PREBOARDS 1_NP2

Question 1

Nurse Harry is caring for Delilah who is
receiving education about cervical cancer. The following questions apply.

1. When is the earliest time when a female can receive a human papillomavirus (HPV) vaccine for prevention of cervical cancer?

*
1 point
a. 11 years old
b. 15 years old
c. 18 years old
d. 21 years old

Answer 1

a. 11 years old

11 years old: To help prevent HPV, it is recommended that all girls receive three injections of this vaccine beginning at 11
to 12 years of age. The second dose should be administered 2 months after the first and the third dose 6 months after the first dose

Question 2

Ms. Delilah is being evaluated for her knowledge about cervical cancer. Which among the following statements require follow-up?

*
1 point
a. Symptoms of cervical carcinoma include vaginal spotting in between menstrual periods, vaginal discharge, and postcoital spotting.
b. It is the most frequent type of reproductive tract malignancy.
c. There is increased risk for cervical cancer in females with herpes simplex 1 infection.
d. It can be diagnosed by colposcopy.`

Answer 2

c. There is increased risk for cervical cancer in females with herpes simplex 1 infection.

HS1: Oral herpes
HS2: Genital herpes

Question 3

Ms. Delilah is asked about the possible therapeutic modalities to address cervical cancer. Which would require follow-up?

*
1 point
a. Conization
b. Intracavitary teletherapy
c. Excision by surgery
d. Trachelectomy

Answer 3

b. Intracavitary teletherapy

Teletherapy: External Radiation
Intracavitary: Brachytherapy

Question 4

Three specimens are required when obtaining smears for a Pap test. The following are areas where smear is obtained aside from:

*
1 point
a. Endocervix
b. Anterior vaginal fornix
c. Posterior vaginal fornix
d. Cervical os

Answer 4

b. Anterior vaginal fornix
Except:

3 sites: Endocervix, Cervical os

Question 5

The following women are recommended to have more frequent Pap smears except:

*
1 point
a. A 31-year old with history of human papillomavirus infection.
b. A 25-year old who smokes cigarettes.
c. A 23-year old who had her coitarche at 15 years old.
d. A 27-year old with excessive alcohol intake.

Answer 5

(-)
d. A 27-year old with excessive alcohol intake.
Hx of Smoking, early coitus -> higher risk

Question 6

Situation:
Nurse Rocket is counselling Zoey about normal changes in pregnancy. Zoey just found out that
she is pregnant and has visited the health center for prenatal consult.

6. Zoey verbalized to Nurse Rocket that she is not very much sure how to feel about the news of her pregnancy. The nurse correctly replies to Patient Zoey by saying the following except:

*
1 point
a. Often women immediately experience something less than pleasure and closer to disappointment or anxiety at the news that they are pregnant.
b. The positive feelings counteract negative feelings, that is why you can be left feeling nothing toward your pregnancy.
c. This is normal. Most women are able to change their attitude toward the pregnancy by the time they feel the child move inside them.
d. Ambivalence is common. It refers to the interwoven feelings of wanting and not wanting that can exist at high levels.

Answer 6

b. The positive feelings counteract negative feelings, that is why you can be left feeling nothing toward your pregnancy.

Question 7

The commonly used laboratory tests for pregnancy are based on detecting the presence of human chorionic gonadotropin (hCG). Which among the following is an exception to these commonly used tests?

*
1 point
a. Radioimmunoassay
b. Radioreceptor assay
c. Urine test
d. Enzyme-linked immunosorbent assay

Answer 7

C Urine Test
- not commonly use not
- use in Home PT

Question 8

Nurse Rocket is discussing the presumptive signs and symptoms that Zoey must expect during the course of her pregnancy. Which among the following is not correct?

*
1 point
a. Breast changes at 6 weeks age of gestation.
b. Linea nigra at 24 weeks age of gestation.
c. Quickening at 18 weeks age of gestation.
d. Uterine enlargement at 12 weeks age of gestation.

Answer 8

a. Breast changes at 6 weeks age of gestation. = can occur as early as 2 weeks of gestation

Question 9

Nurse Rocket is discussing the probable signs and symptoms that Zoey must expect during the course of her pregnancy. Which among the following is not correct?

*
1 point
a. Chadwick’s sign is the color change of the vagina from pink to violet.
b. Ultrasound of gestational sac shows evident characteristic spots.
c. Fetal outline felt can be palpated by examiner.
d. Ballottement is when lower uterine segment is tapped, the fetus can be felt to rise against abdominal wall.

Answer 9

b. Ultrasound of gestational sac shows evident characteristic spots. - it should be ring, not spot

Question 10

Nurse Rocket has also noticed that there is slight enlargement in the thyroid gland of Zoey. The following statements are true except:

*
1 point
a. The basal body metabolic rate increases by about 20%.
b. Emotional lability and diaphoresis are to be expected by Zoey.
c. Zoey should be tested further for thyroid hormone to determine possible thyroid problem.
d. Zoey could be mistaken for a case of hyperthyroidism if pregnancy was not determined.

Answer 10

c. Zoey should be tested further for thyroid hormone to determine possible thyroid problem.

Question 11

Situation:
Nurse Jenny is educating
a group of pregnant women regarding nutritional health during pregnancy.

11. To supply adequate calcium and phosphorus for bone formation, pregnant women need to eat foods high in calcium and vitamin D. The recommended amount of calcium during pregnancy is:

*
1 point
a. 1300 mg
b. 1000 mg
c. 2000 mg
d. 800 mg

Answer 11

a. 1300 mg

Question 12

A woman asks, “Do I need to take calcium to support the bone and teeth development of my baby inside my womb?” The correct explanation of Nurse Jenny is:

*
1 point
a. Yes. Tooth formation begins as early as 8 weeks in utero. Bones begin to calcify at 12 weeks.
b. Correct. The skeleton and teeth constitute a major portion of a fetus. Tooth formation begins as early as 10 weeks in utero. Bones begin to calcify at 12 weeks.
c. Yes. The skeleton and teeth constitute a major portion of a fetus. Tooth formation begins as early as 8 weeks in utero. Bones begin to calcify at 16 weeks.
d. Correct. Tooth formation begins as early as 10 weeks in utero. Bones begin to calcify at 16 weeks

Answer 12

a. Yes. Tooth formation begins as early as 8 weeks in utero. Bones begin to calcify at 12 weeks.

Question 13

The daily recommended intake of calories for pregnant women is:

*
1 point
a. 2200 calories
b. 2500 calories
c. 3000 calories
d. 3200 calories

Answer 13

b. 2500 calories
Child bearing age 2200 plus 300 if pregnant

Question 14

To fulfill the fat needs of the pregnant women, Jenny teaches them to also try to consume foods high in omega-3 oils such as the following except:

*
1 point
a. Salmon
b. Cage-free chicken
c. Chia seeds
d. Seaweed

Answer 14

b. Cage-free chicken = protein

Question 15

The following foods should be avoided or limited by the pregnant woman because these could have potentially teratogenic effects, except:

*
1 point
a. Swordfish
b. Foods with caffeine
c. Artificial sweetener
d. Vitamin A

Answer 15

(-)
Vitamin A
Only recommended in 2nd tri but question does not contains a of
A. Mercury contamination
B. Increase rate of miscarriage
C. Eliminate slow from fetal bloodstream

Question 16

Situation:
Nurse Patpat is
conducting health education classes to pregnant women regarding teratogenicity
and preventing fetal exposure to these factors.

16. Which two infections can cause abnormalities in organs that were originally formed normally?

*
1 point
a. Syphilis and toxoplasmosis
b. Cytomegalovirus and syphilis
c. Rubella and toxoplasmosis
d. Lyme disease and cytomegalovirus

Answer 16

A.

Question 17

To prevent toxoplasmosis, which is considered a teratogenic infection, the following measures must be instituted by the pregnant woman except:

*
1 point
a. Removing cats from the home during pregnancy.
b. Avoid undercooked meat.
c. Refrain from changing a cat litter box.
d. Work in soil in an area where cats may defecate.

Answer 17

a. Removing cats from the home during pregnancy. = UNWISE

d. Work in soil in an area where cats may defecate.

Question 18

The following statements are correct regarding rubella virus aside from:

*
1 point
a. The rubella virus usually causes only a mild rash and mild systemic illness.
b. A titer of greater than 1:8 suggests that a woman is susceptible to viral invasion.
c. After a rubella immunization, a woman is advised not to become pregnant for 3 months, until the rubella virus is no longer active.
d. All pregnant women should avoid contact with children with rashes.

Answer 18

b. A titer of greater than 1:8 suggests that a woman is susceptible to viral invasion. = it should be LESSER THAN 1:8

Question 19

Thalidomide is a classic example of a teratogenic drug that was prescribed for morning sickness in Europe. The teratogenic effect of thalidomide is:

*
1 point
a. Patent ductus arteriosus
b. Neural tube defect
c. Amelia
d. Low-birth weight

Answer 19

c. Amelia

Question 20

Certain drugs are being considered as teratogenic. Which of the following statements requires further questioning?

*
1 point
a. Tetracycline, used to treat infections, can cause teeth and bone deformities.
b. Tretinoin, used to treat acne, can cause CNS anomalies.
c. Valproic acid, used to treat seizures, can cause neural tube defects.
d. NSAIDs, used to treat mild pain, can cause fetal bleeding.

Answer 20

d. NSAIDs, used to treat mild pain, can cause fetal bleeding. = IT CAN CAUSE PDA

Question 21

Situation:
Nurse
Lei is caring for patient Dany who experienced miscarriage. The following
questions apply.
21. Patient Dany stated that she suffered from incomplete miscarriage and asked what it means. Nurse Lei correctly responds by stating that incomplete miscarriage occurs when:

*
1 point
a. The entire products of conception (fetus, membranes, and placenta) are expelled spontaneously without any assistance.
b. The fetus dies in utero but is not expelled.
c. Part of the conceptus (usually the fetus) is expelled, but the membrane or placenta is retained in the uterus.
d. There is scant and usually bright red vaginal bleeding, but no cervical dilatation.

Answer 21

c. Part of the conceptus (usually the fetus) is expelled, but the membrane or placenta is retained in the uterus.

Question 22

Dany asked Nurse Lei what could have caused her condition. The following questions could be used by Nurse Lei to assess the patient’s predisposition to miscarriage except:

*
1 point
a. Have you had any urinary tract infections during your pregnancy?
b. Did you use creams or ointments to treat acne?
c. Were you drinking alcohol during your pregnancy?

Answer 22

d. How long did the bleeding episode last and how much bleeding occurred? = IT ONLY ASSESSES THE PATTERN OF BLEEDING

Question 23

Nurse Lei was informed by the manager that another patient, 16-week aog, was admitted for missed miscarriage. Which among the following statements about this condition requires follow-up?

*
1 point
a. An ultrasound confirms fetal death.
b. Dilatation and evacuation is the treatment for this condition.
c. Labor will be actively induced primarily with oxytocin then followed by misoprostol.
d. There is a high risk for the development of disseminated intravascular coagulation (DIC) if the active termination of pregnancy was not done.

Answer 23

(-)
c. Labor will be actively induced primarily with oxytocin then followed by misoprostol.

Miso ports ok (dilation First) Then Oxytocin

Question 24

Nurse Lei is about to administer RhIG to patient Dany. As she was about to give it, Dany asked Nurse Lei what it is for. Nurse Lei correctly responds that:

*
1 point
a. You will receive this to prevent the buildup of antibodies in the event the conceptus was Rh positive.
b. You will receive this to promote isoimmunization thereby preventing the buildup of antibodies.
c. If you are Rh negative, and in case the baby is Rh positive, this will promote the production of antibodies against Rh-positive blood.
d. These antibodies you will receive would attempt to protect the red blood cells of your Rh positive infant during the months that infant is in utero.

Answer 24

a. You will receive this to prevent the buildup of antibodies in the event the conceptus was Rh positive.

Question 25

During the immediate period after patient Dany suffered from miscarriage, which among the following actions should be the priority of Nurse Lei?

*
1 point
a. Infection
b. Septic Abortion
c. Powerlessness
d. Shock

Answer 25

d. Shock = DIC = HEMORRHAGIC SHOCK

LAY WOMAN FLAT AND MASSAGE FUNDUS

Question 26

Situation:
Nurse Miley is attending
to patient Diana who is about to undergo Caesarean birth. The following
questions apply.

26. Diana asks Nurse Miley what is the possible reason why she was recommended to undergo Caesarean delivery rather than normal delivery. The following could be possible indications except:

*
1 point
a. Cervical cerclage
b. Previous Caesarean birth
c. Microcephaly
d. As an elective procedure

Answer 26

c. Microcephaly = Hydrocephalus is indicated for CS not microcephaly

Question 26

Diana is concerned if she will lose a lot of blood in the process. Which among the following is the correct response by Nurse Miley?

*
1 point
a. You will lose more blood as compared to normal delivery, and this is a little bit concerning.
b. A total of 1,500mL of blood will be lost. This is considered normal and there is nothing to worry about.
c. There will be an additional 200-500mL of blood loss in Caesarean delivery.
d. During a Caesarean birth, a woman usually loses 300 to 500 mL of blood.

Answer 26

c. There will be an additional 200-500mL of blood loss in Caesarean delivery.

NORMAL: 500mL
CESAREAN: 1000mL

Question 27

Nurse Miley is preparing the patient for the surgery. She is facilitating preoperative diagnostic procedures. Which of the following is not an expected laboratory parameter to assess preoperatively?

*
1 point
a. Leukocyte count
b. Serum electrolytes and pH
c. CBC
d. Ultrasound

Answer 27

a. Leukocyte count = NORMAL for woman in labor to have elevated leukocyte count (up to 20,000/MM3)

Question 28

Diana does not want the incision to be easily seen. She is very concerned about the body image issues it could bring her. Which among the following incision types do you anticipate the physician to recommend to the patient?

*
1 point
a. Midline
b. Pfannenstiel
c. Kocher
d. Transverse

Answer 28

b. Pfannenstiel

Question 29

A student nurse is teaching Diana during the preoperative period. Which among the following statements by the student requires intervention?

*
1 point
a. “After the surgery, take 5 to 10 deep breaths each hour to prevent infections.”
c. “A pair of TEDS will be fitted on your legs to encourage circulation.”
d. “You will use an incentive spirometer after the surgery to aerate the lungs. This works by inhaling using the device.”

Answer 29

b. “You will be placed on NPO before the surgery to prevent any possible aspiration when you are already in the operating room.”

R: Do not use medical terms when explaining to pt because they already have stress and anxiety

Question 30

Situation:
Nurse Jane is caring for
an adolescent pregnant client, Chantel. The following questions apply.

31. The following statements are true about pregnancy during adolescent years aside from:

*
1 point
a. Teenage pregnancies still continue due to increase in the rate of sexual activity among teenagers.
b. A girl in the process of separating from her parents may be devastated by the reality of someone else being dependent on her.
c. Many adolescents do not seek prenatal care until late in their pregnancies.
d. Adolescents are considered high-risk clients because they have a high incidence of ectopic pregnancy.

Answer 30

d. Adolescents are considered high-risk clients because they have a high incidence of ectopic pregnancy.

R: they are at high risk of PIH, IDA, Premature labor, LBW infants, CPD, high rate of intimate partner abuse

Question 31

Chantel asks Nurse Jane, “Do I have higher risk of complications because of my age?” The nurse would reply that Chantel has high risk for developing the following conditions except:

*
1 point
a. Pregnancy-induced hypertension
b. Folate deficiency anemia
c. Premature labor
d. Cephalopelvic disproportion

Answer 31

B. Folate Deficiency Anemia

Question 32

When caring for Chantel, Nurse Jane communicates with careful consideration of the patient’s circumstance. The following statements are considered acceptable when explaining to the patient her health status except:

*
1 point
a. “Oh, you’re starting to have colostrum.”
b. “Your blood pressure is 110/80mmHg. It is considered normal.”
c. “If you find it difficult to refrain from consuming soft drinks, I suggest that you may continue to do so but choose the non-caffeinated ones.”
d. “There are ways to maintain companionship of your friends such as watching movies together or joining a club.”

Answer 32

a. “Oh, you’re starting to have colostrum.”

Question 33

Young adolescents are more prone to postpartum hemorrhage than the average woman. Nurse Chantel knows that the reason for this is:

*
1 point

a. If a uterus is not yet fully developed, it becomes overdistended by pregnancy.
b. If a laceration occurs, it usually heals relatively slower.
c. The blood supply in an adolescent’s uterus is richer than that of an adult woman.
d. An adolescent may have difficulty following instructions by the health care provider.

Answer 33

a. If a uterus is not yet fully developed, it becomes overdistended by pregnancy.

Question 34

Factors that contribute to the lack of prenatal care among adolescent pregnant females are the following except:

*
1 point
a. Denial of pregnancy
b. Peer pressure
c. Knowledge deficit
d. Fear of vaginal examination

Answer 34

b. Peer pressure

Question 35

Situation:
Nurse Minya is caring for
patient Vanessa, a 24-week aog pregnant client with pregnancy-induced
hypertension. The following questions apply:

36. Nurse Minya is teaching a student nurse about PIH. Which among the following statements by the student requires follow-up?

*
1 point
a. PIH is a condition in which vasospasm occurs during pregnancy in both small and large arteries.
b. Proteinuria occurs once hypertension and edema are present.
c. PIH is classified as gestational hypertension, mild preeclampsia, severe pre-eclampsia, and eclampsia.
d. Any status below a point of seizures is pre-eclampsia.

Answer 35

b. Proteinuria occurs once hypertension and edema are present.

Proteinuria occurs first then edema

Question 36

Which among the following are clinical manifestations of severe pre-eclampsia?

I.160/110mmHg or above

II.2+ or 3+ on a random urine sample

III.140/90mmHg or above

IV.Edema over bony prominences

V.Seizure

VI.Facial edema

VII.Oliguria

VIII.Polyuria

*
1 point

a. I, IV, VI, VII
b. II, III, IV, VII
c. I, II, VI, VIII
d. II, IV, V, VIII

Answer 36

a. I, IV, VI, VII

Question 37

Eclampsia is the most severe classification of PIH. Nurse Minya knows that the fetal prognosis with eclampsia is poor because of:

*
1 point
a. Fetal hypoxia and acidosis
b. Maternal convulsions
c. Circulatory overload
d. Hyperalbuminemia

Answer 37

a. Fetal hypoxia and acidosis

Question 38

Nurse Minya noted that the PIH of Chantel was classified as severe. The following nursing actions are appropriate to be performed by the nurse except:

*
1 point
a. Place in a private room.
b. Darken the room.
c. Administer nifedipine as ordered.

Answer 38

d. Weigh the patient every morning and afternoon.
WT PT DAILY AT THE SAME TIME

Question 39

On the next day, during the start of her shift, Nurse Minya noted in the chart that Chantel’s condition has complicated into eclampsia. She will plan the following nursing interventions but:

*
1 point
a. Apply an external fetal heart monitor.
b. After a seizure episode, encourage the preterm delivery of the baby.
c. Check for vaginal bleeding to detect low-lying placenta.
d. Administer magnesium sulfate as ordered.

Answer 39

c. Check for vaginal bleeding to detect low-lying placenta. = low lying placenta is not checked

Complication of seizure = placental separation

Question 40

Situation:
HELLP syndrome occurs in
4% to 12% of patients with PIH. It is a serious syndrome because it results in
a maternal mortality rate as high as 24% and an infant mortality rate as high as
35%. The following questions apply.

41. HELLP syndrome is a variation of PIH named for the common symptoms that occur, specifically as follows, except:

                     I.        RBC destruction
    
                    II.        Thrombocytopenia
    
                  III.        Low hemoglobin
    
                   IV.        Decreased AST, ALT
    
                     V.        Clotting tendencies

*
1 point
a. I, III, IV
b. II, IV, V
c. I, II, III
d. III, IV, V

Answer 40

HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelets)

Correct Answer
-Decreased AST, ALT
-Clotting tendencies

Question 41

Other than the hallmark signs of HELLP syndrome, the following are associated clinical manifestations except:

*
1 point
a. Proteinuria
b. Epigastric pain
c. General malaise
d. Right lower quadrant tenderness

Answer 41

d. Right lower quadrant tenderness

R: it should be RUQ tenderness due to LIVER inflammation

Question 42

The following are complications associated with HELLP syndrome aside from:

*
1 point
a. Renal failure
b. Hyperglycemia
c. Hemorrhage
d. Encephalopathy

Answer 42

b. Hyperglycemia

R: It should be hypoglycemia since there’s no gluconeogenesis & no glycogenolysis = Liver inflamed

Question 43

The nurse caring for a patient with HELLP syndrome shall anticipate the following therapeutic interventions except: (-)

*
1 point
a. Acetylsalicylic acid for abdominal pain as ordered.
b. Infusion of intravenous glucose.
c. Infant is delivered as soon as possible even if preterm.
d. Transfusion of fresh frozen plasma

Answer 43

a. Acetylsalicylic acid for abdominal pain as ordered.

R: Acetylsalicylic acid is an anti-platelet drug. The pt is already bleeding and can cause further hemorrhage.

Question 44

All of the following statements about HELLP syndrome are correct except:

*
1 point
a. Women with the HELLP syndrome need close observation for clotting tendencies.
b. The liver enzyme levels are elevated from necrosis of the liver.
c. Fetal complications can include growth restriction and preterm birth.
d. Laboratory studies reveal erythrocytes that appear fragmented on a peripheral blood smear.

Answer 44

(-)
a. Women with the HELLP syndrome need close observation for clotting tendencies.
Not clotting tendencies but Hemorrhage

Question 45

Situation:
You are assigned in an OB
outpatient clinic for a month. Aside from the maternal and fetal wellbeing, one
should also look out for infections that may cause danger to the fetus and
pregnancy itself.

46. Chloe, 25 years old, visited the clinic for her second check-up of the first trimester. This is her first pregnancy and admitted that she has no one near to guide her during the pregnancy. Lately, she has been experiencing vaginal discharge characterized by very foul-smelling odor, frothy, yellow-greenish in color. What is the likely causative agent of this infection?

*
1 point
A. Syphilis
B. Trichomoniasis
C. Bacterial Vaginosis “ fishy odor”
D. Moniliasis “cheese-like”

Answer 45

B. Trichomoniasis: yellowish to greenish, frothy, mucopurulent, copious

Syphilis: ulcerative, painless lesions

Question 46

Upon assessment and history taking, you found out that Chloe had a previous infection of Syphilis during her teenage years in which she completed treatment for. Which of the following is incorrect about the infectious disease?

*
1 point
A. It is a chronic infectious disease caused by the organism Treponema pallidum.
B. Organism may cross the placenta and is passed to the fetus after the second month of pregnancy as congenital syphilis
C. A serum test called Venereal Disease Research Laboratory is done on the first prenatal visit
D. Most infectious stage of syphilis is the primary stage.

Answer 46

B. Organism may cross the placenta and is passed to the fetus after the second month of pregnancy as congenital syphilis = it should be fully developed placenta, not after second month of pregnancy should be 4th month

Question 47

Sam, 27 years old, came to the clinic due to the appearance of small and large wartlike growths on her genitals. Upon history taking, she stated that she has multiple sex partners and does not usually use protection. She was diagnosed with an infection Condyloma acuminatum. Which of the following are included in your health teaching for Sam?

I. Condyloma acuminatum is caused by HPV

II. Condyloma acuminatum is caused by Moniliasis

III. Encourage Papanicolaou test every year

IV. Encourage Papanicolaou test every 2 years once treatment is completed

V. HPV is associated with cervical malignancies

VI. Infection affects the cervix, urethra and does not affect the anus, penis, and scrotum

VII. Transmission does not occur during vaginal birth

*
1 point
a. I, III, V, VI, VII
b. I, IV, V, VII
c. I, III, V, VI
d. I, III, V

Answer 47

d. I, III, V

Condyloma acuminatum is caused by HPV (human papillomavirus)
Encourage Papanicolaou test every year
HPV is associated with cervical malignancies
Intection attects the cervix, urethra, anus, penis, and scrotum
Transmission may occur during vaginal birth

Question 48

Monica, 25 years old on, 8 weeks AOG, came to the clinic with complaints of fever, night sweats, chills, fatigue, and productive cough with yellow sputum. She is very worried as this is similar to the signs of pulmonary tuberculosis that her father has when they visited him last month. She wasn’t aware that she was pregnant during that visit. Which of the following are true about tuberculosis during pregnancy?

*
1 point
a. If a chest radiograph is required for the client, it is done only after 12 weeks of gestation, and a lead shield for the abdomen is required
b. Transplacental transmission is rare
c. Tuberculin skin testing is safe during pregnancy; however, the PHCP may want to delay testing until after 2nd trimester
d. Active disease during pregnancy has been associated with an increase in hyperglycemia in pregnancy

Answer 48

b. Transplacental transmission is rare

A - Chest radiograph should be done at 20 weeks of gestation

C - Tuberculin skin test should be after delivery

D - Hypertensive not hyperglycemia

Question 49

Monica also has a 9-month-old baby. She asked if it is still possible to breastfeed if she is confirmed to have PTB?

*
1 point
a. No, in all cases
b. Yes, if the baby is above 6 months old.
c. Yes, if the mother is under medications
d. Yes, if the client is noninfectious.

Answer 49

d. Yes, if the client is noninfectious.

Promote breast-feeding/chest-feeding only if the client is noninfectious. If you have tuberculosis (TB), you may breastfeed if you are currently taking medication and no longer infectious. Mothers with untreated TB at the time of delivery should not breastfeed or be in direct contact with their newborn until they have started appropriate drug treatment and they are no longer infectious

Question 50

Situation:
Daria,
an HIV+ infant was brought to the hospital due to having severe diarrhea. Her
mother Kyla was concerned about her child’s prognosis and admits that she does
not have enough knowledge about her daughter’s condition. You, being a
proficient nurse was tasked to educate Kyla about the facts on HIV in children.

51. Which of the following vaccines would the nurse expect to give to Daria who is extremely immunocompromised?

*
1 point
a. IPV
b. OPV
c. BCG
d. MMR

Answer 50

a. IPV - the only inactivated vaccine

Question 51

The Centers for Disease Control and Prevention has developed a classification system to describe the spectrum of HIV disease in children. Which of the following manifestations belong to the moderately symptomatic category?

*
1 point
a. Lymphoid interstitial pneumonitis (LIP)
b. Pneumocystis carinii pneumonia
c. Hepatosplenomegaly
d. Lymphadenopathy

Answer 51

a. Lymphoid interstitial pneumonitis (LIP)

B - SEVERE
C - MILD
D - MILD

Question 52

What kind of transmission occurs between a mother who is HIV+ and her infant?

*
1 point
a. Diagonal transmission
b. Horizontal transmission
c. Vertical transmission
d. Airborne transmission

Answer 52

c. Vertical transmission

Horizontal = Intimate sexual contacts or parenteral exposure to blood or body fluids

Question 53

What is the drug of choice for Pneumocystis carinii pneumonia in children with HIV?

*
1 point
a. dapsone
b. Trimethoprim/sulfamethoxazole
c. Pentamidine
d. Atovaquone

Answer 53

b. Trimethoprim/sulfamethoxazole

Dapsone > leprosy
Pntamidine > Antiprotozoan
Atovaquone > Pneumocytis jirovecii (Pneumonia in Adults)

Question 54

What is the preferred test used in detecting HIV for infants older than 1 month?

*
1 point
a. Polymerase Chain Reaction test
b. Enzyme-Linked Immunosorbent Assay
c. Western blot
d. CD4 count

Answer 54

a. Polymerase Chain Reaction test - preferred test to determine HIV infection in infants

Question 55

When are virologic diagnostic tests performed on breastfed infants older than six months who were perinatally exposed to HIV?

*
1 point
a. Every 1 month
b. Every 3 months
c. Every 6 months
d. Every 1 year

Answer 55

b. Every 3 months

Infants continuing to be breastfed beyond 6 months of age should have virologic diagnostic testing every 3 months during breastfeeding.
At cessation of breastfeeding, virologic
diagnostic testing should be performed at 4 to 6 weeks, 3 months, and 6 months after breastfeeding has ended, regardless of the age of the child when breastfeeding is discontinued. If an infant’s virologic test result is positive, a repeat test should be performed as soon as possible and ART should be initiated.

Question 56

Situation:
Nurse
Nikki was doing her rounds and was preparing to administer medications in the
pediatric ward. Before going into each of her patients’ rooms, she adheres to
the ten rights of medication administration to promote her patients’ safety and
prevent medication errors.

57. Which of the following statements is true regarding the administration of medication to pediatric patients?

*
1 point
a. Dosages should be calculated based on adult weight.
b. Pediatric patients require lower dosages compared to adults.
c. All medications can be administered using the same dosage guidelines for adults.
d. Medication administration is not necessary for pediatric patients.

Answer 56

b. Pediatric patients require lower dosages compared to adults.

Question 57

What is the preferred site for infants under 1 year receiving an intramuscular injection?

*
1 point
a. Lateral aspect of the vastus lateralis muscle
b. Medial portion of the vastus lateralis muscle
c. Medial portion of the dorsogluteal muscle
d. Lateral aspect of the ventrogluteal muscle

Answer 57

a. Lateral aspect of the vastus lateralis muscle

Question 58

Cassie, a 7-year-old girl, will be given an antibiotic intravenously in her dominant hand. What would be the most appropriate activity for her to do while her medicine is infusing?

*
1 point
a. Drawing flowers on a paper
b. Making origami figures
c. Fingerpainting
d. Listening to her favorite music

Answer 58

d. Listening to her favorite music

Question 59

Nurse Nikki is going to administer acetaminophen in one of her pediatric patients. What is the best way to identify him?

*
1 point
a. Ask the child his name
b. Read the name on the ID band
c. Read the name on the chart and ask the child of that was him
d. Ask the other nurses if they know who the child is

Answer 59

b. Read the name on the ID band

Question 60

What is the correct way of instilling eardrops in a 6-year-old pediatric patient?

*
1 point
a. Allow the child to place the eardrops by herself for a sense of control.
b. Pull the pinna of her ear down and back to straighten the canal.
c. Pull the pinna of her ear up and back to straighten the canal.
d. Refrigerate the drug first so it numbs the ear canal.

Answer 60

c. Pull the pinna of her ear up and back to straighten the canal.

If the child is older than 2 years = pull pinna up and back

Younger than 2 yers = down and back

Question 61

Situation:
Ian,
a 2-year-old boy, is transported to the emergency room due to cyanosis
precipitated by crying. His mother noticed that he becomes fatigued after
playing. Tetralogy of Fallot was his diagnosis.

62. What position would Ian automatically assume?

*
1 point
a. Low Fowlers
b. Squatting
c. High Fowlers
d. Sitting

Answer 61

b. Squatting - resistance is high

Question 62

Hypoxic spells or tet spells could cause which of the following, EXCEPT?

*
1 point
a. Polycythemia
b. Alkalosis
c. Thrombophlebitis
d. Cerebrovascular accident

Answer 62

b. Alkalosis

It should be acidosis

A - to increase oxygenation in blood

Question 63

“Why do my child’s fingertips look like that?” his mother asks the nurse. The nurse responds based on the concept that clubbing happens as a result of:

*
1 point
a. chronic hypoxia
b. a left-to-right shunting of blood
c. decreased cardiac output
d. untreated congestive heart failure

Answer 63

a. chronic hypoxia

Question 64

Among the four common anomalies of Tetralogy of Fallot, which one develops as a compensatory mechanism?

*
1 point
a. Pulmonary stenosis
b. Overriding of aorta
c. Right ventricular hypertrophy
d. Ventricular septal defect

Answer 64

c. Right ventricular hypertrophy (boot sign in x-ray)

Response to problem of pulmonary stenosis

Question 65

Ian will undergo a procedure that utilizes a synthetic shunt between the subclavian artery and the pulmonary artery in order to prevent scarring of the subclavian artery. What is procedure is going to be performed?

*
1 point
a. Classic Blalock-Taussig Shunt
b. Modified Blalock-Taussig Shunt
c. Brock procedure
d. Waterson shunt

Answer 65

b. Modified Blalock-Taussig Shunt

Question 66

After performing the Blalock-Taussig procedure, the nurse assessed Ian and cannot seem to find a palpable pulse in his right arm after the procedure. This is _______.

*
1 point
a. Normal, because the subclavian artery is used.
b. Abnormal, because the pulse should still be palpable after the procedure.
c. Abnormal, this might be a lethal complication post-surgery.
d. None of the above

Answer 66

a. Normal, because the subclavian artery is used. The right subclavian artery supplies the blood to the right arm.

Question 67

Situation:
Growth and development refer to the physical, cognitive, emotional, and
social changes that occur throughout an individual’s lifespan. It encompasses
various aspects of human development, from infancy to adulthood.

68. Which of the following infant reflex groups is present at birth and remains throughout adulthood?

*
1 point
a. Rooting, blink, cough, gag
b. Blink, cough, sneeze, stepping
c. Blink, sneeze, cough, gag
d. Rooting, sneeze, cough, swallowing

Answer 67

c. Blink, sneeze, cough, gag

Rooting and stepping is usually gone after 1st year

Question 68

Which statement is true about the principles of growth and development?

*
1 point
a. Different children pass through the predictable stages at the same rates.
b. All body systems develop at the same rate.
c. Gross motor skills are developed first before fine motor skills.
d. Development proceeds from distal to proximal body parts.

Answer 68

c. Gross motor skills are developed first before fine motor skills.

Question 69

According to Erikson, what should the nurse anticipate when assessing a toddler?

*
1 point
a. Taking pride in pulling off the lollipop wrapper
b. Participating in school activities
c. Questioning sexual identity
d. Engaging in fantasy activities

Answer 69

a. Taking pride in pulling off the lollipop wrapper (AUTONOMOUS ACTIVITY)

B = School age
C = Adolescents
D = Preschool

Question 70

The mother of an 8-month-old told the nurse that her child continually cries whenever she goes to work. This attitude displayed by the infant is in what stage of Piaget’s Theory?

*
1 point
a. Sensorimotor stage
b. Preoperational thought
c. Concrete operational thought
d. Formal operational thought

Answer 70

a. Sensorimotor stage = continue to cry because they still don’t know that parents exist (Object permanence)

Question 71

In what stage of Kohlberg’s theory of moral development is a person linked with obeying a law even if it is discriminatory towards a racial group?

*
1 point
a. Society-maintaining orientation
b. Universal ethical principle orientation
c. Instrumental relativist orientation
d. Social contract orientation

Answer 71

d. Social contract orientation = follows laws even it can be discriminatory to others

C - satisfying one’s needs and sometimes need of others

B - does not follow law if unfair to others

Question 72

Callie, 4 years old believes that there is more chocolate milk in her sister’s tall thin glass that her short, wide glass. She has not yet achieved with of the following principles of Piaget?

*
1 point
a. Object permanence
b. Assimilation
c. Conservation
d. Accommodation

Answer 72

c. Conservation

Assimilation = toddlers seeing world according to what they know
Accommodation = child develops new schema or modifies existing ones to accommodate new information different from what was already known

Question 73

Which of the following best describes the cognitive development of an 18-month-old child?

*
1 point
a. The child can follow one-part directions
b. The child understands the concept of “forever”
c. The child can name six body parts
d. The child has an attention span of approximately 5 minutes

Answer 73

a. The child can follow one-part directions - they imitate the behavior of others

Question 74

A nurse is assisting a client and her nine-month-old daughter. The mother says, “Sometimes, she is so naughty! I had to put her in time-out yesterday for throwing toys!” What is the nurse’s most suitable response?

*
1 point
a. “Where do you place her when she goes to time-out?”
b. “Keep doing that to teach her the right way; eventually she will stop throwing toys.”
c. “At this age, she should stay in time-out for nine minutes.”
d. “Remind her not to throw toys but don’t discipline her for this behavior.”

Answer 74

d. “Remind her not to throw toys but don’t discipline her for this behavior.” = child does not know importance as to why it should not be done

Timeout = Toddlers and preschool; 1 minute = age per year

Question 75

Situation:
Edward,
a 2-year-old boy was hospitalized with pneumonia. His mother reported that he
has been vomiting for 3 days and has a fever of 38.7°C. Upon assessment, he
exhibited the following signs and symptoms: chills, tachypnea, tachycardia,
chest pain and crackles was auscultated.

76. The nurse was making rounds and took Edward’s temperature which went up to 40°C. What physiological process explains why Edward is at risk for developing dyspnea?

*
1 point
a. Fever raises metabolic demands, requiring more oxygen.
b. Blood glucose levels are low, and cells lack the energy to utilize oxygen.
c. Hyperventilation causes an increase in carbon dioxide production.
d. Hyperventilation causes a decrease in carbon dioxide production.

Answer 75

a. Fever raises metabolic demands, requiring more oxygen.

Question 76

What behavior would Edward most likely exhibit?

*
1 point
a. lie quietly as the nurse auscultates his lungs
b. ask many questions about what the nurse is doing
c. cry and push the nurse away
d. plays cheerfully with a stethoscope

Answer 76

c. cry and push the nurse away - toddlers will demonstrate negative behaviour; hesitant around strangers and resist close contact with people they do not know. They cry to communicate stress.

Question 77

Edward complains of discomfort on his right side and that ibuprofen is not effective. Which instruction should the nurse provide to the mother?

*
1 point
a. Increase the dose of ibuprofen.
b. Administer another ibuprofen.
c. Encourage the child to lie on the left side.
d. Encourage the child to lie on the right side

Answer 77

d. Encourage the child to lie on the right side = Lying on the same side decreases discomfort

Question 78

Edward is going to be given oxygen. When the nurse came near, he became agitated and began to cry. What is the best course of action for a child who is afraid of receiving oxygen?

*
1 point
a. tightly secure the oxygen mask straps to the face.
b. place oxygen tubing through a hole in a paper cup.
c. use a face mask instead of a nonrebreather mask.
d. have a parent restrain the child as you give oxygen.

Answer 78

b. place oxygen tubing through a hole in a paper cup.

Question 79

The nurse is about to administer the last dose of ceftriaxone (Rocephin) but discovers that the IV has become obstructed. The nurse should?

*
1 point
a. Contact the prescriber to request a prescription change.
b. Arrange for early discharge.
c. Start the IV line on the other hand
d. Administer the medication intramuscularly.

Answer 79

a. Contact the prescriber to request a prescription change.

Note that it’s the last dose already, ask the physician for other forms of administration like PO or IM

Question 80

Situation:
Faye,
is an 8-year-old with sickle cell anemia. She was rushed into the emergency
room due to having a vaso-occlusive crisis.

81. Which amino acid takes the place of glutamic acid in sickle cell anemia?

*
1 point
a. Valine
b. Isoleucine
c. Alanine
d. Tyrosine

Answer 80

a. Valine

Question 81

What kind of hemoglobin does a child with sickle cell anemia have?

*
1 point
a. Hemoglobin AC
b. Hemoglobin SS
c. Hemoglobin AS
d. Hemoglobin O

Answer 81

b. Hemoglobin SS - pt must have 2 abnormal alleles

Question 82

This type of crisis occurs when there is a pooling and increased destruction of sickled cells in the liver and spleen causing the spleen to become enlarged and tender.

*
1 point
a. Megaloblastic crisis
b. Sequestration crisis
c. Hyper hemolytic crisis
d. Aplastic crisis

Answer 82

b. Sequestration crisis

A - very large rbcs
C - hemoglobin levels drops rapidly
D - suddenly stop producing RBC

Question 83

Which of the following manifestations will the nurse expect to assess in Faye following her vaso-occlusive crisis?

*
1 point
a. Epistaxis
b. Petechiae
c. Hematuria
d. Melena

Answer 83

c. Hematuria

Vaso-occlusive crisis = organ infarction = kidney infarction = Hematuria

Question 84

Which of the following blood components is increased in sickling cell crisis?

*
1 point
a. Erythrocyte
b. Hematocrit
c. Hemoglobin
d. Reticulocyte

Answer 84

d. Reticulocyte - Immature Red Blood cells

Hct and Hgb will be decreased

Question 85

Situation:
: A 3-year-old child named James was admitted in the
hospital. His mother stated that he has raised, red, ring-like rash with
central clearing on his lower back. She also reported that James cries at night
because it was very itchy.
86. What would be the appropriate diagnosis for James?

*
1 point
a. Tinea cruris
b. Tinea capitis
c. Tinea pedis
d. Tinea corporis

Answer 85

d. Tinea corporis = epidermal layer of the skin (anywhere)

Cruris = Groin
Capitis = Scalp
Pedis = Foot

Question 86

Whichof the following statements is true regarding dermatophytosis?

*
1 point
a. The causative agent is a worm and cannot be transferred from one person to another.
b. The causative agent is a fungus and can be transferred from one person to another.
c. The causative agent is a bacteria and cannot be transferred from one person to another.
d. The causative agent is a virus and can be transferred from one person to another.

Answer 86

b. The causative agent is a fungus and can be transferred from one person to another. - can also be passed through infected items such as comb, clothing, pets, shower surfaces

Question 87

Situation:
Another
child, Kiera presented to the emergency department with an itchy irritated
scalp and infected areas on her head. Assessment reveals lice and nits in her
hair.

88. Which of the following discharge instructions would the nurse include?

*
1 point
a. Manual removal of nits for several days to ensure they do not hatch
b. Permethrin 10% applied to hair and body after shower and shampoo
c. Child should not return to school until all lice and nits are gone
d. Washing sheets and towels in hot water

Answer 87

d. Washing sheets and towels in hot water

permethrin should only be 1%
c is wrong as advised by CBC

Question 88

. Which of the following indicates incorrect understanding regarding the use of permethrin shampoo?

*
1 point
a. Apply the shampoo to the head and scalp only.
b. Allow the shampoo to sit in the hair for 1 hour.
c. Cover the areas behind the ears and on the back of the neck.
d. When the hair is dry, comb the hair with a fine-toothed comb to remove any remaining nits.

Answer 88

b. Allow the shampoo to sit in the hair for 1 hour. (It should be only 10 minutes)

Question 89

This medication for pediculosis is not recommended to be used anymore due to its toxic effects.

*
1 point
a. Lindane
b. Permethrin
c. Griseofulvin
d. Terbinafine

Answer 89

a. Lindane = it can cause neurotoxic effects such as seizure and convulsions

Question 90

June, a 4-month-old is brought to the emergency department with severe dehydration. Upon assessment he has a heart rate of 196 and a blood pressure of 60/30. The anterior fontanel appeared to be sunken. The nurse notes that the infant does not cry when the intravenous line is inserted. June’s parents state that he has not “held anything down” in 18 hours. The nurse obtains a finger-stick blood sugar of 94. Which would the nurse expect to do immediately?

*
1 point
a. Administer a bolus of normal saline.
b. Administer a bolus of D10W.
c. Administer a bolus of normal saline with 5% dextrose added to the solution.
d. Offer the child an oral rehydrating solution

Answer 90

a. Administer a bolus of normal saline.

NO BOLUS OF DEXTROSE = IT COULD LEAD TO CEREBRAL EDEMA

Question 91

The nurse is caring for an infant with pyloric stenosis. The parent asks if any future children will likely have pyloric stenosis. Which is the nurse’s best response?

*
1 point
a. “You seem worried; would you like to discuss your concerns?”
b. “It is very rare for a family to have more than one child with pyloric stenosis.”
c. “Pyloric stenosis can run in families. It is more common among males.”
d. “Although there can be a genetic link, it is very unusual for girls to have pyloric stenosis.”

Answer 91

c. “Pyloric stenosis can run in families. It is more common among males.” - PROVIDE INFORMATION AND THEN ASK ABOUT PARENTS’ CONCERN

Question 92

Which statement by the parent would be typical for a child with pyloric stenosis?

*
1 point
a. “The baby is a very fussy eater and just does not want to eat.”
b. “The baby tends to have a very forceful vomiting episode about 30 minutes after most feedings.”
c. “The baby is always hungry after vomiting, so I feed her again.”
d. “The baby is happy in spite of getting really upset after spitting up.”

Answer 92

c. “The baby is always hungry after vomiting, so I feed her again.” = infants always appear hungry and appear malnourished, they are hungry because their feedings do not get absorbed.

Question 93

The nurse is caring for an infant with biliary atresia. The parents ask why the child is receiving cholestyramine. Which is the nurse’s best response?

*
1 point
a. To lower the infant’s cholesterol.
b. To relieve the infant’s itching.
c. To help the infant gain weight.
d. To help feedings be absorbed in a more efficient manner

Answer 93

b. To relieve the infant’s itching.

In biliary atresia = there’s increased bilirubin > uncontrollable pruritus

Question 94

The nurse knows that Nissen fundoplication involves which of the following?

*
1 point
a. The fundus of the stomach is wrapped around the inferior stomach, mimicking a lower esophageal sphincter.
b. The fundus of the stomach is wrapped around the inferior esophagus, mimicking a cardiac sphincter.
c. The fundus of the stomach is wrapped around the middle portion of the stomach, decreasing the capacity of the stomach.
d. The fundus of the stomach is dilated, decreasing the likelihood of reflux.

Answer 94

c. The fundus of the stomach is wrapped around the middle portion of the stomach, decreasing the capacity of the stomach.

Question 95

The nurse is caring for a 6-month-old infant diagnosed with meningitis. Findings upon assessment include an altered level of consciousness, decreased urine output, and temperature of 103.4°F (39.7°C). When the infant is placed in a supine position and flexes his neck, he also flexes his knees and hips. What is the best room assignment for a newly admitted child with bacterial meningitis.

*
1 point
a. Semiprivate room with a roommate who has bacterial meningitis but has received intravenous antibiotics for more than 24 hours.
b. Semiprivate room with a roommate who also has bacterial meningitis.
c. Private room that is dark and quiet with minimal stimulation.
d. Private room that is bright and colorful and has developmentally appropriate activities available.

Answer 95

c. Private room that is dark and quiet with minimal stimulation.

Question 96

A child with Reye syndrome is described in the nurse’s notes as follows: comatose with sluggish pupils; when stimulated, demonstrates decerebrate posturing. To treat a common manifestation of Reye syndrome, which medication would the nurse expect to have readily available?

*
1 point
a. Furosemide (Lasix)
b. Insulin
c. Glucose
d. Morphine

Answer 96

c. Glucose = hypoglycemia

Question 97

Which can elicit the Gower sign? Have the child:

*
1 point
a. Close the eyes and touch the nose with alternating index fingers.
b. Hop on one foot and then the other.
c. Bend from the waist to touch the toes.
d. Walk like a duck and rise from a squatting position.

Answer 97

d. Walk like a duck and rise from a squatting position.

Question 98

A teen who was hospitalized for chronic kidney disease (CKD) develops symptoms of polyuria, polydipsia, and bone pain. Which body mineral might be causing these symptoms?

*
1 point
a. Elevated calcium
b. Low phosphorus
c. Low magnesium
d. High aluminum hydroxide

Answer 98

a. Elevated calcium = due to kidney not being able to process it

Elevated phosphorus due to renal impairment
Elevated Mg due because it is not excreted in the urine

Question 99

Which classification of osteogenesis imperfecta (OI) is lethal in utero and in infancy?

*
1 point
a. Type I.
b. Type II.
c. Type III.
d. Type IV.

Answer 99

b. Type II.

lethal in utero and in infancy because of multiple fractures and deformities and underdeveloped lungs.