COMPETENCY OPTIMIZING REVIEW (CORe) 3.

A 22-year old woman has missed two of her regular menstrual

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

98. Which of the following findings indicate fast breathing?

a. Respiratory rate of 30 or more breaths for a 15 months old child
b. Respiratory rate of 40 or more breaths for a 2 months old child
c. Respiratory rate of 50 or more breaths for a 2 weeks old infant
d. Respiratory rate of 60 or more breaths for a 6 weeks old infant
ANSWER: D
There is fast breathing if a child whose age is:
1 week to 2 months old infant have 60 or more breaths per minute
2 to 12 months old child have 50 or more breaths per minute
12 months to 5 years old child have 40 or more breaths per minute
Reference: WHO. IMCI Manual. 2009 Edition. Page 2.

99. A correlation coefficient of –0.80 between the number of hours

studied for a test and the scores on the test
indicates that:
a. As the number of hours studied decreases, test scores increase.
b. As the number of hours studied increases, test scores increase.
c. There is a strong correlation between the number of hours studied
for a test and test scores.
d. The number of hours studied is correlated with test scores.
ANSWER: A
Students may have difficulty answering this question because they
would expect a positive relationship, not a
negative relationship, between the number of hours studied and test
scores. However, the minus sign in front of the
correlation coefficient indicates a negative relationship. The –.80
correlation is a fairly strong correlation.
Reference: Polit and Beck. Nursing Reseach. 8th
edition Page 453

100. Probability sampling involves:

a. The use of a random selection process c. Haphazardly selecting
names from a telephone book
b. Asking one subject to recommend three more d. The use of
sequential lists
ANSWER: A
The term “random” seems haphazard but is actually a determined
selection process with the goal to examine
representative units of populations. Random sampling is a very
systematic and scientific process.
Reference: Polit and Beck. Nursing Reseach. 8th
edition Page 344