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Nursing in the Phils. The nurse is required to maintain competence by continual learning through continuing professional education to be provided by the accredited professional organization. 2. Among children candidates for organ transplant, when all selected children have appropriate tissue matches for the same donated organ, the basis for the decision as to which child gets the organ is that the organ is given to the child who: A. will receive the most benefit from the new organ B. is most likely to die without the transplant C. is selected by the lottery system for available organs D. is at the top of the list and has waited the longest time CORRECT ANSWER: A RATIONALE: Page 2427 Med-surg: those people who are having higher survival rate 3. The nurse uses what equipment to check for fluid between the parietal and visceral layers of the tunica vaginalis, the outermost covering of the testes? A. 30 cc syringe B. Transilluminator C. Fluid meter D. Manometer CORRECT ANSWER: B RATIONALE: Transillumination- is a light shined thru a body organ to detect fluid 4. Which of the following examples best defines the term role reversal? A. A lazy person becomes very productive in the family B. The good child takes on a bad child role C. A person who has been a good provider quits his or her job D. The child assumes a caregiver role toward the caregiver CORRECT ANSWER: D RATIONALE: Role Reversal - This condition occurs when one person assumes the behaviors of the other person in a reciprocal role, as when a child acts as a parent to his or her parents. (Source: www.unc.edu/~rooney/roletheory.htm) 5. When a nurse breaches the duty of confidentiality, he or she can be disciplined by both the employer and the Board of Nursing. In addition to this discipline, he or she can: A. be held responsible for any damages that result B. be fined by the federal government C. be sentenced for up to 1 year in jail D. immediately lose his or her nursing license CORRECT ANSWER: A RATIONALE: It cannot beB, C or D because as stated in the law no one can be fined imprisoned or license revoked without undergoing due process and have been proven guilty by the court of law. (source: Professional Nsg in the Philippines by Venzon) 6. A strategy for change that focuses on teaching workers new technology is: A. normative-reeducative B. training C. providing information D. power coercive CORRECT ANSWER: B RATIONALE: Training is a dual purpose strategy, it can communicate information ad well as the application of information and technology that can be utilized hands on.(Leadership Roles & Mngt Functions in Nursing p 406) 7. The nurse knows that the occurrence of shoulder dystocia during labor is most likely related to: A. polyhydramnios B. maternal age C. preterm birth D. macrosomia Reproduction is strictly prohibited… RN International Review Center 1
CORRECT ANSWER: D RATIONALE: page 606 pilliteri : shoulder dystocia occurs in most woman with diabetes, multipara and in postdate pregnancies. 8. The nurse instructs the mother that when overstimulated the infant will: A. show increased alertness and eye contact B. respond with coordinated, synchronous body movement C. look away to reduce the intensity of the interaction D. drift off to deep sleep to shut out the interaction CORRECT ANSWER: A RATIONALE: page 689 pilliteri The sense of touch is already well developed at birth, demonstrate it by quieting at a soothing touch and by positive sucking and rooting reflex, and reacts to pain stimuli 9. Some strategies to maintain professional health are listed below. Which is NOT necessarily correct? A. Networking with others in the health care field B. Join a professional organization C. Goal setting D. Read fiction and nonfiction materials CORRECT ANSWER: D RATIONALE: A,B & C are all necessary and required to maintain professional health, this is according to Kozier p.13- Socialization to Nursing. 10. The nurse is assessing a 6 month old infant for head lag, pulling the infant by the hands from a supine to a sitting position. The head does not stay in line with the body when being putted forward. Which of the following statements best represents the significance of this finding? A. Head lag should not be tested until the child is over 1 year of age. B. Significant head lag after the age of 6 months may indicate brain injury and needs further investigations. C. The nurse has not conducted the test correctly and must do it again using proper technique. D. This is a normal finding, as the infant's head will not stay in line until after 3 months of age. CORRECT ANSWER: D RATIONALE: page 697 pelliteri If they are pulled into a sitting position from a supine position, the head will lag considerably. However they should make an effort to control and steady the head as they reach sitting position. Head lag disappears at 3 months 11. Which statement is correct regarding the use of the cervical cap? A. It may affect Pap smear results B. It does not need to be fitted by a physician C. It does not require the use of a spermicide D. It must be removed within 24 hours CORRECT ANSWER: D RATIONALE: Cervical caps are used by woman to prevent conception, it should be fitted by a doctor and uses a spermicide to prevent the sperm from getting inside. A cap should be removed before 24 hours to prevent infection 12. The major components of the communication process are: A. verbal, written, and nonverbal B. speaker, listener and reply C. facial expression, tone of voice, and gestures D. message, sender, channel, receiver, and feedback CORRECT ANSWER: D RATIONALE: (Kozier p.421-422) All are essential components to communication. 13. The extent of burns in children are normally assessed and expressed in terms of: A. the amount of body surface that is unburned B. percentages of total body surface area (TBSA) C. how deep the deepest burns are D. the severity of the burns on a 1 to 5 burn scale CORRECT ANSWER: B RATIONALE: The assessment of burn injuries used for both adults and children are the same, the only difference are the percentages assigned.
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14. The school nurse notices a child who is wearing old, dirty, poor fitting clothes; is always hungry; has no lunch money; and is always tired. When the nurse asks the boy his tiredness, he talks of playing outside until midnight. The nurse will suspect that this child is; A. being raised by a parent of level intelligence quotient (IQ) B. an orphan C. a victim of child neglect D. the victim of poverty CORRECT ANSWER: B RATIONALE: All the above mentioned manifestations are signs of child neglect. Child neglect constitutes 54% of the identified case of child abuse worldwide. (wikepedia.org- child abuse) 15. Which of the following indicates the type(s) of acute renal failure? A. Four types: hemorrhagic with and without clotting, and nonhemorrhagic with and without clotting B. One type: acute C. Three types: prerenal, intrarenal and postrenal D. Two types: acute and subacute CORRECT ANSWER: C RATIONALE: There are only 3 types or etiologies for ARF – renal ischemia (pre-renal), kidney tissue disease (intra-renal) and obstructive (postrenal). 16. A means of facilitating professional staff development is by building upon skills, abilities, and experience of each practitioner is called: A. The novice to expert model B. Situational leadership model C. Career enhancement D. Clinical ladder CORRECT ANSWER: D RATIONALE: A clinical ladder serves as an incentive for to continually improve their knowledge,skills, and competency. It allows the staff to become involved with decision-making activities and encourages holistic thinking, broadening their view of being an integral part of the process of patient care 17. Which of the following questions by the nurse would best fit the philosophy of the nursing mutual participation model of care (NMPMC)? A. "Have you brushed your child's teeth today?" B. "How does your child look to you today?" C. "Where have you been all morning?" D. "Do you think your child's color is worse?" CORRECT ANSWER: B RATIONALE: Nursing Mutual Participation Model of Care (NMPMC) provides nurse-patient interactions that establish a caring attitude toward the parent, help ascertain parental goals and expectations, assesses the parent's perception of their child's illnesses and attitudes, seeks parental suggestions and preferences, and invites parental participation in nurturing care. 18. There are numerous definitions of the word "health". Which definition below is from Florence Nightingale? A. A state or a process of being and becoming an integrated and whole person B. The state of being free from illness or injury C. Being well and using every power the individual possesses to the fullest extent. D. A state of complete physical, social, and mental well-being and not merely the absence of disease or infirmity CORRECT ANSWER: C RATIONALE: Definition of health by Nightingale as stated in the book of Kozier, p 171. 19. Informal communication takes place when individuals talk and is best described by saying the participants: A. are involved in a preexisting informal relationship B. talk with slang words C. have no particular agenda or protocol D. are relaxed CORRECT ANSWER: C RATIONALE: The main difference between formal and informal communication is the structure, where formal always possess a structured agenda, goal or direction as well as protocols. 20. Tertiary care by the home health nurse is directed toward children with: A. problems in mobility B. short-term needs C. minor problems Reproduction is strictly prohibited… RN International Review Center 3
D. clinically apparent disease CORRECT ANSWER: A RATIONALE: problems in mobility requires rehabilitation. Other options requires secondary care. 21. The endometrium thickens during which phase of the menstrual cycle? A. Secretory phase B. Menstrual phase C. Proliferative phase D. Ischemic phase CORRECT ANSWER: C RATIONALE: Release of estrogen during the proliferative phase entails the thickening of the endometrial lining in preparation for fertilization 22. A measurement tool to articulate the nursing workload for a specific patient or groups of patients over a specific period of time is called: A. Staffing pattern B. Skill mix C. Benchmarking D. Patient classification CORRECT ANSWER: D RATIONALE: A,B & C are components of the workload measurement tool known as PCS or Patient Classification System. (Source- Leadership Roles & Mngt Functions in Nursing. p. 425) 23. The mother of a 9-month-old infant is concerned that the head circumference of her baby is greater than the chest circumference. The BEST response by the nurse is: A. “These circumferences normally are the same, but in some babies this just differs.” B. "Perhaps your baby was small for gestational ago or premature." C. “This is normal until the age of 1 year, when the chest will be greater." D. "Let me ask you a few questions, and perhaps we can figure out the cause of this difference." CORRECT ANSWER: C RATIONALE: page 682 pelliteri The head of the newborn is generally larger than the chest upon delivery which is 2cm less than the head circumference. Head will be equal to the chest by 1 year old, and chest will be greater than the head by 2 years of age. Monitoring the head and chest circumference is important in noting problems like hydrocephalus in children 24. Which of the following approaches would work best when the nurse is communicating with an infant? A. Use an adult voice just as you would for anyone B. Communicate through the caregivers C. Allow the child lime to warm up to the nurse D. Respond only after the child cries for a little while CORRECT ANSWER: C RATIONALE: page 689 pilliteri Newborn appear to have difficulty locating sound, however, and do not turn toward it consistently. Perhaps they must learn to interpret small differences amoung sounds arriving at their ears at different times. 25. Evidence-based care started in medicine as a way to: A. promote technological advances in medicine B. incorporate collaboration within all health care disciplines C. integrate individual experience with clinical research D. teach medical students the art and science of medicine CORRECT ANSWER: C RATIONALE: Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. EBM recognizes that many aspects of medical care depend on individual factors such as quality and value-of-life judgments, which are only partially subject to scientific methods. EBM, however, seeks to clarify those parts of medical practice that are in principle subject to scientific methods and to apply these methods to ensure the best prediction of outcomes in medical treatment, even as debate about which outcomes are desirable continues. (source- wikipedia.org/evidencebased-healthcare) 26. The nurse assessing newborn babies and infants during their hospital stay after birth will notice which of the following symptoms as a primary manifestation of Hirschsprung's disease? A. A fine rash over the trunk B. Failure to pass meconium during the first 24 to 40 hours after birth Reproduction is strictly prohibited… RN International Review Center 4
C. The skin turns yellow and then brown over the first 48 hours of life D. High-grade fever CORRECT ANSWER: B RATIONALE: Hirschprung’s disease is characterized by the absence of ganglionic nerve cells responsible for peristaltic movements. An absence of these cells predisposes a child to inability in passing out meconium in the 1st 24 hours of life 27. A client is 7 months pregnant and has just been diagnosed as having a partial placenta previa. She is stable and has minimal spotting and is being sent home. Which of these instructions to the client may indicate a need for further teaching? A. Maintain bed rest with bathroom privileges B. Avoid intercourse for three days C. Call if contractions occur D. Stay on left side as much as possible when lying down CORRECT ANSWER: B RATIONALE: Pregnant woman is considered high risk at this time with a diagnosis of placenta previa. Coitus now is contraindicated in the entire length of her pregnancy as it will predispose the woman to further bleeding. 28. Which of the following groups of people in the world disproportionately represents the homeless population? A. Hispanics B. Asians C. African Americans D. Caucasians CORRECT ANSWER: C RATIONALE: According to the National Coalition for the Homeless Research, African Americans comprise a higher majority of homeless, followed closely by Hispanics and Caucasians. Asians have the lowest homeless rate. 29. The nurse notices that the infant is wearing a plastic-coated diaper. If a topical medication were to be prescribed and it were to go on the stomach or buttocks, the nurse would teach the caregivers to: A. avoid covering the area of the topical medication with the diaper B. avoid the use of clothing on top of the diaper C. put the diaper on as usual D. apply an icepack for 5 minutes to the outside of the diaper CORRECT ANSWER: C RATIONALE: Unless otherwise stated, there is no contraindication for placing clothing above topical medication. 30. The nurse assessing a child of adolescent with a diagnosis of dysrhythmic disorder would find which of the following symptoms? A. Labile mood and hyperactive thyroid with an increase in circulating thyroid hormones and associated symptoms B. Severe shaking of the hands when trying to hold a glass of water or other object C. A depression that is deeper, more acute, and more likely to lead to suicide than major depressive disorder D. A depressed or irritable mood for most of the day, on most days, for 2 or more years and low energy or fatigue CORRECT ANSWER: D RATIONALE: Characterized by a chronic depressive syndrome that is usually present for most of the day, more days than not, for at least 2 years. ( p.455 Foundations of Psychiatric Mental Health Nursing) 31. You were the nurse assigned to work with a child who has had whole brain radiation. You have assessed the child to be sleeping up to 20 hours a day and is having some nausea, malaise, fever, and dysphasia. Based on this assessment, you have to work with the parents in which of the following areas? A. Accepting a reoccurrence of the tumor B. Dealing with the side effects of radiation therapy C. Caring for the dying child D. Accepting the imminent death of their child CORRECT ANSWER: B RATIONALE: The above mentioned manifestations are all side effects of radiation therapy. 32. The nurse is planning interventions for a child who has inflammatory bowel disease (IBD) with a nursing diagnosis of "Nutrition: Less than body requirements". Which of the following interventions will be most helpful in resolving this nursing problem? A. Two large meals a day instead of several minimeals and snacks B. Special IBD diet (diet that has been proven effective for treating IBD) C. Salt-free diet high in potassium, vitamins, and minerals Reproduction is strictly prohibited… RN International Review Center 5
D. Diet as tolerated with lactose, hydrolyzed milk instead of milk products, and omission of highly seasoned foods, and reduction of fiber CORRECT ANSWER: D RATIONALE: There is no special diet for IBD, a well balanced diet is indicated, preferably a bland diet with no gastric irritants and reduced fiber or roughage- emedicinehealth.com & carl balita nursing review p272 33. Emotional intelligence consists of a number of competencies. Some of these are listed below. Which is NOT a characteristic of emotional intelligence? A. Self-esteem B. Self-awareness C. Empathy D. Self-regulation CORRECT ANSWER: D RATIONALE: According to Hein’s definition emotional intelligence is the use, recognition, communication, manipulation and management of emotions to affect growth & development. Self regulation is not an emotional activity and is usually an end result of the of E.I. and its composite interaction with toher G & D factors. (www.eqi.org) 34. Data collection for driving and restraining forces, including costs, desirability, and feasibility, is a: A. people issue B. structural issue C. political issue D. technology issue CORRECT ANSWER: A RATIONALE: Driving and restraining forces are essentially people issues which serves as motivating factors. It cannot be structural as it does not deal with systems, nor is it political because it is not guided by certain ideologies nor is it technology because it does not utilize tools & machines. 35. One of four factors describing the experience of sexually abused children and the effect it has on their growth and development is somatization that occurs when: A. a child blames him-or herself for the sexual abuse and begins to withdraw and isolate B. newspapers and the media don't keep sexual abuse private and accidentally or on purpose reveal the name of the victim C. the child has been blamed by the abuser for his or her sexual behaviors, saying that the child asked to be touched or did not make the abuser stop D. the child is shared by other members of the family or friends when the sexual abuse becomes public knowledge CORRECT ANSWER: A RATIONALE: Somatization is brought about by un-resolved and undifferentiated stress, choices B,C,B are all heavy stressors especially to the already abused child and may cause . Choice A is already a manifestation of depression & inability to handle stress. 36. The painful phenomenon known as "back labor" occurs in a client whose fetus in what position? A. Brow Position B. Right Occipito-Anterior Position C. Breech Position D. Left Occipito-Posterior Position CORRECT ANSWER: D RATIONALE: back labor occurs when the baby is in an awkward position as it enters the birth canal — such as when the baby's head is pressing against the mother's tailbone (sacrum).which is the left occipal area of the fetus is in posterior position 37. FOCUS methodology stands for: A. Focus, Organize, Clarify, Understand, Solution B. Focus, Opportunity, Continuous, Utilize, Substantiate C. Focus, Organize, Clarify, Understand, Substantiate D. Focus, Opportunity, Continuous(process), Understand Solution CORRECT ANSWER: C RATIONALE: This is the definition of the FOCUS Methodology in Research and Problem solving which a more systematic approach that can be used in making a clearer goals for creating and undertaking a research. 38. While community health nurses focus on the individual or the family, which of the following do they also have as their final objective? A. The well-being of the chronically ill Reproduction is strictly prohibited… RN International Review Center 6
B. The financial well being of the family C. The well-being of the extended family D. The well-being of the community CORRECT ANSWER: D RATIONALE: According to the concepts of community health nursing, the practice of CHN covers not just the individual, but the family and whole community was well. (CHN-DOH p.17) 39. Which of the following is the best example of the ethical principle of fidelity? A. Doing whatever the client or the client's physician asks of you B. Keeping a promise to return to the client's room at a given time C. Being a good friend to the client by sharing secrets D. Saving the client time and money by not wasting supplies CORRECT ANSWER: B RATIONALE: In ethics fidelity often is related to the concept of faithfulness and keeping a promise. 40. Which of the following factors is most important in determining the success of relationships used in delivering nursing care? A. Type of illness of the client B. Transference and counter transference C. Effective communication D. Personality of the participants CORRECT ANSWER: C RATIONALE: Communication is the most important component or factor in establishing any forms of relationships. It determines the success or failures of a relationship based on the quality of communication ensuing between two parties.
41. Which of the following statements best describes the term glove type burn?
A. The parent was wearing heavy gloves or stockings on his or her hands while immersing the child in hot scalding water. B. The parents have dipped the child into hot liquid while he or she was asleep. C. The child was wearing a glove when immersed in hot liquid. D. The bum has the look of a glove immersed in hot scalding water. CORRECT ANSWER: D RATIONALE: Glove type burn is a type of burn that shaped like a glove. 42. The school nurse keeps a list of enrolled students who have medical or religious objections lo immunizations and those who are likely to have decreased immunity The nurse likely keeps this just to: A. provide statistics for the Department of Health B. reassure the family that the nurse will respect the family's wishes at all times C. meet national government requirements D. facilitate exclusion in case of an outbreak of a highly communicable disease in the school CORRECT ANSWER: A RATIONALE: Recording are done to provide statistics. 43. Preschoolers are able to see things from which of the following perspectives? A. Their peers B. Their own and their caregivers C. Their own and their mother's D. Only their own CORRECT ANSWER: D RATIONALE: Prescholers like children ages 4 years old normally has imaginary playmates or friends. 44. In conflict management, the win-win approach occurs when: A. there are two conflicts and the parties agree to each win one B. each party gives in on 50% of the disagreements making up the conflict C. both parties involved are committed to solving the conflict D. the conflict is settled out of court so the legal system and the parties win CORRECT ANSWER: C RATIONALE: This conflict resolution strategy is called collaboration, where both parties look for mutually satisfying solutions. 45. According to the social-interactional systemic perspective of child abuse and neglect, four factors place the family members at risk for abuse. These risk factors are the family itself, the caregiver the child, and Reproduction is strictly prohibited… RN International Review Center 7
A. B. C. D.
the presence of a family crisis genetics the national emphasis on sex chronic poverty
CORRECT ANSWER: A RATIONALE: Family crisis according to cornell.edu can include poverty as a risk factor. 46. When a person is discussing the strong influences that child-rearing methods have on the development of the child, this person is most probably coming from which of the following viewpoints or theories? A. Naturalistic B. Nature C. Neoclassic D. Nurture CORRECT ANSWER: D RATIONALE: In the rearing method theories “nature vs. nurture” nurture is geared towards the external environment and not the genetic predisposition. This includes child rearing methods, show of care, discipline 47. In working with the caregivers of a child with an acute or chronic illness, the nurse would: A. teach care dairy and let the caregivers do a return demonstration just before discharge B. delegate care of the child to a nurse's aide and make certain he or she understands the care delegated and completes it C. teach care early and allow the caregivers to provide daily care for as many aspects of the child's care as possible D. take responsibility for the child's care until the day before discharge, and then give caregivers instructions CORRECT ANSWER: A RATIONALE: Asking the caregiver to give a return demonstration of the care given to the patient will actually demonstrate the learning, as well as an understanding of the type of care as well as the quality of care that needs to be given. 48. Which of the following signs and symptoms would you most likely find when assessing an infant with Arnold-Chiari malformation? A. Weakness of the leg muscles, loss of sensation in the legs, and restlessness B. Difficulty swallowing, diminished or absent gag reflex, and respiratory distress C. Difficulty sleeping, hypervigilant, and an arching of the back D. Paradoxical irritability, diarrhea, and vomiting. CORRECT ANSWER: A RATIONALE: wikipedia- Chiari is often associated with major headaches, sometimes mistaken as migraines. Chiari headaches usually include intense throbbing in the back of the head. Chiari also includes extreme muscle soreness and low energy levels. It also can cause a hoarseness in the voice. 49. A patient calls you and frantically reports that her child has gotten into her ferrous sulfate pills and ingested a number of these pills. The child is now vomiting, has bloody diarrhea, and is complaining of abdominal pain. You will tell the mother to: A. call emergency medical services (EMS) and get the child to the emergency room B. relax because these symptoms will pass and the child will be fine C. administer syrup of ipecac D. call the poison control center CORRECT ANSWER: C RATIONALE: The mother has already called you, the nurse so no need to call EMS, the best advice the nurse can give is letter C to induce vomiting to stop absorption of the medication. 50. A client says she heard from a friend that you stop having periods once you are on “the pill". The most appropriate response would be A. "The pill prevents the uterus from making such endometrial lining; that is why periods may often be scant or skipped occasionally." B. "If your friend has missed her period, she should stop taking the pills and get a pregnancy test as soon as possible." C. "The pill should cause a normal menstrual period every month. It sounds like your friend has not been taking the pills properly." D. "Missed periods can be very dangerous and may lead to the formation of precancerous cells." CORRECT ANSWER: C RATIONALE: wikipedia -Other possible side effects are: vaginal discharge, changes in menstrual flow, breakthrough bleeding, nausea, vomiting, headaches, changes in the breasts, changes in blood pressure, loss of scalp hair, skin problems and skin improvements. Reproduction is strictly prohibited… RN International Review Center 8
51. You are the nurse assigned to work with a child with acute glomerulonephritis. Try following the prescribed treatment regimen, the child experiences a remission. You are not checking to make sure the child does not have a relapse. Which finding would most lead you to the conclusion that a relapse is happening? A. Elevated temperature, cough, sore throat, changing complete blood count (CBC) with differential B. A urine dipstick measurement of 2+ proteinuria or more for 3 days, or the child found to have 3-4+ proteinuria plus edema C. The mine dipstick showing glucose in the urine for 3 days. Extreme thirst, increase in urine output and a moon face D. A temperature of 37.8 degrees C(100 degrees F), flank pain, burning, frequency, urgency on voiding, and cloudy urine CORRECT ANSWER: B RATIONALE: In relapse cases, the child has been treated but the classic manifestations and symptoms have once again resurfaced, prompting immediate treatment. That’s is why careful assessment should be done. (Essential Pediatric Nursing p.998) 52. The nurse is working with an adolescent who complains of being lonely and having a lack of fulfillment in her life. This adolescent shies away from intimate relationships at times, yet at other times she appears promiscuous. The nurse will likely work with this adolescent in which of the following areas? A. Isolation B. Loneliness C. Lack of fulfillment D. Identity CORRECT ANSWER: D RATIONALE: According to Erickson, Adolescent staghe is identity vs. role confusion, as a nurse it is our responsibility to encourage self expression for an adolescent to find identity which will result to finding love and fulfillment in themselves. 53. The use of interpersonal decision making, psychomotor skills, and application of knowledge expected in the role of a licensed health care professional in the context of public health welfare and safety is an example of: A. Delegation B. Supervision C. Responsibility D. Competence CORRECT ANSWER: D RATIONALE: Competence is a standardized requirement for an individual to properly perform a specific job. It encompasses a combination of knowledge, skills and behavior utilized to improve performance. More generally, competence is the state or quality of being adequately or well qualified, having the ability to perform a specific role. 54. A child suffers a head injury in a tumbling accident in gym class. The nurse's best course of action is to: A. get the child up walking and make sure he or she stays awake B. leave the child and go get help C. leave the child in the care of an older child and go get help D. stay with the child, keep assessing, and have someone call the caregivers CORRECT ANSWER: D RATIONALE: Staying with the child limits the fear/anxiety the child experiences and never move the child in case of any possible cns problems. 55. The American Academy of Pediatrics suggests that caregivers do which of the following things in regard to physical activities for preschoolers? A. Push the child lo practice sports activities while they are more flexible B. Encourage a variety of physical activities in a noncompetitive environment C. Have the child engage in competitive sports to see where they excel D. Keep physical activities to a minimum until the child is in grade school CORRECT ANSWER: B RATIONALE: The child this age is beginning to establish motor skills, that’s why non-specific activities is encouraged. This is true for this developmental stage of a child. 56. Which of the following arrangements is generally considered to be best for the parents of a hospitalized infant or young child? A. Rooming-in B. Separate caregiver sleeping room on the unit C. Day visits and sleeping at home D. Staying at a nearby hotel or motel Reproduction is strictly prohibited… RN International Review Center 9
CORRECT ANSWER: A RATIONALE: The infant is bound to experience separation anxiety without the presence of the mother as well as stranger anxiety. For any intervention, treatment, assessment to be done for an ifant a caregiver or mother should always be around. 57. When one person allows the conflict to be reserved at his or her own expense, this is referred to in conflict management as: A. losing B. winning while losing C. the win-lose approach D. the lose-win approach CORRECT ANSWER: C RATIONALE: This approach is known as COOPERATION, otherwise known as the “Win-Loose” where one party sacrifices his own belief and allow the other party to win. 58. Which of the following statements best describes acquaintance rape? A. Sexual intercourse when one person engaging in the activity is unsure about wanting to do so B. When two people don't love each other and engage in sexual activities C. When someone on a date tricks the other person into having sexual intercourse D. Sexual intercourse committed with force or the threat of force without a person's consent CORRECT ANSWER: C RATIONALE: the definition of date rape is forcible sexual intercourse by a male acquaintance of a woman, during a voluntary social engagement in which the woman did not intend to submit to the sexual advances and resisted the acts by verbal refusals, denials or pleas to stop, and/or physical resistance. 59. The school nurse is teaching a health education and hygiene course to a group of high schools males, which includes a number of young men who are on competitive sports teams. Which of the following health practices would the nurse most stress in preventing the transmission of human immunodeficiency virus (HIV) virus in case any team member has HIV or acquired immunodeficiency syndrome (AIDS)? A. No sharing of underarm deodorant or shower soap B. No storing of razors or toothbrushes C. Making certain towels have been washed in boiling water D. Avoiding physical contact such as sports hugs or swats CORRECT ANSWER: B RATIONALE: These are implements that come in direct contact with the body’s membranes and fluid secretions, and possible blood. To share these tools would be first and foremost un-hygienic and would also increase probability of transmitting the virus via the secretion left on the tool. 60. At 17 weeks' gestation, a type 1 diabetic undergoes an ultrasound examination. What information about the fetus at this time in pregnancy would the results of this examination provide? A. Placental maturity B. Estimated fetal weight C. Gestational age D. Fetal lung maturity CORRECT ANSWER: A RATIONALE: Noting if the placenta is already fully developed and is producing hormones, placental insulinase(a rapid degenarator of insulin) and HPL human placental lactogen who is an insulin antagonist. Lung maturity of the fetus should be tested after 24 weeks as it is when the surfactants are being produced 61. Which of the following best describes a difference in communicating with school-age children versus toddlers? A. Toddlers require more empathy and more touching and holding B. For toddlers, preparation for procedures is just before the procedure and much earlier for school-aged children C. Caregivers need less information when care involves a school-aged child D. The number of words is more when communicating with a toddler than it is with a school-aged children CORRECT ANSWER: B RATIONALE: Toddlers do not understand procedure, the utilization of play to make the preparation for toddler can be done just before a procedure is done, whereas the school-age child has already developed certain concepts and has already an idea as to what a procedure is(especially is it is medical or surgical in nature) is, more so that one common fear among children this age is the fear of “castration”, so they require more explanation and preparation. 62. Genetic testing should be performed on a child only if: A. the parents both want it performed B. it is in the best interests of the child Reproduction is strictly prohibited… RN International Review Center 10
C. it is necessary for the child to survive D. no one objects CORRECT ANSWER: A RATIONALE: A child is a minor which means any form of procedure or treatment should have a cocurrent consent from the parents. 63. Infant head control is judged by the: A. ability to hold head without support B. presence or absence of head lag C. rigidity of the neck and head D. amount of neck wrinkling CORRECT ANSWER: A RATIONALE: page 697 pelliteri If they are pulled into a sitting position from a supine position, the head will lag considerably. However they should make an effort to control and steady the head as they reach sitting position. Head lag disappears at 3 months 64. Which of the following roles BEST exemplifies the expanded role of the nurse? A. Circulating nurse in surgery B. Medication nurse C. Obstetrical nurse D. Pediatric nurse practitioner CORRECT ANSWER: D RATIONALE: A,B, & C are all traditional or common roles of nurses, whereas a pediatric nurse practitioner is an expanded role of a nurse in a sense that he/she should get s specialization training in order to practice this role. 65. The tone and pitch of the voice, volume, inflection, speed, grunts and other vocalizations are referred to by which of the following terms? A. Paraverbal clues B. Ancillary speech C. Third element D. Enhancements CORRECT ANSWER: A RATIONALE: Paraverbal clues or your non-verbal cues are those factors in communication that does not require the use of spoken or written language, but rather they are the physical manifestations and actions that accompany the spoken language, one which also connotes or heightens the message communicated or said. 66. The plan-do-study-act cycle begins with: A. Four stages B. Five agendas C. Three questions D. Two concepts CORRECT ANSWER: D RATIONALE: This type of cycle connotes two main ideas and stages, which are first, the planning phase where all aspects are identified, goals set, prioritized, evaluated for its efficacy and feasibility, then after that the implementation which is the acting or doing phase, wherein the plans are already put into action and whatever products of the study is already applied to the implementation process. 67. During your shift, you noted one of your pregnant clients considered as “waiting case" manifests morning sickness and which later progressed. Which assessment finding may indicate a possible developing complication? A. Maternal pulse 90 B. Trace glucose in the urine C. FHT 155 D. 1+ ketones in the urine CORRECT ANSWER: D RATIONALE: ketones = diabetes in pregnancy. The fetus absolutely must have energy, so if your pancreas cannot make enough insulin to overcome the hormone-caused resistance, the cells start accessing other sources of energy, like fat stores. The by-product of this is ketones. 68. The nurse is working with a child who is going to have a bone marrow aspiration. The physician orders TAC (tetracaine, adrenaline, and cocaine). Which of the following is the route of administration? A. Application to the skin, covered with a dressing prior to the procedure B. Subcutaneous C. IV using a very slow drip over approximately 4 hours prior to procedure D. Nasal inhalation Reproduction is strictly prohibited… RN International Review Center 11
CORRECT ANSWER: C RATIONALE: Anesthetic is given via IV for either complete or partial sedation. For partial sedation an adjunct topical anesthetic is applied to the site prior the procedure. 69. According to DeRosa and Kochura's (2006) article entitled "Implement Culturally Competent Health Care in your Workplace." cultures have different patterns of verbal and nonverbal communication. Which difference does NOT necessarily belong? A. Personal behavior B. Eye contact C. Subject matter D. Conversational style CORRECT ANSWER: C RATIONALE: This is not a mode of communication, rather it is the topic which tends to be more general if not universal. 70. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is to: A. remind the caregivers to do cord care B. keep the diaper from rubbing the cord C. provide air circulation for the cord D. allow visualization at all times CORRECT ANSWER: C RATIONALE: page 712 pilliteri. Be certain that the diaper are folded below the level of the umbilical cord, so that, when the diaper becomes wet, the cord does not become wet also. 71. The level of health of an individual, family, group, population, or community is called: A. Health assets B. Health status C. Quality of life D. Health needs CORRECT ANSWER: B RATIONALE: Health status is defined as the current state of health of an individual, group or community. 72. The nurse is teaching a group of expectant mothers about the prevention of diaper dermatitis. The nurse explains that one of the preventive measures is the use of: A. absorbent disposable diapers B. baby powder or cornstarch C. plastic panties over diapers D. cloth diaper CORRECT ANSWER: A RATIONALE: page 1122 wong pedia – Superabsorbent disposable paper diaper reduce diaper dermatitis. They contain an absorbent getting material that binds water tightly to decrease skin wetness, maintain pH control by providing a buffering capacity, and decreases skin irritation by preventing mixing of urine and feces in diaper. B – a management of diaper rash or use a Desitin ointment C- leads to diaper rash because of the heat created by the plastic panties D – improperly washed cloth diaper leads to rash 73. The Code of Nurses A. delineates all obligations and responsibilities of the nurse B. is a binding oath, which tells nurses how to make, ethical decisions C. assists the nurse in formulating a personal belief system D. supports the concept of respect for all persons CORRECT ANSWER: A RATIONALE: Codes serves as guidelines on the performance of ones professional duties and responsibilities as well as how to make critical ethical decisions in line with the practice of the profession. (Professional Nursing in the Phil. Vengson p.127) 74. The obligation to correctly perform one's assigned duties is: A. delegation B. assignment C. responsibility D. accountability CORRECT ANSWER: C Reproduction is strictly prohibited… RN International Review Center 12
RATIONALE: A responsibility is an obligation, delegation is to share and impart responsibility, assignment is the task one is responsible for, and accountability is the taking-on of the responsibility. 75. During a routine postpartum assessment following a normal vaginal delivery, the nurse notes the fundus to be slightly boggy. Which action should the nurse take to decrease the risk of uterine inversion during uterine massage? A. Massage only until cramping begins B. Place one hand on the abdomen above the symphysis pubis C. Ask the client to ambulate to the bathroom to empty her bladder D. Position the client in a slight Trendelenburg position CORRECT ANSWER: A RATIONALE: A floppy or boggy uterus that has not contracted down well is the main cause of postpartum hemorrhage. Your caregivers will massage the uterus strongly to make sure it is well contracted. If the bleeding stops with massage, they may give you medication to keep it contracted. If your uterus is well contracted and you continue to bleed too much, they will then look for other causes like tears in the genital tract. When a woman has postpartum hemorrhage, the doctor must determine the exact cause of the problem in order to stop the bleeding. SITUATIONAL Situation 1- Nurse Mercy is a staff nurse in the OB ward of Laoag Medical Center. 76. When the separation begins at the center and the placenta slides down the birth canal like a folded umbrella, this is referred to as: A. Duncan mechanism B. Schultz mechanism C. Brandt Andrews maneuver D. Ritgen’s maneuver CORRECT ANSWER: B RATIONALE: When the placenta separates first at the center and it slide down the birth canal like a folded umbrella with the fetal side being delivered first, it is called Schultz method. The Duncan method of placental delivery is characterized by separation that begins at the edges with the maternal side being delivered first. Brandt-Andrew maneuver is a technique used to deliver placenta safely. Ritgen’s maneuver is a technique used on delivering the fetal head to promote extension and prevent lacerations. A. B. C. D. 77. In the immediate postpartum period, the action of methylergonovine is to: Cause sustained uterine contraction Cause intermittent uterine contractions Relax the uterus Induce sleep so the mother can rest after an exhausting labor CORRECT ANSWER: A RATIONALE: Methylergonovine (and syntocinon or oxytocin) is an oxytocic drug given on the stage of labor, this drug causes sustained uterine contractions. Uterine contraction is the primary mechanism by which bleeding in the placenta site is prevented. 78. Gina, a newly delivered multipara complains of heavy and painful breasts accompanied by fever. The nurse tells Gina that it is normal breast engorgement as the fever is characterized by: More than 38 degree centigrade Does not last more than 24 hours Caused by infection Needs to be treated with antibiotics CORRECT ANSWER: B RATIONALE: Fever caused by breast engorgement does not last more than 24 hours and is usually low grade. No antibiotic is necessary as it is no caused by infection but by increased blood supply to the breast tissue. A. B. C. D. 79. Postpartum depression occurs during which time frame? Within 6 weeks after delivery Within 12 weeks Within 16 weeks Within 24 weeks CORRECT ANSWER: A RATIONALE: Postpartum depression occurs during the first six weeks after delivery. 80. Martha, a 38 year old multipara is admitted with a tentative diagnosis of femoral thrombophlebitis. The nurse assesses the patient with: Burning of urination Reproduction is strictly prohibited… RN International Review Center 13
A. B. C. D.
B. C. D.
Leg pain Abdominal pain Increased lochial flow CORRECT ANSWER: B RATIONALE: Inflammation of the vein resulting in vascular occlusion of the vessels of the pelvis or lower extremities is termed thrombophlebitis.
Situation 2 - To assure wellness and survival of children 0-59 months old, there are activities that are performed by a community health nurse: 81. A. B. C. D. For immediate care of the newborn, what should the nurse do first? Put baby in rooming-in Clear airways Breastfeeding the baby Inject Vit. K CORRECT ANSWER: B RATIONALE: The nurse’s priority when caring for a newborn is to establish and maintain effective respiration. This is achieved by the following measures: • Suctioning secretions from the mouth after delivery of the head and repeating the action after complete delivery of the newborn to remove amniotic fluid and secretions from the airway that could cause aspiration and prevent newborn from breathing effectively. • Stimulating the newborn after the airway is cleared. “A crying baby is a breathing baby” as the infant takes in air and expands his lungs when he cries. • Placing the newborn in trendelenburg position to promote further drainage of secretions. 82. A. B. C. D. What is the standard tool to record vital information about the child and kept in the home? Growth Development Record Growth Monitoring Promotion Growth Monitoring Chart Growth Monitoring Record CORRECT ANSWER: C RATIONALE: All newborns are issued a Growth Monitoring Chart where growth rate and other vital information are recorded and kept at home by the mother. The mother brings the Growth Monitoring Chart to the clinic or center everytime the child is to have a check-up, treatment or immunization. 83. A. B. C. D. When is the immunization of a child completed? 0-12 months 3-4 years 5-6 months 12-24 months CORRECT ANSWER: A RATIONALE: The prescribed immunization for the infant should be completed by the child’s first birthday. During the first year of life, a fully immunized child should already be immunized against the following diseases: • Tuberculosis: BCG • Diptheria: DPT • Pertussis: DPT • Tetanus: DPT • Poliomyelitis: OPV • Measles: Measles vaccines • Hepatitis B: Hepatitis vaccine 84. A. B. C. D. Four hours after birth, which finding in a newborn requires further assessment? Yellowish sclera Bluish palms and soles Moro reflex Heart rate of 160 CORRECT ANSWER: A RATIONALE: Yellowish sclera is a sign of jaundice which is considered abnormal if it appears during the first 24 hours after birth. It indicates hemolysis of red blood cells of the newborn which could be due to ABO or RH incompatibility. Acrocyanosis or bluish discoloration of the newborn’s palms and soles are normal findings during the first 12 hours after birth. Moro reflex and heart rate are also normal findings. 85. The Ligtas Buntis Campaign of the DOH aims to achieve the following goals except: Reproduction is strictly prohibited… RN International Review Center 14
A. B. C. D.
Universal Access to Family Planning Maternal Care Formation Services of Men Services for aging Couples CORRECT ANSWER: D RATIONALE: Ligtas Buntis Campaign targets only men and women in their reproductive years. Its objective is “to deliver the needed FP and Maternal Care education and services to the target population In women, the reproductive age is between 15 to 49 years old. In male, the reproductive age is from 15 years old onwards.
Situation 3 - With the increasing documented cases of CANCER the best alternative to treatment still remains to be PREVENTION. The following conditions apply. 86. Which among the following is the primary focus of prevention of cancer? A. Elimination of conditions causing cancer B. Diagnosis and treatment C. Treatment of early stage D. Early Detection CORRECT ANSWER: A RATIONALE: The primary focus of cancer prevention is promotion of healthy lifestyle which includes removal or lessening of factors that may cause cancer. Secondary to that is early detection to effect higher chances of recovery after proper treatment.
87. In the prevention and control of cancer which of the following activities is the most important function of the
community health nurse? A. Conduct of community assemblies B. Referral to cancer specialist those clients with symptoms of cancer C. Use the nine warning signs of cancer as parameters in our process of detection, control, and treatment modalities D. Teach women about proper/correct nutrition CORRECT ANSWER: D RATIONALE: Proper nutrition is one of the features of health education in the prevention of cancer. 88. Who among the following are recipients of the secondary level of care for cancer cases? A. Those under early case detection B. Those under post case treatment C. Those scheduled for surgery D. Those undergoing treatment CORRECT ANSWER: D RATIONALE: Primary Care is geared towards, Health education, disease prevention and early diagnosis. Secondary Care connotes that patient is already sick-bound for treatment. Tertiary Care is more rehabilitative. 89. Who among the following are recipients of the tertiary level of care for cancer cases? A. Those under early treatment B. Those under supportive care C. Those under early detection D. Those scheduled for surgery CORRECT ANSWER: B RATIONALE: Refer to rationale above. 90. In Community Health nursing, despite the availability and use of many equipment and devices to facilitate the job of the community health nurse, the best tool any nurse should well be prepared to apply is a scientific approach. This approach ensures quality of care even at the community setting. This in nursing parlance is nothing less than the: A. nursing diagnosis B. nursing protocol C. nursing research D. nursing process CORRECT ANSWER: D RATIONALE: Definition of Nursing Process Situation 4 - Dengue hemorrhagic fever is a common health concern in Philippine society. It does not only pose a threat to health but more so to the lives of both young and old and well as rich and marginalized sectors of society. The following conditions apply Reproduction is strictly prohibited… RN International Review Center 15
91. An important rote of the community health nurse in the prevention and control of Dengue H-fever includes: A. Advising the elimination of vectors by keeping water containers covered B. Conducting strong health education drives/campaign directed towards proper garbage disposal . C. Explaining to the individuals, families, groups and community the nature of the disease and its causation D. Practicing residual spraying with insecticides CORRECT ANSWER: C RATIONALE: All the other choices will follow if the community is well educated and informed. 92. Community health nurses should be alert in observing a Dengue suspect. The following is NOT an indicator for hospitalization of H-fever suspects. A. Marked anorexia, abdominal pain and vomiting B. Increasing hematocrit count C. Fever for more than 2 days D. Persistent headache CORRECT ANSWER: D RATIONALE: All the other manifestations are signs that would indicate immediate hospitalization. 93. The community health nurses' primary concern in the immediate control of hemorrhage among patients with dengue is: A. advising low fiber and non-fat diet B. providing warmth through light weight covers C. observing closely the patient for vital signs leading to shock D. keeping the patient at rest CORRECT ANSWER: D RATIONALE: PHN immediate responsibility in cases of bleeding os to keep the patient at rest to prevent aggravating the condition. PHN 267 94. Which of these signs may NOT be REGARDED as a truly positive signs indicative of Dengue H-Fever? A. Prolonged bleeding time B. Appearance of at least 5 petechiae C. Steadily increasing hematocrit count D. Fall in the platelet count CORRECT ANSWER: B RATIONALE: 20 or more petechiae for every 1 inch square means positive for the disease. 95. Which of the following is the most important treatment of patients with Dengue H-fever? A. Give aspirin for fever B. Replacement of body fluids C. Avoid unnecessary movement of patient D. Ice cap over the abdomen in case of melena CORRECT ANSWER: B RATIONALE: PHN p.266. Situation 5 - Two children were brought to you. One with chest in-drawing and the other had diarrhea. The following questions apply. 96. Using the Integrated Management & Childhood Illness (IMCI) approach, how would you classify the 1st child? A. Bronchopneumonia B. No pneumonia: cough or cold C. Severe pneumonia D. Pneumonia CORRECT ANSWER: C RATIONALE: According to IMCI guidelines, a child with chest in-drawing, any danger signs and stridor in a calm child is classified as with severe pneumonia. 97. The 1st child who is 13 months has fast breathing using IMCI parameters he has: A. 40 breaths per minute or more B. 50 breaths per minute C. 30 breaths per minute or more D. 60 breaths per minute CORRECT ANSWER: A RATIONALE: IMCI guidelines states that a child 12 mos. up with 40 or more breaths per minute is fast breathing. Reproduction is strictly prohibited… RN International Review Center 16
98. Nina, the 2nd child has diarrhea for 5 days. There is no blood in the stool. She is irritable, and her eyes are sunken. The nurse offered fluids and the child drinks eagerly. How would you classify Nina's illness? A. Some dehydration B. Dysentery C. Severe dehydration D. No dehydration CORRECT ANSWER: A RATIONALE: All are s/s of some diarrhea as classified by IMCI. 99. Nina's treatment should include the following EXCEPT. A. Reassess the child and classify him for dehydration B. For infants under 6 months old who are not breastfed, give 100-200 ml clean water as well during this period C. Give in the health center the recommended amount of ORS for 4 hours D. Do-not give any other foods to the child for home treatment CORRECT ANSWER: D RATIONALE: Plan B Treatment Plan for Some Diarrhea states that together with recommended mode of treatment, feeding should be continued. 100. While on treatment, Nina, 18 months old weighed 10kg and her temperature registered at 37° C. Her mother says she developed cough 3 days ago. Nina has no general danger signs. She has 45 breaths/minute, no chest indrawing, no stridor. How would you classify Nina's manifestation? A. No pneumonia B. Severe pneumonia C. Pneumonia D. Bronchopneumonia CORRECT ANSWER: C RATIONALE: Fast breathing without danger signs is indicative of pneumonia.
Reproduction is strictly prohibited… RN International Review Center 17
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