NP II Flashcards
- Which of the following is a positive sign of pregnancy?
A. Positive pregnancy test
B. Amenorrhea
C. Fetal movement felt by the examiner
D. Quickening
C. Fetal movement felt by the examiner
RATIONALE
A Probable
B Presumptive
D Presumptive
- One of the earliest presumptive signs of pregnancy is:
A. Hegar’s sign
B. Missed menstruation period
C. Linea nigra
D. Braxton Hick’s contractions
B. Missed menstruation period
- A patient who is a mother of 5-year-old son and is now pregnant again should be classified as:
A. Gravida 1, para 1
B. Gravida 2, para 2
C. Gravida 2, para 1
D. Gravida 2, para 0
C. Gravida 2, para 1
- What is the major function of the placenta?
A. It passes medications from mother to fetus
B. It allows the fetus to develop more rapidly
C. Nutrients are passed from mother to fetus
D. It functions as kidney and the stomach of the fetus
C. Nutrients are passed from mother to fetus
- A young couple wants to know when the gender of the fetus is determined. The correct answer is
A. At birth
B. At conception
C. During an amniocentesis
D. From results of blood work after first prenatal visit
B. At conception
- A student nurse asks, “How is the baby’s gender determined?” The nursing instructor responds:
A. X chromosome from the ovum
B. A random number of chromosome
C. Y or X chromosome from the sperm
D. Genes that are carried by DNA and protein
C. Y or X chromosome from the sperm
- A patient whose LMP began May 18 should have an EDC of
A. February 9
B. February 11
C. February 15
D. February 25
D. February 25
- During a nutritional assessment, a nurse is concerned when the patient makes which of the following statements?
A. “I love vegetables, especially broccoli.”
B. “Some days I am so busy, so I eat fast food.”
C. “I take a lot of milk, but I guess I need it for the baby.”
D. “I take a lot of vitamins.”
D. “I take a lot of vitamins.”
RATIONALE
Vitamins are teratogenic to fetus especially during 1st trimester.
- The BMR of a prenatal patient generally increases. An explanation of this would be:
A. Hormone production is increased
B. The thyroid gland increases in size
C. Cardiac output and rate increases
D. The baby causes the need for excess energy
B. The thyroid gland increases in size
RATIONALE
BMR is determined by the thyroid gland.
- Prenatal care is considered the primary means of circumnavigating complications of pregnancy. What complication would you consider as most affected by good prenatal care?
A. Placenta previa
B. Hyperemesis gravidarum
C. PIH
D. Abortion
C. PIH
- A patient in prenatal class asks about whether Kegel exercises are beneficial in pregnancy. The most appropriate response by the nurse would be?
A. “Absolutely not! They are dangerous to your heart.”
B. “They help some people but the benefit is minimal.”
C. “Yes, they can help tighten the pelvic floor muscles.”
D. “Yes, these exercises will help with leg cramps.”
C. “Yes, they can help tighten the pelvic floor muscles.”
- A primigravida in the sixth month of pregnancy is complaining of indigestion. The nurse explains that this is caused by:
A. A growing uterus pushing on the diaphragm
B. Eating small, frequent meals that increase gastric acid secretions
C. An increasing BMR, leading to increases appetite
D. Increased nausea and vomiting, common in this trimester
A. A growing uterus pushing on the diaphragm
- A prenatal patient is experiencing leg cramps. A nursing intervention should include:
A. Advising hot compress daily
B. Instructing her to elevate her legs at least 15 minutes three times daily
C. Encouraging her to decrease intake of carbonated beverages
D. Advising her to chew Tums for calcium
C. Encouraging her to decrease intake of carbonated beverages
RATIONALE
A and B are not management for leg cramps.
D is a medical management
- A mother in her first trimester confides to the nurse that she is worried she will not be a good mother. She is disappointed that she will not be able to go back to school as she had planned, the nurse should:
A. Reassure the mother that her feelings of ambivalence are normal in the first trimester
B. Tell her that she has to let everyone in the family to help her
C. Instruct her that she made the baby and she has to take responsibility for it
D. Assure her that as the pregnancy progresses her feelings will become more positive
A. Reassure the mother that her feelings of ambivalence are normal in the first trimester
- A woman of reproductive age was immunized with rubella vaccine. Which of the following is an appropriate instruction of the nurse?
A. “Do not get pregnant within 3 months.”
B. “Do not engage in coitus for 3 days.”
C. “Avoid strenuous activities for one week.”
D. AOTA
A. “Do not get pregnant within 3 months.”
- The communicable childhood disease most likely to affect pregnancy with harmful effects to the fetus is
A. Chickenpox
B. Rubella
C. Varicella
D. Rubeola
B. Rubella
- A couple asks why is it important to the fetus for both of them to stop smoking. The nurse responds:
A. “Smoking and second hand smoke cause decreased oxygenation to the fetus.”
B. “Pregnant women who smoke or who are found around the smoke tend to have larger babies.”
C. “Pregnant women who smoke tend to have babies who are diabetic.”
D. “Pregnant women who smoke tend to have babies with cardiac anomalies.”
A. “Smoking and second hand smoke cause decreased oxygenation to the fetus.”
- A prenatal patient asks when she should stop working. The most appropriate response for the nurse is:
A. “Around the start of the eight months.”
B. “Everyone is different; it is up to you.”
C. “What do you do for a living?”
D. “Two weeks before your EDC.”
C. “What do you do for a living?”
- The patient is 4 weeks pregnant. She is gravida 2, para 1. Her 3 year old child was born with spina bifida. In addition to regular vitamin supplements, the health care provider prescribes an additional supplement. The nurse should know that this supplement would most likely be
A. Vitamin K
B. Thiamine
C. Vitamin E
D. Folic acid
D. Folic acid
- One of the important test during pregnancy is alpha-fetoprotein test, which
A. Determines fetal maturity
B. Detects neural tube defects
C. Detects Tay-Sachs disease
D. Detects respiratory distress syndrome (RDS)
B. Detects neural tube defects
- Which of the following statements is correct relative to differences between a stress test and nonstress test (NST)?
A. An NST is done by abdominal palpation by the physician
B. An NST is done early in the pregnancy to determine gender of the infant
C. A stress test is usually done late in pregnancy to measure fetal response to uterine contractions
D. A stress test is done after the mother has been given orange juice to drink
C. A stress test is usually done late in pregnancy to measure fetal response to uterine contractions
RATIONALE
Tip: Process of elimination.
A NST is done after mother has ingested food
B NST is not a gender identification test
D A stress test is done by stimulating the nipple
- Decreases in FHR during labor are called?
A. Accelerations
B. Decelerations
C. Baseline rate
D. Variability
B. Decelerations
- What is the period of rapid growth?
A. First trimester
B. Second trimester
C. Third trimester
D. Before pregnancy
C. Third trimester
- Cathy, 22 years old, has missed two of her regular menstrual periods. Her doctor confirms an early intrauterine pregnancy. This is her first pregnancy. To determine her expected due date, which of the following assessments is most important?
A. Date of first menstrual period
B. Date of last intercourse
C. Date of last normal menstrual period
D. Age at menarche
C. Date of last normal menstrual period
- The nurse learns that the woman’s LMP was March 17. How many weeks is her AOG on her initial visit which is on June 10?
A. 11-12
B. 12-13
C. 13-14
D. 10-11
B. 12-13
RATIONALE Computation: March 31-17 = 14 April = 30 May = 31 June = 10
85 days x 1 week/7 days = 12.14 = 12-13
- On which of the following areas would the nurse expect to observe chloasma?
A. Breast, areola, and nipples
B. Chest, neck, arms and legs
C. Abdomen, breast, and thighs
D. Cheeks, forehead, and nose
D. Cheeks, forehead, and nose
- The nurse observes that Vikki’s abdomen has irregular scar lines as a result of stretching of the skin due to pregnancy. This refers to:
A. Linea nigra
B. Chloasma
C. Striae gravidarum
D. Melasma
C. Striae gravidarum
- Which of the following is not a positive sign of pregnancy?
A. Fetal heart tones on auscultation
B. Fetal movement felt by the examiner
C. Fetal outline on ultrasound
D. Positive pregnancy test
D. Positive pregnancy test
RATIONALE
A probable sign.
- Which of the following urinary symptoms does the pregnant woman most frequently experience during the first trimester?
A. Dysuria
B. Frequency
C. Incontinence
D. Burning
B. Frequency
- Which of the following drug is given to Carmina to relieve nausea and vomiting?
A. Dry crackers
B. Coffee
C. Metoclopramide
D. Furosemide
C. Metoclopramide
RATIONALE
A and B are not drugs
D is a diuretic
- Increase absorption of phosphorus is thought to be responsible for which of the following discomforts of pregnancy?
A. Constipation
B. Heartburn
C. Back ache
D. Leg cramps
D. Leg cramps
RATIONALE
⬆️P=⬇️Ca=Leg cramps
- A married 25 year old housewife is 6 weeks pregnant and is being seen for her first prenatal visit. In relation to normal maternal acceptance of pregnancy, the nurse would expect that the client feels:
A. Some ambivalence now that the pregnancy is confirmed
B. Overwhelmed by the thought of future changes
C. Much happiness and enjoyment in the event
D. Detached from the event until physical changes occur
A. Some ambivalence now that the pregnancy is confirmed
RATIONALE
B Happens in 2nd trimester
C Happens in 3rd trimester
D Happens in 2nd trimester
- A client approximately 11 weeks pregnant and her husband are seen in the antepartal clinic. The client’s husband tells the nurse that he has been experiencing nausea and vomiting and fatigue along with his wife. The nurse interprets these findings as suggesting that the client’s husband is experiencing which of the following?
A. Ptyalism
B. Mittelschmerz
C. Couvades syndrome
D. Pica
C. Couvades syndrome
- What is the most important information for the nurse to discuss with the pregnant woman during her first prenatal visit?
A. Components of a balanced diet with increased intake of meat and poultry as well as whole grain products
B. The importance of attending the childbirth programs and understanding the growth of the fetus and normal changes during the pregnancy
C. It is important for the client to understand measures to decrease risk associated with pregnancy
D. It is very important for her to report problems with swelling of hands and face, as well as increased vaginal discharge
B. The importance of attending the childbirth programs and understanding the growth of the fetus and normal changes during the pregnancy
RATIONALE
Tip: Umbrella effect
- How often her pre natal visit will be at 7 months age of gestation?
A. Every week
B. Every 2 weeks
C. Once a month
D. It is not necessary
C. Once a month
RATIONALE
1st-7th month: Once a month
8th month: Every 2 weeks
9th month: Every week
- At 22 weeks AOG the nurse will palpate the fundus
A. At the xiphoid process
B. At the umbilicus
C. At the symphysis pubis
D. Not palpable
B. At the umbilicus
RATIONALE
(Multiply by 4 to get weeks)
8 mos: xiphoid process
9 mos: just below xiphoid process (due to lightening)
7 mos: below xiphoid process
6 mos: above umbilicus
5 mos: umbilicus
4 mos: between umbilicus and symphysis pubis
3 mos: symphysis pubis
- What is the normal weight gain during pregnancy?
A. 10-15 lbs
B. 15-25 lbs
C. 25-35 lbs
D. 35-45 lbs
C. 25-35 lbs
RATIONALE 1st trimester: 4 lbs 2nd trimester: 12 lbs 3rd trimester: 12 lbs TOTAL: 28 Range: 25-35
- The nurse discusses the importance of Vitamin C during her pregnancy. Her health teaching is effective when the client states that Vitamin C
A. Prevents the fetus from neural tube malformation
B. Helps metabolize fats
C. Is required to promote blood clot and collagen formation
D. Helps in fetal bone formation
C. Is required to promote blood clot and collagen formation
RATIONALE
A Folic acid
B Liver enzymes
D Calcium
- Women who drink alcohol during pregnancy
A. Often produce more alcohol dehydrogenase
B. Usually become intoxicated faster than before
C. Can give birth to an infant with fetal alcohol syndrome disorder
D. Gain fewer pounds throughout the gestation
C. Can give birth to an infant with fetal alcohol syndrome disorder
- TORCH is group of infections especially devastating to the fetus causing abortions, malformations and evem fetal death. This term includes
A. Varicella, herpes, tetanus
B. Rubella, herpes, hepatitis C
C. Toxoplasmosis, hepatitis C, herpes, rubella
D. Cytomegalovirus, herpes, rubella, toxoplasmosis
D. Cytomegalovirus, herpes, rubella, toxoplasmosis
RATIONALE TORCH stands for: • Toxosplasmosis • Other diseases: Hepatitis A and B; syphilis; HIV • Rubella (German Measles) • Cytomeglovirus • Herpes simplex
- Which of the following is an incorrect statement comparing the differences between true and false labor?
A. True labor discomfort is usually felt in the lower back and lower abdomen
B. In false labor, walking tends to relieve or decrease contractions
C. In false labor, bloody show is often present
D. In true labor, contractions gradually develop a regular pattern
C. In false labor, bloody show is often present
RATIONALE
In false labor, bloody show is a sign of true labor.
- A nurse is teaching a student how to palpate contractions. The correct position of the examiner’s hand is
A. On the symphysis pubis
B. In the vagina
C. On the fundus of the uterus
D. On the woman’s umbilicus
C. On the fundus of the uterus
- The duration of contraction is defined as
A. The time from the beginning of one contraction to the beginning of another
B. The length of the contraction measured from the beginning to its completion
C. The amount of indentation of the uterus
D. The time labor started
B. The length of the contraction measured from the beginning to its completion
RATIONALE
A Frequency
C and D Irrelevant
- The primary power involved in labor and delivery is
A. Bearing down ability of mother
B. Valsalva technique
C. Cervical effacement and dilatation
D. Uterine contraction
D. Uterine contraction
RATIONALE
A and B are secondary power
C Irrelevant
- Which of the following techniques during labor and delivery can lead to uterine inversion?
A. Fundal pressure applied to assist the mother in bearing down during delivery of the fetal head
B. Applying light traction when delivering the placenta that has already detached from the uterine wall
C. Strongly tugging on the umbilical cord to deliver the placenta and hasten placental separation
D. Massaging the fundus to encourage the uterus to contract
C. Strongly tugging on the umbilical cord to deliver the placenta and hasten placental separation
RATIONALE
A, B and D may lead also to uterine inversion but at least chances.
- A patient in labor is examined and is told that she is 100% effaced, 5cm dilated and at +1 station. Her husband asks what does this mean. The nurse explains:
A. She is in active labor, but the head is not yet engaged
B. She is in active labor, and the head is engaged
C. She is in transitional labor and about to deliver
D. She is in the latent phase, the head is fully engaged
B. She is in active labor, and the head is engaged
RATIONALE
Latent phase: 0-3 cm cervical dilatation
Active phase: 4-7 cm cervical dilatation
Transitional phase: 8-10 cervical dilatation
+1 station means the presenting part of the fetus is 1 cm below the ischial spine; thus engaged.
- A laboring patient is walking in the hallway. She is 80% effaced and at 0 station. She suddenly experiences a gush of fluid. Which of the following actions should the nurse take first:
A. Have the patient return to her bed to assess the fetal heart
B. Call the doctor
C. Perform a vaginal exam to determine the dilatation
D. Place the patient in Trendelenburg to prevent cord prolapse
A. Have the patient return to her bed to assess the fetal heart
- Nurses should observe the amniotic fluid released by the rupture of the membranes for signs of meconium staining. Meconium staining is associated with which of the following situations would give the LEAST cause of alarm?
A. Vertex presentation
B. Transverse presentation
C. Breech presentation
D. Posterior presentation
C. Breech presentation
RATIONALE
Meconium staining happens on the area around the pelvic inlet where the presenting part is located. In Breech presentation, there is no alarm since the head is around the fundal area.
- Lochia is a post partum vaginal discharge that contains
- RBC
- Mucus
- WBC
- Decidual remnants
A. 134
B. 123
C. 14
D. All of these
D. All of these
SITUATION: Mrs. O, G2P1, is admitted to the labor and delivery area in labor. Initial assessment reveals cervical dilatation of 5cm; cervical effacement 80%; station negative 3; frequency of contractions every 5-8 minutes; duration of contractions 40 to 50 seconds; membranes ruptured spontaneously 1 hour before admission; presentation is vertex with LOA position.
- Based on Mrs. O’s initial assessment findings, the fetal presenting part is:
A. At the level of the pelvic inlet
B. At the level of the ischial spines
C. 1 cm below the ischial spines
D. At the perineum
A. At the level of the pelvic inlet
RATIONALE
B 0
C +1
D Irrelevant
SITUATION: Mrs. O, G2P1, is admitted to the labor and delivery area in labor. Initial assessment reveals cervical dilatation of 5cm; cervical effacement 80%; station negative 3; frequency of contractions every 5-8 minutes; duration of contractions 40 to 50 seconds; membranes ruptured spontaneously 1 hour before admission; presentation is vertex with LOA position.
- The FHR should be most audible in which quadrant of Mrs. O’s abdomen?
A. LLQ
B. LUQ
C. RLQ
D. RUQ
A. LLQ
- During the labor, effacement of the cervix occurs. This is:
A. Widening of the cervical os
B. Turning “inside out” of the vertical os
C. Molding and elongation of the cervix
D. Thinning and shortening of the cervix
D. Thinning and shortening of the cervix
- An IV drip pitocin 10 units in 1000 ml of D5 water is started for Andrea. Possible side effects of oxytocin administration include all of the following except:
A. Water intoxication
B. HPN
C. Tonic uterine contractions
D. Diuresis
D. Diuresis
RATIONALE
Posterior Pituitary Gland secretes both oxytocin and ADH. Thus, side effects of both hormones are expected.
- If fetus is in LOA position during labor, you would interpret this mean the fetus is
A. In a longitudinal lie facing the right posterior
B. Facing the right anterior abdominal quadrant
C. In a common breech delivery position
D. Presenting with the face as the presenting part
A. In a longitudinal lie facing the right posterior
RATIONALE
B LOP
C RSA/LSA/RSP/LSP
D RMA/LMA/RMP/LMP
- An assessment of a primigravida documents the following information; the patient is 2cm dilated with mild contractions every 15 minutes, lasting 40 seconds, she is alert and talkative. Which phase of labor is she in?
A. Active
B. Transition
C. Latent
D. Fourth
C. Latent
- The HCP is evaluating whether the second stage of labor has begun. The nurse knows that this would be when
A. The woman feels the urge to push
B. The fetus is at station 1
C. The cervix is fully dilated at 10 cm
D. The placenta is delivered
C. The cervix is fully dilated at 10 cm
- The primary reason for having a Foley catheter inserted before a cesarean birth is
A. To make certain that the urinary output is adequate during surgery
B. To prevent infection
C. To keep the bladder empty so that it does not interfere with surgery
D. To eliminate the need for early ambulation after surgery
C. To keep the bladder empty so that it does not interfere with surgery
- A woman who has just given birth is complaining of shaking and chills. The most appropriate nursing intervention is
A. Provide a warm blanket
B. Contact the physician
C. Monitor vital signs
D. Offer her a warm milk
A. Provide a warm blanket
- Which of the following statements by a teenage mom would most indicate the nurse that the patient is accepting her new role?
A. “My mom is taking care of the baby so that I can go to school.”
B. “The baby is going to cause many changes in my schedule.”
C. “She is so cute; I just love her so much.”
D. “My friends have all promised to help.”
B. “The baby is going to cause many changes in my schedule.”
- When is the first stage of labor considered to be achieved?
A. Presenting part is at station +1
B. Cervix is 10cm dilated
C. Uterine contractions occur every 2-3 minutes interval
D. Cervix is fully effaced
B. Cervix is 10cm dilated
- The client is in active phase of labor. The physician has administered epidural anesthesia. Which of the following nursing actions should be given highest priority by the nurse?
A. Ensuring patent IV access line
B. Checking for rupture of membrane
C. Monitoring duration of each contraction
D. Providing food and fluids
A. Ensuring patent IV access line
- Who among these pregnant clients is at risk for bleeding?
A. The client who has history of preterm delivery
B. The client who has twins in her present pregnancy
C. The client who is 18 years of age and is pregnant for the first time
D. The client who is pregnant for the third time
B. The client who has twins in her present pregnancy
- The woman is in active labor. The presentation of the fetus is left occiput posterior (LOP). Which of the following measures should be included when caring for the client?
A. Provide foods and fluids
B. Assist the client to ambulate
C. Provide back massage
D. Allow the client to sleep
C. Provide back massage
RATIONALE
The back of the fetus in LOP/ROP position gives pressure to the back of the mother.
- The postpartum client is bleeding heavily 2 hours after delivery. The fundus of the uterus is firm; uterus at the center of the abdomen. Which of the following actions should the nurse do next?
A. Change the perineal pads
B. Notify the physician
C. Massage the uterus
D. Check the perineum
D. Check the perineum
RATIONALE
There may be possible perineal laceration.
- A pregnant woman on 36 weeks gestation experiences sudden gush of fluids from the vagina. Which of the following should be the initial action by the nurse?
A. Notify the physician
B. Check the fluid pH
C. Prepare the client for delivery
D. Place the client in knee-to-chest position
B. Check the fluid pH
- A woman is in active labor. In what position does the nurse properly place the client?
A. Semi-fowler’s position
B. Side-lying position
C. Trendelenburg position
D. Supine position
B. Side-lying position
- A patient who is on her 39 weeks gestation comes to the hospital accompanied by her husband. She tells the nurse she thinks she is in labor. Which of the following questions should the nurse ask to help confirm if the patient is in true labor?
A. Do your contractions feel like severe menstrual cramps?
B. Do you feel pressure in your legs?
C. Do you feel as if you can bathe easier?
D. Does your pain increase in intensity when you are moving around?
D. Does your pain increase in intensity when you are moving around?
RATIONALE
In true labor, pain increases even during ambulation.
- A nurse is reviewing the record of a client in the labor room and notes that the nurse-midwife has documented that the fetus is at negative 1 (-1) station. The nurse determines that the fetal presenting part is:
A. 1 inch below the coccyx
B. 1 inch below the iliac crest
C. 1 cm above the ischial spine
D. 1 finger breadth below the symphysis pubis
C. 1 cm above the ischial spine
- Nurse is monitoring a client in labor. The nurse suspects umbilical cord compression. If which of the following is noted on the external monitor tracing during a contraction?
A. Late decelerations
B. Early decelerations
C. Short-term variability
D. Variable decelerations
D. Variable decelerations
RATIONALE
A Caused by uteroplacental insufficiency
B Caused by head compression
C Irrelevant
- A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of slowing labor. The nurse is reviewing the physician’s orders and would expect to note which of the following prescribed treatments for this condition?
A. Increased hydration
B. Oxytocin (Pitocin) infusion
C. Medication that will provide sedation
D. Administration of a tocolytic medication
B. Oxytocin (Pitocin) infusion
RATIONALE
Oxytocin promotes uterine contraction.
- A prenatal patient who has had diabetes for 2 years is admitted to a maternity unit for hyperglycemia. She is 9 weeks pregnant and she admits to the nurse that she does not always take her diabetes medications. Which of the following would most likely be ordered for the patient?
A. Oral hypoglycemic
B. Regular insulin to cover elevated blood sugars
C. Oral antibiotics to protect against infection
D. NPH and regular insulin
D. NPH and regular insulin
- A 28 years old has had diabetes mellitus since she was an adolescent. She is 8 weeks pregnant. Hyperglycemia during her first trimester will have what effect on the fetus?
A. Hyperinsulinemia
B. Excessive fetal size
C. Malformed organs
D. Abnormal positioning
C. Malformed organs
RATIONALE
During first trimester, there is organogenesis and the fetus is risk for maldevelopment when the mother is taking drugs.
- A woman who is pregnant for the first time calls the clinic to say she is bleeding. To obtain important information, the nurse should next ask
A. “When did you last feel the baby move?”
B. “How long have you been pregnant?”
C. “When was your pregnancy test done?”
D. “Are you having any uterine cramping?”
B. “How long have you been pregnant?”
- Bleeding during the first trimester can be caused by the following except:
A. Abortion
B. Ectopic pregnancy
C. Premature labor
D. NOTA
C. Premature labor
RATIONALE
Happens during third trimester, along with placenta previa and abruptio placenta.
- In the Philippines, if a nurse performs abortion on the mother who wants it done and she gets paid for doing it, she will be held liable because
A. Abortion is illegal because majority in our country are Catholics and it is prohibited by the church
B. Abortion is both immoral and illegal in our country
C. Abortion is immoral and prohibited by the church
D. Abortion is considered illegal because you got paid for doing it
B. Abortion is both immoral and illegal in our country
- In contrast to threatened abortion, inevitable abortion is characterized by:
A. Closed cervix BOW (+)
B. Closed cervix BOW (-)
C. Less amount of vaginal bleeding
D. Open cervix BOW (-)
D. Open cervix BOW (-)
- The nurse assesses a client for signs and symptoms of ectopic pregnancy. What is the most common finding associated with this antepartum complication?
A. Temperature elevation
B. Vaginal bleeding
C. Nausea and vomiting
D. Abdominal pain
D. Abdominal pain
- A woman is diagnosed with a possible ectopic pregnancy. Which of the following would not be possible cause?
A. Inflammation of the fallopian tubes
B. A congenital malformation of the fallopian tubes
C. A history of infection in the fallopian tubes
D. A chronic vaginal infection
D. A chronic vaginal infection
- A patient is diagnosed with abruptio placenta. The physician orders fibrinogen levels every 15 minutes. The patient’s husband is frightened and asks the nurse why the physician has to withdraw so much blood. The nurse best response should be:
A. “You may ask the physician yourself.”
B. “Would you like me to inquire for you?”
C. “This test determines the status of the clotting factor.”
D. “The physician is determining whether to give her a transfusion or whether to operate.”
C. “This test determines the status of the clotting factor.”
- A patient who is in her third trimester of pregnancy suddenly notices that she is bleeding. At first, the bleeding was scanty, but it has become heavier. She reported that she has no pain. A nurse should suspect
A. Abruptio placenta
B. Placenta previa
C. Ruptured uterus
D. Ectopic pregnancy
B. Placenta previa
RATIONALE
A Abruptio placenta is painful
C Irrelevant
D Happens only on 1st trimester
- A type of placenta previa where the placenta is implanted in the lower uterine segment is:
A. Partial
B. Marginal
C. Total
D. Low-lying
D. Low-lying
- The etiology of placenta previa includes all of the following except
A. Advancing age
B. Multiparity
C. Heredity
D. Previous CS
C. Heredity
- The MOST important sign of placenta previa is painless hemorrhage which:
A. Does not appear until the near end of the second trimester
B. Does not appear until labor begins
C. Appears anytime during pregnancy
D. Appears on the beginning of the second trimester
A. Does not appear until the near end of the second trimester
RATIONALE
Or happens on third trimester.
- A woman is admitted to the hospital with a diagnosis of PIH. The nurse knows that the client is knowledgeable about the occurrence of PIH when she remarks
A. “It usually appears anytime during pregnancy.”
B. “It is similar to cardiovascular disease.”
C. “PIH occurs during the first trimester.”
D. “PIH occurs after the 20th week of AOG.”
D. “PIH occurs after the 20th week of AOG.”
- A client, gravida 2 para 1, is admitted with HPN and complains that her wedding band is tight. The nurse should expect to assess which of the following with early pre-eclampsia?
A. Blurred vision and proteinuria
B. Epigastric pain and headache
C. Facial swelling and proteinuria
D. Polyuria and hypertonic reflexes
C. Facial swelling and proteinuria
- You prepared the set-up needed for her next attack (O2 tank, suction and emergency kit). As soon as she saw them, she asked, “What are the machines doing here, am I dying?” What will you tell her?
A. “No, you are not dying. These machines are being prepared for future use; right now, we don’t need it.”
B. “Why don’t you ask Dr. A why he ordered for these machines?”
C. “Don’t worry about the machines; they have just to be there.”
D. “That one is oxygen to give you air, the other is a suction to remove your secretions.”
A. “No, you are not dying. These machines are being prepared for future use; right now, we don’t need it.”
- The symptom that is often considered a warning sign of an impending convulsion in the mother with eclampsia is
A. Headache
B. Severe epigastric pain
C. Scotoma
D. Puffy face
B. Severe epigastric pain
- A primigravida who is at 30 weeks gestation is admitted to the maternity unit after having been involved in an automobile accident. She is complaining of dull pain in her lower abdomen. Which of the following assessments would be of the most concern to the nurse?
A. A fetal heart rate (FHR) of 140 to 180 beats/min
B. Complaints of irregular contractions relieved by walking
C. Regular contractions occurring at intervals unrelieved by walking
D. Complaints of SOB
C. Regular contractions occurring at intervals unrelieved by walking
RATIONALE
Indicates True Labor.
- A newly diagnosed Class I cardiac patient is 6 weeks pregnant. The patient asks the nurse to explain what this means. The nurse’s nest response would be:
A. This means that although there has been a cardiac problem identified, you will be able to continue with ordinary physical activity
B. This means that you will require significant amounts of bed rest during your pregnancy
C. This means that you will be on strict bed rest from 24th week on
D. This means that your fetus has a cardiac defect
A. This means that although there has been a cardiac problem identified, you will be able to continue with ordinary physical activity
RATIONALE
B Class II or III
C Class IV
D Irrelevant
- A patient in labor is experiencing dystocia. One possible cause for this is
A. The cervix is just about to reach full dilatation
B. The mother is experiencing extreme fatigue
C. Excessive size of the fetus
D. Prolapsed cord
C. Excessive size of the fetus
- With the community health activities started during the entry phase, which of these activities should not be included:
A. Conduct of deepening social investigation
B. Core group formation
C. Project management
D. Information campaign on health programs
C. Project management
- Identification of potential leaders is crucial during the entry phase. Which of the characteristics may not be necessary to an efficient and effective community leader?
A. A college graduate with management skills
B. Responsive and willing to work for change
C. Must have relatively good communication skills
D. A respected member of the community
A. A college graduate with management skills
RATIONALE Criteria for choosing community leader: • Responsible • Respected member of the community • Willingness to work and learn • Low economic status • No political position/apolitical • Good communication skills
- In identifying potential leaders in the community, the best technique proven to be effective is to:
A. Ask volunteers who are willing to become community leaders
B. Review family background, properties and academic records of community residents
C. Observe people who are active in small mobilization activities that motivate residents to start working
D. Ask community residents to directly name person whom they consider as community leaders
D. Ask community residents to directly name person whom they consider as community leaders
- The core group is composed of individuals in the community who possess leadership potentials organized into a cohesive working unit. The core group works with the team in:
A. Monitoring the performance of the barangay officials
B. Setting-up community organization that will serve the interest of a sector in the community
C. Mobilizing the community to act on their most immediate felt needs and participate in the delivery of essential health services
D. Selecting community activities according to their preferences
C. Mobilizing the community to act on their most immediate felt needs and participate in the delivery of essential health services
- Nurse KC was informed that Magpantay Family is about to lose their home due to foreclosure. The nurse contacts the social service department of the home health care agency for assistance in finding housing for the family. The actions taken by the nurse best exemplify which of the following roles of the community health care nurse?
A. Clinician
B. Advocate
C. Consultant
D. Researcher
B. Advocate
- The child’s symptoms are under the classification of severe dengue hemorrhagic fever of the IMCI strategy. Which of the following treatments should be done immediately?
A. Observe the patient at the health center and refer urgently if the condition worsens
B. Give fluids or ORS and refer urgently to the hospital
C. Immunize the child before referral
D. Give the first dose of appropriate antibiotics and refer urgently to the hospital
B. Give fluids or ORS and refer urgently to the hospital
RATIONALE Classification: Pink Treatment: Urgent and referral needed • IVF/ORS • Paracetamol, no aspirin
- A child needs urgent referral for mastoiditis. The following is a list of treatments for all ear problems in IMCI classification. Which among these pre-referral treatments should not be included:
A. Give the child the appropriate antibiotics for 5 days
B. Do not give any medications
C. Give the child the first dose of antibiotics
D. Give first dose of paracetamol for pain
B. Do not give any medications
RATIONALE Classification: Pink Treatment: Urgent and referral needed • 1st Line: Amoxicillin 2nd line: Cotrimoxazole • Paracetamol for pain
SITUATION: Carol is 15 months old, weighs 8.5 kg., is not eating well and is unable to breast feed. She is not vomiting, has no convulsion and not abnormally sleepy or difficult to awaken. Her temperature is 38.5 degree Celsius. Use the IMCI strategy.
- If you were the nurse in charge of Carol, how will you classify her illness?
A. A child with a general danger sign
B. Very severe febrile disease
C. Severe pneumonia
D. Severe malnutrition
A. A child with a general danger sign
RATIONALE
B No such classification
C ❌Severe pneumonia = ✅C[U]VA, ❌Chest indrawing/stridor
D ❌Severe malnutrition = For ⬆️6 months old: ❌Visible severe wasting ❌Edema of both feet ❌
SITUATION: Carol is 15 months old, weighs 8.5 kg., is not eating well and is unable to breast feed. She is not vomiting, has no convulsion and not abnormally sleepy or difficult to awaken. Her temperature is 38.5 degree Celsius. Use the IMCI strategy.
- Which of the following signs is considered to be a general danger sign in Carol’s case?
A. No vomiting
B. Has no convulsion
C. Temperature of 38.5°C
D. Unable to breastfeed
D. Unable to breastfeed
- Which of the following signs should not be included in deciding that “the child vomits everything”?
A. Child experiences occasional vomiting
B. When offered fluids, may not be able to drink
C. Maybe too weak to drink and eat at all
D. Child is not able to keep anything down at all (what goes down comes back)
A. Child experiences occasional vomiting
- A child should be checked for capillary refill if:
A. If the child has petechiae
B. The child’s extremities feel warm
C. There is fever for more than 7 days
D. If the extremities feel cold
D. If the extremities feel cold
RATIONALE
It may indicate poor circulation.
- The case management process for a sick child age 2 months up to 5 years is presented on three charts. Which chart title is not included?
A. Assess, classify and treat the sick young infant
B. Assess and classify the sick child
C. Counsel the mother
D. Treat the child
C. Counsel the mother
- If this is a follow up visit for the problem:
A. Give follow up care
B. Assess and treat the child
C. Assess and classify the child
D. Assess and give health technique
B. Assess and treat the child
- An 8 month old child is brought to the health facility for “fast breathing”. Your correct interpretation of “fast breathing” in this situation MEANS:
A. 40 breaths per minute
B. 45 breaths per minute
C. 38 breaths per minute
D. 55 breaths per minute
D. 55 breaths per minute
RATIONALE
0-2 months: >60 cpm
2-12 months: >50 cpm
12-60 months: >40 cpm
- Inspired by the singing jail inmates, the nurse suggests to the barangay chairman that the out of school teenagers may be encouraged to stay “out of trouble” by organizing activities that will occupy their time, use up their energy and unify them. To realize such goals/objectives, the nurse’s and community’s actions should proceed in which order?
- Identify what manpower and money resources are needed to implement the program
- Design the program that will meet goal/objectives
- Identify support activities that will sustain the programs
- Determine the program’s impact on the target group
A. 1234
B. 2134
C. 3214
D. 4321
B. 2134
- At the formulation stage of the health program planning process, it is important for the community health nurse to know that:
A. This is the time to make detailed program decisions
B. This is the time where the geographic and population boundaries are kept open
C. This is the time to consider several solutions to the problem
D. This is the time for the client population to recognize the end for the program
A. This is the time to make detailed program decisions
- Which of the following is true about program evaluation?
A. Benefits include refunds of costs from the government
B. The evaluation is designed and conducted by the community
C. Program evaluation is a critical phase in the planning process
D. It determines which program will be retained or stopped
D. It determines which program will be retained or stopped
- Health problems beyond the capacity of PHC units are referred to the RHU. The intermediate health care workers consists of the following except:
A. BHW
B. Nurse
C. Midwife
D. Sanitary Inspectors
A. BHW
RATIONALE
Intermediate healthcare workers have license.
- Which of the following are examples of structured standards that are critical to the success of different public health programs?
- Cold chain in expanded program on immunization (EPI)
- Essential drugs in maternal care health (MCH)
- Nursing care of patients with acute respiratory infections = reflects the Process elements
- TB control program management = process elements
A. 1 and 2
B. 3 and 4
C. All except 3
D. AOTA
A. 1 and 2
RATIONALE
3 Correct: Nursing process is reflected on all nursing care in patients and in all setting
4 Correct: Nursing process is reflected on all nursing and health program management
- A safe water supply is basic to environmental health. Sources of water pollution are:
A. It is a recent phenomenon, coming about since the 1960’s
B. Groundwater coming from the surface through wells and springs
C. Infective substances such as bacteria and parasites
D. It results from industrial and automotive emissions
D. It results from industrial and automotive emissions
- Aling Theresa brought in her infant Kaloy, for his OPV immunization. You have assessed that the infant has diarrhea. Which of the following is the correct action to take?
A. Notify the physician
B. Give the OPV
C. Refer immediately
D. Do not give the OPV
B. Give the OPV
RATIONALE Vaccines are allowed to give even the child has: • Diarrhea • Malnutrition • Cough/mild respiratory problem • Moderate fever
- The vision of the DOH is:
A. Health for all Filipinos by 2012
B. Leader, staunch, advocate and model in promoting health health for all in the Philippines
C. Guarantee equitable and quality health for all Filipinos
D. Equitable and sustainable health for all
B. Leader, staunch, advocate and model in promoting health health for all in the Philippines
- Who is the Chairman of the Municipal Health Board?
A. Mayor
B. Municipal Health Officer
C. Public Health Nurse
D. Any qualified physician
A. Mayor
- The strategy calls for promotion of exclusive breastfeeding for the first 6 months. Exclusive breast feeding means that:
A. Giving only breast milk no other liquids, solids, not even water, vitamins and mineral supplements not permitted
B. Giving only breast milk no other liquids, solids, not even water. Vitamins and mineral supplements permitted
C. Giving only breast milk no other liquids, solids but water can be given; vitamins and mineral supplements not permitted
D. Giving only breast milk no other liquids, solids but water can be given; vitamins and mineral supplements permitted
B. Giving only breast milk no other liquids, solids, not even water. Vitamins and mineral supplements permitted
- Food fortification is one of the strategies to prevent micronutrient deficiency conditions. RA 8976 mandates fortification of certain food items. Which of the following is among these food items?
A. Sugar
B. Bread
C. Margarine
D. Fiiled milk
A. Sugar
RATIONALE
SECTION 6. Mandatory Food Fortification
(a) The fortification of staple foods based on standards set by the DOH through the BFAD is hereby made mandatory for the following:
(1) Rice - with Iron;
(2) Wheat flour - with vitamin A and Iron;
(3) Refined sugar - with vitamin A; and
(4) Cooking oil - with vitamin A; and
- A disease is said to be communicable if:
A. It is capable of being transmitted from an infected person or species to a susceptible host
B. It persists for a long period of time, usually with a duration greater than 3 months
C. It is self limiting
D. It may result from genetic or lifestyle factors
A. It is capable of being transmitted from an infected person or species to a susceptible host
- Directly Observed Treatment Short Course (DOTS) can do all of the following except:
A. Stop resistance to anti-TB drugs
B. Cure TB patients
C. Require hospitalization
D. Prevent new infection among children and adult
C. Require hospitalization
- Which vital statistics relating to TB in our country is INACCURATE?
A. The Philippines is among the 22 highly burdened poor countries in the world
B. TB is the 6th leading cause of illness among Filipinos
C. TB is the 6th leading cause of deaths among Filipinos
D. Most TB patients belong to the 0-15 age groups
D. Most TB patients belong to the 0-15 age groups
RATIONALE
Risk factors
• ⬆️60
• ⬇️5
- The elements of TB DOTS that needs to be fulfilled include all of the following EXCEPT:
A. Regular supply of anti-TB drugs
B. Supervised treatment by a treatment partner
C. Regular chest X-ray for diagnosis
D. Standardized recording and reporting of TB data
C. Regular chest X-ray for diagnosis
- Which of the following statements about TB treatment is INCORRECT?
A. Combination of 3-4 anti-TB drugs is the treatment of choice
B. Single drug is appropriate
C. Treatment renders patients non-infectious and cured
D. Tuberculosis is a curable disease
B. Single drug is appropriate
RATIONALE
Drug combination is applied.
