Jun 25, 2010

NP2 Nursing Board Exam June 2008 Answer Key 'Community Health Nursing and Care of Mother and Child'

100 Nursing Board Exam test questions of June 2008 Nurse Licensure Examination (NLE)
Nursing Practice II – Community Health Nursing and Care of Mother and Child
Community Health Nursing / O.B. (Obstetric)

PART 1 Board Exam test questions 51 - 100

51. A public health nurse would instruct a pregnant woman to notify the physician immediately if which of the following symptoms occur during pregnancy?
A. Presence of dark color in the neck
B. Increased vaginal discharge
C. Swelling of the face
D. Breast tenderness

52. A woman who is week 9 pregnant comes to the Health center with moderate bright red vaginal bleeding. On physical examination, the physician finds the client’s cervix 2 cm dilated. Which term best describes the client’s condition?
A. missed abortion
B. Incomplete abortions
C. Inevitable abortion
D. Threatened abortion

53. In a big government hospital, Nurse Pura is taking care of a woman with diagnosis of abruption placenta. What complication of this condition is most concerned to Nurse Pura?
A. Urinary tract infection
B. Pulmonary embolism
C. Hypocalcemia
D. Disseminated intravascular coagulation

54. Which of the following findings on a newly delivered woman’s chart would indicate she is at risk for developing postpartum hemorrhage?
A. Post-term delivery
B. Epidural anesthesia
C. Grand multiparity
D. Premature rupture of membrane

55. Mrs. Hacienda Gracia, 35 years old postpartum client is at risk of thrombophlebitis. Which of the following nursing interventions decrease her chances of developing postpartum thrombophlebitis?
A. Breastfeeding the newborn
B. Early ambulation
C. Administration of anticoagulant postpartum
D. Immobilization and elevation of the lower extremities

Situation – With increasing documented cases of CANCER the best alternative to treatment still remains to be PREVENTION. The following conditions apply.

56. Which among the following is the primary focus of prevention of cances?
A. Elimination of conditions causing cancer
B. Diagnosis and treatment
C. Treatment at early stage
D. Early detection

57. In the prevention and control of cancer, which of the following activities is the most important function of the community health nurse?
A. Conduct community assembles
B. Referral to cancer specialist those clients with symptoms of cancer
C. Use the nine warning signs of cancer as parameters in our process of detection, control, and treatment modalities
D. Teach woman about proper/ correct nutrition

58. Who among the following are recipients of the secondary level of care for cancer cases?
A. Those under early case detection
B. Those under post case treatment
C. Those under early detection
D. Those scheduled for surgery

59. Who among the following are recipients of the tertiary level of care for cancer cases?
A. Those under treatment
B. Those under supportive care
C. Those under early detection
D. Those scheduled for surgery

60. In Community Health Nursing, despite the availability and the use of many equipment and devices to facilitate the job of the community health nurse, the best tool any nurse should be well be prepared to apply is a scientific approach. This approach ensures quality of care even at the community setting. This in nursing parlance is nothing less than the:
A. Nursing diagnosis
B. Nursing protocol
C. Nursing research
D. Nursing process

61. The tone and pitch of the voice, volume, inflection, speed, grunts and other vocalizations are referred to by which of the following terms?
A. Paraverbal clues
B. Ancillary speech
C. Third element
D. Enhancements

62. The plan-do-study-act cycle begins with:
A. Four stages
B. Five agendas
C. Three questions
D. Two concepts

63. During your shift, you noted one of your pregnant clients considered as “waiting case” manifests morning sickness and which later progressed. Which assessment finding may indicate possible developing complication?
A. Maternal pulse 90
B. Trace glucose in the urine
C. FHT 155
D. 1 + ketones in the urine

64. The nurse is working with a child who is going to have a bone marrow aspiration. The physician orders TAC (tetracaine, adrenaline and cocaine). Which of the following is the route of administration?
A. Application to the skin, covered with a dressing prior to the procedure
B. Subcutaneous
C. IV using very slow drip over approximately 4 hours prior to procedure
D. Nasal inhalation

65. Infant head control is judged by the:
A. Ability to hold the head without support
B. Presence or absence of head lag
C. Rigidity of the neck and head
D. Amount of neck wrinkling

66. Which of the following could be included in the outcome criteria for a patient with a nursing diagnosis, “Knowledge Deficit related to potential for altered tissue perfusion in fetus or mother related to maternal cardiovascular”?
A.      Bedrest is maintained at home after the 36th wee of gestation
B.      Fetal heart rate will remain between 120 and 160 beats a minute
C.      Jugular vein distention is evident when lying at 45 degrees
D.      Maternal blood pressure maintained above the 150 systolic

 67. Pregnant women should be taught to be careful to avoid accidental injury. They are prone to falls for which of the following reasons?
            A. additional weight from pregnancy may disturb balance when walking
            B. fetal activity stimulates the nerves of the legs and causes weakness
            C. high levels of hormones often impair judgment resulting in reckless behavior
            D. increased adrenalin released during pregnancy causes women to move faster than usual

68 . When a nurse uses the IMCI model, the IMCI chart uses illness classification, e.g. the pink row needs:
            A. no specific treatments such as antibiotics                                 
B. urgent referral       
C. appropriate antibiotics
D. no urgent measures

69. Which of the four signs of good attachment is true in this statement?
A. the chin should touch the breast while the mouth is wide open and while the lower lip is turned inward more areola  is visible above than below
B. the chin should touch the breast, the mouth is wide open while the lower lip turned outward and more areola visible above than below
C. the chin should touch the breast  while the mouth is wide open while the lower lip turned outward and more areola  visible below than above
D. the chin should touch the breast while the mouth is wide open and the lower lip turned inward, more areola is visible above than below

70. Which type of research inquiry investigates the issues of human complexity ( e. g.  understanding the human expertise?)
            A. positivism                                                     
            B. quantitative research             
C. logical position                      
D. natural inquiry

71. Carol is 15 months old and weighs 5.5 kgs and it is her initial visit. Her mother says that Carol is not eating well and unable to breastfeed, he has no vomiting, has no convulsion and not abnormally sleepy or difficult to awaken. Her temperature is 38.9 deg C.  Using the integrated management of childhood illness or IMCI strategy, if you were the nurse in charge of Carol, how will you classify her illness?
            A. a child at a general danger sign                      
            B. very severe febrile disease                      
C. severe pneumonia    
D. severe malnutrition

72. Why are small for gestational age newborns at risk for difficulty maintaining body temperature?
            A. their skin is more susceptible to conduction of cold
            B. they are preterm so are born relatively small in size
            C. they do not have as many fat stored as other infants
            D. they are more active than usual so they throw off comes

73. Oxytocin is administered to Rita to augment labor. What are the first symptoms of water intoxication to observe for during this procedure?
            A. headache and vomiting                                         
            B. a swollen tender tongue                                 
C. a high choking voice  
D. abdominal bleeding and pain

74. Which of the following treatment should NOT be considered if the child has severe dengue hemorrhagic fever?
            A. use plan C if there is bleeding from the nose or gums
            B. give ORS if there is skin Petechiae, persistent vomiting, and positive tourniquet test
            C. give aspirin
            D. prevent low blood sugar

75. In assessing the patient’s condition using the Integrated Management of Childhood Illness approach strategy, the first thing that a nurse should do is to:
            A. ask what are the child’s problem                          
            B. check the patient’s level of consciousness        
C. check for the four main symptoms      
D. check for the general danger signs

76. A child with diarrhea is observed for the following EXCEPT:
            A. how long the child has diarrhea                                              
B. skin Petechiae                                           
C. presence of blood in the stool
D. signs of dehydration

77. The child with no dehydration needs home treatment. Which of the following is NOT included in the care for home management at this case?
            A. give drugs every 4 hours                          
            B. continue feeding the child                   
C. give the child more fluids       
D. inform when to return to the health center

78. Ms. Jordan, RN, believes that a patient should be treated as individual. This ethical principle that the patient referred to:
            A. beneficence                                                              
B. nonmaleficence         
C. respect for person
D. autonomy

79. When patients cannot make decisions for themselves, the nurse advocate relies on the ethical principle of:
            A. justice and beneficence                                  
            B. fidelity and nonmaleficence    
C. beneficence and nonmaleficence             
D. fidelity and justice

80. Being a community health nurse, you have the responsibility of participating in protecting the health of people. Consider this situation: Vendors selling bread with their bare hands. They receive money with these hands. You do not see them washing their hands. What should you say/do?
            A. “Miss, may I get the bread myself because you have not washed your hands”
            B. All of these
            C. “Miss, it is better to use a pick up forceps/ bread tong”
            D. “Miss, your hands are dirty. Wash your hands first before getting the bread”

Situation 7 – Nurse Joanna works as an OB-Gyne Nurse and attends to several HIGH-RISK
PREGNANCIES: Particular women with preexisting or Newly Acquired illness. The following
conditions apply

81. Bernadette is a 22-year old woman. Which condition would make her more prone than
others to developing a Candida infection during pregnancy?
A. Her husband plays golf 6 days a week
B. She was over 35 when she became pregnant
C. She usually drinks tomato juice for breakfast
D. She has developed gestational diabetes

82. Bernadette develops a deep vein thrombosis following an auto accident and is
prescribed heparin sub-Q. What should Joanna educate her about in regard to this?
A. Some infants will be born with allergic symptoms to heparin
B. Her infant will be born with scattered petechiae on his trunk
C. Heparin can cause darkened skin in newborns
D. Heparin does not cross placenta and so does not affect a fetus

83. The cousin of Bernadette with sickle-cell anemia alerted Joanna that she may need
further instruction on prenatal care. What statement signifies this fact?
A. I’ve stopped jogging so I don’t risk becoming dehydrated.
B. I take an iron pill every day to help grow new red blood cells
C. I am careful to drink at least eight glasses of fluid every day
D. I understand why folic acid is important for red cell formation

84. Bernadette routinely takes acetylsalicylic acid (aspirin) for arthritis. Why should she limit
or discontinue this toward the end of pregnancy?
A. Aspirin can lead to deep vein thrombosis following birth
B. Newborns develop a red rash from salicylate toxicity
C. Newbors develop withdrawal headaches from salicylates
D. Salicylates can lead to increased maternal bleeding at childbirth

85. Bernadette received a laceration on her leg from her automobile accident. Why are
lacerations of lower extremities potentially more serious in pregnant women than others?
A. Lacerations can provoke allergic responses because of gonadothropic hormone
B. Increased bleeding can occur from uterine pressure on leg veins
C. A woman is less able to keep the laceration clean because of her fatigue
D. Healing is limited during pregnancy, so these will not heal until after birth.

Situation 8 – Still in your self-managed Child Health Nursing Clinic, you encounter these

86. Josie brought her 3 months old child to your clinic because of cough and colds. Which of
the following is your primary action?
A. Give cotrimoxazole tablet or syrup
B. Assess the patient using the chart on management of children with
C. Refer to the doctor
D. Teach the mother how to count her child’s breathing

87. In responding to the care concerns of children with severe disease, referral to the
hospital is of the essence especially if the child manifests which of the following?
A. Wheezing
B. Stop feeding well
C. Fast breathing
D. Difficulty to awaken

88. Which of the following is the most important responsibility of a nurse in the prevention
of unnecessary deaths from pneumonia and other severe diseases?
A. Giving antibiotics
B. Taking of the temperature of the sick child
C. Provision of Careful Assessment
D. Weighing of the sick child

89. You were able to identify factors that lead to respiratory problems in the community
where your health facility serve. Your primary role therefore in order to reduce morbidity
due to pneumonia is to:
A. Teach mothers how to recognize early signs and symptoms of pneumonia
B. Make home visits to sick children
C. Refer cases to hospitals
D. Seek assistance and mobilize the BHWs to have a meeting with mothers

90. Which of the following is the principal focus of the CARI program of the Department of
A. Enhancement of health team capabilities
B. Teach mothers how to detect signs and where to refer
C. Mortality reduction through early detection
D. Teach other community health workers how to assess patients.

Situation – Among common conditions found in children especially among poor
communities are ear infections/problems. The following questions apply.

91. A child with ear problem should be assessed for the following, EXCEPT:
A. is there any fever?
B. Ear discharge
C. If discharge is present for how long?
D. Ear pain

92. If the child does not have ear problem, using IMCI, what should you as the nurse do?
A. Check for ear discharge
B. Check for tender swellings behind the ear
C. Check for ear pain
D. Go to the next question, check for malnutrition

93. A ear discharge that has been present for more than 14 days can be classified as:
A. mastoiditis
B. chronic ear infection
C. acute ear infection
D. complicated ear infection

94. An ear discharge that has been present for less than 14 days can be classified as:
A. chronic ear infection
B. mastoiditis
C. acute ear infection
D. complicate ear infection

95. If the child has severe classification because of ear problem, what would be the best
thing that you as the nurse can do?
A. instruct mother when to return immediately
B. refer urgently
C. give an antibiotic for 5 days
D. dry the ear by wicking

Situation – If the child with diarrhea registers one sign in the pink row and one in the
yellow row in the IMCI Chart:

96. We can classify the patient as:
A. moderate dehydration
B. some dehydration
C. no dehydration
D. severe dehydration

97. The child with no dehydration needs home treatment. Which of the following is not
included in the rules for home treatment in this case:
A. continue feeding the child
B. gives oresol every 4 hours
C. know when to return to the health center
D. give the child extra fluids

98. A child who has had diarrhea for 14 days but has no sign of dehydration is classified as:
A. severe persistent diarrhea
B. dysentery
C. severe dysentery
D. persistent diarrhea

99. If the child has sunken eyes, drinking eagerly, thirsty and skin pinch goes back slowly,
the classification would be:
A. no dehydration
B. moderate dehydration
C. some dehydration
D. severe dehydration

100. Genetic testing should be performed on a child only if:
A. The parents both want it performed
B. It is in the best interest of the clinic
C. It is necessary for the child to survive
D. No one objects

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