TEST II - Community Health Nursing and Care of the Mother and

Child

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?

a. Inevitable b.
Incomplete c.
Threatened d.
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?

a. Age 36 years
b. History of syphilis
c. History of genital herpes
d. 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?

a. Monitoring weight
b. Assessing for edema
c. Monitoring apical pulse
d. 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:

a. Decreased caloric intake

b. Increased caloric intake
c. Decreased Insulin
d. Increase Insulin

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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?

a. Excessive fetal activity.

b. Larger than normal uterus for gestational age.
c. Vaginal bleeding
d. 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:

a. Urinary output 90 cc in 2 hours.

b. Absent patellar reflexes.
c. Rapid respiratory rate above 40/min.
d. 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:

a. Presenting part is 2 cm above the plane of the ischial spines.

b. Biparietal diameter is at the level of the ischial spines.
c. Presenting part in 2 cm below the plane of the ischial spines.
d. 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:

a. Contractions every 1 ½ minutes lasting 70-80 seconds.

b. Maternal temperature 101.2
c. Early decelerations in the fetal heart rate.
d. 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:

a. Ventilator assistance
b. CVP readings
c. EKG tracings
d. Continuous CPR

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10. A trial for vaginal delivery after an earlier caesareans, would likely to be
given to a gravida, who had:

a. First low transverse cesarean was for active herpes type 2

infections; vaginal culture at 39 weeks pregnancy was positive.
b. First and second caesareans were for cephalopelvic disproportion.

c. First caesarean through a classic incision as a result of severe fetal

distress.
d. 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:

a. Talk to the mother first and then to the toddler. b.

Bring extra help so it can be done quickly. c.
Encourage the mother to hold the child. d.
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?

a. Avoid touching the suture line, even when cleaning. b.

Place the baby in prone position. c. Give the baby a
pacifier.
d. 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?

a. Feed the infant when he cries.

b. Allow the infant to rest before feeding.
c. Bathe the infant and administer medications before feeding.
d. 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?

a. Skim milk and baby food. b.

Whole milk and baby food. c.
Iron-rich formula only.
d. 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

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 infant looks for it. The nurse is aware that estimated age of the infant
would be:

a. 6 months b.
4 months c.
8 months d.
10 months

16. 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
catchments 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.

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. Vangie is a new B.S.N. graduate. She wants to become a Public Health
Nurse. Where should she apply?

a. Department of Health b.
Provincial Health Office c.
Regional Health Office d.
Rural Health Unit

19. Tony is aware the Chairman of the Municipal Health Board is:

a. Mayor
b. Municipal Health Officer c.
Public Health Nurse d. 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?

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 a. 1
b. 2c.
3
d. 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?

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 is 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 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?

a. Poliomyelitis b.
Measles c. Rabies
d. Neonatal tetanus

23. May knows that the step in community organizing that involves training of
potential leaders in the community is:

a. Integration
b. Community organization c.
Community study
d. Core group formation

24. Beth a public health nurse takes an active role in community participation.
What is the primary goal of community organizing?

a. To educate the people regarding community health problems

b. To mobilize the people to resolve community health problems
c. To maximize the community's resources in dealing with health
problems.
d. To maximize the community's resources in dealing with health
problems.

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25. Tertiary prevention is needed in which stage of the natural history of
disease?

a. Pre-pathogenesis b.
Pathogenesis c.
Prodromal d.
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)?

a. Intrauterine fetal death. b.

Placenta accreta. c.
Dysfunctional labor.
d. Premature rupture of the membranes.

27. A fullterm client is in labor. Nurse Betty is aware that the fetal heart rate
would be:

a. 80 to 100 beats/minute b.
100 to 120 beats/minute c.
120 to 160 beats/minute d.
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:

a. Change the diaper more often.

b. Apply talc powder with diaper changes.
c. Wash the area vigorously with each diaper change.
d. 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:

a. Atrial septal defect b.

Pulmonic stenosis
c. Ventricular septal defect d.
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:

a. Anemia

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 b. Decreased urine output
c. Hyperreflexia
d. 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:

a. Menorrhagia b.
Metrorrhagia c.
Dyspareunia d.
Amenorrhea

32. Jannah is admitted to the labor and delivery unit. The critical laboratory
result for this client would be:

a. Oxygen saturation b.
Iron binding capacity c.
Blood typing
d. Serum Calcium

33. Nurse Gina is aware that the most common condition found during the
second-trimester of pregnancy is:

a. Metabolic alkalosis b.
Respiratory acidosis c.
Mastitis
d. 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. A crying 5 year old child with a laceration on his scalp.

b. A 4 year old child with a barking coughs and flushed appearance.
c. A 3 year old child with Down syndrome who is pale and asleep in
his mother's arms.
d. 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?

a. Placenta previa
b. Abruptio placentae
c. Premature labor
d. Sexually transmitted disease

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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:

a. Just before bedtime

b. After the child has been bathe c.
Any time during the day d.
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?

a. Irritability and seizures b.

Dehydration and diarrhea c.
Bradycardia and
hypotension d. 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?

a. "I should check the diaphragm carefully for holes every time I use it"
b. "I may need a different size of diaphragm if I gain or lose weight
more than 20 pounds"
c. "The diaphragm must be left in place for atleast 6 hours after
intercourse"
d. "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:

a. Drooling
b. Muffled voice c.
Restlessness
d. Low-grade fever

40. How should Nurse Michelle guide a child who is blind to walk to the
playroom?

a. Without touching the child, talk continuously as the child walks

down the hall.
b. Walk one step ahead, with the child's hand on the nurse's elbow. c.
Walk slightly behind, gently guiding the child forward. d. Walk next
to the child, holding the child's hand.

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41. When assessing a newborn diagnosed with ductus arteriosus, Nurse
Olivia should expect that the child most likely would have an:

a. Loud, machinery-like murmur. b.

Bluish color to the lips.
c. Decreased BP reading in the upper extremities d.
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:

a. Less oxygen, and the newborn's metabolic rate increases. b.

More oxygen, and the newborn's metabolic rate decreases. c.
More oxygen, and the newborn's metabolic rate increases. d.
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:

a. Stable blood pressure b.

Patant fontanelles c.
Moro's reflex d. Voided

44. Nurse Carla should know that the most common causative factor of
dermatitis in infants and younger children is:

a. Baby oil
b. Baby lotion
c. Laundry detergent
d. Powder with cornstarch

45. During tube feeding, how far above an infant's stomach should the nurse
hold the syringe with formula?

a. 6 inches b. 12
inches c. 18
inches d. 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?

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 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.

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?

a. Advice them on the signs of German measles.

b. Avoid crowded places, such as markets and movie houses. c.
Consult at the health center where rubella vaccine may be
given. d. 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:

a. Contact tracing
b. Community survey c.
Mass screening tests d.
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?

a. Hepatitis A b.
Hepatitis B c.
Tetanus
d. 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?

a. Giardiasis
b. Cholera
c. Amebiasis

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d. Dysentery