant with the chief complaint of diarrhea in the category of SOME DEHYDRATION.
Based on the IMCI management guidelines, which of the following will you do?
A. Bring the infant to the nearest facility where IV fluids can be given
B. Supervise the mother in giving 200 to 400 ml of Oresol in 4 hours
C. Give the infant’s mother instructions on home management
D. Keep the infant in your health center for close observation
102. A mother is using Oresol’ in the management of diarrhea of her 3-year old child. She asked you what to do if her child vomits. You will tell her
to:
103. A 1 1/2 year old child was classified as having 3rd degree of protein energy malnutrition, kwashjorkor. Which of the following signs will be
most apparent in this child?
A. Voracious appetite
B. Wasting
C. Apathy
D. Edema
104. Assessment of a 2-year old child revealed “baggy pants”. Using the IMCI guidelines, how will you manage this child?
A. Refer the child urgently to a hospital for confinement
B. Coordinate with the social worker to enroll the child in a feeding program
C. Make a teaching plan for the mother, focusing on the menu planning for her child
D. Assess and treat the child for health problems like infections and intestinal parasitism
105. During the physical examination of a young child, what is the earliest sign of xerophthalmia that may observe?
A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis
106. To prevent xerophthalmia, young children are given Retinol capsule every 6 months. What is the dose given to preschoolers?
A. 10, 000 IU
B. 20, 000 IU
C. 100, 000 IU
D. 200, 000 IU
107. The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac
108. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. RA 8976 mandates fortification of certain food items.
Which of the following is among these food items?
A. Sugar
B. Bread
C. Margarine
D. Filled milk
109. What is the best course of action when there is a measles epidemic in a nearby municipality?
110. A mother brought her daughter, 4 years old, to the RHU because of cough and colds. Following the IMCI assessment guide, which of the
following is a danger sign that indicates the need for urgent referral to a hospital?
A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days
111. Management of a child with measles includes the administration of which of the following?
112. A mother brought her 10 month old infant for consultation because of fever which started 4 days prior to consultation. To determine malaria
risk, what will you do?
A. Do a tourniquet test
B. Ask where the family resides
C. Get a specimen for blood smear
D. Ask if the fever is present everyday
113. The following are strategies implemented by the DOH to prevent mosquito-borne diseases. Which of these is most effective in the control of
Dengue fever?
115. Scotch tape swab is done to check for which intestinal parasite?
A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma
116. Which of the following signs indicates the need for sputum examination for AFB?
A. Hematemesis
B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week
119. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of leprosy?
A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nose bridge
120. Which of the following clients should be classified as a case of mutibacillary leprosy?
121. In the Philippines, which condition is the most frequent cause of death associated by schistosomiasis?
A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation
122. What is the most effective way of controlling schistosomiasis in an endemic area?
A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots
123. When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is:
A. I
B. II
C. III
D. IV
124. For prevention of Hepatitis A, you decided to conduct health education activities. Which of the following is Irrelevant?
125. Which biological used in EPI should not be stored in the freezer?
A. DPT
B. OPV
C. Measles vaccine
D. MMR
126. You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
A. 45
B. 50
C. 55
D. 60
127. In IMCI, severe conditions generally require urgent referral to a hospital. Which of the following severe conditions Does not always require
urgent referral to hospital?
A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease.
128. A client was diagnosed as having Dengue Fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed
does not return within how many seconds?
A. 3
B. 5
C. 8
D. 10
129. A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test
result. In the absence of other signs, which of the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?
130. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the:
A. Nasal Mucosa
B. Buccal mucosa
C. Skin on the abdomen
D. Skin on the antecubital surface
A. Viral conjunctivitis
B. Acute poliomyelitis
C. Diphtheria
D. Measles
132. Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
A. Hemophilus Influenzae
B. Morbillivirus
C. Streptococcus Pneumoniae
D. Neisseria meningitides
133. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis
134. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis .
135. Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for
malaria control?
136. A 4-year old client was brought to the health center with chief complaint of severe diarrhea and the passage of “rice water”. The client is most
probably suffering from which condition?
A. Giardiasis
B. Cholera
C. Amebiasis
D. Dysentery
A. S. mansoni
B. S. japonicum
C. S. malayensis
D. S. haematobium
138. A 32 year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were
muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded
in flood waters about 2 weeks before the onset of symptoms. Based on this history/ which disease condition will you suspect?
A. Hepatitis A
B. Hepatitis B
C. Tetanus
D. Leptospirosis
139. MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?
A. I
B. II
C. III
D. IV
140. You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course
of action that you may take?
A. Get a thorough history of the client, focusing on the practice of high risk behavior
B. Ask the client to be accompanied by a significant person before revealing the result.
C. Refer the client to the physician since he is the best person to reveal the result to the client
D. Refer the client for a supplementary test, such as Western blot, since the ELISA result maybe false
142. The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic infections is
characterized by tonsilllopharyngitis?
A. Respiratory candidiasis
B. Infectious mononucleosis
C. Cytomegalovirus disease
D. Pneumocystis carinii pneumonia
143. To determine the possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health
nurse?
A. Contact tracing
B. Community survey
C. Mass screening tests
D. Interview suspects
144. Antiretroviral agents, such as AZT are used in the management of AIDS. Which of the following is not an action expected of these drugs?
145. A barangay had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to women in the
first trimester of pregnancy in the barangay?
1. Answer: (B) To enhance the capacity of individuals, families and communities to cope with their health needs.
To contribute to national development through promotion of family welfare, focusing particularly on mothers and children.
2. Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs and problems.
Community-based practice means providing care to people in their own natural environments: the home, school and workplace, for example.
8. Answer: (B) The statement is false; people pay indirectly for public health services.
Community health services, including public health services, are prepaid paid services, through taxation, for example.
9. Answer: (A) For people to attain their birthrights of health and longevity
According to Winslow, all public health efforts are for people to realize their birthrights of health and longevity.
13. Answer: (B) Ensure the accessibility and quality of health care
16. Answer: (B) Conducting random classroom inspection during a measles epidemic
Random classroom inspection is assessment of pupils/students and teachers for signs of a health problem prevalent in the community.
19. Answer: (C) To empower the people and promote their self-reliance
People empowerment is the basic motivation behind devolution of basic services to LGU’s.
27. Answer: (B) Health education and community organizing are necessary in providing community health services.
The community health nurse develops the health capability of people through health education and community organizing activities.
32. Answer: (D) To maximize the community’s resources in dealing with health problems
Community organizing is a developmental service, with the goal of developing the people’s self-reliance in dealing with community health
problems. A, B and C are objectives of contributory objectives to this goal.
33. Answer: (A) Participate in community activities for the solution of a community problem
Participation in community activities in resolving a community problem may be in any of the processes mentioned in the other choices.
40. Answer: (B) It provides an opportunity to do first hand appraisal of the home situation.
Choice A is not correct since a home visit requires that the nurse spend so much time with the family. Choice C is an advantage of a group
conference, while choice D is true of a clinic consultation.
41. Answer: (C) A home visit should be conducted in the manner prescribed by the RHU.
The home visit plan should be flexible and practical, depending on factors, such as the family’s needs and the resources available to the nurse and
the family.
42. Answer: (B) Should minimize if not totally prevent the spread of infection.
Bag technique is performed before and after handling a client in the home to prevent transmission of infection to and from the client.
43. Answer: (A) Wash his/her hands before and after providing nursing care to the family members.
Choice B goes against the idea of utilizing the family’s resources, which is encouraged in CHN. Choices C and D goes against the principle of
asepsis of confining the contaminated surface of objects.
45. Answer: (D) Evaluating the effectiveness of the implementation of the Integrated Management of Childhood Illness
Epidemiology is used in the assessment of a community or evaluation of interventions in community health practice.
46. Answer: (C) Participating in the investigation to determine the source of the epidemic
Epidemiology is the study of patterns of occurrence and distribution of disease in the community, as well as the factors that affect disease patterns.
The purpose of an epidemiologic investigation is to identify the source of an epidemic, i.e., what brought about the epidemic.
48. Answer: (D) There is a gradual build up of cases before the epidemic becomes easily noticeable.
A gradual or insidious onset of the epidemic is usually observable in person-to-person propagated epidemics.
53. Answer: (D) Health programs are sustained according to the level of development of the community.
Primary health care is essential health care that can be sustained in all stages of development of the community.
56. Answer: (A) R.A. 8423 or “AN ACT CREATING THE PHILIPPINE INSTITUTE OF TRADITIONAL AND ALTERNATIVE HEALTH CARE
(PITAHC) TO ACCELERATE THE DEVELOPMENT OF TRADITIONAL AND ALTERNATIVE HEALTH CARE IN THE PHILIPPINES, PROVIDING
FOR A TRADITIONAL AND ALTERNATIVE HEALTH CARE DEVELOPMENT FUND AND FOR OTHER PURPOSES” signed to a law on
December 9, 1997.
77. Answer: (D) Its main strategy is certification of health centers able to comply with standards.
Sentrong Sigla Movement is a joint project of the DOH and local government units. Its main strategy is certification of health centers that are able
to comply with standards set by the DOH.
78. Answer: (D) Those who just had a delivery within the past 15 months
The ideal birth spacing is at least two years. 15 months plus 9 months of pregnancy = 2 years.
79. Answer: (C) Adequate information for couples regarding the different methods
To enable the couple to choose freely among different methods of family planning, they must be given full information regarding the different
methods that are available to them, considering the availability of quality services that can support their choice.
83. Answer: (D) Note the interval, duration and intensity of labor contractions.
Assessment of the woman should be done first to determine whether she is having true labor and, if so, what stage of labor she is in.
84. Answer: (D) Explain to her that putting the baby to breast will lessen blood loss after delivery.
Suckling of the nipple stimulates the release of oxytocin by the posterior pituitary gland, which causes uterine contraction. Lactation begins 1 to 3
days after delivery. Nipple stretching exercises are done when the nipples are flat or inverted. Frequent washing dries up the nipples, making them
prone to the formation of fissures.
86. Answer: (B) The mother does not feel nipple pain.
When the baby has properly latched on to the breast, he takes deep, slow sucks; his mouth is wide open; and much of the areola is inside his
mouth. And, you’re right! The mother does not feel nipple pain.
101. Answer: (B) Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
In the IMCI management guidelines, SOME DEHYDRATION is treated with the administration of Oresol within a period of 4 hours. The amount of
Oresol is best computed on the basis of the child’s weight (75 ml/kg body weight). If the weight is unknown, the amount of Oresol is based on the
child’s age.
102. Answer: (D) Let the child rest for 10 minutes then continue giving Oresol more slowly.
If the child vomits persistently, that is, he vomits everything that he takes in, he has to be referred urgently to a hospital. Otherwise, vomiting is
managed by letting the child rest for 10 minutes and then continuing with Oresol administration. Teach the mother to give Oresol more slowly.
111. Answer: (D) Retinol capsule regardless of when the last dose was given
An infant 6 to 12 months classified as a case of measles is given Retinol 100,000 IU; a child is given 200,000 IU regardless of when the last dose
was given.
117. Answer: (D) Clients diagnosed for the first time through a positive sputum exam
Category I is for new clients diagnosed by sputum examination and clients diagnosed to have a serious form of extrapulmonary tuberculosis, such
as TB osteomyelitis.
118. Answer: (B) Having the health worker or a responsible family member monitor drug intake
Directly Observed Treatment Short Course is so-called because a treatment partner, preferably a health worker accessible to the client, monitors
the client’s compliance to the treatment.
129. Answer: (B) Instruct the mother to give the child Oresol.
Since the child does not manifest any other danger sign, maintenance of fluid balance and replacement of fluid loss may be done by giving the
client Oresol.
140. Answer: (D) Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.
A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A negative supplementary test result means that
the ELISA result was false and that, most probably, the client is not infected.
144. Answer: (D) They are able to bring about a cure of the disease condition.
There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic infections and prolong life, but does not cure the
underlying immunodeficiency.
145. Answer: (D) Consult a physician who may give them rubella immunoglobulin.
Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in pregnancy. Immune globulin, a specific prophylactic
against German measles, may be given to pregnant women.
1. May arrives at the health care clinic and tells the nurse that her last menstrual period was 9 weeks ago. She also tells the nurse that a home
pregnancy test was positive but she began to have mild cramps and is now having moderate vaginal bleeding. During the physical examination of
the client, the nurse notes that May has a dilated cervix. The nurse determines that May is experiencing which type of abortion?
Inevitable
Incomplete
Threatened
Septic
2. Nurse Reese is reviewing the record of a pregnant client for her first prenatal visit. Which of the following data, if noted on the client’s record,
would alert the nurse that the client is at risk for a spontaneous abortion?
Age 36 years
History of syphilis
History of genital herpes
History of diabetes mellitus
3. Nurse Hazel is preparing to care for a client who is newly admitted to the hospital with a possible diagnosis of ectopic pregnancy. Nurse Hazel
develops a plan of care for the client and determines that which of the following nursing actions is the priority?
Monitoring weight
Assessing for edema
Monitoring apical pulse
Monitoring temperature
4. Nurse Oliver is teaching a diabetic pregnant client about nutrition and insulin needs during pregnancy. The nurse determines that the client
understands dietary and insulin needs if the client states that the second half of pregnancy require:
Decreased caloric intake
Increased caloric intake
Decreased Insulin
Increase Insulin
5. Nurse Michelle is assessing a 24 year old client with a diagnosis of hydatidiform mole. She is aware that one of the following is unassociated
with this condition?
Excessive fetal activity.
Larger than normal uterus for gestational age.
Vaginal bleeding
Elevated levels of human chorionic gonadotropin.
6. A pregnant client is receiving magnesium sulfate for severe pregnancy induced hypertension (PIH). The clinical findings that would warrant use
of the antidote , calcium gluconate is:
Urinary output 90 cc in 2 hours.
Absent patellar reflexes.
Rapid respiratory rate above 40/min.
Rapid rise in blood pressure.
7. During vaginal examination of Janah who is in labor, the presenting part is at station plus two. Nurse, correctly interprets it as:
Presenting part is 2 cm above the plane of the ischial spines.
Biparietal diameter is at the level of the ischial spines.
Presenting part in 2 cm below the plane of the ischial spines.
Biparietal diameter is 2 cm above the ischial spines.
8. A pregnant client is receiving oxytocin (Pitocin) for induction of labor. A condition that warrant the nurse in-charge to discontinue I.V. infusion of
Pitocin is:
Contractions every 1 ½ minutes lasting 70-80 seconds.
Maternal temperature 101.2
Early decelerations in the fetal heart rate.
Fetal heart rate baseline 140-160 bpm.
9. Calcium gluconate is being administered to a client with pregnancy induced hypertension (PIH). A nursing action that must be initiated as the
plan of care throughout injection of the drug is:
Ventilator assistance
CVP readings
EKG tracings
Continuous CPR
10. A trial for vaginal delivery after an earlier caesareans, would likely to be given to a gravida, who had:
First low transverse cesarean was for active herpes type 2 infections; vaginal culture at 39 weeks pregnancy was positive.
First and second caesareans were for cephalopelvic disproportion.
First caesarean through a classic incision as a result of severe fetal distress.
First low transverse caesarean was for breech position. Fetus in this pregnancy is in a vertex presentation.
11.Nurse Ryan is aware that the best initial approach when trying to take a crying toddler’s temperature is:
Talk to the mother first and then to the toddler.
Bring extra help so it can be done quickly.
Encourage the mother to hold the child.
Ignore the crying and screaming.
12.Baby Tina a 3 month old infant just had a cleft lip and palate repair. What should the nurse do to prevent trauma to operative site?
Avoid touching the suture line, even when cleaning.
Place the baby in prone position.
Give the baby a pacifier.
Place the infant’s arms in soft elbow restraints.
13. Which action should nurse Marian include in the care plan for a 2 month old with heart failure?
Feed the infant when he cries.
Allow the infant to rest before feeding.
Bathe the infant and administer medications before feeding.
Weigh and bathe the infant before feeding.
14.Nurse Hazel is teaching a mother who plans to discontinue breast feeding after 5 months. The nurse should advise her to include which foods in
her infant’s diet?
Skim milk and baby food.
Whole milk and baby food.
Iron-rich formula only.
Iron-rich formula and baby food.
15.Mommy Linda is playing with her infant, who is sitting securely alone on the floor of the clinic. The mother hides a toy behind her back and the
infant looks for it. The nurse is aware that estimated age of the infant would be:
6 months
4 months
8 months
10 months
16.Which of the following is the most prominent feature of public health nursing?
It involves providing home care to sick people who are not confined in the hospital.
Services are provided free of charge to people within the catchments area.
The public health nurse functions as part of a team providing a public health nursing services.
Public health nursing focuses on preventive, not curative, services.
17.When the nurse determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating
Effectiveness
Efficiency
Adequacy
Appropriateness
18.Vangie is a new B.S.N. graduate. She wants to become a Public Health Nurse. Where should she apply?
Department of Health
Provincial Health Office
Regional Health Office
Rural Health Unit
19.Tony is aware the Chairman of the Municipal Health Board is:
Mayor
Municipal Health Officer
Public Health Nurse
Any qualified physician
20.Myra is the public health nurse in a municipality with a total population of about 20,000. There are 3 rural health midwives among the RHU
personnel. How many more midwife items will the RHU need?
1
2
3
The RHU does not need any more midwife item.
21.According to Freeman and Heinrich, community health nursing is a developmental service. Which of the following best illustrates this
statement?
The community health nurse continuously develops himself personally and professionally.
Health education and community organizing are necessary in providing community health services.
Community health nursing is intended primarily for health promotion and prevention and treatment of disease.
The goal of community health nursing is to provide nursing services to people in their own places of residence.
22.Nurse Tina is aware that the disease declared through Presidential Proclamation No. 4 as a target for eradication in the Philippines is?
Poliomyelitis
Measles
Rabies
Neonatal tetanus
23.May knows that the step in community organizing that involves training of potential leaders in the community is:
Integration
Community organization
Community study
Core group formation
24.Beth a public health nurse takes an active role in community participation. What is the primary goal of community organizing?
To educate the people regarding community health problems
To mobilize the people to resolve community health problems
To maximize the community’s resources in dealing with health problems.
To maximize the community’s resources in dealing with health problems.
25.Tertiary prevention is needed in which stage of the natural history of disease?
Pre-pathogenesis
Pathogenesis
Prodromal
Terminal
26.The nurse is caring for a primigravid client in the labor and delivery area. Which condition would place the client at risk for disseminated
intravascular coagulation (DIC)?
Intrauterine fetal death.
Placenta accreta.
Dysfunctional labor.
Premature rupture of the membranes.
27.A fullterm client is in labor. Nurse Betty is aware that the fetal heart rate would be:
80 to 100 beats/minute
100 to 120 beats/minute
120 to 160 beats/minute
160 to 180 beats/minute
28.The skin in the diaper area of a 7 month old infant is excoriated and red. Nurse Hazel should instruct the mother to:
Change the diaper more often.
Apply talc powder with diaper changes.
Wash the area vigorously with each diaper change.
Decrease the infant’s fluid intake to decrease saturating diapers.
29.Nurse Carla knows that the common cardiac anomalies in children with Down Syndrome (tri-somy 21) is:
Atrial septal defect
Pulmonic stenosis
Ventricular septal defect
Endocardial cushion defect
30.Malou was diagnosed with severe preeclampsia is now receiving I.V. magnesium sulfate. The adverse effects associated with magnesium
sulfate is:
Anemia
Decreased urine output
Hyperreflexia
Increased respiratory rate
31.A 23 year old client is having her menstrual period every 2 weeks that last for 1 week. This type of menstrual pattern is bets defined by:
Menorrhagia
Metrorrhagia
Dyspareunia
Amenorrhea
32. Jannah is admitted to the labor and delivery unit. The critical laboratory result for this client would be:
Oxygen saturation
Iron binding capacity
Blood typing
Serum Calcium
33.Nurse Gina is aware that the most common condition found during the second-trimester of pregnancy is:
Metabolic alkalosis
Respiratory acidosis
Mastitis
Physiologic anemia
34.Nurse Lynette is working in the triage area of an emergency department. She sees that several pediatric clients arrive simultaneously. The
client who needs to be treated first is:
A crying 5 year old child with a laceration on his scalp.
A 4 year old child with a barking coughs and flushed appearance.
A 3 year old child with Down syndrome who is pale and asleep in his mother’s arms.
A 2 year old infant with stridorous breath sounds, sitting up in his mother’s arms and drooling.
35.Maureen in her third trimester arrives at the emergency room with painless vaginal bleeding. Which of the following conditions is suspected?
Placenta previa
Abruptio placentae
Premature labor
Sexually transmitted disease
36.A young child named Richard is suspected of having pinworms. The community nurse collects a stool specimen to confirm the diagnosis. The
nurse should schedule the collection of this specimen for:
Just before bedtime
After the child has been bathe
Any time during the day
Early in the morning
37.In doing a child’s admission assessment, Nurse Betty should be alert to note which signs or symptoms of chronic lead poisoning?
Irritability and seizures
Dehydration and diarrhea
Bradycardia and hypotension
Petechiae and hematuria
38.To evaluate a woman’s understanding about the use of diaphragm for family planning, Nurse Trish asks her to explain how she will use the
appliance. Which response indicates a need for further health teaching?
“I should check the diaphragm carefully for holes every time I use it”
“I may need a different size of diaphragm if I gain or lose weight more than 20 pounds”
“The diaphragm must be left in place for atleast 6 hours after intercourse”
“I really need to use the diaphragm and jelly most during the middle of my menstrual cycle”.
39.Hypoxia is a common complication of laryngotracheobronchitis. Nurse Oliver should frequently assess a child with laryngotracheobronchitis for:
Drooling
Muffled voice
Restlessness
Low-grade fever
40.How should Nurse Michelle guide a child who is blind to walk to the playroom?
Without touching the child, talk continuously as the child walks down the hall.
Walk one step ahead, with the child’s hand on the nurse’s elbow.
Walk slightly behind, gently guiding the child forward.
Walk next to the child, holding the child’s hand.
41.When assessing a newborn diagnosed with ductus arteriosus, Nurse Olivia should expect that the child most likely would have an:
Loud, machinery-like murmur.
Bluish color to the lips.
Decreased BP reading in the upper extremities
Increased BP reading in the upper extremities.
42.The reason nurse May keeps the neonate in a neutral thermal environment is that when a newborn becomes too cool, the neonate requires:
Less oxygen, and the newborn’s metabolic rate increases.
More oxygen, and the newborn’s metabolic rate decreases.
More oxygen, and the newborn’s metabolic rate increases.
Less oxygen, and the newborn’s metabolic rate decreases.
43.Before adding potassium to an infant’s I.V. line, Nurse Ron must be sure to assess whether this infant has:
Stable blood pressure
Patant fontanelles
Moro’s reflex
Voided
44.Nurse Carla should know that the most common causative factor of dermatitis in infants and younger children is:
Baby oil
Baby lotion
Laundry detergent
Powder with cornstarch
45.During tube feeding, how far above an infant’s stomach should the nurse hold the syringe with formula?
6 inches
12 inches
18 inches
24 inches
46. In a mothers’ class, Nurse Lhynnete discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox
is correct?
The older one gets, the more susceptible he becomes to the complications of chicken pox.
A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
To prevent an outbreak in the community, quarantine may be imposed by health authorities.
Chicken pox vaccine is best given when there is an impending outbreak in the community.
47.Barangay Pinoy had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to women in the
first trimester of pregnancy in the barangay Pinoy?
Advice them on the signs of German measles.
Avoid crowded places, such as markets and movie houses.
Consult at the health center where rubella vaccine may be given.
Consult a physician who may give them rubella immunoglobulin.
48.Myrna a public health nurse knows that to determine possible sources of sexually transmitted infections, the BEST method that may be
undertaken is:
Contact tracing
Community survey
Mass screening tests
Interview of suspects
49.A 33-year old female client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms
were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he
waded in flood waters about 2 weeks before the onset of symptoms. Based on her history, which disease condition will you suspect?
Hepatitis A
Hepatitis B
Tetanus
Leptospirosis
50.Mickey a 3-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of “rice water” stools.
The client is most probably suffering from which condition?
Giardiasis
Cholera
Amebiasis
Dysentery
51.The most prevalent form of meningitis among children aged 2 months to 3 years is caused by which microorganism?
Hemophilus influenzae
Morbillivirus
Steptococcus pneumoniae
Neisseria meningitidis
52.The student nurse is aware that the pathognomonic sign of measles is Koplik’s spot and you may see Koplik’s spot by inspecting the:
Nasal mucosa
Buccal mucosa
Skin on the abdomen
Skin on neck
53.Angel was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed does
not return within how many seconds?
3 seconds
6 seconds
9 seconds
10 seconds
54.In Integrated Management of Childhood Illness, the nurse is aware that the severe conditions generally require urgent referral to a hospital.
Which of the following severe conditions DOES NOT always require urgent referral to a hospital?
Mastoiditis
Severe dehydration
Severe pneumonia
Severe febrile disease
55.Myrna a public health nurse will conduct outreach immunization in a barangay Masay with a population of about 1500. The estimated number of
infants in the barangay would be:
45 infants
50 infants
55 infants
65 infants
56.The community nurse is aware that the biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?
DPT
Oral polio vaccine
Measles vaccine
MMR
57.It is the most effective way of controlling schistosomiasis in an endemic area?
Use of molluscicides
Building of foot bridges
Proper use of sanitary toilets
Use of protective footwear, such as rubber boots
58.Several clients is newly admitted and diagnosed with leprosy. Which of the following clients should be classified as a case of multibacillary
leprosy?
3 skin lesions, negative slit skin smear
3 skin lesions, positive slit skin smear
5 skin lesions, negative slit skin smear
5 skin lesions, positive slit skin smear
59.Nurses are aware that diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of leprosy?
Macular lesions
Inability to close eyelids
Thickened painful nerves
Sinking of the nosebridge
60.Marie brought her 10 month old infant for consultation because of fever, started 4 days prior to consultation. In determining malaria risk, what
will you do?
Perform a tourniquet test.
Ask where the family resides.
Get a specimen for blood smear.
Ask if the fever is present everyday.
61.Susie brought her 4 years old daughter to the RHU because of cough and colds. Following the IMCI assessment guide, which of the following is
a danger sign that indicates the need for urgent referral to a hospital?
Inability to drink
High grade fever
Signs of severe dehydration
Cough for more than 30 days
62.Jimmy a 2-year old child revealed “baggy pants”. As a nurse, using the IMCI guidelines, how will you manage Jimmy?
Refer the child urgently to a hospital for confinement.
Coordinate with the social worker to enroll the child in a feeding program.
Make a teaching plan for the mother, focusing on menu planning for her child.
Assess and treat the child for health problems like infections and intestinal parasitism.
63.Gina is using Oresol in the management of diarrhea of her 3-year old child. She asked you what to do if her child vomits. As a nurse you will tell
her to:
Bring the child to the nearest hospital for further assessment.
Bring the child to the health center for intravenous fluid therapy.
Bring the child to the health center for assessment by the physician.
Let the child rest for 10 minutes then continue giving Oresol more slowly.
64.Nikki a 5-month old infant was brought by his mother to the health center because of diarrhea for 4 to 5 times a day. Her skin goes back slowly
after a skin pinch and her eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category?
No signs of dehydration
Some dehydration
Severe dehydration
The data is insufficient.
65.Chris a 4-month old infant was brought by her mother to the health center because of cough. His respiratory rate is 42/minute. Using the
Integrated Management of Child Illness (IMCI) guidelines of assessment, his breathing is considered as:
Fast
Slow
Normal
Insignificant
66.Maylene had just received her 4th dose of tetanus toxoid. She is aware that her baby will have protection against tetanus for
1 year
3 years
5 years
Lifetime
67.Nurse Ron is aware that unused BCG should be discarded after how many hours of reconstitution?
2 hours
4 hours
8 hours
At the end of the day
68.The nurse explains to a breastfeeding mother that breast milk is sufficient for all of the baby’s nutrient needs only up to:
5 months
6 months
1 year
2 years
69.Nurse Ron is aware that the gestational age of a conceptus that is considered viable (able to live outside the womb) is:
8 weeks
12 weeks
24 weeks
32 weeks
70.When teaching parents of a neonate the proper position for the neonate’s sleep, the nurse Patricia stresses the importance of placing the
neonate on his back to reduce the risk of which of the following?
Aspiration
Sudden infant death syndrome (SIDS)
Suffocation
Gastroesophageal reflux (GER)
71.Which finding might be seen in baby James a neonate suspected of having an infection?
Flushed cheeks
Increased temperature
Decreased temperature
Increased activity level
72.Baby Jenny who is small-for-gestation is at increased risk during the transitional period for which complication?
Anemia probably due to chronic fetal hyposia
Hyperthermia due to decreased glycogen stores
Hyperglycemia due to decreased glycogen stores
Polycythemia probably due to chronic fetal hypoxia
73.Marjorie has just given birth at 42 weeks’ gestation. When the nurse assessing the neonate, which physical finding is expected?
A sleepy, lethargic baby
Lanugo covering the body
Desquamation of the epidermis
Vernix caseosa covering the body
74.After reviewing the Myrna’s maternal history of magnesium sulfate during labor, which condition would nurse Richard anticipate as a potential
problem in the neonate?
Hypoglycemia
Jitteriness
Respiratory depression
Tachycardia
75.Which symptom would indicate the Baby Alexandra was adapting appropriately to extra-uterine life without difficulty?
Nasal flaring
Light audible grunting
Respiratory rate 40 to 60 breaths/minute
Respiratory rate 60 to 80 breaths/minute
76. When teaching umbilical cord care for Jennifer a new mother, the nurse Jenny would include which information?
Apply peroxide to the cord with each diaper change
Cover the cord with petroleum jelly after bathing
Keep the cord dry and open to air
Wash the cord with soap and water each day during a tub bath.
77.Nurse John is performing an assessment on a neonate. Which of the following findings is considered common in the healthy neonate?
Simian crease
Conjunctival hemorrhage
Cystic hygroma
Bulging fontanelle
78.Dr. Esteves decides to artificially rupture the membranes of a mother who is on labor. Following this procedure, the nurse Hazel checks the fetal
heart tones for which the following reasons?
To determine fetal well-being.
To assess for prolapsed cord
To assess fetal position
To prepare for an imminent delivery.
79.Which of the following would be least likely to indicate anticipated bonding behaviors by new parents?
The parents’ willingness to touch and hold the new born.
The parent’s expression of interest about the size of the new born.
The parents’ indication that they want to see the newborn.
The parents’ interactions with each other.
80.Following a precipitous delivery, examination of the client’s vagina reveals
a fourth-degree laceration. Which of the following would be contraindicated when caring for this client?
Applying cold to limit edema during the first 12 to 24 hours.
Instructing the client to use two or more peripads to cushion the area.
Instructing the client on the use of sitz baths if ordered.
Instructing the client about the importance of perineal (kegel) exercises.
81. A pregnant woman accompanied by her husband, seeks admission to the labor and delivery area. She states that she’s in labor and says she
attended the facility clinic for prenatal care. Which question should the nurse Oliver ask her first?
“Do you have any chronic illnesses?”
“Do you have any allergies?”
“What is your expected due date?”
“Who will be with you during labor?”
82.A neonate begins to gag and turns a dusky color. What should the nurse do first?
Calm the neonate.
Notify the physician.
Provide oxygen via face mask as ordered
Aspirate the neonate’s nose and mouth with a bulb syringe.
83. When a client states that her “water broke,” which of the following actions would be inappropriate for the nurse to do?
Observing the pooling of straw-colored fluid.
Checking vaginal discharge with nitrazine paper.
Conducting a bedside ultrasound for an amniotic fluid index.
Observing for flakes of vernix in the vaginal discharge.
84. A baby girl is born 8 weeks premature. At birth, she has no spontaneous respirations but is successfully resuscitated. Within several hours she
develops respiratory grunting, cyanosis, tachypnea, nasal flaring, and retractions. She’s diagnosed with respiratory distress syndrome, intubated,
and placed on a ventilator. Which nursing action should be included in the baby’s plan of care to prevent retinopathy of prematurity?
Cover his eyes while receiving oxygen.
Keep her body temperature low.
Monitor partial pressure of oxygen (Pao2) levels.
Humidify the oxygen.
85. Which of the following is normal newborn calorie intake?
110 to 130 calories per kg.
30 to 40 calories per lb of body weight.
At least 2 ml per feeding
90 to 100 calories per kg
86. Nurse John is knowledgeable that usually individual twins will grow appropriately and at the same rate as singletons until how many weeks?
16 to 18 weeks
18 to 22 weeks
30 to 32 weeks
38 to 40 weeks
87. Which of the following classifications applies to monozygotic twins for whom the cleavage of the fertilized ovum occurs more than 13 days after
fertilization?
conjoined twins
diamniotic dichorionic twins
diamniotic monochorionic twin
monoamniotic monochorionic twins
88. Tyra experienced painless vaginal bleeding has just been diagnosed as having a placenta previa. Which of the following procedures is usually
performed to diagnose placenta previa?
Amniocentesis
Digital or speculum examination
External fetal monitoring
Ultrasound
89. Nurse Arnold knows that the following changes in respiratory functioning during pregnancy is considered normal:
Increased tidal volume
Increased expiratory volume
Decreased inspiratory capacity
Decreased oxygen consumption
90. Emily has gestational diabetes and it is usually managed by which of the following therapy?
Diet
Long-acting insulin
Oral hypoglycemic
Oral hypoglycemic drug and insulin
91. Magnesium sulfate is given to Jemma with preeclampsia to prevent which of the following condition?
Hemorrhage
Hypertension
Hypomagnesemia
Seizure
92. Cammile with sickle cell anemia has an increased risk for having a sickle cell crisis during pregnancy. Aggressive management of a sickle cell
crisis includes which of the following measures?
Antihypertensive agents
Diuretic agents
I.V. fluids
Acetaminophen (Tylenol) for pain
93. Which of the following drugs is the antidote for magnesium toxicity?
Calcium gluconate (Kalcinate)
Hydralazine (Apresoline)
Naloxone (Narcan)
Rho (D) immune globulin (RhoGAM)
94. Marlyn is screened for tuberculosis during her first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin
bacilli is given. She is considered to have a positive test for which of the following results?
An indurated wheal under 10 mm in diameter appears in 6 to 12 hours.
An indurated wheal over 10 mm in diameter appears in 48 to 72 hours.
A flat circumcised area under 10 mm in diameter appears in 6 to 12 hours.
A flat circumcised area over 10 mm in diameter appears in 48 to 72 hours.
95. Dianne, 24 year-old is 27 weeks’ pregnant arrives at her physician’s office with complaints of fever, nausea, vomiting, malaise, unilateral flank
pain, and costovertebral angle tenderness. Which of the following diagnoses is most likely?
Asymptomatic bacteriuria
Bacterial vaginosis
Pyelonephritis
Urinary tract infection (UTI)
96. Rh isoimmunization in a pregnant client develops during which of the following conditions?
Rh-positive maternal blood crosses into fetal blood, stimulating fetal antibodies.
Rh-positive fetal blood crosses into maternal blood, stimulating maternal antibodies.
Rh-negative fetal blood crosses into maternal blood, stimulating maternal antibodies.
Rh-negative maternal blood crosses into fetal blood, stimulating fetal antibodies.
97. To promote comfort during labor, the nurse John advises a client to assume certain positions and avoid others. Which position may cause
maternal hypotension and fetal hypoxia?
Lateral position
Squatting position
Supine position
Standing position
98. Celeste who used heroin during her pregnancy delivers a neonate. When assessing the neonate, the nurse Lhynnette expects to find:
Lethargy 2 days after birth.
Irritability and poor sucking.
A flattened nose, small eyes, and thin lips.
Congenital defects such as limb anomalies.
99. The uterus returns to the pelvic cavity in which of the following time frames?
7th to 9th day postpartum.
2 weeks postpartum.
End of 6th week postpartum.
When the lochia changes to alba.
100. Maureen, a primigravida client, age 20, has just completed a difficult, forceps-assisted delivery of twins. Her labor was unusually long and
required oxytocin (Pitocin) augmentation. The nurse who’s caring for her should stay alert for:
Uterine inversion
Uterine atony
Uterine involution
Uterine discomfort
1. A pregnant woman who is at term is admitted to the birthing unit in active labor. The client has only progressed from 2cm to 3 cm in 8 hours. She
is diagnosed with hypotonic dystocia and the physician ordered Oxytocin (Pitocin) to augment her contractions. Which of the following is the most
important aspect of nursing intervention at this time?
Abruption placenta.
Caput succedaneum.
Pathological hyperbilirubinemia.
Umbilical cord prolapse.
9. The nurse is caring to a client diagnosed with severe depression. Which of the following nursing approach is important in depression?
Sit up.
Pick up and hold a rattle.
Roll over.
Hold the head up.
11. The physician calls the nursing unit to leave an order. The senior nurse had conversation with the other staff. The newly hired nurse answers
the phone so that the senior nurses may continue their conversation. The new nurse does not knowthe physician or the client to whom the order
pertains. The nurse should:
Ask the physician to call back after the nurse has read the hospital policy manual.
Take the telephone order.
Refuse to take the telephone order.
Ask the charge nurse or one of the other senior staff nurses to take the telephone order.
12. The staff nurse on the labor and delivery unit is assigned to care to a primigravida in transition complicated by hypertension. A new pregnant
woman in active labor is admitted in the same unit. The nurse manager assigned the same nurse to the second client. The nurse feels that the
client with hypertension requires one-to-one care. What would be the initial actionof the nurse?
Accept the new assignment and complete an incident report describing a shortage of nursing staff.
Report the incident to the nursing supervisor and request to be floated.
Report the nursing assessment of the client in transitional labor to the nurse manager and discuss misgivings about the new assignment.
Accept the new assignment and provide the best care.
13. A newborn infant with Down syndrome is to be discharged today. The nurse is preparing to give the discharge teaching regarding the proper
care at home. The nurse would anticipate that the mother is probably at the:
40 years of age.
20 years of age.
35 years of age.
20 years of age.
14. The emergency department has shortage of staff. The nurse manager informs the staff nurse in the critical care unit that she has to float to the
emergency department. What should the staff nurse expect under these conditions?
The float staff nurse will be informed of the situation before the shift begins.
The staff nurse will be able to negotiate the assignments in the emergency department.
Cross training will be available for the staff nurse.
Client assignments will be equally divided among the nurses.
15. The nurse is assigned to care for a child client admitted in the pediatrics unit. The client is receiving digoxin. Which of the following questions
will be asked by the nurse to the parents of the child in order to assess the client’s risk for digoxin toxicity?
“Has he been exposed to any childhood communicable diseases in the past 2-3 weeks?”
“Has he been taking diuretics at home?”
“Do any of his brothers and sisters have history of cardiac problems?”
“Has he been going to school regularly?”
16. The nurse noticed that the signed consent form has an error. The form states, “Amputation of the right leg” instead of the left leg that is to be
amputated. The nurse has administered already the preoperative medications. What should the nurse do?
Determine who is responsible for the mistake and terminate his or her employment.
Record the event in an incident/variance report and notify the nursing supervisor.
Reassure both mothers, report to the charge nurse, and do not record.
Record detailed notes of the event on the mother’s medical record.
19. Before the administration of digoxin, the nurse completes an assessment to a toddler client for signs and symptoms of digoxin toxicity. Which of
the following is the earliest and most significant sign of digoxin toxicity?
Tinnitus
Nausea and vomiting
Vision problem
Slowing in the heart rate
20. Which of the following treatment modality is appropriate for a client with paranoid tendency?
Activity therapy.
Individual therapy.
Group therapy.
Family therapy.
21. The client with rheumatoid arthritis is for discharge. In preparing the client for discharge on prednisone therapy, the nurse should advise the
client to:
“Try using Kegel (perineal) exercises and limiting fluids before bedtime. If you have frequency associated with fever, pain on voiding, or blood in
the urine, call your doctor/nurse-midwife.
“Placental progesterone causes irritability of the bladder sphincter. Your symptoms will go away after the baby comes.”
“Pregnant women urinate frequently to get rid of fetal wastes. Limit fluids to 1L/daily.”
“Frequency is due to bladder irritation from concentrate urine and is normal in pregnancy. Increase your daily fluid intake to 3L.”
23. Which of the following will help the nurse determine that the expression of hostility is useful?
Main objective is a written plan that combines discipline-specific processes used to measure outcomes of care.
Main purpose is to identify expected client, family and staff performance against the timeline for clients with the same diagnosis.
Main focus is comprehensive coordination of client care, avoid unnecessary duplication of services, improve resource utilization and decrease cost.
Primary goal is to understand why predicted outcomes have not been met and the correction of identified problems.
25. The physician orders a dose of IV phenytoin to a child client. In preparing in the administration of the drug, which nursing action is not correct?
Infuse the phenytoin into a smaller vein to prevent purple glove syndrome.
Check the phenytoin solution to be sure it is clear or light yellow in color, never cloudy.
Plan to give phenytoin over 30-60 minutes, using an in-line filter.
Flush the IV tubing with normal saline before starting phenytoin.
26. The pregnant woman visits the clinic for check –up. Which assessment findings will help the nurse determine that the client is in 8-week
gestation?
Leopold maneuvers.
Fundal height.
Positive radioimmunoassay test (RIA test).
Auscultation of fetal heart tones.
27. Which of the following nursing intervention is essential for the client who had pneumonectomy?
Each member of the team can independently make decisions regarding the client’s care without necessarily consulting the other members.
The physician makes most of the decisions regarding the client’s care.
The team uses the expertise of its members to influence the decisions regarding the client’s care.
Nurses decide nursing care; physicians decide medical and other treatment for the client.
31. A nurse is giving a health teaching to a woman who wants to breastfeed her newborn baby. Which hormone, normally secreted during the
postpartum period, influences both the milk ejection reflex and uterine involution?
Oxytocin.
Estrogen.
Progesterone.
Relaxin.
32. One staff nurse is assigned to a group of 5 patients for the 12-hour shift. The nurse is responsible for the overall planning, giving and evaluating
care during the entire shift. After the shift, same responsibility will be endorsed to the next nurse in charge. This describes nursing care delivered
via the:
Ovum viability.
Tubal motility.
Spermatozoal viability.
Secretory endometrium.
35. An older adult client wakes up at 2 o’clock in the morning and comes to the nurse’s station saying, “I am having difficulty in sleeping.” What is
the best nursing response to the client?
“I’ll give you a sleeping pill to help you get more sleep now.”
“Perhaps you’d like to sit here at the nurse’s station for a while.”
“Would you like me to show you where the bathroom is?”
“What woke you up?”
36. The nurse is taking care of a multipara who is at 42 weeks of gestation and in active labor, her membranes ruptured spontaneously 2 hours
ago. While auscultating for the point of maximum intensity of fetal heart tones before applying an external fetal monitor, the nurse counts 100 beats
per minute. The immediate nursing action is to:
Antihistamines.
NSAIDs.
Antacids.
Salicylates.
38. A male client is brought to the emergency department due to motor vehicle accident. While monitoring the client, the nurse suspects increasing
intracranial pressure when:
Client is oriented when aroused from sleep, and goes back to sleep immediately.
Blood pressure is decreased from 160/90 to 110/70.
Client refuses dinner because of anorexia.
Pulse is increased from 88-96 with occasional skipped beat.
39. The nurse is conducting a lecture to a class of nursing students about advance directives to preoperative clients. Which of the following
statement by the nurse js correct?
“The spouse, but not the rest of the family, may override the advance directive.”
“An advance directive is required for a “do not resuscitate” order.”
“A durable power of attorney, a form of advance directive, may only be held by a blood relative.”
“The advance directive may be enforced even in the face of opposition by the spouse.”
40. A client diagnosed with schizophrenia is shouting and banging on the door leading to the outside, saying, “I need to go to an appointment.”
What is the appropriate nursing intervention?
Suture set.
Tracheostomy set.
Suction equipment.
Wire cutters.
43. A mother is in the third stage of labor. Which of the following signs will help the nurse determine the signs of placental separation?
3+ peripheral pulses.
Change in level of consciousness and headache.
Occasional dysrhythmias.
Heart rate of 100/bpm.
45. A client who undergone left nephrectomy has a large flank incision. Which of the following nursing action will facilitate deep breathing and
coughing?
Absence of ferning.
Thin, clear, good spinnbarkeit.
Thick, cloudy.
Yellow and sticky.
47. A client with ruptured appendix had surgery an hour ago and is transferred to the nursing care unit. The nurse placed the client in a semi-
Fowler’s position primarily to:
Icterus neonatorum
Multiple hemangiomas
Erythema toxicum
Milia
52. The client is brought to the emergency department because of serious vehicle accident. After an hour, the client has been declared brain dead.
The nurse who has been with the client must now talk to the family about organ donation. Which of the following consideration is necessary?
Stand with legs apart and touch hands to floor three times per day.
Ten minutes of walking per day with an emphasis on good posture.
Ten minutes of swimming or leg kicking in pool per day.
Pelvic rock exercise and squats three times a day.
54. A client with obsessive-compulsive behavior is admitted in the psychiatric unit. The nurse taking care of the client knows that the primary
treatment goal is to:
Provide distraction.
Support but limit the behavior.
Prohibit the behavior.
Point out the behavior.
55. After ileostomy, the nurse expects that the drainage appliance will be applied to the stoma:
It is impossible to determine the fertile period reliably. So it is best to assume that a woman is always fertile.
In a 28-day cycle, ovulation occurs at or about day 14. The egg lives for about 24 hours and the sperm live for about 72 hours. The fertile period
would be approximately between day 11 and day 15.
In a 28- day cycle, ovulation occurs at or about day 14. The egg lives for about 72 hours and the sperm live for about 24 hours. The fertile period
would be approximately between day 13 and 17.
In a 28-day cycle, ovulation occurs 8 days before the next period or at about day 20. The fertile period is between day 20 and the beginning of the
next period.
57. Which of the following statement describes the role of a nurse as a client advocate?
Intellectualization.
Suppression.
Repression.
Denial.
61. Which of the following situations cannot be delegated by the registered nurse to the nursing assistant?
Collect a specimen at the clinic, place in iced container, and give to laboratory personnel immediately.
Collect specimen after 48-72 hours of abstinence and bring to clinic within 2 hours.
Collect specimen in the morning after 24 hours of abstinence and bring to clinic immediately.
Collect specimen at night, refrigerate, and bring to clinic the next morning.
64. The physician ordered Betamethasone to a pregnant woman at 34 weeks of gestation with sign of preterm labor. The nurse expects that the
drug will:
Treat infection.
Suppress labor contraction.
Stimulate the production of surfactant.
Reduce the risk of hypertension.
65. A tracheostomy cuff is to be deflated, which of the following nursing intervention should be implemented before starting the procedures?
Gloves are worn when handling the client’s tissue, excretions, and linen.
Both client and attending nurse must wear masks at all times.
Nurse and visitors must wear masks until chemotherapy is begun. Client is instructed in cough and tissue techniques.
Full isolation; that is, caps and gowns are required during the period of contagion.
67. A client with lung cancer is admitted in the nursing care unit. The husband wants to know the condition of his wife. How should the nurse
respond to the husband?
A telephone call notifying the school nurse that the child’ pediatrician has informed the mother that the child will need cardiac repair surgery within
the next few weeks.
A telephone call notifying the school nurse that the child’s pediatrician has informed the mother that the child has head lice.
A telephone call notifying the school nurse that a child has a temperature of 102ºF and a rash covering the trunk and upper extremities of the body.
A telephone call notifying the school nurse that a child underwent an emergency appendectomy during the previous night.
71. Which of the following signs and symptoms that require immediate attention and may indicate most serious complications during pregnancy?
The symptoms of a somatoform disorder are an attempt to adjust to painful life situations or to cope with conflicting sexual, aggressive, or
dependent feelings.
The major fundamental mechanism is regression.
The client’s symptoms are imaginary and the suffering is faked.
An extensive, prolonged study of the symptoms will be reassuring to the client, who seeks sympathy, attention and love.
74. An infant is brought to the health care clinic for three immunizations at the same time. The nurse knows that hepatitis B, DPT, and
Haemophilus influenzae type B immunizations should:
Flat in bed.
On the side only.
With the foot of the bed elevated.
With the head elevated 45-degrees (semi-Fowler’s).
76. The nurse wants to know if the mother of a toddler understands the instructions regarding the administration of syrup of ipecac. Which of the
following statement will help the nurse to know that the mother needs additional teaching?
“I’ll give the medicine if my child gets into some toilet bowl cleaner.”
“I’ll give the medicine if my child gets into some aspirin.”
“I’ll give the medicine if my child gets into some plant bulbs.”
“I’ll give the medicine if my child gets into some vitamin pills.”
77. To assess if the cranial nerve VII of the client was damaged, which changes would not be expected?
“it is no unusual to take 6-12 months to get pregnant, especially when the partners are in their mid-30s. Eat well, exercise, and avoid stress.”
“Start planning adoption. Many couples get pregnant when they are trying to adopt.”
“Consult a fertility specialist and start testing before you get any older.”
“Have sex as often as you can, especially around the time of ovulation, to increase your chances of pregnancy.”
82. The nurse is caring for a cient who Is a retired nurse. A 24-hour urine collection for Creatinine clearance is to be done. The client tells the
nurse, “I can’t remember what this test is for.” The best response by the nurse is:
“It provides a way to see if you are passing any protein in your urine.”
“It tells how well the kidneys filter wastes from the blood.”
“It tells if your renal insufficiency has affected your heart.”
“The test measures the number of particles the kidney filters.”
83. The nurse observes the female client in the psychiatric ward that she is having a hard time sleeping at night. The nurse asks the client about it
and the client says, “I can’t sleep at night because of fear of dying.” What is the best initial nursing response?
“It must be frightening for you to feel that way. Tell me more about it.”
“Don’t worry, you won’t die. You are just here for some test.”
“Why are you afraid of dying?”
“Try to sleep. You need the rest before tomorrow’s test.”
84. In the hospital lobby, the registered nurse overhears a two staff members discussing about the health condition of her client. What would be the
appropriate action for the registered nurse to take?
A toy gun.
A stuffed animal.
A ball.
Legos.
87. The LPN/LVN asks the registered nurse why oxytocin (Pitocin), 10 units (IV or IM) must be given to a client after birth fo the fetus. The nurse is
correct to explain that oxytocin:
1g
500 mg
250 mg
125 mg
90. The nurse is completing an obstetric history of a woman in labor. Which event in the obstetric history will help the nurse suspects dysfunctional
labor in the current pregnancy?
Total time of ruptured membranes was 24 hours with the second birth.
First labor lasting 24 hours.
Uterine fibroid noted at time of cesarean delivery.
Second birth by cesarean for face presentation.
91. The nurse is planning to talk to the client with an antisocial personality disorder. What would be the most therapeutic approach?
Begin with questions about client care assignments, advancement opportunities, and continuing education.
Decline to ask questions, because that is the responsibility of the interviewer.
Ask as many questions about the facility as possible.
Clarify information regarding salary, benefits, and working hours first, because this will help in deciding whether or not to take the job.
94. The nurse advised the pregnant woman that smoking and alcohol should be avoided during pregnancy. The nurse takes into account that the
developing fetus is most vulnerable to environment teratogens that cause malformation during:
Silence.
“Where’s the bug? I’ll kill it for you.”
“I don’t see a bug in your bed, but you seem afraid.”
“You must be seeing things.”
96. A pregnant client in late pregnancy is complaining of groin pain that seems worse on the right side. Which of the following is the most likely
cause of it?
Beginning of labor.
Bladder infection.
Constipation.
Tension on the round ligament.
97. The nurse is conducting a lecture to a group of volunteer nurses. The nurse is correct in imparting the idea that the Good Samaritan law
protects the nurse from a suit for malpractice when:
The nurse stops to render emergency aid and leaves before the ambulance arrives.
The nurse acts in an emergency at his or her place of employment.
The nurse refuses to stop for an emergency outside of the scope of employment.
The nurse is grossly negligent at the scene of an emergency.
98. A woman is hospitalized with mild preeclampsia. The nurse is formulating a plan of care for this client, which nursing care is least likely to be
done?
Panic reaction.
Medication overdose.
Toxic reaction to an antibiotic.
Delirium tremens.
Answers and Rationales
A. The oxytocic effect of Pitocin increases the intensity and durations of contractions; prolonged contractions will jeopardize the safetyof the fetus
and necessitate discontinuing the drug.
B. It is of paramount importance to prevent the client from hurting himself or herself or others.
B. After tonsillectomy, clear, cool liquids should be given. Citrus, carbonated, and hot or cold liquids should be avoided because they may irritate
the throat. Red liquids should be avoided because they give the appearance of blood if the child vomits. Milk and milk products including pudding
are avoided because they coat the throat, cause the child to clear the throat, and increase the risk of bleeding.
A. Phenylephrine, with frequent and continued use, can cause rebound congestion of mucous membranes.
B. The N 95 respirator is a high-particulate filtration mask that meets the CDC performance criteria for a tuberculosis respirator.
C. The most frequent cause of noncompliance to the treatment of chronic, or open-angle glaucoma is the miotic effects of pilocarpine. Pupillary
constriction impedes normal accommodation, making night driving difficult and hazardous, reducing the client’s ability to read for extended periods
and making participation in games with fast-moving objects impossible.
B. This stops the sucking of air through the tube and prevents the entry of contaminants. In addition, clamping near the chest wall provides for
some stability and may prevent the clamp from pulling on the chest tube.
D. Because umbilical cord’s insertion site is born before the fetal head, the cord may be compressed by the after-coming head in a breech birth.
B. It is important to externalize the anger away from self.
D. Development normally proceeds cephalocaudally; so the first major developmental milestone that the infant achieves is the ability to hold the
head up within the first 8-12 weeks of life. In hypothyroidism, the infant’s muscle tone would be poor and the infant would not be able to achieve
this milestone.
D. Get a senior nurse who know s the policies, the client, and the doctor. Generally speaking, a nurse should not accept telephone orders.
However, if it is necessary to take one, follow the hospital’s policy regarding telephone orders. Failure to followhospital policy could be considered
negligence. In this case, the nurse was new and did not know the hospital’s policy concerning telephone orders. The nurse was also unfamiliar with
the doctor and the client. Therefore the nurse should not take the order unless a) no one else is available and b) it is an emergency situation.
C. The nurse is obligated to inform the nurse manager about changes in the condition of the client, which may change the decision made by the
nurse manager.
A. Perinatal risk factors for the development of Down syndrome include advanced maternal age, especially with the first pregnancy.
B. Assignments should be based on scope of practice and expertise.
B. The child who is concurrently taking digoxin and diuretics is at increased risk for digoxin toxicity due to the loss of potassium. The child and
parents should be taught what foods are high in potassium, and the child should be encouraged to eat a high-potassium diet. In addition, the child’s
serum potassium level should be carefully monitored.
A. The responsible for an accurate informed consent is the physician. An exception to this answer would be a life-threatening emergency, but there
are no data to support another response.
D. Asking the client to cough and take a deep breath will help determine if the chest tube is kinked or if the lungs has reexpanded.
B. Every event that exposes a client to harm should be recorded in an incident report, as well as reported to the appropriate supervisors in order to
resolve the current problems and permit the institution to prevent the problem from happening again.
D. One of the earliest signs of digoxin toxicity is Bradycardia. For a toddler, any heart rate that falls below the norm of about 100-120 bpm would
indicate Bradycardia and would necessitate holding the medication and notifying the physician.
B. This option is least threatening.
D. In preparing the client for discharge that is receiving prednisone, the nurse should caution the client to (a) take oral preparations after meals; (b)
remember that routine checks of vital signs, weight, and lab studies are critical; (c) NEVER STOP OR CHANGE THE AMOUNT OF MEDICATION
WITHOUT MEDICAL ADVICE; (d) store the medication in a light-resistant container.
A. Progesterone also reduces smooth muscle motility in the urinary tract and predisposes the pregnant woman to urinary tract infections. Women
should contact their doctors if they exhibit signs of infection. Kegel exercise will help strengthen the perineal muscles; limiting fluids at bedtime
reduces the possibility of being awakened by the necessity of voiding.
B. This is the proper use of anger.
C. There are several models of case management, but the commonality is comprehensive coordination of care to better predict needs of high-risk
clients, decrease exacerbations and continually monitor progress overtime.
A. Phenytoin should be infused or injected into larger veins to avoid the discoloration know as purple glove syndrome; infusing into a smaller vein is
not appropriate.
C. Serum radioimmunoassay (RIA) is accurate within 7days of conception. This test is specific for HCG, and accuracy is not compromised by
confusion with LH.
D. Surgery and anesthesia can increase mucus production. Deep breathing and coughing are essential to prevent atelectasis and pneumonia in
the client’s only remaining lung.
B. Newborns can get pneumonia (tachypnea, mild hypoxia, cough, eosinophilia) and conjunctivitis from Chlamydia.
D. The client may perceive this as avoidance, but it is more important to redirect back to the client, especially in light of the manipulative behavior
of drug abusers and adolescents.
C. It describes a democratic process in which all members have input in the client’s care.
A. Contraction of the milk ducts and let-down reflex occur under the stimulation of oxytocin released by the posterior pituitary gland.
B. In case management, the nurse assumes total responsibility for meeting the needs of the client during the entire time on duty.
A. Smoke inhalation affects gas exchange.
C. Sperm deposited during intercourse may remain viable for about 3 days. If ovulation occurs during this period, conception may result.
B. This option shows acceptance (key concept) of this age-typical sleep pattern (that of waking in the early morning).
D. Taking the mother’s pulse while listening to the FHR will differentiate between the maternal and fetal heart rates and rule out fetal Bradycardia.
A. Antihistamines cause pupil dilation and should be avoided with glaucoma.
A. This suggests that the level of consciousness is decreasing.
D. An advance directive is a form of informed consent, and only a competent adult or the holder of a durable power of attorney has the right to
consent or refuse treatment. If the spouse does not hold the power of attorney, the decisions of the holder, even if opposed by the spouse, are
enforced.
C. Gentle but firm guidance and nonverbal direction is needed to intervene when a client with schizophrenic symptoms is being disruptive.
C. Suctioning is only done for 10 seconds, intermittently, as the catheter is being withdrawn.
D. The priority for this client is being able to establish an airway.
A. Signs of placental separation include a change in the shape of the uterus from ovoid to globular.
B. This could indicate intracranial bleeding. Alteplase is a thrombolytic enzyme that lyses thrombi and emboli. Bleeding is an adverse effect.
Monitor clotting times and signs of any gastrointestinal or internal bleeding.
D. Because flank incision in nephrectomy is directly below the diaphragm, deep breathing is painful. Additionally, there is a greater incisional pull
each time the person moves than there is with abdominal surgery. Incisional pain following nephrectomy generally requires analgesics
administration every 3-4 hours for 24-48 hours after surgery. Therefore, turning, coughing and deep-breathing exercises should be planned to
maximize the analgesic effects.
B. Under high estrogen levels, during the period surrounding ovulation, the cervical mucus becomes thin, clear, and elastic (spinnbarkeit),
facilitating sperm passage.
D. After surgery for a ruptured appendix, the client should be placed in a semi-Fowler’s position to promote drainage and to prevent possible
complications.
C. Directing and evaluation of staff is a major responsibility of a nursing manager.
A. The recommended procedure for administering eyedrops to any client calls for the drops to be placed in the middle of the lower conjunctival sac.
B. Thirst and restlessness indicate hypovolemia and hypoxemia. Internal bleeding is difficult to recognized and evaluate because it is not apparent.
C. Erythema toxicum is the normal, nonpathological macular newborn rash.
D. The family needs to understand what brain death is before talking about organ donation. They need time to accept the death of their family
member. An environment conducive to discussing an emotional issue is needed.
A. Bending from the waist in pregnancy tends to make backache worse.
B. Support and limit setting decrease anxiety and provide external control.
C. The stoma drainage bag is applied in the operating room. Drainage from the ileostomy contains secretions that are rich in digestive enzymes
and highly irritating to the skin. Protection of the skin from the effects of these enzymes is begun at once. Skin exposed to these enzymes even for
a short time becomes reddened, painful and excoriated.
B. It is the most accurate statement of physiological facts for a 28-day menstrual cycle: ovulation at day 14, egg life span 24 hours, sperm life span
of 72 hours. Fertilization could occur from sperm deposited before ovulation.
C. An advocate role encourage freedom of choice, includes speaking out for the client, and supports the client’s best interests.
A. Abstinence will eliminate any unnecessary pain during intercourse and will reduce the possibility of transmitting infection to one’s sexual partner.
B. Anxiety is generated by group therapy at 9:00 AM. The ritualistic behavioral defense of hand washing decreases anxiety by avoiding group
therapy.
D. Denial is a very strong defense mechanism used to allay the emotional effects of discovering a potential threat. Although denial has been found
to be an effective mechanism for survival in some instances, such as during natural disasters, it may in greater pathology in a woman with potential
breast carcinoma.
B. The registered nurse cannot delegate the responsibility for assessment and evaluation of clients. The status of the client in restraint requires
further assessment to determine if there are additional causes for the behavior.
C. The client with chest pain may be having a myocardial infarction, and immediate assessment and intervention is a priority.
B. Is correct because semen analysis requires that a freshly masturbated specimen be obtained after a rest (abstinence) period of 48-72 hours.
C. Betamethasone, a form of cortisone, acts on the fetal lungs to produce surfactant.
A. Secretions may have pooled above the tracheostomy cuff. If these are not suctioned before deflation, the secretions may be aspirated.
C. Proper handling of sputum is essential to allay droplet transference of bacilli in the air. Clients need to be taught to cover their nose and mouth
with tissues when sneezing or coughing. Chemotherapy generally renders the client noninfectious within days to a few weeks, usually before
cultures for tubercle bacilli are negative. Until chemical isolation is established, many institutions require the client to wear a mask when visitors are
in the room or when the nurse is in attendance. Client should be in a well-ventilated room, without air recirculation, to prevent air contamination.
A. It is best to establish baseline information first.
B. Listening is probably the most effective response of the four choices.
A. Urine flow is continuous. The pouch has an outlet valve for easy drainage every 3-4 hours. (the pouch should be changed every 3-5 days, or
sooner if the adhesive is loose).
C. A high fever accompanied by a body rash could indicate that the child has a communicable disease and would have exposed other students to
the infection. The school nurse would want to investigate this telephone call immediately so that plans could be instituted to control the spread of
such infection.
A. Severe abdominal pain may indicate complications of pregnancy such as abortion, ectopic pregnancy, or abruption placenta; fluid discharge
from the vagina may indicate premature rupture of the membrane.
D. Gentle aspiration of mucus helps maintain a patent airway, required for effective gas exchange.
A. Somatoform disorders provide a way of coping with conflicts.
C. Immunization should never be mixed together in a syringe, thus necessitating three separate injections in three sites. Note: some manufacturers
make a premixed combination of immunization that is safe and effective.
A. Clients with radioactive implants should be positioned flat in bed to prevent dislodgement of the vaginal packing. The client may roll to the side
for meals but the upper body should not be raised more than 20 degrees.
A. Syrup of ipecac is not administered when the ingested substances is corrosive in nature. Toilet bowl cleaners, as a collective whole, are highly
corrosive substances. If the ingested substance “burned” the esophagus going down, it will “burn” the esophagus coming back up when the child
begins to vomit after administration of syrup of ipecac.
B. Inability to open eyelids on operative side is seen with cranial nerve III damage.
A. Assessment of physical injuries (like bruises, lacerations, bleeding and fractures) is the first priority.
C. The nurse who is supervising others has a legal obligation to determine that they are competent to perform the assignment, as well as legal
obligation to provide adequate supervision.
D. Increasing hydrostatic pressure in the urinary tract will facilitate passage of the calculi.
A. Infertility is not diagnosed until atleast 12months of unprotected intercourse has failed to produce a pregnancy. Older couples will experience a
longer time to get pregnant.
B. Determining how well the kidneys filter wastes states the purpose of a Creatinine clearance test.
A. Acknowledging a feeling tone is the most therapeutic response and provides a broad opening for the client to elaborate feelings.
C. The behavior should be stopped. The first is to remind the staff that confidentiality maybe violated.
C. With a right-sided cerebrovascular accident the client would have left-sided hemiplegia or weakness. The client’s good side should be closest to
the bed to facilitate the transfer.
D. Legos are small plastic building blocks that could easily slip under the child’s cast and lead to a break in skin integrity and even infection.
Pencils, backscratchers, and marbles are some other narrow or small items that could easily slip under the child’s cast and lead to a break in skin
integrity and infection.
D. Oxytocin (Pitocin) is used to maintain uterine tone.
B. The submission of reports about incidents that expose clients to harm does not remove the obligation to report ongoing behavior as long as the
risk to the client continues.
C. The recommended dosage of tetracycline is 25-50mg/kg/day. If the child weighs 20kg and the maximum dose is 50mg/kg, this would indicate a
total daily dose of 1000mg of tetracycline. In this case, the child is being given this medication four times a day. Therefore the maximum single
dose that can be given is 250mg (1000 mg of tetracycline divided by four doses.)
C. An abnormality in the uterine muscle could reduce the effectiveness of uterine contractions and lengthen the duration of subsequent labors.
A. Personality disorders stem from a weak superego, implying a lack of adequate controls.
C. The basal body temperature is the lowest body temperature of a healthy person that is taken immediately after waking and before getting out of
bed. The BBT usually varies from 36.2 ºC to 36.3ºC during menses and for about 5-7 days afterward. About the time of ovulation, a slight drop in
temperature may be seen, after ovulation in concert with the increasing progesterone levels of the early luteal phase, the BBT rises 0.2-0.4 ºC.
This elevation remains until 2-3 days before menstruation, or if pregnancy has occurred.
A. This choice implies concern for client care and self-improvement.
C. The first trimester is the period of organogenesis, that is, cell differentiation into the various organs, tissues, and structures.
C. This response does not contradict the client’s perception, is honest, and shows empathy.
D. Tension on round ligament occurs because of the erect human posture and pressure exerted by the growing fetus.
D. The Good Samaritan Law does not impose a duty to stop at the scene of an emergency outside of the scope of employment, therefore nurses
who do not stop are not liable for suit.
C. Although reducing environment stimuli and activity is necessary for a woman with mild preeclampsia, she will most probably have bathroom
privileges.
B. A normal respiratory rate for a newborn is 30-40 breaths per minute.
D. The behavior described is likely to be symptoms of delirium tremens, or alcohol withdrawal (often unsuspected on a surgical unit.)
1. For the client who is using oral contraceptives, the nurse informs the client about the need to take the pill at the same time each day to
accomplish which of the following?
Decrease the incidence of nausea
Maintain hormonal levels
Reduce side effects
Prevent drug interactions
2. When teaching a client about contraception. Which of the following would the nurse include as the most effective method for preventing sexually
transmitted infections?
Spermicides
Diaphragm
Condoms
Vasectomy
3. When preparing a woman who is 2 days postpartum for discharge, recommendations for which of the following contraceptive methods would be
avoided?
Diaphragm
Female condom
Oral contraceptives
Rhythm method
4. For which of the following clients would the nurse expect that an intrauterine device would not be recommended?
Woman over age 35
Nulliparous woman
Promiscuous young adult
Postpartum client
5. A client in her third trimester tells the nurse, “I’m constipated all the time!” Which of the following should the nurse recommend?
Daily enemas
Laxatives
Increased fiber intake
Decreased fluid intake
6. Which of the following would the nurse use as the basis for the teaching plan when caring for a pregnant teenager concerned about gaining too
much weight during pregnancy?
10 pounds per trimester
1 pound per week for 40 weeks
½ pound per week for 40 weeks
A total gain of 25 to 30 pounds
7. The client tells the nurse that her last menstrual period started on January 14 and ended on January 20. Using Nagele’s rule, the nurse
determines her EDD to be which of the following?
September 27
October 21
November 7
December 27
8. When taking an obstetrical history on a pregnant client who states, “I had a son born at 38 weeks gestation, a daughter born at 30 weeks
gestation and I lost a baby at about 8 weeks,” the nurse should record her obstetrical history as which of the following?
G2 T2 P0 A0 L2
G3 T1 P1 A0 L2
G3 T2 P0 A0 L2
G4 T1 P1 A1 L2
9. When preparing to listen to the fetal heart rate at 12 weeks’ gestation, the nurse would use which of the following?
Stethoscope placed midline at the umbilicus
Doppler placed midline at the suprapubic region
Fetoscope placed midway between the umbilicus and the xiphoid process
External electronic fetal monitor placed at the umbilicus
10.When developing a plan of care for a client newly diagnosed with gestational diabetes, which of the following instructions would be the priority?
Dietary intake
Medication
Exercise
Glucose monitoring
11.A client at 24 weeks gestation has gained 6 pounds in 4 weeks. Which of the following would be the priority when assessing the client?
Glucosuria
Depression
Hand/face edema
Dietary intake
12. A client 12 weeks’ pregnant come to the emergency department with abdominal cramping and moderate vaginal bleeding. Speculum
examination reveals 2 to 3 cms cervical dilation. The nurse would document these findings as which of the following?
Threatened abortion
Imminent abortion
Complete abortion
Missed abortion
13.Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?
Risk for infection
Pain
Knowledge Deficit
Anticipatory Grieving
14.Before assessing the postpartum client’s uterus for firmness and position in relation to the umbilicus and midline, which of the following should
the nurse do first?
Assess the vital signs
Administer analgesia
Ambulate her in the hall
Assist her to urinate
15.Which of the following should the nurse do when a primipara who is lactating tells the nurse that she has sore nipples?
Tell her to breast feed more frequently
Administer a narcotic before breast feeding
Encourage her to wear a nursing brassiere
Use soap and water to clean the nipples
16.The nurse assesses the vital signs of a client, 4 hours’ postpartum that are as follows: BP 90/60; temperature 100.4ºF; pulse 100 weak, thready;
R 20 per minute. Which of the following should the nurse do first?
Report the temperature to the physician
Recheck the blood pressure with another cuff
Assess the uterus for firmness and position
Determine the amount of lochia
17.The nurse assesses the postpartum vaginal discharge (lochia) on four clients. Which of the following assessments would warrant notification of
the physician?
A dark red discharge on a 2-day postpartum client
A pink to brownish discharge on a client who is 5 days postpartum
Almost colorless to creamy discharge on a client 2 weeks after delivery
A bright red discharge 5 days after delivery
18.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?
Lochia
Breasts
Incision
Urine
19.Which of the following is the priority focus of nursing practice with the current early postpartum discharge?
Promoting comfort and restoration of health
Exploring the emotional status of the family
Facilitating safe and effective self-and newborn care
Teaching about the importance of family planning
20. Which of the following actions would be least effective in maintaining a neutral thermal environment for the newborn?
Placing infant under radiant warmer after bathing
Covering the scale with a warmed blanket prior to weighing
Placing crib close to nursery window for family viewing
Covering the infant’s head with a knit stockinette
21.A newborn who has an asymmetrical Moro reflex response should be further assessed for which of the following?
Talipes equinovarus
Fractured clavicle
Congenital hypothyroidism
Increased intracranial pressure
22.During the first 4 hours after a male circumcision, assessing for which of the following is the priority?
Infection
Hemorrhage
Discomfort
Dehydration
23.The mother asks the nurse. “What’s wrong with my son’s breasts? Why are they so enlarged?” Whish of the following would be the best
response by the nurse?
“The breast tissue is inflamed from the trauma experienced with birth”
“A decrease in material hormones present before birth causes enlargement,”
“You should discuss this with your doctor. It could be a malignancy”
“The tissue has hypertrophied while the baby was in the uterus”
24. Immediately after birth the nurse notes the following on a male newborn: respirations 78; apical hearth rate 160 BPM, nostril flaring; mild
intercostal
retractions; and grunting at the end of expiration. Which of the following should the nurse do?
Call the assessment data to the physician’s attention
Start oxygen per nasal cannula at 2 L/min.
Suction the infant’s mouth and nares
Recognize this as normal first period of reactivity
25.The nurse hears a mother telling a friend on the telephone about umbilical cord care. Which of the following statements by the mother indicates
effective teaching?
“Daily soap and water cleansing is best”
‘Alcohol helps it dry and kills germs”
“An antibiotic ointment applied daily prevents infection”
“He can have a tub bath each day”
26.A newborn weighing 3000 grams and feeding every 4 hours needs 120 calories/kg of body weight every 24 hours for proper growth and
development. How many ounces of 20 cal/oz formula should this newborn receive at each feeding to meet nutritional needs?
2 ounces
3 ounces
4 ounces
6 ounces
27.The postterm neonate with meconium-stained amniotic fluid needs care designed to especially monitor for which of the following?
Respiratory problems
Gastrointestinal problems
Integumentary problems
Elimination problems
28.When measuring a client’s fundal height, which of the following techniques denotes the correct method of measurement used by the nurse?
From the xiphoid process to the umbilicus
From the symphysis pubis to the xiphoid process
From the symphysis pubis to the fundus
From the fundus to the umbilicus
29.A client with severe preeclampsia is admitted with of BP 160/110, proteinuria, and severe pitting edema. Which of the following would be most
important to include in the client’s plan of care?
Daily weights
Seizure precautions
Right lateral positioning
Stress reduction
30. A postpartum primipara asks the nurse, “When can we have sexual intercourse again?” Which of the following would be the nurse’s best
response?
“Anytime you both want to.”
“As soon as choose a contraceptive method.”
“When the discharge has stopped and the incision is healed.”
“After your 6 weeks examination.”
31.When preparing to administer the vitamin K injection to a neonate, the nurse would select which of the following sites as appropriate for the
injection?
Deltoid muscle
Anterior femoris muscle
Vastus lateralis muscle
Gluteus maximus muscle
32.When performing a pelvic examination, the nurse observes a red swollen area on the right side of the vaginal orifice. The nurse would
document this as enlargement of which of the following?
Clitoris
Parotid gland
Skene’s gland
Bartholin’s gland
33.To differentiate as a female, the hormonal stimulation of the embryo that must occur involves which of the following?
Increase in maternal estrogen secretion
Decrease in maternal androgen secretion
Secretion of androgen by the fetal gonad
Secretion of estrogen by the fetal gonad
34.A client at 8 weeks’ gestation calls complaining of slight nausea in the morning hours. Which of the following client interventions should the
nurse question?
Taking 1 teaspoon of bicarbonate of soda in an 8-ounce glass of water
Eating a few low-sodium crackers before getting out of bed
Avoiding the intake of liquids in the morning hours
Eating six small meals a day instead of thee large meals
35.The nurse documents positive ballottement in the client’s prenatal record. The nurse understands that this indicates which of the following?
Palpable contractions on the abdomen
Passive movement of the unengaged fetus
Fetal kicking felt by the client
Enlargement and softening of the uterus
36.During a pelvic exam the nurse notes a purple-blue tinge of the cervix. The nurse documents this as which of the following?
Braxton-Hicks sign
Chadwick’s sign
Goodell’s sign
McDonald’s sign
37.During a prenatal class, the nurse explains the rationale for breathing techniques during preparation for labor based on the understanding that
breathing techniques are most important in achieving which of the following?
Eliminate pain and give the expectant parents something to do
Reduce the risk of fetal distress by increasing uteroplacental perfusion
Facilitate relaxation, possibly reducing the perception of pain
Eliminate pain so that less analgesia and anesthesia are needed
38.After 4 hours of active labor, the nurse notes that the contractions of a primigravida client are not strong enough to dilate the cervix. Which of
the
following would the nurse anticipate doing?
Obtaining an order to begin IV oxytocin infusion
Administering a light sedative to allow the patient to rest for several hour
Preparing for a cesarean section for failure to progress
Increasing the encouragement to the patient when pushing begins
39.A multigravida at 38 weeks’ gestation is admitted with painless, bright red bleeding and mild contractions every 7 to 10 minutes. Which of the
following assessments should be avoided?
Maternal vital sign
Fetal heart rate
Contraction monitoring
Cervical dilation
40.Which of the following would be the nurse’s most appropriate response to a client who asks why she must have a cesarean delivery if she has a
complete placenta previa?
“You will have to ask your physician when he returns.”
“You need a cesarean to prevent hemorrhage.”
“The placenta is covering most of your cervix.”
“The placenta is covering the opening of the uterus and blocking your baby.”
41.The nurse understands that the fetal head is in which of the following positions with a face presentation?
Completely flexed
Completely extended
Partially extended
Partially flexed
42.With a fetus in the left-anterior breech presentation, the nurse would expect the fetal heart rate would be most audible in which of the following
areas?
Above the maternal umbilicus and to the right of midline
In the lower-left maternal abdominal quadrant
In the lower-right maternal abdominal quadrant
Above the maternal umbilicus and to the left of midline
43.The amniotic fluid of a client has a greenish tint. The nurse interprets this to be the result of which of the following?
Lanugo
Hydramnio
Meconium
Vernix
44.A patient is in labor and has just been told she has a breech presentation. The nurse should be particularly alert for which of the following?
Quickening
Ophthalmia neonatorum
Pica
Prolapsed umbilical cord
45.When describing dizygotic twins to a couple, on which of the following would the nurse base the explanation?
Two ova fertilized by separate sperm
Sharing of a common placenta
Each ova with the same genotype
Sharing of a common chorion
46.Which of the following refers to the single cell that reproduces itself after conception?
Chromosome
Blastocyst
Zygote
Trophoblast
47.In the late 1950s, consumers and health care professionals began challenging the routine use of analgesics and anesthetics during childbirth.
Which of the following was an outgrowth of this concept?
Labor, delivery, recovery, postpartum (LDRP)
Nurse-midwifery
Clinical nurse specialist
Prepared childbirth
48.A client has a midpelvic contracture from a previous pelvic injury due to a motor vehicle accident as a teenager. The nurse is aware that this
could
prevent a fetus from passing through or around which structure during childbirth?
Symphysis pubis
Sacral promontory
Ischial spines
Pubic arch
49.When teaching a group of adolescents about variations in the length of the menstrual cycle, the nurse understands that the underlying
mechanism is
due to variations in which of the following phases?
Menstrual phase
Proliferative phase
Secretory phase
Ischemic phase
50.When teaching a group of adolescents about male hormone production, which of the following would the nurse include as being produced by
the Leydig cells?
Follicle-stimulating hormone
Testosterone
Leuteinizing hormone
Gonadotropin releasing hormone
Answers and Rationales
B . Regular timely ingestion of oral contraceptives is necessary to maintain hormonal levels of the drugs to suppress the action of the
hypothalamus and anterior pituitary leading to inappropriate secretion of FSH and LH. Therefore, follicles do not mature, ovulation is inhibited, and
pregnancy is prevented. The estrogen content of the oral site contraceptive may cause the nausea, regardless of when the pill is taken. Side
effects and drug interactions may occur with oral contraceptives regardless of the time the pill is taken.
C . Condoms, when used correctly and consistently, are the most effective contraceptive method or barrier against bacterial and viral sexually
transmitted infections. Although spermicides kill sperm, they do not provide reliable protection against the spread of sexually transmitted infections,
especially intracellular organisms such as HIV. Insertion and removal of the diaphragm along with the use of the spermicides may cause vaginal
irritations, which could place the client at risk for infection transmission. Male sterilization eliminates spermatozoa from the ejaculate, but it does not
eliminate bacterial and/or viral microorganisms that can cause sexually transmitted infections.
A . The diaphragm must be fitted individually to ensure effectiveness. Because of the changes to the reproductive structures during pregnancy and
following delivery, the diaphragm must be refitted, usually at the 6 weeks’ examination following childbirth or after a weight loss of 15 lbs or more.
In addition, for maximum effectiveness, spermicidal jelly should be placed in the dome and around the rim. However, spermicidal jelly should not
be inserted into the vagina until involution is completed at approximately 6 weeks. Use of a female condom protects the reproductive system from
the introduction of semen or spermicides into the vagina and may be used after childbirth. Oral contraceptives may be started within the first
postpartum week to ensure suppression of ovulation. For the couple who has determined the female’s fertile period, using the rhythm method,
avoidance of intercourse during this period, is safe and effective.
C . An IUD may increase the risk of pelvic inflammatory disease, especially in women with more than one sexual partner, because of the increased
risk of sexually transmitted infections. An UID should not be used if the woman has an active or chronic pelvic infection, postpartum infection,
endometrial hyperplasia or carcinoma, or uterine abnormalities. Age is not a factor in determining the risks associated with IUD use. Most IUD
users are over the age of 30. Although there is a slightly higher risk for infertility in women who have never been pregnant, the IUD is an
acceptable option as long as the risk-benefit ratio is discussed. IUDs may be inserted immediately after delivery, but this is not recommended
because of the increased risk and rate of expulsion at this time.
C . During the third trimester, the enlarging uterus places pressure on the intestines. This coupled with the effect of hormones on smooth muscle
relaxation causes decreased intestinal motility (peristalsis). Increasing fiber in the diet will help fecal matter pass more quickly through the intestinal
tract, thus decreasing the amount of water that is absorbed. As a result, stool is softer and easier to pass. Enemas could precipitate preterm labor
and/or electrolyte loss and should be avoided. Laxatives may cause preterm labor by stimulating peristalsis and may interfere with the absorption
of nutrients. Use for more than 1 week can also lead to laxative dependency. Liquid in the diet helps provide a semisolid, soft consistency to the
stool. Eight to ten glasses of fluid per day are essential to maintain hydration and promote stool evacuation.
D . To ensure adequate fetal growth and development during the 40 weeks of a pregnancy, a total weight gain 25 to 30 pounds is recommended:
1.5 pounds in the first 10 weeks; 9 pounds by 30 weeks; and 27.5 pounds by 40 weeks. The pregnant woman should gain less weight in the first
and second trimester than in the third. During the first trimester, the client should only gain 1.5 pounds in the first 10 weeks, not 1 pound per week.
A weight gain of ½ pound per week would be 20 pounds for the total pregnancy, less than the recommended amount.
B . To calculate the EDD by Nagele’s rule, add 7 days to the first day of the last menstrual period and count back 3 months, changing the year
appropriately. To obtain a date of September 27, 7 days have been added to the last day of the LMP (rather than the first day of the LMP), plus 4
months (instead of 3 months) were counted back. To obtain the date of November 7, 7 days have been subtracted (instead of added) from the first
day of LMP plus November indicates counting back 2 months (instead of 3 months) from January. To obtain the date of December 27, 7 days were
added to the last day of the LMP (rather than the first day of the LMP) and December indicates counting back only 1 month (instead of 3 months)
from January.
D. The client has been pregnant four times, including current pregnancy (G). Birth at 38 weeks’ gestation is considered full term (T), while birth
form 20 weeks to 38 weeks is considered preterm (P). A spontaneous abortion occurred at 8 weeks (A). She has two living children (L).
B. At 12 weeks gestation, the uterus rises out of the pelvis and is palpable above the symphysis pubis. The Doppler intensifies the sound of the
fetal pulse rate so it is audible. The uterus has merely risen out of the pelvis into the abdominal cavity and is not at the level of the umbilicus. The
fetal heart rate at this age is not audible with a stethoscope. The uterus at 12 weeks is just above the symphysis pubis in the abdominal cavity, not
midway between the umbilicus and the xiphoid process. At 12 weeks the FHR would be difficult to auscultate with a fetoscope. Although the
external electronic fetal monitor would project the FHR, the uterus has not risen to the umbilicus at 12 weeks.
A . Although all of the choices are important in the management of diabetes, diet therapy is the mainstay of the treatment plan and should always
be the priority. Women diagnosed with gestational diabetes generally need only diet therapy without medication to control their blood sugar levels.
Exercise, is important for all pregnant women and especially for diabetic women, because it burns up glucose, thus decreasing blood sugar.
However, dietary intake, not exercise, is the priority. All pregnant women with diabetes should have periodic monitoring of serum glucose.
However, those with gestational diabetes generally do not need daily glucose monitoring. The standard of care recommends a fasting and 2- hour
postprandial blood sugar level every 2 weeks.
C. After 20 weeks’ gestation, when there is a rapid weight gain, preeclampsia should be suspected, which may be caused by fluid retention
manifested by edema, especially of the hands and face. The three classic signs of preeclampsia are hypertension, edema, and proteinuria.
Although urine is checked for glucose at each clinic visit, this is not the priority. Depression may cause either anorexia or excessive food intake,
leading to excessive weight gain or loss. This is not, however, the priority consideration at this time. Weight gain thought to be caused by excessive
food intake would require a 24-hour diet recall. However, excessive intake would not be the primary consideration for this client at this time.
B. Cramping and vaginal bleeding coupled with cervical dilation signifies that termination of the pregnancy is inevitable and cannot be prevented.
Thus, the nurse would document an imminent abortion. In a threatened abortion, cramping and vaginal bleeding are present, but there is no
cervical dilation. The symptoms may subside or progress to abortion. In a complete abortion all the products of conception are expelled. A missed
abortion is early fetal intrauterine death without expulsion of the products of conception.
B . For the client with an ectopic pregnancy, lower abdominal pain, usually unilateral, is the primary symptom. Thus, pain is the priority. Although
the potential for infection is always present, the risk is low in ectopic pregnancy because pathogenic microorganisms have not been introduced
from external sources. The client may have a limited knowledge of the pathology and treatment of the condition and will most likely experience
grieving, but this is not the priority at this time.
D. Before uterine assessment is performed, it is essential that the woman empty her bladder. A full bladder will interfere with the accuracy of the
assessment by elevating the uterus and displacing to the side of the midline. Vital sign assessment is not necessary unless an abnormality in
uterine assessment is identified. Uterine assessment should not cause acute pain that requires administration of analgesia. Ambulating the client is
an essential component of postpartum care, but is not necessary prior to assessment of the uterus.
A. Feeding more frequently, about every 2 hours, will decrease the infant’s frantic, vigorous sucking from hunger and will decrease breast
engorgement, soften the breast, and promote ease of correct latching-on for feeding. Narcotics administered prior to breast feeding are passed
through the breast milk to the infant, causing excessive sleepiness. Nipple soreness is not severe enough to warrant narcotic analgesia. All
postpartum clients, especially lactating mothers, should wear a supportive brassiere with wide cotton straps. This does not, however, prevent or
reduce nipple soreness. Soaps are drying to the skin of the nipples and should not be used on the breasts of lactating mothers. Dry nipple skin
predisposes to cracks and fissures, which can become sore and painful.
D. A weak, thready pulse elevated to 100 BPM may indicate impending hemorrhagic shock. An increased pulse is a compensatory mechanism of
the body in response to decreased fluid volume. Thus, the nurse should check the amount of lochia present. Temperatures up to 100.48F in the
first 24 hours after birth are related to the dehydrating effects of labor and are considered normal. Although rechecking the blood pressure may be
a correct choice of action, it is not the first action that should be implemented in light of the other data. The data indicate a potential impending
hemorrhage. Assessing the uterus for firmness and position in relation to the umbilicus and midline is important, but the nurse should check the
extent of vaginal bleeding first. Then it would be appropriate to check the uterus, which may be a possible cause of the hemorrhage.
D. Any bright red vaginal discharge would be considered abnormal, but especially 5 days after delivery, when the lochia is typically pink to
brownish. Lochia rubra, a dark red discharge, is present for 2 to 3 days after delivery. Bright red vaginal bleeding at this time suggests late
postpartum hemorrhage, which occurs after the first 24 hours following delivery and is generally caused by retained placental fragments or
bleeding disorders. Lochia rubra is the normal dark red discharge occurring in the first 2 to 3 days after delivery, containing epithelial cells,
erythrocyes, leukocytes and decidua. Lochia serosa is a pink to brownish serosanguineous discharge occurring from 3 to 10 days after delivery
that contains decidua, erythrocytes, leukocytes, cervical mucus, and microorganisms. Lochia alba is an almost colorless to yellowish discharge
occurring from 10 days to 3 weeks after delivery and containing leukocytes, decidua, epithelial cells, fat, cervical mucus, cholesterol crystals, and
bacteria.
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.
C. Because of early postpartum discharge and limited time for teaching, the nurse’s priority is to facilitate the safe and effective care of the client
and newborn. Although promoting comfort and restoration of health, exploring the family’s emotional status, and teaching about family planning are
important in postpartum/newborn nursing care, they are not the priority focus in the limited time presented by early post-partum discharge.
C. Heat loss by radiation occurs when the infant’s crib is placed too near cold walls or windows. Thus placing the newborn’s crib close to the
viewing window would be least effective. Body heat is lost through evaporation during bathing. Placing the infant under the radiant warmer after
bathing will assist the infant to be rewarmed. Covering the scale with a warmed blanket prior to weighing prevents heat loss through conduction. A
knit cap prevents heat loss from the head a large head, a large body surface area of the newborn’s body.
B. A fractured clavicle would prevent the normal Moro response of symmetrical sequential extension and abduction of the arms followed by flexion
and adduction. In talipes equinovarus (clubfoot) the foot is turned medially, and in plantar flexion, with the heel elevated. The feet are not involved
with the Moro reflex. Hypothyroiddism has no effect on the primitive reflexes. Absence of the Moror reflex is the most significant single indicator of
central nervous system status, but it is not a sign of increased intracranial pressure.
B. Hemorrhage is a potential risk following any surgical procedure. Although the infant has been given vitamin K to facilitate clotting, the
prophylactic dose is often not sufficient to prevent bleeding. Although infection is a possibility, signs will not appear within 4 hours after the surgical
procedure. The primary discomfort of circumcision occurs during the surgical procedure, not afterward. Although feedings are withheld prior to the
circumcision, the chances of dehydration are minimal.
B . The presence of excessive estrogen and progesterone in the maternal fetal blood followed by prompt withdrawal at birth precipitates breast
engorgement, which will spontaneously resolve in 4 to 5 days after birth. The trauma of the birth process does not cause inflammation of the
newborn’s breast tissue. Newborns do not have breast malignancy. This reply by the nurse would cause the mother to have undue anxiety. Breast
tissue does not hypertrophy in the fetus or newborns.
D . The first 15 minutes to 1 hour after birth is the first period of reactivity involving respiratory and circulatory adaptation to extrauterine life. The
data given reflect the normal changes during this time period. The infant’s assessment data reflect normal adaptation. Thus, the physician does not
need to be notified and oxygen is not needed. The data do not indicate the presence of choking, gagging or coughing, which are signs of excessive
secretions. Suctioning is not necessary.
B. Application of 70% isopropyl alcohol to the cord minimizes microorganisms (germicidal) and promotes drying. The cord should be kept dry until it
falls off and the stump has healed. Antibiotic ointment should only be used to treat an infection, not as a prophylaxis. Infants should not be
submerged in a tub of water until the cord falls off and the stump has completely healed.
B. To determine the amount of formula needed, do the following mathematical calculation. 3 kg x 120 cal/kg per day = 360 calories/day feeding q 4
hours = 6 feedings per day = 60 calories per feeding: 60 calories per feeding; 60 calories per feeding with formula 20 cal/oz = 3 ounces per
feeding. Based on the calculation. 2, 4 or 6 ounces are incorrect.
A. Intrauterine anoxia may cause relaxation of the anal sphincter and emptying of meconium into the amniotic fluid. At birth some of the meconium
fluid may be aspirated, causing mechanical obstruction or chemical pneumonitis. The infant is not at increased risk for gastrointestinal problems.
Even though the skin is stained with meconium, it is noninfectious (sterile) and nonirritating. The postterm meconiumstained infant is not at
additional risk for bowel or urinary problems.
C . The nurse should use a nonelastic, flexible, paper measuring tape, placing the zero point on the superior border of the symphysis pubis and
stretching the tape across the abdomen at the midline to the top of the fundus. The xiphoid and umbilicus are not appropriate landmarks to use
when measuring the height of the fundus (McDonald’s measurement).
B . Women hospitalized with severe preeclampsia need decreased CNS stimulation to prevent a seizure. Seizure precautions provide
environmental safety should a seizure occur. Because of edema, daily weight is important but not the priority. Preclampsia causes vasospasm and
therefore can reduce utero-placental perfusion. The client should be placed on her left side to maximize blood flow, reduce blood pressure, and
promote diuresis. Interventions to reduce stress and anxiety are very important to facilitate coping and a sense of control, but seizure precautions
are the priority.
C. Cessation of the lochial discharge signifies healing of the endometrium. Risk of hemorrhage and infection are minimal 3 weeks after a normal
vaginal delivery. Telling the client anytime is inappropriate because this response does not provide the client with the specific information she is
requesting. Choice of a contraceptive method is important, but not the specific criteria for safe resumption of sexual activity. Culturally, the 6-
weeks’ examination has been used as the time frame for resuming sexual activity, but it may be resumed earlier.
C . The middle third of the vastus lateralis is the preferred injection site for vitamin K administration because it is free of blood vessels and nerves
and is large enough to absorb the medication. The deltoid muscle of a newborn is not large enough for a newborn IM injection. Injections into this
muscle in a small child might cause damage to the radial nerve. The anterior femoris muscle is the next safest muscle to use in a newborn but is
not the safest. Because of the proximity of the sciatic nerve, the gluteus maximus muscle should not be until the child has been walking 2 years.
D . Bartholin’s glands are the glands on either side of the vaginal orifice. The clitoris is female erectile tissue found in the perineal area above the
urethra. The parotid glands are open into the mouth. Skene’s glands open into the posterior wall of the female urinary meatus.
D . The fetal gonad must secrete estrogen for the embryo to differentiate as a female. An increase in maternal estrogen secretion does not effect
differentiation of the embryo, and maternal estrogen secretion occurs in every pregnancy. Maternal androgen secretion remains the same as
before pregnancy and does not effect differentiation. Secretion of androgen by the fetal gonad would produce a male fetus.
A . Using bicarbonate would increase the amount of sodium ingested, which can cause complications. Eating low-sodium crackers would be
appropriate. Since liquids can increase nausea avoiding them in the morning hours when nausea is usually the strongest is appropriate. Eating six
small meals a day would keep the stomach full, which often decrease nausea.
B . Ballottement indicates passive movement of the unengaged fetus. Ballottement is not a contraction. Fetal kicking felt by the client represents
quickening. Enlargement and softening of the uterus is known as Piskacek’s sign.
B . Chadwick’s sign refers to the purple-blue tinge of the cervix. Braxton Hicks contractions are painless contractions beginning around the 4th
month. Goodell’s sign indicates softening of the cervix. Flexibility of the uterus against the cervix is known as McDonald’s sign.
C . Breathing techniques can raise the pain threshold and reduce the perception of pain. They also promote relaxation. Breathing techniques do
not eliminate pain, but they can reduce it. Positioning, not breathing, increases uteroplacental perfusion.
A . The client’s labor is hypotonic. The nurse should call the physical and obtain an order for an infusion of oxytocin, which will assist the uterus to
contact more forcefully in an attempt to dilate the cervix. Administering light sedative would be done for hypertonic uterine contractions. Preparing
for cesarean section is unnecessary at this time. Oxytocin would increase the uterine contractions and hopefully progress labor before a cesarean
would be necessary. It is too early to anticipate client pushing with contractions.
D . The signs indicate placenta previa and vaginal exam to determine cervical dilation would not be done because it could cause hemorrhage.
Assessing maternal vital signs can help determine maternal physiologic status. Fetal heart rate is important to assess fetal well-being and should
be done. Monitoring the contractions will help evaluate the progress of labor.
D . A complete placenta previa occurs when the placenta covers the opening of the uterus, thus blocking the passageway for the baby. This
response explains what a complete previa is and the reason the baby cannot come out except by cesarean delivery. Telling the client to ask the
physician is a poor response and would increase the patient’s anxiety. Although a cesarean would help to prevent hemorrhage, the statement does
not explain why the hemorrhage could occur. With a complete previa, the placenta is covering all the cervix, not just most of it.
B . With a face presentation, the head is completely extended. With a vertex presentation, the head is completely or partially flexed. With a brow
(forehead) presentation, the head would be partially extended.
D . With this presentation, the fetal upper torso and back face the left upper maternal abdominal wall. The fetal heart rate would be most audible
above the maternal umbilicus and to the left of the middle. The other positions would be incorrect.
C. The greenish tint is due to the presence of meconium. Lanugo is the soft, downy hair on the shoulders and back of the fetus. Hydramnios
represents excessive amniotic fluid. Vernix is the white, cheesy substance covering the fetus.
D . In a breech position, because of the space between the presenting part and the cervix, prolapse of the umbilical cord is common. Quickening is
the woman’s first perception of fetal movement. Ophthalmia neonatorum usually results from maternal gonorrhea and is conjunctivitis. Pica refers
to the oral intake of nonfood substances.
A . Dizygotic (fraternal) twins involve two ova fertilized by separate sperm. Monozygotic (identical) twins involve a common placenta, same
genotype, and common chorion.
C . The zygote is the single cell that reproduces itself after conception. The chromosome is the material that makes up the cell and is gained from
each parent. Blastocyst and trophoblast are later terms for the embryo after zygote.
D . Prepared childbirth was the direct result of the 1950’s challenging of the routine use of analgesic and anesthetics during childbirth. The LDRP
was a much later concept and was not a direct result of the challenging of routine use of analgesics and anesthetics during childbirth. Roles for
nurse midwives and clinical nurse specialists did not develop from this challenge.
C . The ischial spines are located in the mid-pelvic region and could be narrowed due to the previous pelvic injury. The symphysis pubis, sacral
promontory, and pubic arch are not part of the mid-pelvis.
B . Variations in the length of the menstrual cycle are due to variations in the proliferative phase. The menstrual, secretory and ischemic phases do
not contribute to this variation.
B . Testosterone is produced by the Leyding cells in the seminiferous tubules. Follicle-stimulating hormone and leuteinzing hormone are released
by the anterior pituitary gland. The hypothalamus is responsible for releasing gonadotropin-releasing hormone.
1. Estimate the number of pregnant women who will be given tetanus toxoid during an immunization outreach activity in a barangay with a
population of about 1,500.
265
300
375
400
2. To describe the sex composition of the population, which demographic tool may be used?
Sex ratio
Sex proportion
Population pyramid
Any of these may be used.
3. Which of the following is a natality rate?
4.2/1,000
5.2/1,000
6.3/1,000
7.3/1,000
5. Knowing that malnutrition is a frequent community health problem, you decided to conduct nutritional assessment. What population is
particularly susceptible to protein energy malnutrition (PEM)?
27.8/1,000
43.5/1,000
86.9/1,000
130.4/1,000
8. Which statistic best reflects the nutritional status of a population?
Census
Survey
Record review
Review of civil registry
11. In the conduct of a census, the method of population assignment based on the actual physical location of the people is termed
De jure
De locus
De facto
De novo
12. The Field Health Services and Information System (FHSIS) is the recording and reporting system in public health care in the Philippines. The
Monthly Field Health Service Activity Report is a form used in which of the components of the FHSIS?
Tally report
Output report
Target/client list
Individual health record
13. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which component will be most useful?
Tally report
Output report
Target/client list
Individual health record
14. Civil registries are important sources of data. Which law requires registration of births within 30 days from the occurrence of the birth?
P.D. 651
Act 3573
R.A. 3753
R.A. 3375
15. Which of the following professionals can sign the birth certificate?
Tetanus toxoid
Retinol 200,000 IU
Ferrous sulfate 200 mg
Potassium iodate 200 mg. capsule
21. During prenatal consultation, a client asked you if she can have her delivery at home. After history taking and physical examination, you
advised her against a home delivery. Which of the following findings disqualifies her for a home delivery?
Niacin
Riboflavin
Folic acid
Thiamine
23. You are in a client’s home to attend to a delivery. Which of the following will you do first?
3 months
6 months
1 year
2 years
28. What is given to a woman within a month after the delivery of a baby?
Malunggay capsule
Ferrous sulfate 100 mg. OD
Retinol 200,000 I.U., 1 capsule
Potassium iodate 200 mg, 1 capsule
29. Which biological used in Expanded Program on Immunization (EPI) is stored in the freezer?
DPT
Tetanus toxoid
Measles vaccine
Hepatitis B vaccine
30. Unused BCG should be discarded how many hours after reconstitution?
2
4
6
At the end of the day
Answers and Rationales
Answer: (A) 265. To estimate the number of pregnant women, multiply the total population by 3.5%.
Answer: (D) Any of these may be used. Sex ratio and sex proportion are used to determine the sex composition of a population. A population
pyramid is used to present the composition of a population by age and sex.
Answer: (A) Crude birth rate. Natality means birth. A natality rate is a birth rate.
Answer: (B) 5.2/1,000. To compute crude death rate divide total number of deaths (94) by total population (18,000) and multiply by 1,000.
Answer: (C) 1-4 year old children. Preschoolers are the most susceptible to PEM because they have generally been weaned. Also, this is the
population who, unable to feed themselves, are often the victims of poor intrafamilial food distribution.
Answer: (C) Swaroop’s index. Swaroop’s index is the proportion of deaths aged 50 years and above. The higher the Swaroop’s index of a
population, the greater the proportion of the deaths who were able to reach the age of at least 50 years, i.e., more people grew old before they
died.
Answer: (B) 43.5/1,000. To compute for neonatal mortality rate, divide the number of babies who died before reaching the age of 28 days by the
total number of live births, then multiply by 1,000.
Answer: (A) 1-4 year old age-specific mortality rate. Since preschoolers are the most susceptible to the effects of malnutrition, a population with
poor nutritional status will most likely have a high 1-4 year old age-specific mortality rate, also known as child mortality rate.
Answer: (B) Number of registered live births. To compute for general or total fertility rate, divide the number of registered live births by the number
of females of reproductive age (15-45 years), then multiply by 1,000.
Answer: (B) Survey. A survey, also called sample survey, is data gathering about a sample of the population.
Answer: (C) De facto. The other method of population assignment, de jure, is based on the usual place of residence of the people.
Answer: (A) Tally report. A tally report is prepared monthly or quarterly by the RHU personnel and transmitted to the Provincial Health Office.
Answer: (C) Target/client list. The MDT Client List is a record of clients enrolled in MDT and other relevant data, such as dates when clients
collected their monthly supply of drugs.
Answer: (A) P.D. 651. P.D. 651 amended R.A. 3753, requiring the registry of births within 30 days from their occurrence.
Answer: (D) Any of these health professionals. D. R.A. 3753 states that any birth attendant may sign the certificate of live birth.
Answer: (C) Magnitude of the health problem. Magnitude of the problem refers to the percentage of the population affected by a health problem.
The other choices are criteria considered in both family and community health care.
Answer: (D) Its main strategy is certification of health centers able to comply with standards. Sentrong Sigla Movement is a joint project of the DOH
and local government units. Its main strategy is certification of health centers that are able to comply with standards set by the DOH.
Answer: (D) Those who just had a delivery within the past 15 months. The ideal birth spacing is at least two years. 15 months plus 9 months of
pregnancy = 2 years.
Answer: (C) Adequate information for couples regarding the different methods. To enable the couple to choose freely among different methods of
family planning, they must be given full information regarding the different methods that are available to them, considering the availability of quality
services that can support their choice.
Answer: (B) Retinol 200,000 IU. Retinol 200,000 IU is a form of megadose Vitamin A. This may have a teratogenic effect.
Answer: (A) Her OB score is G5P3. Only women with less than 5 pregnancies are qualified for a home delivery. It is also advisable for a
primigravida to have delivery at a childbirth facility.
Answer: (C) Folic acid. It is estimated that the incidence of neural tube defects can be reduced drastically if pregnant women have an adequate
intake of folic acid.
Answer: (D) Note the interval, duration and intensity of labor contractions.. Assessment of the woman should be done first to determine whether
she is having true labor and, if so, what stage of labor she is in.
Answer: (D) Explain to her that putting the baby to breast will lessen blood loss after delivery. Suckling of the nipple stimulates the release of
oxytocin by the posterior pituitary gland, which causes uterine contraction. Lactation begins 1 to 3 days after delivery. Nipple stretching exercises
are done when the nipples are flat or inverted. Frequent washing dries up the nipples, making them prone to the formation of fissures.
Answer: (B) To stimulate milk production by the mammary acini. Suckling of the nipple stimulates prolactin reflex (the release of prolactin by the
anterior pituitary gland), which initiates lactation.
Answer: (B) The mother does not feel nipple pain.. When the baby has properly latched on to the breast, he takes deep, slow sucks; his mouth is
wide open; and much of the areola is inside his mouth. And, you’re right! The mother does not feel nipple pain.
Answer: (B) 6 months. After 6 months, the baby’s nutrient needs, especially the baby’s iron requirement, can no longer be provided by mother’s
milk alone.
Answer: (C) Retinol 200,000 I.U., 1 capsule. A capsule of Retinol 200,000 IU is given within 1 month after delivery. Potassium iodate is given
during pregnancy; malunggay capsule is not routinely administered after delivery; and ferrous sulfate is taken for two months after delivery.
Answer: (C) Measles vaccine. Among the biologicals used in the Expanded Program on Immunization, measles vaccine and OPV are highly
sensitive to heat, requiring storage in the freezer.
Answer: (B) 4. While the unused portion of other biologicals in EPI may be given until the end of the day, only BCG is discarded 4 hours after
reconstitution. This is why BCG immunization is scheduled only in the morning.
Mobilization
Community organization
Follow-up/extension
Core group formation
2. The public health nurse takes an active role in community participation. What is the primary goal of community organizing?
Pre-pathogenesis
Pathogenesis
Prodromal
Terminal
5. Isolation of a child with measles belongs to what level of prevention?
Primary
Secondary
Intermediate
Tertiary
6. On the other hand, Operation Timbang is _____ prevention.
Primary
Secondary
Intermediate
Tertiary
7. Which type of family-nurse contact will provide you with the best opportunity to observe family dynamics?
Clinic consultation
Group conference
Home visit
Written communication
8. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of families. The youngest child of the de los
Reyes family has been diagnosed as mentally retarded. This is classified as a:
Health threat
Health deficit
Foreseeable crisis
Stress point
9. The de los Reyes couple have a 6-year old child entering school for the first time. The de los Reyes family has a:
Health threat
Health deficit
Foreseeable crisis
Stress point
10. Which of the following is an advantage of a home visit?
Wash his/her hands before and after providing nursing care to the family members.
In the care of family members, as much as possible, use only articles taken from the bag.
Put on an apron to protect her uniform and fold it with the right side out before putting it back into the bag.
At the end of the visit, fold the lining on which the bag was placed, ensuring that the contaminated side is on the outside.
14. The public health nurse conducts a study on the factors contributing to the high mortality rate due to heart disease in the municipality where
she works. Which branch of epidemiology does the nurse practice in this situation?
Descriptive
Analytical
Therapeutic
Evaluation
15. Which of the following is a function of epidemiology?
Epidemic occurrence
Cyclical variation
Sporadic occurrence
Secular variation
21. In the year 1980, the World Health Organization declared the Philippines, together with some other countries in the Western Pacific Region,
“free” of which disease?
Pneumonic plague
Poliomyelitis
Small pox
Anthrax
22. In the census of the Philippines in 1995, there were about 35,299,000 males and about 34,968,000 females. What is the sex ratio?
99.06:100
100.94:100
50.23%
49.76%
23. Primary health care is a total approach to community development. Which of the following is an indicator of success in the use of the primary
health care approach?
Sambong
Tsaang gubat
Akapulko
Lagundi
26. What law created the Philippine Institute of Traditional and Alternative Health Care?
R.A. 8423
R.A. 4823
R.A. 2483
R.A. 3482
27. In traditional Chinese medicine, the yielding, negative and feminine force is termed
Yin
Yang
Qi
Chai
28. What is the legal basis for Primary Health Care approach in the Philippines?
1,500
1,800
2,000
2,300