Community Health Nursing II, 2.

7 , final term
KMU paper BSN
FINAL TERM EXAM :( Year 3 Semester V Generic BSC.
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Subject: Community Health Nursing II
1- A community health nurse is performing an assessment of a Primipara who is being
evaluated in a clinic during her second trimester of pregnancy. Which of the following indicates
an abnormal physical finding necessitating further testing?

a. Consistent increase in fundal height

b. Fetal heart rate of 180 BPM

c. Braxton hicks contractions

d. Quickening

2-……………… is a visual representation of a family in relation to the community. It

demonstrates the nature and quality of family relationships and what kinds of resources or
energies are going in and out of the family.

a. Genogram

b. Ecomap

c. Family map

d. Relationship map

3-A nursing instructor asks a nursing student who is preparing to assist with the assessment of a
pregnant client to describe the Braxton Hicks Contraction. Which of the following statements if
made by the student indicates an understanding of this term?

a. “It is the irregular, painless contractions that occur throughout pregnancy.”

b. “It is the soft blowing sound that can be heard when the uterus is auscultated.”

c. “It is the fetal movement that is felt by the mother.”

d. “It is the thinning of the lower uterine segment.”

4-The resistance to the spread of a contagious disease within a population that results if a
sufficiently high proportion of individuals are immune to the disease, especially through
vaccination.

a. Hidden immunity

b. HERD immunity

c. Active immunity

d. Passive immunity

5-A 19 years old primary gravida comes in emergency at 32 weeks gestation .she is
complaining of blurring of vision , gross edema. On examination her B.P is 170/115 mmHg.
What is most likely diagnosis :

a. Hypertension

b. Renal disease

c. Eclampsia

d. Pre-eclampsia

6-If a pregnant woman's Last Menstrual Period (LMP) was on 24/03/15, what would her
Estimated Date of Delivery (EDD) be, according to Nagle's rule?

a. 31/12/15
b. 24/12/15

c. 01/01/16

d. 01/12/1

7-A woman who has had two live births, a miscarriage at 26 weeks and is currently pregnant
with another child would be described as:

a. Para 3, Gravida 4

b. Para 2 , Gravida 4

c. Para 2 , Gravida 3

d. Para 3, Gravida 3

8-Best position for Breast Feeding is :

a. Football hold

b. Side lying

c. Cross cradle

d. Australian hold

9-The twist in the neck of the fetus that resulted from internal rotation during labour is corrected
by which of the following :

a. Lateral flexion

b. Extension of the head

c. Restitution

d. Engagement

10-After an egg is ovulated; the remaining follicular mass is called:

 a. Vesicular follicle

b. Corpus leuteum

c. Ovum

d. Follicle

11-The process of weakning a pathogen is called

a. Vaccination

b. Attenuation

c. immunization

d. virulence reduction

12-Which of the following statement is true regarding vaccination:

a. vaccination is a method of active immunization

b. vaccination is a method of passive immunization

c. vaccination is a method of artificial passive immunization

d. vaccination is a method of natural passive immunization

13-What is the diameter of fetal skull that presents at vulva during normal labour:

a. Suboccipitofrontal

b. Mentovertical

c. Suboccipitobregmatic

d. Occipitofrontal
14-A 26-year old multigravida is 14 weeks’ pregnant and is scheduled for an alpha-fetoprotein
test. She asks the nurse. “What does the alpha-fetoprotein test indicate?” The nurse bases a
response on the knowledge that this test can detect:

a. Kidney defects

b. Cardiac defects

c. Neural tube defects

d. Urinary tract defects

15- During a Prenatal visit at 38 weeks, a nurse assesses the fetal heart rate. The nurse
determines that the fetal heart rate is normal if which of the following is noted?

a. 80 bpm

b. 100 bpm

c. 180 bpm

d. 150 bpm

16- A pregnant client is week 32 of gestation.At which time interval would you assist the client
in scheduling her next appointment:

a. 1 month

b. 3 weeks

c. 2 weeks

d. 1 week

17- Stage 1 of labor includes which phases in the correct order?

a. Transition, Latent, Active

b. Active, Latent, Transition

 c. Active, Transition, Latent

d. Latent, Active, Transition

18-In which year were the Millennium Development Goals (MDGs) adopted by world leader

a. 1975 b. 2000 c. 1999 d. 1999

19- Which among the following is most heat sensitive vaccine:

a. OPV

b. TT

c. Hep b

d. PCV

20-The class of immunoglobulin which can pass placenta and provide immunity to the fetus is:

a. IgM

b. IgG

c. IgA

d. IgD

21-Number of chromosome in mature sperm is:

a. 23

b. 46
 c. 12

d. 40

22-The most important protective function of the antibody stimulated by tetanus immunization
is:

a. To prevent adherence of the pathogen

b. To opsonize the the pathogen

c. To prevent growth of the pathogen

d. To neutralize the toxin of the pathogen

23- 3 P’s of 2nd stage of labour include which of the following:

a. Power ,Passage, Pressure

b. Passenger, Progress , Passage

c. Power ,Passage , Passenger

d. None of the above

24- Among the following which is not the danger signals during labour :

a. Prolapse of cord or hand

b. Meconium liquor

c. Slow irregular or excessive fast fetal heart rate

d. Retraction Ring

25-Which of the following is not a component of the Apgar score?

a. Muscle tone

b. Respiratory effort
c. Heart rate

d. Blood pressure

26-The 4 “T’s” of PPH are: 1. Trauma 2. Toxins 3. Travel 4. Tissue 5.Threads 6.Thrombin
7.Tears 8. Tone

a. 1, 4, 6 & 8

b. 1, 5 7 & 8

c. 1, 2, 3 & 6

d. 3, 4, 5 & 6

27-The class of immunoglobulin most abundant in body is :

a. IgM

b. IgA

c. IgD

d. IgG

28-Where would you expect the uterus to extend to in a woman of 36 weeks' gestation?

a. Xiphoid Sternum

b. Umbilicus

c. Just above the pubic symphysis

d. Half way between the umbilicus and the xiphoid sternum

29-After the delivery of fetus placenta should be removed through:

a. Manual removel

b. C-section
c. Controlled cord traction

d. Fundal pressure

30-Which of the following statements describes the second stage of labour correctly?

a. The second stage begins at full dilation of the cervix and ends once the baby and placenta have been expelled
from uterus.

b. The second stage begins when the cervix is 7 cm dilated and ends when the cervix reaches full dilatation.

c. The second stage begins at full dilatation of the cervix and ends when the baby is born.

d. The second stage begins when the cervix is 3 cm dilated and ends when the cervix reaches full dilatation

31-What is the definition of Postpartum haemorrhage (PPH)?

a. Loss of >500ml of blood from the vagina within 24 hours of delivery

b. Loss of >200ml of blood from the vagina within 24 hours of delivery

c. Loss of >200ml of blood from the vagina during delivery

d. Loss of >500ml of blood from the vagina during delivery

32-Which factor is not considered as a high risk factor during antenatal period:

a. A short stature brim

b. Women below 145cm in height

c. Weight < 40 kg or more then 80 kg

d. 2nd ,3rd 4th pregnancy only

33-At 28 weeks gestation where would you expect to feel the uterine fundus?

a. Symphysis pubis

b. Halfway between xiphi sternum and umbilicus

c. Xiphisternum

d. Umbilicus

34. Stage 1 of labor includes which phases in the correct order?

a. Transition, Latent, Active

b. Active, Latent, Transition
c. Active, Transition, Latent
d. Latent, Active, Transition

35- Your laboring patient has transitioned to stage 2 of labor. What changes in the perineum
indicate the birth of the baby is imminent?
a. Increase in meconium-stained fluid and retracting perineum
b. Retracting perineum and anus with an increase of bloody show
c. Rapid and intense contractions
d. Bulging perineum and rectum with an increase in bloody show

36- After birth, where do you expect to assess fundal height?

a. At the xiphoid process

b. 5 cm below the umbilicus

c. 2 cm above the pubic symphysis

d. At or near the umbilicus

37- Term Multi Parous means :

a. Never carried a pregnancy to viability

b. Has had two or more deliveries that were carried to viability

c. Pregnant for first time

d. Pregnant more than once

38-A first time mother is 25 weeks pregnant. She asks the nurse what the best position to sleep in
is. Which position should the nurse instruct the mother to sleep in?

a. Left side
b. On back

c. Right side

d. Stomach

39-A family consisting of a couple , the children they have had together , and their children from
previous relationship:

a. Nuclear family

b. Patrilineal family

c. Blended family

d. Mongymous family

40- From the time the children are gone till the marital couple retires from
employment. Developmental task include Renewing and redefining the marriage relationship,
maintaining ties with children and their families, preparing for retirement years, is which stage of
family life cycle :

a. Stage 6: launching

b. Stage 7: empty nest

c. Stage 4: family with school age children

d. Stage 2: Childbearing family

41- HELLP syndrome is characterised by the following features except:

a. Hemolysis

b. Elevated liver enzyme

c. Low platelet count

d. Hyperflexia
 42. Which of the following factor increase the risk of communicability of a disease:

a. Immunization
b. Prophylactic measure
c. Immunosuppressant drugs
d. Breast feeding

43-Which of the following age group is having least risk of acquiring Communicable diseases:

a. Infants who are on bottle feed

b. Young adults after organ transplant
c. Newborn baby in overcrowded area
d. Female young during pregnancy

44-Diphtheria is an acute, toxin-mediated disease and its name (Diptheria) is denoting the
disease characteristic which means:

a. Plastic sheet
b. Cough
c. Leather Hide
d. Coagulation crust

45-Diphtheria disease was described 5th century BCE by Hippocrates, and its first epidemics
were described in:

a. 5th century AD by Aetius

b. 6th century AD by Aetius
c. 7th Century by Klebs
d. 6th Century By Kleb’s

46-Which of the following is not true about the C. Diptheriae:

a. Aerobic
b. Gram Positive
c. Anaerobic
d. Bacillus

47-Coryne Bacterium Diphtheria produces a toxin that inhibits cellular protein synthesis and is
responsible for :

a. local tissue destruction and pseudo membrane formation.

b. Nerve degeneration and Pseudo membrane formation
c. Developing local inflammatory condition
d. Desensitization of area which is infected.

48-Which drug is used to control fits during Eclampsia :

a. Hdralyzin
b. MgSO4

c. Labetolol

d. Nefidipine

49-A patient having age 54 years was presented with fever and rashes on the skin clustered in a
specific area of the skin. Patient is also complaining of pain in dermatome having rashes what is
the possible diagnosis:

a. Varecella Zoster
b. Chicken Pox
c. Herpes Zoster
d. Measles

50-Which among the following characteristic is true about Mycobacterium tubercle Bacillus:

a. It is a gram positive anaerobic acidophilic Bacteria

b. It is a gram negative aerobic thermophilic Bacteria
c. It is Obligate anaerobe spore forming and non-motile Bacteria
d. It is an obligate aerobe Non spore forming, Non Motile Bacteria

51-According to statistical data 2017,in Pakistan the mortality rate of TB among 100 000
population ranges is:

a. 15 (18.8-20)
b. 20 (17-24)
c. 27 (21-34)
d. 25 (21-26)

52-Which of following sign and symptom best match the clinical presentation of Tuberculosis:

a. Cough lasting for 3 weeks or more, blood in sputum, and lethargy.

b. Cough lasting for 3 weeks or more, blood in sputum, and weight loss,
c. Cough lasting for 3 weeks or more, blood in sputum, and abdominal pain.
d. Cough lasting for 3 weeks or more, blood in sputum, and weight loss, loss of appetite.

53- Which among the following sign/symptom best interlink with the weight loss of an
individual having Tuberculosis:

a. Night sweet
b. Fever
c. Loss of appetite
d. Cough

54-In latent phase of TB an individual which of the following results are usual after laboratory
and radiological examination:
 a. Skin test indicating no infection while sputum test will be positive
b. Abnormal finding in chest X-Ray and skin test indicating infection
c. Normal skin test and chest X-Ray findings
d. Skin test or blood test will be positive and negative sputum smear.

55-All of the following statement are true except one :

a. A positive skin test does not necessarily mean that you have active disease
b. A negative skin test does not mean you definitely are not infected with the bacteria that cause TB
c. If one have had the BCG vaccination, individual may have a negative skin test.
d. People with severely weakened immune systems can have a negative skin test even if they are
infected with the bacteria.

56-Based on the result of sputum smear Negative pulmonary TB status must be on the Basis of
the following criteria:

a. At least two negative sputum smear and one positive sputum smear (Including one specimen
collected at morning)
b. At least three negative sputum smear(Including one specimen collected at morning
c. At least two negative sputum smear (All specimen collected at morning)
d. At least four negative sputum smear (two collected at morning)

57-In herpes Zoster infection new lesion in primary dermatomes usually stop with in :

a. 2 to 5 days
b. 3 to 7 days
c. 3 to 5 days
d. 2 to 6 days

58-Which among the following is correct dose, route of administration and correct time of BCG
vaccine:

a. 0.5 ml, intramuscular, One month after birth

b. 0.05 ml intravenously, soon after birth
c. 0.5 ml intradermal, Soon after birth
d. 0.05m; intravenously soon after birth

59-Tuberculin test result is interpreted after :

a. 48 to 72 hours
b. 36 to 48 hours
c. 48 to 96 hours
d. 24 to 48 hours

60-Postherpetic Neuralgia PHN is the most common and debilitating complication of herpes
zoster in a population based study 10% of patient experiences:

a. PHN lasting for 4 weeks to more than 10 years

b. PHN lasting for more than 1 year
c. PHN lasting for more than 5 years
 d. PHN lasting for 10 weeks

61- Incubation period of VZV is :

a. 10 to 22 days
b. 10 to 20 days
c. 11 to 21 days
d. 10 to 21 days

62-The most common complication of VZV is :

a. Myocarditis and Nuritis

b. Leukemia
c. Thrombocytopenia
d. Pancytopenia

63-Which among the following complication of measles is developed in 1 among 1000 :

a. Bronchitis
b. Laryngitis
c. Pneumonia
d. Encephalitis

64-In measles disease specific spots in inside of cheek called Koplik’s Spot are characterized by
:
a. Large yellowish spot having bright dark background
b. Small red spots with bluish background
c. Small bluish-white spot on a bright red background
d. Small bluish-white spot on a bright yellow background

65-In how much time non immunized individuals including infants exposed to measles should
be given measles vaccine:

a. Within 24 hours
b. Within 24 to 48 hours
c. Within 72 hours
d. Within 36 hours

66-As per WHO recommendation at what age children should get 1st measles vaccines :

a. 1st months of life

b. 12 to 15 months
c. 10 to 12 months
d. 10 to 12 years

67-Which time period during disease process of measles is considered highly contagious :

a. Four days before to four days after the rash

b. Ten days after the rash burst out.
c. From the onset of fever till recovery
d. Before the onset of fever and after recovery
 68- The perinatal mortality include:

a. Deaths of live-born infants through the first 7 days of life

b. Fetal deaths after 28 weeks of gestation.

c. Both A and B

d. Death of an infant between 28 days and one year after birth

69-“A disease of the reproductive system defined by the failure to achieve a clinical pregnancy
after 12 months or more of regular unprotected sexual intercourse is called :

a. Subfertility

b. Infertility

c. Fertility

d. None of the above

70- A nurse is reviewing the record of a client who has just been told that a pregnancy test is
positive. The physician has documented the presence of a Goodell’s sign. The nurse determines
this sign indicates:

a) A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus.

b) A softening of the cervix

c) The presence of hCG in the urine

d) The presence of fetal movement